Tying Every Settlement Dollar to a Documented Gap
A Medium-Sized County's Model for Allocating $397,500 a Year
Yolo County built a countywide model to map local substance use gaps and direct opioid settlement dollars toward recovery, treatment, prevention, and early intervention, moving from a small, informal budget to a formal, coalition-informed allocation process administered through the county Health and Human Services Agency.
The Challenge They Were Addressing
Yolo County needed a structured way to allocate a small but growing opioid settlement budget across a set of substance use system gaps, city needs, treatment and recovery support, and high-impact abatement activities. When the county began receiving direct settlement funds, the projected annual budget was just under $400,000, a very small amount relative to the range of allowable uses and the needs across a county of about 224,410 residents. Opioid settlement funding does not arrive every day, its uses are broad, and decisions about it can carry political weight. Hence, the county wanted a clear, defensible way to decide where the money should go first.
Yolo County describes itself as a “smedium” county: formally medium-sized but on the smaller side of medium. That creates a practical bind. State mandates hold the county to medium-county standards, but the staffing and infrastructure sit closer to those of a smaller place. The county needed an allocation process that could address that gap, direct limited dollars toward the highest-impact needs, and evolve into a formal governance structure as the budget expanded.
The county also spans a wide range of communities. Davis, Woodland, and West Sacramento are the larger cities, but most of the land is rural and agricultural, with smaller towns spread across it. Several cities transferred their settlement share to the county for administration, with the expectation that their residents would be served. That arrangement gave the county both reach and responsibility, and it raised the stakes on getting the allocation process right.
What They Built
Yolo County built an allocation and governance model rather than a single service. The model starts with a gap analysis of the local substance use system, maps identified needs to allowable settlement uses, funds a set of treatment, recovery, prevention, and early intervention activities tied to those gaps, and then reports on the spending. Over time, the county moved this work from an informal, leadership-driven process toward a formal budget with coalition input, Board of Supervisors review, and structured reporting.
The work began with prior forensic and system process mapping, and a substance use system-of-care performance improvement and gap analysis led by Health Management Associates (HMA). About 19 provider agencies and county departments took part in a two-day event, the first held virtually during the COVID period and a follow-up held in person. HMA produced a roughly 20-page report that included the gap analysis, and that report became the basis for the first opioid budget. Because contractor representatives were in the room, the county could build the budget directly off the needs and gaps they identified.
In 2024, the county ran a follow-up in-person gap analysis with a broader group: treatment providers, homeless and crisis services, the public defender, the district attorney, the courts, probation, the usual county partners, and community members. As the budget grew, the county moved from a systems-only view of needs toward a broader, community-informed process. County leadership then presented a proposed budget, based on the gap analysis, to the Board of Supervisors.
The county sits inside an integrated “super agency.” HHSA houses behavioral health, public health, social services, veterans’ services, in-home support services, and adult protective services under one structure. The substance use disorder team leads settlement work and collaborates with other divisions, cities, community partners, the Board of Supervisors, fiscal staff, and the Yolo Opioid Coalition. Last year, the county established that coalition as a community body, shared the gaps and needs with its members, and had them identify priorities that shaped the FY 2026–2027 budget.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
HHSA administers the funds and leads the work; the Board of Supervisors authorizes the budget; the cities entrust their shares to the county; treatment providers and the coalition tell the county where the real service gaps are. Without those relationships, the county could not translate a gap analysis into a defensible allocation that the Board and the cities trust.
Justice partners, public health, the community health clinic, hospitals, the sheriff's office and jail, and the public guardian are essential contributors to the analysis and to specific funded activities, and their roles have grown as the process has formalized. The integrated super agency structure helps here: because so many county functions sit under one roof, the substance use team can reach across systems that, in other counties, sit in separate departments.
Budget Breakdown
What is the minimum viable budget to replicate this?
The minimum viable version is not a fixed dollar figure but a discipline: understand the settlement rules and the local substance use system, map gaps with providers and community members, and start with a small budget tied to clear gaps rather than spreading money thin. Yolo County started with just under $400,000 a year and directed it toward a short list of documented needs. A county with $75,000 could run the same logic on a smaller scale: one or two clearly identified gaps, one or two willing providers, and a simple written link between each dollar and the gap it addresses. Formalize the budget, reporting, and decision-making as the dollars grow.
What Worked and Why
Specific decisions or design features that drove success
Running a gap analysis before spending was the decision that set the direction. Rather than divide a small budget by intuition, the county mapped its substance use system with providers, county departments, and outside agencies, and let documented gaps drive the first allocations. Because contractor representatives were in the room, the budget reflected real service gaps from the start.
Bringing providers and community members into the analysis, and later the coalition, kept the allocations grounded. When the Yolo Opioid Coalition independently reviewed the gaps and needs and set priorities, its list closely matched the county's existing list, confirming the earlier work and giving the budget community backing. The county then organized the shared list into budget categories.
Administering the funds within an integrated super agency gave the substance use team reach across behavioral health, public health, social services, and justice-adjacent functions that would otherwise sit in separate departments. That structure made it practical to fund work that crosses systems, such as diversion and deflection, recovery residence beds, and transportation to treatment.
Earning and keeping city-to-county trust mattered. Several cities allocated their settlement shares to the county on the condition that their residents would be served, and the county committed to ensuring that a defined share would reach each participating city. The director's transparent updates to the cities and the Board supported that trust even before a public budget was posted.
Over time, formalizing the process turned a small, informal budget into a governance structure. What began as one or two staff members shepherding the work and briefing the Board informally has evolved into a projected budget, coalition priority-setting, and structured reporting so that the model can outlast any single leader.
Early outcomes and data
The original annual budget of $397,500 was allocated through a documented gap analysis; it has since grown.
First direct settlement allocations dispersed around FY 2023–2024 following the first gaps and needs analysis.
Purchased recovery residence beds for people not on probation, who historically could not be placed there.
Medication-assisted treatment expansion delivered through an NTP/OTP contractor.
Naloxone purchases and support for people leaving the justice system through diversion and deflection.
Bridge transportation for NTP/OTP clients before Medi-Cal transportation begins, plus transportation for other clients.
FY 2026–2027 budget categories built with Yolo Opioid Coalition priority-setting; an emergency-room-connected navigator and peer role are being added.
Lessons Learned
Map the gaps before you spend. The gap analysis, first through system process mapping and HMA's system-of-care work, then through community-informed analysis, gave every allocation a documented reason and made the budget defensible to the board and the cities.
Let the community confirm the priorities. When the Yolo Opioid Coalition independently reviewed the gaps and found that its priorities matched the county's list, the alignment validated the work and gave the budget community backing.
Use the structure you already have. Administering the funds within an integrated super agency enables the substance use team to span systems and fund work that spans treatment, recovery, prevention, and justice.
Protect city-to-county trust with transparency. Cities handed their shares to the county on trust; transparent updates and a clear commitment to serve their residents kept that trust even before a public budget existed.
Formalize as the dollars grow. Moving from informal briefings to a projected budget, coalition priority-setting, and structured reporting turned a small allocation into durable governance.
Start small and expand on provider-identified gaps. The county funded a short list first, then expanded as the budget grew and providers identified new gaps, such as bridge transportation and an emergency-room navigator and peer role.