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
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 what to fund. 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 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, so 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 not a single service. It 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 each, to run meetings, manage the grant process, and lead the assessment work.
The foundation is the region's needs and gaps report. The co-facilitators conducted 64 one-on-one qualitative interviews with community members, including law enforcement, judges, nurses, doctors, therapists, counselors, and people in recovery, as well as six focus groups with people in recovery. Each conversation centered on what people face in accessing effective treatment and sustaining recovery, what is missing, and what they would recommend the council fund. The report turned scattered opinion into a defensible set of regional priorities.
Those priorities now steer the money. The council operates as a regrantor, the middleman that moves settlement dollars to local organizations. It runs grant cycles the way most Colorado councils do: a letter of interest, then a request for proposals, with council members scoring and grading applications, deliberating on the highest scorers, and funding accordingly. Starting with the next grant cycle, applications that address the report's priority areas will receive higher scores, so the assessment is built directly into the scoring rubric.
The council also invested in 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 paradigms of addiction session, 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 later funding conversations far more productive.
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 felt underrepresented when both of a county's seats effectively came from the county. The council worked through it with one-on-one conversations with every member and a revised model that allocated one seat to the county and one to a city, a compromise that did not make everyone happy but produced fairer representation. Knowing the members well and communicating constantly are what allow 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 scaled-down 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 six 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 more favorable scores, so every funding decision will trace back to community-identified need. 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.
Investing in 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 paradigms 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 6 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 pretrial and medically guided treatment services, peer support in jails, a $100,000 youth mentoring prevention program, therapy scholarships, and student fellowships in 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 paradigm 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 addiction paradigms gave members from very different backgrounds a common framework and vocabulary, which made later funding conversations far more productive.
Measure impact, not just activity. 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 ecosystem. 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.