Fundraising & Capital Plan
Two kinds of money do two jobs: grants pay the one-time cost of building each unit, and insurance billing — mostly Medicaid and Medicare — pays to run it. Grants come first so the build and early ramp don't require giving up ownership, and the steady-state business is profitable on billing alone.
The capital logic: grants build it, billing runs it
Two money problems, each with its own source. The one-time cost of building a unit — the mobile treatment van and its build-out, licensing, first-year clinical staffing, and start-up working capital — is paid by grants (opioid-settlement dollars and federal programs). The ongoing cost of running the clinic — every visit, medication, therapy session, and behavioral-health service — is paid by insurance billing, mostly Medicaid and Medicare. We don't ask a grant to do an insurer's job, or make an insurer wait on equipment a grant was built to buy.
The van and its build-out, the licensing to carry all three approved opioid-use-disorder medications, the first-year clinical staff ramp, and start-up working capital. Three sources can cover the van — county settlement money, the federal rural opioid program, or the state mobile-unit grant — so no single program has to come through for the first unit to get on the road.
Once a patient is in care, the services are billable: medication and psychiatric med management, individual and group therapy, intensive outpatient, care coordination, and peer support. Medicaid carries most of the Illinois volume and Medicare covers the rest. That recurring revenue makes the unit profitable on its own at steady state — see the financial model.
Two Dreams is already a state-licensed addiction-treatment provider (Illinois' substance-use authority, IDHS/SUPR). That clears this funding's biggest hurdle: most Illinois settlement and state opioid-response awards require the license, and some require the higher opioid-treatment-program status needed to dispense methadone. Being a for-profit — which blocks many direct federal grants — is no barrier on the Illinois settlement awards or the federal rural opioid program. The license is the entry ticket, and we hold it.
The core grants, in plain terms
Four grant sources fund the build, run in parallel and ordered by speed and fit. County settlement money is quickest to reach. The federal rural opioid program is open now (applications due July 8, 2026) and for-profits can apply. The state opioid-response grant flows through Illinois' substance-use authority to licensed providers. The state's dedicated mobile-unit grant is the best single fit but is closed right now, so we keep a ready-to-file application on the shelf.
County opioid-settlement money
What it is: each Illinois county gets its share of national opioid-settlement funds to spend locally on treatment and recovery; we contract directly with the county to serve its residents.
Amount: roughly $50K–$500K+ per county per year, adding up when one van's route covers several counties.
What it funds: treatment capacity, clinical staff, the mobile van (purchase and build-out), and care for that county's residents.
Why it's fast: a direct county contract skips the longer state grant cycle. About 60–120 days to a signed contract, then invoicing begins — the earliest realistic cash for a van.
Federal rural opioid program (RCORP)
What it is: a federal program (HRSA) funding opioid treatment, recovery, and prevention in rural areas.
Amount: up to $750,000 per year for four years.
What it funds: rural treatment and recovery services, including new places to start medication treatment — a mobile van fits cleanly.
Eligibility: for-profits can apply, so Two Dreams can lead. The lead must team up with at least two other local organizations, and the service area must qualify as rural. A rare major federal grant where for-profit status isn't a barrier.
Timeline: open now — applications due July 8, 2026; awards in fall, funds early in the new federal year. Worth filing this cycle wherever a rural footprint is real.
State opioid-response grant (SOR)
What it is: federal opioid-response money that comes to Illinois as a block and passes through to licensed providers via the state's substance-use authority (IDHS/SUPR).
Amount: Illinois receives about $36M a year; a provider's slice is typically $50K–$500K+ per year.
What it funds: medications, clinical staff, and treatment capacity — the state has used it for mobile delivery before.
Eligibility: state-licensed providers, which Two Dreams already is. We access it as a sub-recipient rather than applying to the federal government directly.
Timeline: a scoped sub-award off the existing state grant can move in about 60–120 days, through Dr. Barthwell's relationships with the state authority.
State mobile-unit grant (MMHU)
What it is: Illinois' purpose-built grant for mobile opioid-treatment units, funded from the state's settlement trust.
Amount: up to $700K per unit across the funding period.
What it funds (when open): the mobile unit and build-out, licensing, clinical staff, and services — designed for a van that can dispense all three approved opioid-use-disorder medications, including methadone.
Eligibility: licensed providers and opioid treatment programs, alone or partnered for the methadone piece. Two Dreams' license is the entry ticket.
Status: earlier rounds have closed and no new round is announced as of June 2026. We keep a ready-to-file application on the shelf and watch for a re-opening — the plan does not depend on it.
| Source | Who runs it | Can we apply directly? | Award size | Covers the van? | Speed to money |
|---|---|---|---|---|---|
| County settlement money | Illinois counties | Yes — direct contract | $50K–$500K+/yr | Yes | Fastest (60–120 days) |
| Federal rural opioid program (RCORP) | HRSA (federal) | Yes — for-profits eligible | $750K/yr × 4 yr | Yes | Open now — July 8, 2026 |
| State opioid-response grant (SOR) | State authority (IDHS/SUPR) | Yes — as a sub-recipient | ~$36M/yr to IL | Medications, staff, some mobile | Fast–medium |
| State mobile-unit grant (MMHU) | State authority (IDHS/SUPR) | Closed for now | Up to $700K/unit | Yes — purpose-built | Closed (ready if it re-opens) |
Additional grants that stack on top
Beyond the four core sources, more programs add funding without replacing the plan. They fall into two groups: programs a for-profit can use today, and a larger set that opens up if Two Dreams stands up or partners with a related non-profit.
Available to a for-profit now — lower the cost of staff
Clinical staff is the biggest operating cost, and clinician loan repayment is the cleanest way to cut it. These programs don't pay the company; they pay off employees' student loans in exchange for a service commitment, letting us recruit and keep good people well below market cost. They stack as long as each program covers a different person.
Federal clinician loan repayment (NHSC)
Pays off up to $75,000–$80,000 of a prescriber's student loans for a three-year commitment at an approved site. Private and for-profit clinics — including office-based buprenorphine sites and mobile units — qualify if the site is in a designated shortage area and offers the medication. Site approval takes 3–4 months, so we start now.
Federal SUD-workforce loan repayment (STAR)
Up to $250,000 in loan repayment over six years, reaching more job types than the prescriber-only program — counselors and behavioral-health roles included. Different employees can go on this and the federal prescriber program at once.
Illinois loan-repayment programs
Two state programs add money on top: one for behavioral-health and recovery roles (including certified peer-recovery specialists) and one for prescribers (psychiatrists, nurse practitioners, primary-care physicians). We enroll our sites and confirm approved-employer status.
Larger upside through a related non-profit
The biggest structural funding levers are reserved for non-profits and government. Setting up or partnering with an affiliated non-profit unlocks a second tier of money and a higher Medicaid rate — with the for-profit delivering services under contract.
Certified behavioral-health clinic (CCBHC)
A clinic certified under this model is paid a cost-based Medicaid rate usually far higher than ordinary per-service Medicaid, because it reimburses the real cost of care — a durable boost to revenue per visit. The certified clinic must be a non-profit, so Two Dreams would reach it through an affiliate. Illinois runs this as a Medicaid program with an annual application window.
340B drug pricing
Lets eligible non-profit clinics buy outpatient drugs — including buprenorphine — at deep discounts while billing at normal rates, keeping the spread to fund services. Reachable only through the affiliate; a recurring margin that grows with dispensing volume.
USDA & foundation grants
Through the affiliate, two more pools open up: USDA community-facilities funding for vehicles, equipment, and build-out in rural areas, and opioid-focused foundations (such as FORE) granting roughly $500K–$1.1M for new services and pilots. One-time money on top of operating revenue — good for outfitting more vans.
The four core grants build the unit and bridge the early ramp; loan-repayment programs sit on top and cut staffing cost on day one; the non-profit affiliate then unlocks the certified-clinic Medicaid rate, 340B drug margin, and USDA and foundation capital. None replaces the others — settlement and federal grants fund capacity, the higher Medicaid rate and billing fund operations, and loan repayment plus 340B improve the margin underneath.
How Two Dreams applies for each one
Two Dreams raises as a treatment provider, not a vendor — the existing license and Dr. Barthwell's standing convert directly into applications. The approach differs by source:
With a county
Start with counties where Dr. Barthwell has the warmest relationship and overdose data shows the greatest need — our county targeting index is the pitch — and that haven't yet committed their settlement share. Offer a county-dedicated van serving that county's residents, then sign a direct contract.
For the state mobile-unit grant (if it re-opens)
Closed for now, but the fit is strong, so we stay ready: we hold a complete application — including a workable plan for the licensing to dispense all three medications — to file within days of a new round. We also confirm our exact license class to decide whether to apply alone or with a methadone partner.
For the state opioid-response grant
We go straight to the state authority's grants team to find current and upcoming treatment-expansion slots, then scope a medication-and-mobile-delivery sub-award off the existing state grant.
For the federal rural opioid program
Where the service area is rural, we form the required local partnership with Two Dreams as lead and file this cycle — confirming rural eligibility with the federal tool first.
For the loan-repayment programs
We get our clinic and mobile sites approved by the federal and state programs now — approval takes a few months — so clinicians can enroll in the next cycle and we cut staffing cost as soon as we hire.
For the non-profit-affiliate track
In parallel, we evaluate standing up or partnering with an affiliated non-profit — the decision that unlocks the certified-clinic Medicaid rate, 340B drug pricing, and USDA and foundation grants, the larger, longer-term tier.
State contracts require Illinois grant pre-qualification (GATA) and state purchasing-system registration; federal applications require SAM.gov registration. These gate everything and run on their own clock, so we begin them alongside the applications, not after.
The first-year timeline
We run every live source in parallel: county and state opioid-response money produce near-term cash, the federal rural opioid program is filed this cycle, and in-clinic billing turns on within weeks to bridge the ramp. A ready-to-file mobile-unit application waits on the shelf in case that grant re-opens.
Clear the registrations and start billing
Begin state and federal grant registrations and confirm our exact license class. Stand up in-clinic and telehealth buprenorphine billing in 4–8 weeks under the existing license, so revenue begins while grants are pending. Start loan-repayment site approvals.
Open the county conversations
Dr. Barthwell makes warm introductions to two or three target counties, pitching a county-dedicated van via the targeting index. We contact the state grants team to scope an opioid-response sub-award and get on the mobile-unit notification list.
First grant dollars sign
The first county settlement contract signs (60–120 days) and funds the van purchase and build-out; the opioid-response sub-award is scoped and moving; the federal rural opioid program is filed by the July 8, 2026 deadline where a rural footprint fits.
Grants draw down, census ramps
The opioid-response sub-award executes and grant draw-downs begin, covering peer and case-management staff, van operating costs, and care for uninsured patients. The mobile-unit application stays ready to file. Patient census builds toward breakeven (~248 active patients).
Van on the road, billing scales
The first buprenorphine outreach van deploys on the county route. Medicaid and Medicare billing scales across the integrated behavioral-health services — the recurring revenue engine taking over from grant draw-downs as the unit nears breakeven.
Cross into profit and prove it works
The unit crosses breakeven and moves toward its steady-state profile of about 340 active patients. We document outcomes to win the next, larger grant and open a second county — the start of the scaling path.
Grants buy the van and bridge the ramp; billing carries the ongoing load. A buprenorphine outreach van runs about $170–290K in capital cost, funded by the county, federal rural, or state mobile-unit grant. Below breakeven, grant draw-downs cover the gap, so the unit funds its own build and early losses rather than relying on outside equity. See the full build on the financial model.
Which grant covers which cost
The map between funding and spending: grants cover the build and the highest-risk early costs; recurring billing covers the durable core — clinical salaries, administrative staff, facilities, and insurance. This split is why the steady-state business is profitable on billing alone, with grants adding margin on top.
| Cost line | Funded by |
|---|---|
| Mobile van purchase and build-out | Grant — state mobile-unit, county settlement, or federal rural program |
| Van operating costs (fuel, insurance, maintenance) | Grant — federal rural, opioid-response, or county settlement |
| Peer-recovery specialist and case management | Grant — opioid-response or county settlement |
| Care for uninsured patients | Grant — county settlement, opioid-response, or mobile-unit |
| Medications | Grant — mobile-unit or opioid-response (and 340B margin via the affiliate) |
| Outreach and referral development | Grant — federal rural or opioid-response |
| Data and analytics tools | Grant — federal rural or foundation grants |
| Clinical prescriber and nursing salaries | Billing (loan repayment lowers the cost) |
| CTO, office coordinator, billing staff | Billing |
| Facilities and rent | Billing |
| Malpractice and liability insurance | Billing |
At steady state, one clinic plus one van earns about $1.84M a year against about $1.35M in cost — roughly $497K in profit at a ~27% margin, on billing alone. The grants above offset about $173K of operating costs, lifting net profit to about $670K (~36% margin); loan repayment and 340B improve it further. Full detail is on the financial model.
Grants first, then billing, equity optional
The plan is built so the venture funds itself: grants pay for the build, billing pays for the operation, and outside equity is optional — useful only to speed up expansion, never required to start or sustain the business.
Grant capital
County settlement money, the federal rural program, and the state opioid-response grant fund the van, build-out, licensing, and start-up staff — with the state mobile-unit grant as upside if it re-opens. Strong outcomes then make the next, larger grant easier to win.
Earned revenue (Medicaid / Medicare)
The integrated behavioral-health services make the unit profitable with a lean team. Billing sustains operations and steadily reduces dependence on grants — at steady state, profitable on billing alone.
Equity (only to accelerate)
Considered only to grow the network faster than grants and billing would fund on their own, and only on terms that keep the business healthy. Because the grant and billing engines work without it, equity is a choice, not a necessity.
Run the live grant lanes in parallel — county settlement money, the federal rural opioid program (open now, due July 8, 2026), and the state opioid-response grant — stack loan-repayment programs on top to cut staffing cost, and let billing carry the operation. That gets the first unit on the road and to steady-state profit without outside capital. The non-profit affiliate, if pursued, opens a larger second tier — the higher Medicaid rate, 340B, and additional grants — as upside.