The County Role in Public Health
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Counties play a critical role in promoting and protecting the health of people and the communities in which they live, learn, work and play. As administrators and operators of the local health safety net, county agencies employ a wide range of public health services that protect resident health and well-being through the prevention of illness, injury and other adverse health outcomes.
A robust public health system centers equity and actively promotes policies, systems and overall community conditions that drive optimal health.1
Public health is an intersectional field that works to address the underlying causes of health outcomes. This work requires both intergovernmental collaboration between federal, state and local governments, as well as multisectoral partnership across local government agencies.
This brief provides an overview of how counties provide integral public health services for all Americans, describes their public health authority, their role in preparedness and response efforts, and local public health efforts to address social determinants of health (SDOH) in our communities. The brief will also outline key federal policy recommendations for our federal partners to safeguard funding and authority for local public health services and programs.
NACo offers new Medicaid resources as Congress advances Budget Resolutions with major Medicaid reform implications
On April 10, the U.S. House of Representatives voted to adopt a Senate-passed budget resolution, marking the next step in the budget reconciliation process. The proposed funding levels therein represent significant potential cost shifts to counties, particularly in the area of Medicaid financing. To help county leaders understand what’s at stake, NACo has developed two new resources.
County Countdown – April 21, 2025
Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership. This week features the ARPA reporting deadline, a budget reconciliation update and more
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.
Bird flu update: What county leaders should know
As of April 7, there have been 70 confirmed cases of bird flu in the United States, but no person-to-person spread has been detected.
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.
Federal Reforms to Medicaid Financing: What Counties Should Know (Part 2)
This two-part webinar series will examine the vital role Medicaid plays in supporting county-administered behavioral health and primary care services.
Ask a Public Health Expert: The Resurgence of Measles
Join NACo on Thursday, May 15 at 2 p.m. ET for a webinar on the resurgence of measles and what county leaders need to know. As outbreaks emerge across the U.S., this session will cover the history of measles, the importance of vaccination, current trends and how counties can respond effectively. The hour-long webinar will feature a 30-minute expert presentation followed by 20 minutes of audience Q&A. Don't miss this opportunity to hear from public health experts and get your questions answered.
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