Sixth Street Clinic to The Colorado Health Foundation

Dear Program Officer,

Sixth Street Clinic runs the only 7-day overdose outreach program in Pueblo County. I am writing to ask whether the Foundation would welcome an application for $74,985 to put a peer recovery specialist on the overnight and weekend shift, which is the shift we currently cannot cover.

Pueblo County recorded 64 overdose deaths in 2025, a rate of 37.9 per 100,000 residents, the highest of Colorado's ten most populous counties (Colorado Department of Public Health and Environment, Vital Statistics Program, provisional 2025 data, released April 2026). That is the condition. I will leave the rest of the county's health picture to other letters.

Our own record is narrower and more useful to you. When someone survives an opioid overdose in the emergency department at St. Isidore Regional Medical Center, a Sixth Street peer recovery specialist meets them at the bedside within 30 minutes, seven days a week, from 7 a.m. to 11 p.m. A clinician starts buprenorphine before the patient leaves. The peer then stays with that person for 90 days: a call at 24 hours, another at 72 hours, then weekly for twelve weeks, with a standing Tuesday and Thursday walk-in slot held open at the clinic. In FY2025 we enrolled 214 adults this way. 168 of them, 79%, started buprenorphine within 72 hours of the overdose. 129, 60%, were still in medication treatment at 90 days. All-in cost was $2,855 per participant, from last year's actuals.

Between 11 p.m. and 7 a.m., and after 11 p.m. on weekends, nobody comes. The emergency department calls, the phone rings at an empty desk, and the patient is discharged with a pamphlet. Between July 2025 and June 2026 that happened to 41 people who met every criterion for the program. We later reached 18 of them. We never reached the other 23.

This request funds one 1.0 FTE peer recovery specialist for the Friday, Saturday and Sunday overnight shifts, plus that peer's fringe, mileage, supervision, an encrypted phone, and buprenorphine for uninsured participants. The lines add to $74,985, which is why the ask is $74,985 and not $75,000. We expect the position to reach 60 additional adults in the grant year. That is below our current rate of 89 participants per peer FTE, because overnight shifts carry fewer presentations per hour than daytime ones, and I would rather tell you the lower number now.

We read the Foundation's priority "Maintain Healthy Bodies and Minds" as covering exactly this work. Your cornerstone commitment to serving Coloradans with low income covers the people we see. Of last year's 214 participants, 143 were uninsured at intake, 67%. Pueblo County's median household income runs well below the state's.

Sixth Street Clinic has operated in Pueblo since 2004 and is a $4.18 million organization with 31 full-time staff and 44 volunteer clinicians. Our FY2025 financial statements carry a clean opinion, and our FY2025 Single Audit, required because federal awards exceeded $750,000, found no findings and no material weaknesses.

I should be direct about the timing. Second Door has been paid for since March 2023 by a State Opioid Response subaward through the Colorado Behavioral Health Administration. That subaward ends 30 September 2026 and we do not expect it back at the same level. This request is a bridge, not a rescue. The clinic already pays for the program manager, the prescriber, the clinic space and the evaluation contract out of other revenue. Colorado Medicaid reimburses peer support services. Our finance director's estimate is that Medicaid would eventually recover about $24,500 of this position's $55,676 salary and fringe. It would not recover all of it. I am not going to tell you the program becomes self-funding, because it does not.

If this fits your priorities, I would be glad to submit a full application with the emergency department MOU, the evaluator's letter of commitment, and the position description attached. If it does not fit, I would rather know that now and stop taking your time. Either answer is useful to me.

Thank you for reading.

Sincerely,