Top 10 County Policy Priorities for Behavioral Health Reform
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Blaire Bryant
Naomi Freel
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County Behavioral Health Landscape
America’s 3,069 counties are integral to America’s behavioral health system. Counties annually invest over $130 billion in community health systems, including behavioral health services. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance use conditions. County-based behavioral health systems exist in 23 states that represent 75 percent of the U.S. population.
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NACo Commission on Mental Health and Wellbeing
(2023-2024) Counties increasingly handle direct mental health service. NACo’s Commission on Mental Health and Wellbeing developed reports and united county leaders to address the mental health crisis through key policy priorities.
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NACo submits recommendations on the 2026 National Drug Control Strategy
On June 20, NACo submitted formal comments to the White House Office of National Drug Control Policy (ONDCP) to help shape the development of its 2026 National Drug Control Strategy. This strategy serves as the nation’s blueprint for reducing illicit drug use, and the ONDCP plays a central role in coordinating federal drug policy across government agencies.
U.S. House of Representatives introduces legislation to expand Medicaid coverage for behavioral health treatment facilities
On June 20, a bipartisan group of lawmakers introduced the Increasing Behavioral Health Treatment Act in the U.S. House of Representative. This bill aims to improve access to behavioral health care nationwide by removing long-standing Medicaid funding restrictions for behavioral health treatment in certain facilities, providing new flexibility for states and counties to meet growing behavioral health needs.
U.S. House reintroduces legislation to address the Medicaid Inmate Exclusion Policy with NACo support
Two bipartisan bills aimed at addressing the Medicaid Inmate Exclusion Policy (MIEP) were recently reintroduced in the U.S. House of Representatives.