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Blaire Bryant

Legislative Director, Health | Large Urban County Caucus

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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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Advocacy

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.

Canyon County, Idaho Sheriff Kieran Donahue swears in new recruits to his office in 2022.
County News

ICE hiring surge challenges county law enforcement

Local governments hope that their law enforcement personnel will favor the familiarity of the communities they serve when weighing potentially lucrative immigration enforcement recruitment bonuses, which may require them to uproot their lives.

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Advocacy

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. 

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Advocacy

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. 

Local leaders and healthcare workers rally for sales tax increase to cover healthcare costs in Santa Clara County, Calif.
County News

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.