Shaping Crisis Response Spotlight Series
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The National Association of Counties (NACo), in collaboration with The Pew Charitable Trusts and RAND, hosted a series of conversations with county leaders to understand the progress, challenges and lessons learned from 911/988 interoperability across various models, including embedded clinicians, call transfer and co-located response. This series will spotlight the work of five of the innovative counties shaping crisis response systems.
Douglas County, Kan.
- County Seat: Lawrence, Kan.
- Population: 118,785
Douglas County, Kan. exemplifies how investment in local systems and human service partnerships can streamline behavioral health care within communities.
Durham County, N.C.
- County Seat: Durham
- Population: 324,833
Durham County leverages a strategic partnership with the City of Durham to create a community-driven vision for public safety and crisis response.
Los Angeles County, Calif.
- County Seat: Los Angeles, Calif.
- Population: 10,014,009
Los Angeles (LA) County is the most populous county in the United States, with over 10 million residents, 70 public safety answering points (PSAP) centers and 80 law enforcement agencies, making the integration of 988 and 911 a challenge.
Travis County, Texas
- County Seat: Austin
- Population: 1,290,188
Travis County’s commitment to transforming behavioral health care into a readily available emergency resource is apparent the minute 911 dispatchers ask, “Are you calling for police, fire, EMS or mental health services?”
Pima County, Ariz.
- County Seat: Tucson, Ariz.
- Population: 1,043,433
Pima County serves as a leader in crisis response by becoming one of the first communities in the country to embed clinicians within their 911 operating system.
Webinar
Building and Supporting Comprehensive Behavioral Health Crisis Response Systems
In this panel discussion, experts and county leaders will discuss the role of 988 in building and supporting comprehensive behavioral health care systems.
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.
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.
HHS announces major restructuring
On March 27, the U.S. Department of Health and Human Services (HHS) announced a sweeping reorganization that will consolidate agencies, shift key programs under a new framework and eliminate thousands of positions. This change brings HHS in line with President Trump's Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”
HHS moves to reduce public comment in rulemaking
On February 28, the U.S. Department of Health and Human Services (HHS) announced a policy change limiting public comment opportunities to only those required by law. Published in the Federal Register on March 3, the decision rescinds the “Richardson Waiver,” a 1971 directive from then-HHS Secretary Elliot Richardson that encouraged broader public input on regulations related to public benefits, grants and healthcare policies.
HHS renews Public Health Emergency Declaration to address national opioid crisis
On March 18, the U.S. Department of Health and Human Services (HHS), under the direction of Secretary Robert F. Kennedy, Jr. renewed the public health emergency (PHE) declaration to address the ongoing opioid crisis, extending critical federal support for coordination, treatment expansion and research efforts. While overdose deaths have declined by 25.5 percent over the past year, synthetic opioids like fentanyl continue to drive fatalities, with approximately 150 Americans dying daily from overdoses.
Featured Initiative
NACo Commission on Mental Health and Wellbeing
(2023-2024) Counties increasingly handle direct mental health service. NACo’s Commission on Mental Health and Wellbeing developed reports and united county leaders to address the mental health crisis through key policy priorities.
