How Six Rural Counties Decide What to Fund
An Assessment-Driven Model for Regranting Settlement Dollars Across County Lines
The Southwest Colorado Opioid Regional Council is a six-county rural council that used a large community needs and gaps assessment to decide how to spend opioid settlement dollars, then regrants roughly $1.5 million every two years to local organizations working on treatment, recovery support, prevention, and care for justice-involved residents.
The Challenge They Were Addressing
The South West Colorado Opioid Regional Council (SWCORC) of Region 14 covers six rural, geographically isolated counties in southwest Colorado, and the council charged with spending its opioid settlement dollars faced a problem common to rural regions: it was not certain where funding was most needed. The council had already run two grant cycles and supported strong projects, but it kept receiving quality applications with no shared benchmark for judging them. As one SWCORC co-facilitator put it, if you get two good applications, how do you choose between them without knowing the community's biggest needs? The dollars were limited and had to land where they would do the most good.
Colorado structures this work through regional opioid councils, one per abatement region, funded by a share of the state's settlement dollars. By statute, a council must be composed of government representatives, with seats for entities such as sheriffs, public health, and county commissioners, as well as representation from each member community. That design gets the right officials to the table. Still, in 2021, the Region 14 council was essentially a group of agency representatives meeting and talking without dedicated facilitation or a data-driven approach to setting priorities.
Two things were missing. First, the council lacked a defensible picture of the region's most pressing treatment and recovery needs. Hence, funding decisions risked chasing what looked good on paper rather than what the community actually needed. Second, community voice, especially the voice of people with lived experience of addiction and recovery, was not yet shaping the council's decisions. The council set out to fix both by building the assessment and the governance habits that would let community needs drive the money.
What They Built
The council's central innovation is a data-informed governance model: a way of organizing a rural region in which a comprehensive needs assessment, real community voice, and a disciplined grant process together determine how settlement dollars are spent. In 2024, the council brought on two dedicated co-facilitators, funded directly by the council at up to 20 hours a week for each facilitator. These facilitators run meetings, manage the grant process, do community outreach, and lead the assessment work.
To better understand the region's most pressing needs and ensure funding decisions reflected community priorities, the co-facilitators conducted 64 one-on-one interviews with stakeholders including law enforcement, judges, nurses, physicians, therapists, counselors and five focus groups with people in recovery. Each conversation explored barriers to treatment and recovery, unmet needs, and recommendations for future investments. The resulting Needs/Gaps Analysis transformed a range of community perspectives into a clear, evidence-informed framework that now guides the council's funding decisions.
The council also worked on how it makes decisions together. Members came from very different backgrounds, from law enforcement to public health to behavioral health, and did not start with a shared understanding of addiction or a shared vocabulary. The council brought in an outside facilitator to deliver a roughly two-hour training that mapped where each member's view of addiction falls, from moral to biological to social to identity models, and why. That shared language made subsequent funding discussions more productive by giving council members a common understanding of one another's perspectives and decision-making approaches.
As a regranting organization, SWCORC is using the assessment to refine its grantmaking process. Planned enhancements for the next grant cycle include adding a Letter of Interest (LOI) phase and incorporating the assessment's priority areas into the application review and scoring criteria. The goal is to encourage high-quality proposals that directly address regional needs while creating a more focused, strategic, and transparent funding process.
The assessment identified two priority areas for funding: (1) expanding support for justice-involved individuals and (2) increasing access to addiction treatment and detoxification services. Justice-involved individuals emerged as a significant gap in the region's continuum of care. Interviews and community feedback highlighted the justice system as a critical point for intervention, particularly for individuals whose substance use was linked to incarceration, housing instability, and loss of other supports. The findings underscored the need for coordinated services that reduce repeat contact with the justice system and support long-term recovery.
In response, SWCORC pursued additional state funding through an Infrastructure Share grant. Working with regional partners, the Council expanded peer support, medically guided treatment, and recovery services across all intercepts of the Sequential Intercept Model, strengthening continuity from initial justice system contact through reentry and community supervision. These efforts secured more than $1.2 million in additional funding, nearly equal to SWCORC's two-year grant budget.
The assessment also identified limited access to addiction treatment and detoxification services across Southwest Colorado. In response, SWCORC partnered with regional organizations to develop a multi-county application through Colorado's Rural Health Transformation Project (RHTP) to expand treatment capacity and establish community-based detoxification services. This approach is particularly important in rural areas, where residential and hospital-based detoxification services can be difficult to access, and would allow individuals to receive medically supported care closer to home while strengthening connections to ongoing treatment and recovery services.
Although the RHTP funding decision is still pending, the planning process has already strengthened regional partnerships and clarified service priorities. Regardless of the outcome, SWCORC intends to continue advancing treatment and detoxification capacity through future grant cycles and other funding opportunities.
Together, these efforts demonstrate how the needs/gaps analysis has moved SWCORC beyond simply identifying problems toward deliberate funding of the infrastructure, services, and relationships needed to address them. The council is increasingly working to build a continuum of care in which people can access meaningful support at multiple points, from crisis and detoxification, through treatment and recovery, and, when justice involvement occurs, throughout the process of returning to the community.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
The partners that make this council work fall into three groups. Government members are required by law to hold the votes, so the council cannot function without them at the table. The paid co-facilitators are what turn a group of officials into a functioning body: they run the process, carry the knowledge, and do the assessment work that gives the council its direction. And the community members who sat for interviews and focus groups are essential in another way: their input forms the evidence that the whole model rests on.
Getting representation right was one of the hardest parts. Some cities objected that both of a county's seats effectively came from the county government. The council worked through it with one-on-one conversations with every member and a revised model that allocated one voting seat to the county and one vote to a city, a compromise that produced fairer representation. Knowing the members well and communicating constantly allowed the council to resolve a genuine governance conflict without stalling the work.
Budget Breakdown
What is the minimum viable budget to replicate this?
A rural region does not need a large budget to start; it needs a facilitator, a credible assessment, and a fair process. The council is candid that the two paid co-facilitator roles make everything else possible; without dedicated people to run meetings, manage grants, and lead the assessment, a volunteer council tends to stall. After that, the minimum is a defensible way to learn community needs, even a smaller set of interviews and focus groups, and a scored grant process that ties awards back to those needs. The regranting dollars can start small and grow as the council proves it can move money to measurable, community-informed work.
What Worked and Why
Specific decisions or design features that drove success
Grounding the money in a real assessment was the decision that changed everything. Rather than guessing, the council ran 64 interviews and 5 focus groups and let the findings define its priorities. That evidence base told the council what to fund, and it made the region's own grant applications far stronger, which the council credits with helping secure a $1.2 million infrastructure award, one of the largest for a rural region in the state.
Wiring the assessment into the scoring rubric kept the report from gathering dust. Beginning with the next RFP cycle, applications that address the documented priority areas will receive higher scores, ensuring that every funding decision traces back to community-identified needs. The council co-creates deliverables with grantees and pushes them to define not just how many people they will serve, but what impact they are trying to achieve and how it will be measured.
Paying for facilitation was a small line item with an outsized effect. Two co-facilitators at up to 20 hours a week gave the council continuity, someone to author the report, run the grant cycle, and hold the process together. Before dedicated facilitation, the council was mostly agency representatives meeting and talking; afterward, it could actually structure the work and produce results.
Building shared language up front made the hard conversations possible. Because members came from law enforcement, public health, and behavioral health, they did not begin with a common view of addiction or even a common vocabulary. A short, outside-led session on views of addiction gave everyone a shared framework, so acronyms and assumptions did not derail funding debates later.
Treating funded work as a continuum, not a set of disconnected grants, strengthened both the applications and the likely results. The council framed pretrial and medically guided treatment services together with peer support in jails so a justice-involved person could be supported from the moment they enter the system through their release, a coherent design that reviewers could see and fund.
Early outcomes and data
Completed a regional needs and gaps report built on 64 one-on-one interviews and 5 focus groups.
Secured a $1.2 million infrastructure award, among the largest for a rural region in Colorado.
Completed two grant cycles funding treatment, recovery support, prevention, and justice-involved care.
Funded projects include Transforming Rural Health: WCU's Workforce Development for Opioid/Substance Use Disorder Prevention, Gunnison Valley Mentors, CB State of Mind, River Valley Family Health Centers, Advantage Treatment Centers, Tri-County Health Network, San Miguel and Ouray Juvenile Services, Gunnison Sanctuary Housing, Telluride Regional Medical Center, and the Delta, Montrose, and Gunnison Opioid Response Groups, supporting services such as pretrial programming, medically guided treatment, peer support in jails, youth mentoring and prevention, therapy scholarships, and student fellowships focused on substance use disorder work.
Redesigned council seat allocation (one county seat, one city seat) to resolve a representation dispute and improve fairness.
Built shared understanding through a views of addiction training and is developing a compensated lived-experience advisory council.
Lessons Learned
Let the community voice drive the money. The single most important move was listening to the community through a real assessment and letting those findings, not guesswork, set funding priorities. It produced both better decisions and stronger, better-funded applications.
Pay for facilitation. Dedicated, council-funded co-facilitators are what turned a group of agency representatives into a functioning body capable of assessing needs, administering grants, and delivering results.
Build shared understanding before you decide. A short session on views of addiction gave members from very different backgrounds a common framework and vocabulary, which made later funding conversations far more productive.
Measure impact. Counting clients served or naloxone distributed matters, but the council pushes grantees to define and measure what the work actually means for people, co-creating deliverables so awards buy impact.
Fund the whole recovery system. Treatment gains disappear without recovery support afterward, so the council thinks in terms of recovery capital, funding peer support, community connection, and stable basic needs alongside clinical treatment.
Work through representation, do not go around it. When some communities felt unrepresented, direct one-on-one conversations and a revised seat model resolved the conflict and kept the council moving.