NACo commission on mental health sends letter to Congress

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Blaire Bryant

Senior Legislative Director, Health | Large Urban County Caucus
Naomi Freel

Naomi Freel

Associate Director for Grassroots & Legislative Advocacy

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Key Takeaways

On November 13, members of NACo's Commission on Mental Health and Wellbeing sent a letter to the U.S. Senate Committees on Finance and Health, Education, Labor and Pensions. The Commission called on Congress to support counties in delivering high-quality, accessible mental health services to address residents' comprehensive behavioral health needs in any mental health legislation package. 

County's Crucial Role in Behavioral Health

  • Counties serve as the backbone of the nation's behavioral health system, providing first responders, crisis lines, public hospitals and detention centers. 
  • Over 750 county-supported or operated behavioral health authorities cater to about two-thirds of the U.S. population. 

Urgent Policy Reforms Needed

  • Passage of the Due Process Continuity of Care Act (S.971)
    • Legislation addresses care continuity for individuals with mental illness and substance use disorder in pretrial detention.
    • Aims to prevent disruptions in primary and behavioral health care services for justice-involved populations. 
  • Increased funding authorizations for the National Health Services Corps (NHSC) and other workforce programs
    • The NHSC supports the behavioral health workforce by offering scholarships and awards for loan repayments to primary medical, dental and behavioral health professionals serving in areas facing workforce shortages.
    • Currently, 47 percent of the U.S. population resides in mental health workforce shortage areas. 
Areas of Continued Collaboration with Federal Partners 
  • Modernizing Institutions for Mental Diseases (IMD) Exclusion: Focus on reducing barriers to comprehensive behavioral health treatment and increasing access to short-term residential treatment.
  • Youth Mental Health Access: Address workforce shortages and insurance barriers hindering children and adolescents from accessing crucial mental and behavioral health services. 
  • Medicaid Reentry Act (S.1165): Advocacy for Medicaid payment for medical services for incarcerated individuals during the 30-day period preceding release.
  • Modernizing Crisis Response Systems: Strengthening federal support for service facilities, training and technical assistance to enhance local crisis response infrastructure. 

Commitment to Action

The NACo Commission on Mental Health and Wellbeing expresses unwavering dedication to addressing the growing mental health crisis through these public policy advancements. The Commission emphasizes the importance of a robust intergovernmental partnership to achieve shared goals, ensuring county residents have the necessary resources for long-term behavioral and mental health needs.

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(From left:) San Joaquin County, Calif. Health Care Services Director Genevieve Valentine and Supervisor Steven Ding and David Wetmore of Capri & Clay meet during the 2026 NACo Legislative Conference with U.S. Department of Housing and Urban Development Congressional Liaison Officer Geoffrey Smith, an unidentified staffer, former U.S. Interagency Council on Homelessness Executive Director Robert Marbut and Deputy Assistant HUD Bryan Horn. Photo by Nichole Goehring
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