Howard County, Maryland has earned 391 NACo Achievement Awards since December 2018. In 2026 alone it took 113, a Maryland record, spanning 16 of the 18 national award categories. What makes that record useful to other counties is the judging standard. The NACo Achievement Awards are scored on merit rather than against other applicants, so every program meeting the criteria wins. The result is a working catalog of approaches that counties have already tested. Below are five county public health programs from recent award cycles, chosen because another county could reasonably run them.
Howard County Builds Billing Infrastructure Into Its Health Department
Among Howard County’s 2025 awards was a program with an unglamorous name and a serious payoff: establishing a Clinical Billing Unit inside the county health department to support accessible health services. The problem it solves is familiar to any county running clinical services. Health departments deliver care they can bill for, then leave revenue uncollected because no one inside the department is set up to handle claims. Building billing capability turns reimbursable services into a funding stream that sustains the services themselves. Howard County has also been recognized for its Harm Reduction and Peer Recovery Services Program, which pairs harm reduction with peer support for residents in recovery. The replicable lesson here is administrative rather than clinical. Counties evaluating their health department’s sustainability should audit what services they already provide that could be billed and are not being billed.
Boulder County Turns Policy Comparison Into Method
Boulder County Public Health earned a Best in Category award for a project that any county could copy next quarter. The department’s Healthy Eating, Active Living team worked with the City of Boulder’s planning department to strengthen food security policy in the city’s Agriculture and Food chapter. Rather than drafting policy from intuition, the team analyzed comprehensive plans from twelve comparable municipalities. They scanned each plan for relevant themes, then identified 34 model policies and sorted them into three buckets: policies already present in Boulder’s plan (10), policies somewhat present (14), and policies absent entirely (10). The gap analysis then generated a community survey. NACo’s write-up makes the key point explicitly. The methodology transfers to any topic, not just food policy. Pick a domain, gather plans from peer jurisdictions, catalog what they contain, and measure your own plan against the catalog. The output is a defensible, evidence-backed list of what to add.
Albany County Treats Mental Health as a Human Services Problem
Albany County, New York earned a 2026 NACo Achievement Award for its Veteran Peer-to-Peer Support Program, one of only three New York programs recognized that year and the only Human Services program from the state on the list. The program is a non-clinical mental health initiative. It connects veterans with other veterans who served in similar eras, building support on shared experience rather than clinical intervention. County Executive Daniel McCoy, a past president of the County Executives of America, has framed the premise as recognizing that mental health support does not always start in a doctor’s office. Note where the award landed. This is a mental health program, and it won in Human Services rather than Health. That placement is the useful part. Counties running peer support, transportation assistance, or housing stability programs are doing public health work whether or not the health department’s name sits on the org chart. For a county that already operates a veterans services bureau, the model asks for coordination more than new headcount. The infrastructure to identify and reach veterans is usually in place. What the program adds is a structured way to connect those veterans to each other.
Los Angeles County Takes Services to People Who Cannot Reach Them
The Los Angeles County Department of Public Health earned 20 NACo Achievement Awards in 2025 across a wide span of work. Two of the winning programs illustrate a pattern worth noting. The Mobile Vaccine and Testing Team operates within a unit serving people experiencing homelessness, delivering immunization and testing to residents who will not present at a clinic. A separate award recognized work on produce prescriptions as a tool for addressing social needs and managing chronic disease. Both share a design premise: the barrier to care is not always clinical capacity. Sometimes it is transportation, or the assumption that residents will come to a fixed location. Mobile delivery removes that assumption. Counties without Los Angeles County’s budget can still apply the principle at a smaller scale. A single mobile unit paired with an existing outreach program covers considerable ground.
Cook County and Maricopa County Show the Cross-Department Pattern
The Cook County Department of Public Health earned five NACo awards in 2025, and notably they landed across multiple categories: health, workforce development, and equity. Cook County’s award total that year reached 78 countywide, spanning health equity, digital inclusion, sustainability, and housing access. Maricopa County’s public health department earned 22 awards in the same cycle, contributing to a county total of 85 that set a record for that jurisdiction. The pattern across the largest winners is consistent. Public health programs that earn recognition tend to be built with another department, not inside the health department alone. Boulder County partnered with city planning. Albany County’s health-adjacent work sits in a veterans services bureau. Cook County’s health awards touched workforce and equity categories. Counties preparing an application should look first at work already happening across department lines.
What Winning County Public Health Programs Share
Four traits show up repeatedly across county public health programs that earn NACo recognition:
- A named problem: Winning applications describe a specific gap, not a general aspiration.
- Documented results: Numbers of residents reached, dollars recovered, or policies adopted.
- Cross-department collaboration: The strongest programs involve at least two county entities. Albany County’s award landed in Human Services for a mental health program, which is the pattern in miniature.
- Replicability: NACo’s criteria explicitly value programs another county could adopt.
That last trait cuts both ways. It is what makes a program award-worthy, and it is what makes the winners’ database useful to everyone else. Counties pairing program design with local healthcare employment data can also target where the need concentrates rather than where it is loudest. The same cross-department pattern shows up in county emergency response technology, where the strongest programs bridge public safety and IT.
Frequently Asked Questions
Are the NACo Achievement Awards competitive?
No. Applications are judged on their own merits against published criteria rather than ranked against one another. Every qualifying program receives an award, and 18 Best in Category winners receive additional recognition.
How many award categories are there?
Eighteen, covering the full range of county responsibilities including health, public safety, technology, and economic development. The program has run since 1970.
Where can I see past winning public health programs?
NACo maintains a searchable Achievement Awards database of winning programs, organized by category and year.
Does a county need a large budget to win?
No. Several award-winning programs are methodological or administrative rather than capital-intensive. Boulder County’s policy comparison project was built on analysis rather than new infrastructure.
The Takeaway
The counties collecting the most public health awards are running programs that other counties can adopt, which is precisely why they win. Reviewing the winners’ database is a low-cost way to find a tested approach to a problem your county is already facing. Start with the categories closest to your current priorities, and look for programs built across department lines. That’s where the replicable models tend to be.