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% of the US population.

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County Leaders Visit Washington to Share Local Perspective on Budget Reconciliation

Elected officials from five states sound alarm about administrative and funding changes to SNAP and Medicaid.

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Ramsey County, Minn. cuts juvenile justice admissions with assessment tool

The county's Risk Assessment Index focuses on the critical window between arrest and first court appearance. 

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Advocacy

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.

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Advocacy

U.S. House of Representatives re-establishes Bipartisan Mental Health Caucus with NACo support

On May 7, members of the U.S. House of Representatives appointed new leadership to the Bipartisan Mental Health Caucus, reaffirming their commitment to addressing the nation’s mental health crisis through cross-party collaboration.

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Advocacy

House passes SUPPORT Act reauthorization

On June 4, the U.S. House of Representatives passed the SUPPORT for Patients and Communities Reauthorization Act of 2025 (H.R. 2483) by a strong bipartisan vote of 366–57. The bill, which reauthorizes billions of dollars for critical programs that target overdose prevention, now heads to the Senate Committee on Health, Education, Labor and Pensions, where a version of the bill was overwhelmingly advanced with bipartisan support in the 118th Congress. 

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Advocacy

CMS increases oversight on states’ use of Medicaid funds for undocumented immigrants

On May 27, the Centers for Medicare & Medicaid Services (CMS) announced it is increasing federal oversight of state Medicaid programs to ensure compliance with federal law regarding the use of Medicaid funds for undocumented immigrants.