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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Thurston County, Wash. Commissioner Carolina Mejia answers a question during NACo’s Public Health Leadership Academy June 4 in Washington, D.C. To her right is Dr. Jen Freiheit, director of the Thurston County Public Health and Social Services Department. Photo by Charlie Ban
County News

Partnerships drive better community health, leaders say

Participants in NACo's Public Health Leadership Academy focused on building trust between public health professionals and elected leaders.

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Advocacy

NACo endorses bipartisan legislation to help volunteer first responders access affordable housing

On June 10, Sens. Tammy Baldwin (D-Wis.) and Kevin Cramer (R-N.D.) reintroduced the Volunteer First Responder Housing Act (S.4737), bipartisan legislation that would help qualified volunteer first responders access affordable housing.

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Advocacy

CMS Issues Interim Final Rule on Medicaid Community Engagement Requirements

On June 1, 2026, the Centers for Medicare & Medicaid Services (CMS) issued an Interim Final Rule with Comment Period (IFR) establishing binding standards for how states must implement Medicaid community engagement ("work") requirements enacted under the One Big Beautiful Bill Act (P.L. 119-21), also referred to as H.R. 1. 

Firefighters
Advocacy

Firefighter and First Responder Grants Now Open for Counties

On May 18, the U.S. Department of Homeland Security (DHS), through the Federal Emergency Management Agency (FEMA), announced $648 million in grant funding for firefighters and other first responders nationwide.

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Advocacy

New Law Brings Long-Sought Transparency to FEMA Disaster Reimbursements

A new federal law requires FEMA to publish a publicly accessible, interactive dashboard tracking all Public Assistance reimbursement requests, giving counties unprecedented visibility into disaster recovery funding.