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 announces new funding opportunity to promote holistic health innovation

On March 13, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Funding Opportunity (NOFO) for the Make America Healthy Again – Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) Model.

Children participating in Miami-Dade County, Fla.’s Zero Drowning initiative show off their drawstring backpacks.
News

‘Zero drowning’ program boosts safety and prevents deaths

Miami-Dade County, Fla. teaches children how to swim at no-cost and provide more community education around water safety, cutting down on what had been the leading cause of death for children ages 1-14.

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Advocacy

The Michelle Alyssa Go Act: Why Reforming the IMD Exclusion Matters for County Behavioral Health

Reintroduced in the U.S. House of Representatives in September 2025, the bipartisan Michelle Alyssa Go Act (H.R. 5462) aims to modernize the IMD exclusion and expand access to care.

After completing the Okeechobee High School CTE Fire Program, Braxton Lewis (pictured in the middle) was offered a job with Fire Rescue. Photo courtsey of Okeechobee County
County News

Rural county program preps students for first responder careers

Okeechobee County, Fla.’s public safety career programs are giving young people the tools to jumpstart their careers and helping address the county’s workforce shortages in fire rescue, dispatch and law enforcement. 

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Advocacy

CMS issues guidance on six-month Medicaid renewals

On March 6, the Centers for Medicare & Medicaid Services (CMS) released a letter to State Medicaid Directors with implementation guidance on six-month Medicaid renewals required under H.R. 1. 

HHS Secretary Robert F. Kennedy, Jr. discusses health issues Feb. 24 at the NACo Legislative Conference at the Washington Hilton. Photo by Denny Henry
County News

HHS Secretary Kennedy touts fixes for obesity, chronic illness, mental health issues

Counties can help improve health outcomes by prioritizing prevention over treatment, Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services told NACo Legislative Conference attendees.