Public Health Leadership Initiative
Sections
Counties are essential to the public health system, delivering services that protect and promote community well-being. From addressing substance use to tackling food insecurity, county policies and programs shape the conditions in which residents live and work. County investments in health ensure that all residents have access to the services they need to thrive.
NACo’s Public Health Leadership Initiative will engage county leaders on their role in public health and equip them with the skills needed to become public health champions in their communities. The initiative will include cohort programs as well as one-off peer exchange events and best practice briefs focused on highlighting successful strategies for empowering county officials to improve community health.
By the numbers
1,900
Local health departments
Counties support public health through the operation of more than 1,900 local health departments
$100B
Invested in community health
Counties invest $100 billion in community health and hospitals each year to provide community and public health services and support county-owned hospitals
$62.8B
Allocated to provide a safety net
Annually, counties allocate $62.8 billion to provide a safety net for the most vulnerable residents
Get Involved
The first Public Health Leadership cohort will begin in Spring 2026 and applications will open in January. Sign up here to be notified when the Public Health Leadership cohort application launches:
Resource
The County Role in Public Health
This brief provides an overview of how counties provide integral public health services for all Americans, describes their public health authority, their role in preparedness and response efforts, and local public health efforts to address social determinants of health (SDOH) in our communities.
Resource
Building a Legacy of Health: Transforming the Health and Wellbeing of Our Communities
In partnership with the de Beaumont Foundation, NACo offers insights and actionable strategies to help county leaders build a legacy of health in our communities – beyond increasing access to clinical care.
Program
Healthy Counties Innovation Council
NACo’s Healthy Counties Innovation Council elevates national trends and county innovations in promoting and protecting the health and well-being of America’s residents; in addition, the Council advises NACo on the organization’s health programming.
Committee
Health Policy Steering Committee
The committee covers all matters pertaining to public health and healthy communities, including disease and injury prevention and health promotion, health disparities reduction, mental and behavioral health services, and financing delivering health care.
CMS requires state Medicaid suspension upon arrest versus termination
Effective January 1, 2026, federal law now requires states to suspend, rather than terminate, Medicaid coverage when an individual is incarcerated.
States submit Rural Health Transformation Program funding applications
On December 29, the Centers for Medicare & Medicaid Services (CMS) announced $50 billion in awards over 5 years to all 50 states under the Rural Health Transformation Program.
CMS issues new guidance on Medicaid Community Engagement Requirements
On December 8, the Centers for Medicare & Medicaid Services (CMS) released a Medicaid and CHIP Services Informational Bulletin (CIB) directing states on how to implement the Medicaid community engagement requirements enacted under Section 71119 of the One Big Beautiful Bill Act legislation (Public Law 119-21), or H.R. 1.
California county sales tax measure backfills federal healthcare cuts
Santa Clara County, Calif. will raise an estimated $330 million each year from a sales tax to backfill lose Medicaid funding.
County Countdown – Dec. 15, 2025
Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.