Top 10 County Policy Priorities for Behavioral Health Reform
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County Behavioral Health Landscape
America’s 3,069 counties are integral to America’s behavioral health system. Counties annually invest $83 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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U.S. House reintroduces legislation to address the Medicaid Inmate Exclusion Policy
Two bipartisan bills aimed at addressing the Medicaid Inmate Exclusion Policy (MIEP) were recently reintroduced in the U.S. House of Representatives.
House E&C Committee advances SUPPORT Act reauthorization
On April 9, the U.S. House Energy and Commerce Committee marked up the SUPPORT for Patients and Communities Reauthorization Act of 2025. The bipartisan bill aims to reauthorize critical programs that target overdose prevention amid the renewal of the opioid crisis Public Health Emergency declaration.
HHS issues termination notices for health grant funding
On March 25, the U.S. Department of Health and Human Services (HHS) sent letters to state authorities and counties with direct grant funding announcing the immediate termination of several pandemic-related grants, which was previously set to run through September 2025.