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

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.

(From left:) San Joaquin County, Calif. Health Care Services Director Genevieve Valentine and Supervisor Steven Ding and David Wetmore of Capri & Clay meet during the 2026 NACo Legislative Conference with U.S. Department of Housing and Urban Development Congressional Liaison Officer Geoffrey Smith, an unidentified staffer, former U.S. Interagency Council on Homelessness Executive Director Robert Marbut and Deputy Assistant HUD Bryan Horn. Photo by Nichole Goehring
County News

Counties eye potential Medicaid reimbursement remedies

Increasing the number of beds in mental health treatment facilities eligible for Medicaid reimbursement would empower counties to do more to help their residents.

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Press Release

Counties Recognize Mental Health Awareness Month

The National Association of Counties (NACo) again this year will mark Mental Health Awareness Month throughout the month of May with counties advocating for solutions that support the wellbeing of residents and address the nation’s mental health crisis.

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Advocacy

House clears budget resolution, advancing Reconciliation 2.0 to fund DHS and CBP

On April 21, U.S. Senate Budget Committee Chairman Lindsey Graham (R-S.C.) unveiled a budget resolution to advance a party-line reconciliation package focused on immigration enforcement and funding for agencies within the U.S. Department of Homeland Security (DHS), including the Federal Emergency Management Agency (FEMA). The resolution is the first step in a two-part process aimed at producing final legislation by June 1.