San Miguel County officials heard a presentation June 18 on how Colorado's opioid settlement payments are being distributed in the Southwest Colorado Opioid Regional Council (Region 14), and how local organizations will use awards for treatment, recovery and prevention services.

County Public Health Director Grace Franklin and regional coordinators described a mix of multi-year grants intended to expand behavioral health access and harm-reduction services. Franklin said the regional council expects Colorado will receive some $871 million over roughly 18 years from opioid settlements, with regional councils and local governments making spending decisions for their portions.

Janet Rowland of Community Matters and Cole Cooper, a regional facilitator, walked the commissioners through the awards that affect San Miguel County. Cooper said three local programs received awards: San Miguel and Ouray Juvenile Services received funds to expand a bilingual case manager from part time to full time and to add prevention programming; Tri-County Health Network will expand a “Recovery Access Fund” (RAF) to pay for counseling scholarships for people with substance-use challenges; and Telluride Regional Medical Center (TMC) won funding to build a medically assisted treatment (MAT) program offering screening, initiation appointments and ongoing medication-assisted care (predominantly Suboxone) for people with opioid use disorder.

The regional pot divides settlement money by fixed buckets: Rowland said roughly 60% of Colorado's received funds are distributed regionally, 20% goes directly to local governments, 10% to a statewide infrastructure grant program, and 10% to the state. She said the region's recent two‑year grant cycle totaled about $1.5 million; the awards discussed for San Miguel County represent two‑year commitments that run through 2026.

Program details and funding highlights
- Juvenile services (San Miguel/Ouray): $200,000 over two years to expand a bilingual case manager to full time, add parenting support groups and youth peer supports, and sustain prevention activities. Cole Cooper said the job will be posted competitively.
- Tri‑County Health Network RAF: Tri‑County will expand a recovery access scholarship that pays for six therapy sessions (with an option to apply for six additional sessions depending on income, up to 400% of the federal poverty level). The RAF is modeled on Tri‑County’s behavioral health fund and is open to residents who live or work in participating counties and attest that substance use is the primary reason for the request. Tri‑County representatives said the program helps bridge gaps for people who are uninsured or underinsured and supports a behavioral-health navigator role that assists with benefits, transportation and connecting to clinicians.
- Telluride Regional Medical Center MAT: Hannah Max (grant writer) and Laura Catell (physician assistant) told commissioners TMC will implement universal screening, clinical initiation visits and rapid linkage to medication and counseling. They described an initiation appointment that may last several hours and an initial cadence of visits every few days in the first two weeks, moving to biweekly or monthly maintenance visits. TMC and Tri‑County said they expect a small number of uninsured or underinsured patients (TMC estimated roughly seven patients per year) will need sliding‑scale or free medication and visit support; settlement funding plus local philanthropy are expected to cover those costs through 2027.

Why it matters: access and continuity

County commissioners and staff emphasized the local need. Tri‑County representatives noted their existing behavioral health fund serves about 300 San Miguel County residents annually and that more than half of counseling sessions now address substance use. The regional awards were described as extending local capacity: prevention and education, harm reduction and workforce development, treatment, recovery housing capital support, and planning/administration. Franklin and Rowland said these regional awards are specifically governed by an intergovernmental agreement with Colorado’s Attorney General and must be spent in defined buckets.

Next steps and administration

Rowland said United Way manages regional grant logistics (application portal and scoring) and Montrose County is the fiscal agent for Region 14. Grant winners must follow the region’s reporting and deliverable requirements; Tri‑County and TMC now need to stand up program operations and begin outreach so residents know services are available.

Commissioners asked about the broader national settlement process and whether new settlements (such as the Purdue case) would add funds later; Rowland and other speakers said pending settlements are expected to flow into the same statewide distribution framework and could increase available funds. Speakers also estimated the regional pot will support roughly $750,000 distributed per year for their region over the life of the settlement, with the region’s total likely to exceed $8 million (and more if Purdue proceeds) over the program horizon.

Speakers
- Grace Franklin, Public Health Director, San Miguel County (government)
- Janet Rowland, Community Matters / Opioid Regional Council facilitator (nonprofit)
- Cole Cooper, Southwest Colorado Opioid Regional Council facilitator (nonprofit)
- Melanie (Tri‑County representative) (nonprofit/health care)
- Hannah Max, Grant Writer, Telluride Regional Medical Center (business/health care)
- Laura Catell, Physician Assistant, Telluride Regional Medical Center (health care)

Clarifying details
- Regional settlement allocation: roughly 60% regional share, 20% local direct share, 10% state infrastructure grants, 10% state use (per presentation).
- San Miguel/Ouray Juvenile Services award: $200,000 (two years) for bilingual case manager expansion and prevention work.
- Tri‑County recovery access fund expansion: award (amount not specified for San Miguel alone) to expand RAF regionally; RAF provides six sessions with option for six more depending on income.
- Telluride Regional Medical Center MAT funding: award to support initiation and ongoing medication-assisted treatment and to cover some uninsured patients through 2027; TMC estimated ~7 uninsured patients per year may need subsidy.

Community relevance
- Geographies: Telluride, Norwood, San Miguel County (unincorporated and incorporated areas)
- Impact groups: people with opioid or other substance-use disorders; underinsured/uninsured residents; youth served by juvenile services

Topics and newsroom scoring
- Primary topic: behavioral health/substance use treatment
- Topics: [{"name":"opioids","justification":"Article details local spending of opioid settlement funds and funded programs.","scoring":{"topic_relevance":0.98,"depth_score":0.85,"opinionatedness":0.05,"controversy":0.25,"civic_salience":0.88,"impactfulness":0.78,"geo_relevance":1.00}}]

Actions
- No formal county vote recorded; presentation and Q&A only. The regional council awards were reported as already decided by the regional grant process.

Why this matters: The regional council awards add staff and program capacity for prevention, treatment and harm‑reduction services in San Miguel County and neighboring counties. Several funded projects — a full‑time bilingual juvenile‑services case manager, a therapy scholarship fund (RAF) and a new MAT program at the Telluride Regional Medical Center — are intended to expand access to care and reduce service gaps caused by insurance or geography.

Ending: County staff and the regional council said they will proceed with program start‑up and reporting; commissioners and community partners said they would follow outreach and enrollment so the new services reach people who need them.