Mariposa County, California and Crook County, Oregon have suffered severe, historical droughts in recent years. Drought may have substantial effects on affected communities, including compromised quality and quantity of potable water, adverse behavioral health outcomes, and increased disease incidence. The Mariposa County and Crook County Health Departments, along with California Department of Public Health and Oregon Health Authority and CDC, conducted two Community Assessments for Public Health Emergency Response (CASPERs) in 2016 and 2017. We provided action items to consider for strengthening the drought response, including promoting proper hygienic practices, consider expanding mental health services, and identifying HHs who may be eligible for dead tree removal assistance in Mariposa.