Denver's STAR Program Offers Promising Alternative Response to Mental Health and Substance Use Crises

Support Team Assisted Response (STAR) Program | City and County of Denver

Support Team Assisted Response (STAR) | WellPower

2022 Mid-Year Report | Support Team Assisted Response (STAR)

“Denver successfully sent mental health professionals, not police, to hundreds of calls” by Grace Hauck from USA Today

“These First-Responder Superheroes Don’t Wear Capes or Even Uniforms” by Matt Levin from Oprah Daily

“Denver's STAR set to expand amid tension over its future” by Esteban L. Hernandez from Axios

“As STAR expands, community members feel left out of planning. Here’s why it matters.” by Victoria Carodine from Rocky Mountain PBS

[00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Be sure to subscribe to the podcast to get the full versions of our Friday week-in-review show and our Tuesday topical show delivered to your podcast feed. If you like us, the most helpful thing you can do is leave a review wherever you listen to Hacks & Wonks. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes.

On today's program, we're going to talk about the STAR program in Denver, which has been making news as a promising example of an alternative response to the traditional police response that we're familiar with. It combines the expertise of behavioral health clinicians with paramedics - and that collaboration makes them more effectively engage with individuals who are experiencing mental health distress, or struggling with substance use disorders, or a variety of other needs that may occur in the community.

Today, we're excited to speak with Evan Thompkins, who is the STAR Program Specialist with the Denver Department of Public Health and Environment. He oversees the STAR Program for the City of Denver. Evan has a master's in public health and has been working on addressing mental health, substance misuse, and housing issues for the last six years. We'll also be speaking with Stephanie Van Jacobs, who is a Licensed Clinical Social Worker and a Licensed Addiction Counselor. She has ten years of experience in the mental health field and has held roles as a Case Manager, Outpatient Therapist, Co-Responder, Assistant Program Manager, and is currently a Program Manager at WellPower. Stephanie oversees the Support Team Assisted Response, also known as STAR, an alternative response model that responds to low-level 911 calls alongside Denver Health paramedics. Stephanie has helped to expand the STAR program since 2021. Welcome to both of you.

Starting out, I'm wondering what was happening in Denver that made people feel that they needed a different kind of response than the traditional police response, or something different to address substance use disorder and mental health crises in the community.

[00:02:32] Evan Thompkins: I would say over time, there's been a rise in the number of calls coming into 911 related to mental health, substance misuse, and resource needs. For years and years, 911 has been a catch-all system addressing these types of calls that really aren't police calls. Denver has had a co-responder program since 2016 - this program is different from STAR - but it's a behavioral health clinician who rides with a police officer. So Denver has been trying to send the correct response for quite some time - that program led the way for a STAR-like program to be created. There became this recognition from 911, safety, community members, and other organizations that while having a co-response team is great, there is these low-level calls that just the presence of a police officer would escalate a person. And so this thought began to percolate of how can we respond to these calls? How can we get the people in distress the appropriate need without having a police officer there? So in 2019, members from 911, Servicios de la Raza, community activists - all went to Eugene, Oregon and saw the CAHOOTS program. After that, we came back with some ideas from that program and began work on implementing the STAR program.

[00:03:57] Crystal Fincher: So how was the STAR program put together? Who was involved, and how did you decide what to include?

[00:04:05] Evan Thompkins: Yeah, so members from the community, some partner organizations, community groups, safety, City government collaborated - WellPower was a big part too. In Eugene, they have a different model. We wanted to have licensed behavioral health clinicians just in the rare case that one of our clinicians would need to write an M1 hold - a Mental Health hold - which is something we do try to avoid. And then having an EMT or paramedic because we understand there's such an interplay between health as a whole - with physical health, mental health, and different resources needs - how they can all interplay. So a lot of times people may have overlapping medical concerns that could be important to address as well.

[00:04:52] Crystal Fincher: Can you explain what WellPower is?

[00:04:56] Stephanie Van Jacobs: Yeah, absolutely. WellPower is Denver's community mental health center. We are one of the main resources in Denver for individuals. WellPower offers numerous services such as case management, psychiatry, residential. We also have our walk-in crisis center that's open to the public 24-7. And more recently, we have our behavioral health solution center, which is a first responder drop-off - which STAR and corresponders are able to utilize - which is essentially a walk-in crisis center that then provides a crisis stabilization unit and then a 30-day shelter. So community mental health center - really on the spectrum, meeting a lot of needs for individuals.

Just to expand on what Evan was speaking to, we really wanted to provide an alternative response that could meet community members where they are. And we wanted the EMT & paramedic and the mental health clinician so that we could meet on both sides of the spectrum - so we could potentially solve in real-time problems or advocacy for those community members. So the EMT & paramedic can provide support in those low level medical needs, such as checking blood pressure or blood sugar. And our mental health clinicians can provide de-escalation, they can provide connection to resources. And the collaboration of the EMT & paramedic and the mental health clinician really just provide an entire overall coverage of support when we're meeting individuals in the community. Since our STAR program is 100% in the community, we want to be able to provide as many resources in real-time.

[00:06:34] Crystal Fincher: Stephanie, what is the STAR program? What does it include, and what do they do?

[00:06:40] Stephanie Van Jacobs: Our STAR program is an alternative response. We're responding through 911 dispatch to low-level, low-acuity calls. The concept is really that we are meeting community members where they are. The EMT & paramedic and the mental health clinician receive these calls from 911 dispatch, and then they respond out in the community. They arrive on scene, really meet that person where they are, and then they have the time to just really sit with that individual, build rapport, and collaborate with them - almost leading from one step behind of, How could we provide support? How could we provide advocacy or connection to resource? We want the community to be able to have this alternative response where they're just speaking to these two individuals without having that traditional response - so being able to respond independently of police and still providing those support. Oftentimes when officers respond on scene, they're emergent - they're very busy, they have to go to one call to another. And with STAR, we can slow down this process. We can really take that time to make sure that we're providing culturally appropriate services. We can make sure we're providing appropriate resources. The idea is that we are that next branch of response that can really spend that time to connect individuals to care, expanding on that idea of the Continuum of Care.

[00:08:02] Crystal Fincher: I want to get an idea of what this looks like, practically on the ground, to residents in the community. What is a typical example - "typical" may not be an accurate word - what are some of the examples, or an example of a call that you receive? How is that call placed? Who responds and what happens when they're on the scene? Can you walk me through that?

[00:08:24] Stephanie Van Jacobs: Absolutely. I can walk you through what a typical call would look like from start to finish. So from the very beginning, an individual can call in for themselves, or maybe another community member, or another family member. They call in to 911 dispatch utilizing our non-emergency line or our STAR-specific line. And then from there, they speak to a call taker who asks questions and they can even request for a STAR response. So once they're done talking to our call takers and dispatchers where all the information is gathered, it is then sent to or dispatched to one of our STAR teams. And then our STAR teams, including the EMT or paramedic and mental health clinician, they then respond to where that person is - so it could be somewhere in the community. And then upon arrival, they arrive on scene in the STAR vans - which we can talk a little bit more as well about - they respond, show up with their vans. And then really, they have the time to be really creative with that interaction - so meeting that individual, listening to them, what their needs are, what it is they called in for. And then it really goes to triaging or connecting the individual to the appropriate next step. We brought on Servicios de la Raza last year, which is our referral connection. So if our STAR team interacts with a community member and they're interested in that follow-up care, then the next step would be that our STAR team would send a referral to Servicios de la Raza, where they then could pick up that string for that Continuum of Care and connect those individuals to longer term care within the community. And so then our contacts over at Servicios will really be the contact point for those individuals so that we are making sure that there is a "golden thread" or a continued thread from start to finish. And those calls can be quick. Maybe the individual just needs a ride to the shelter or maybe their primary care appointment. Maybe it's a little bit longer because the mental health clinician and paramedic or EMT are addressing some low-level medical needs, or addressing maybe some de-escalation and some mental health assessments, and then they go to the next step. So the beauty about STAR is that they have the time to make sure all of these steps are taken to make sure that we're meeting the needs of the individual we're encountering.

[00:10:49] Crystal Fincher: Evan, what would that response have looked like before STAR? And what difference does it make to the person needing help and to the community to have this kind of response that STAR provides?

[00:11:01] Evan Thompkins: Before STAR, it could have been a co-response since we had that since 2016. But before that, it would have just been a traditional police response. For the last 60 years or so - if you call 911, they are going to send a police officer at some point in time, which can lead to people being escalated. Police officers don't necessarily have the resources or the know-how to de-escalate people or connect them with the appropriate services. So sometimes some of these calls could just end with someone getting a ticket, arrested - when really what they might need is help, connection, or just a ride across town. I know the STAR program responds to a decent amount of trespassing calls, so we have the ability to just go and work with that person, meet them where they're at, and then - working with us is always voluntary, but by coming in an empathetic way, we can get people like - Hey, this area, you're not supposed to be here. Can we give you a ride? Is there somewhere else you'll feel comfortable? What's going on? - where traditionally that just might be a police officer showing up, arresting, or writing someone a ticket.

[00:12:12] Stephanie Van Jacobs: I will add - our co-responder program has been in Denver since 2016, as Evan previously expanded on - this concept of the mental health clinician with the Denver police officer. And it's very helpful because our clinicians that are co-response, as of now, and our STAR clinicians are all employed by WellPower - so we really try to promote this right response at the right time. So if a police officer and a mental health clinician are the response that is sent out, and the clinician arrives on scene and says - Hey, this is better for alternative response - our clinicians are able to collaborate to make sure to send that right response if maybe co-responder is not it, or maybe STAR is not it. So our co-responders have been really helpful in acclimating STAR within the city and county of Denver. And both of these programs work parallel to each other so that our co-response program is really responding to those high-level, high-acute calls, where maybe safety is more of a primary factor. And our STAR program is able to respond to those low-level, low-acute calls and operate more independently within the community.

[00:13:19] Crystal Fincher: Wanted to learn a little bit more about the co-response versus the solo STAR response. We're here in Seattle - both Seattle and several cities in the area are either deploying pilots, or limited trials, or in the early stages of deploying co-response models. And some are perhaps considering an individual response but haven't gotten there yet. How did you evolve from having a co-response model to also including STAR? What were those conversations in that evolution like? And what was the response from the community and police?

[00:13:58] Evan Thompkins: Community members started talking about this idea in 2017. We have a Community Advisory Committee for the STAR program, and a lot of those members had been there from the beginning of dreaming what a truly alternative response would look like. It's great that we have co-responders, but again, as we've mentioned, sometimes with these lower-level calls, the presence of a police officer can really escalate a person in need. So, there is those conversations. There is conversations within the city, too, of what this response might look like. And then it was coming together - Servicios, WellPower, members of the community - to discuss what this program could entail. And then going to Eugene, Oregon - seeing the program there, and coming back, and starting to work on what our program would look like here in Denver.

[00:14:52] Stephanie Van Jacobs: I was just going to add that a lot of conversations have been had of allowing officers to focus on what it is they signed up for. And so having our co-responders has been incredibly helpful - we have a great relationship with DPD [Denver Police Department] - and when we arrive on scene as co-responders, there's still this police presence. And so the idea is that STAR, this alternative response, is able to break down those barriers. A lot of individuals in the community have hesitation when calling 911 or reaching out for that traditional response. And so the conversation is - STAR can operate independently and we're still reaching those community members, just in an alternative route.

[00:15:32] Crystal Fincher: So I want to talk a little bit more about the impact that it has had on traditional police response. Certainly one of the benefits you talked about and that a lot of other cities, including in our region, have discussed is the potential for an alternative response model to free up police to respond to more urgent criminal matters. Has that happened with this program? What has been the impact in that area?

[00:15:59] Evan Thompkins: I know in 2022, we responded to like 5,200 calls that would have traditionally went to police. Overall, since inception, we've now responded to over 12,000 calls that would have had a police response to those calls - so there's definitely that impact. But again, we've had this relationship built, too, that a decent amount of our calls actually start with a police officer arriving on scene and then recognizing the call is not appropriate for police, and then deciding to call in STAR. So I think it even shows on their end that they understand that there's a better way for things to be done - and sometimes that's not them. When a call comes in through 911 with someone in distress, it's not necessarily always black and white. Maybe someone calls and says - Help, help, someone's robbing my house - and so they send the police. And when police get there, they see there's actually nothing like that going on here - this person appears to be in some sort of mental health crisis. So can we step back and provide a more appropriate response?

[00:17:09] Crystal Fincher: In considering how this does impact the police response and where you're at now, what does the capacity of the program currently look like? And are there continued plans to expand? What has the path of expansion looked like so far?

[00:17:27] Evan Thompkins: In 2020, we started our pilot in our downtown District 6 with limited hours from 10 a.m. to 6 p.m. District 6 has our highest level of people experiencing homelessness, so we started with one van. We then started a full citywide project where we expanded to five vans in service - so 10 behavioral health clinicians and 10 EMTs-paramedics. And then we've recently expanded to eight vans, so we have eight vans in service and then up to 16 behavioral health clinicians and 16 EMTs & paramedics. We are always still thinking about expansion. So when a call comes in through 911, it's marked as STAR-eligible, and then our dispatcher can dispatch the STAR team. Currently, we're only able to respond to about 50% of those calls. So that really shows that there is a continued need for expansion, and we're going to continue to expand until we can actually meet the needs of our community. So I think we have a lot of buy-in from our community, city council, the mayor, the residents of Denver - that we need to keep expanding this program until we can meet that need. Furthermore, we're only in service right now, 6 a.m. to 10 p.m., so we want to expand for this program to eventually be 24-7 as well.

[00:18:49] Crystal Fincher: What is the need that you've seen in the times that you aren't currently in service - that overnight or late night, early morning service? Are you seeing a demand in STAR-eligible calls there that you would like to expand to cover?

[00:19:05] Evan Thompkins: So, yes. We record when all STAR-eligible calls are coming in. Typically, most of our calls are coming in 9 to 5 because that's when people are coming into the city, that's when people are working - so that's our highest concentration of calls. The call volume does drop off in those overnight hours. However, there is still a need for a response during those hours. Also, people know the program's not available during those hours, so if you would be eligible for a STAR response or thinking about wanting to utilize the program at 2 a.m. - you're not going to call STAR if you know it's not available. So there's definitely that need. And then our overnight staff at 911, they're not necessarily assigning STAR calls, so there could be continued work there too to really make sure that there's continual training so at least they're marking calls as STAR-eligible to make sure we're fully capturing the number of calls. But I would assume when we move to 24-7, that call volume is going to increase over time. Just something to think about when we get there is - it's great to meet people in that moment, but also thinking about what kind of services can we really provide at 3 a.m. in the morning. A lot of shelters close their doors at 9 or 10 p.m., there's not follow-up resources at those times of the night. So thinking about not just expanding to have STAR in service, but also our follow-up network - if we can make sure that we can connect people to resources that are appropriate to them any time of the day.

[00:20:46] Crystal Fincher: I want to talk a little bit more about the vans. Are they specially equipped with elements that you need for your response? And do people respond differently when they see one of your STAR vans show up as opposed to a police car, Stephanie?

[00:21:00] Stephanie Van Jacobs: Our STAR vans, especially our new ones - we have fitted the interior to make it more trauma-informed, make it more appropriate to have conversations in the van - so the placement of where individuals can sit have changed. We also have inventory on the van that we're able to provide to community members in real-time. So in this inventory, we often carry Narcan, fentanyl testing strips, and then we have weather-appropriate clothing, hygienic products, and then really anything else that we're hearing - we like to turn it back to the community members and ask what would be beneficial for them to have in these vans. So we also always have snack, we have waters. Recently, we added fidget spinners for our I/DD [Intellectual and Developmental Disabilities] community. And we'll continue to evolve this inventory to make sure that we are reflecting the needs of our community members. And I absolutely do think it makes a difference - sometimes an individual we encounter within the community just needs time to speak with somebody. And in that time speaking with someone, having a water and a snack - it breaks down those barriers or that power differential. And it really turns it into a collaboration or more of a conversation where individuals can feel comfortable speaking about mental health, which is oftentimes stigmatized in our communities. So absolutely, I think it's beneficial - it's something we will continue to have on the vans and continue to add to, so that we can support our community members in real-time.

[00:22:29] Evan Thompkins: Just to add on real quick - most of our vans have wheelchair lifts on them to make sure we can provide that resource to anyone in the community. And then, having a police car or a fire truck show up - lights flashing - that can be stigmatizing for people too, especially if you're thinking about - Man, my neighbors are going to ask a lot of questions about this I don't want to answer. So how the STAR vans look - they're white vans, we're working on having pretty small logos on them that say STAR - just so that people are comfortable with us showing up too in the community.

[00:23:05] Crystal Fincher: That definitely makes a difference. I'm wondering about your transport services. When designing the program, why was it important to include transport as part of what you do? And where are you transporting people to, and how is that helpful?

[00:23:22] Stephanie Van Jacobs: Transportation is crucial because oftentimes it can be the main barrier stopping someone from accessing a resource. If an individual doesn't have transportation or maybe never have utilized the bus route, they may never seek out resources. And so we want STAR to be able to eliminate that barrier right out of the gate. So if an individual is expressing that they are really needing a shelter for the evening, or they're really needing a community resource that provides primary care or psychiatry - we can spend most of the time problem-solving how to schedule an appointment, which route to take, without having to focus on how is the individual going to get there. We want them to be able to focus on what it is that they need in that moment and how can STAR be the support to get them there. So transportation oftentimes can really debilitate individuals from seeking out support. And I would say since 2020, STAR - within the community - has really gained the reputation of being able to provide transportation, which is wonderful because we're reaching more individuals who maybe they just need to get to that resource and may have never called before. And we're then able to build those connections during transport - we are having conversations, we're building rapport, we're digging deeper of how we can continue that care after the interaction with STAR.

[00:24:51] Crystal Fincher: I'm also wondering - for our benefit here, where with the number of these programs under consideration - there's been a vibrant community-based and political discussion surrounding these, with people having varied opinions and with different police departments and police unions having different opinions on whether this is something that they feel is useful and helpful and want to have. And the need to provide funding when budgets can be tight in many areas - and currently many cities are facing deficits - can be a challenge. How did the community conversation evolve? How have conversations about funding and continued support of the program been?

[00:25:35] Evan Thompkins: I would say we live in a community where we have a lot of people who recognize the need for this program. We have a lot of buy-in from our city council, our residents, community, the mayor, the organizations, our police department. For places who don't necessarily have that buy-in, I would say that programs like STAR can actually save money for cities. They're alleviating the time it takes for an officer to show up at the scene, write a ticket, take someone to jail - there's a lot of cost savings. And then police officers can actually focus on the things that they need to do. So we're taking low-level calls off their plate that they probably don't necessarily even want to respond to in the first place. Also, with having an EMT and a paramedic there, they can definitely triage medical concerns for people. So maybe they take someone to a pharmacy, maybe they give them a ride to their primary care, maybe they take them to urgent care. In the past, if you called 911 and they send an ambulance, a lot of ambulances are licensed - they have to take you to an emergency department. Well, that can cost systems a lot of money, especially if that person doesn't have the correct insurance.

Another thing we've definitely ran into in other places when they come and talk to us - is these calls have been handled from 911 for such a long time, there's a lot of fear in 911 about the safety of their people. One of the main concerns is safety - making sure you come home at night. So the thing is, they think - Well, what if something really bad happens to this person? And our response is - people have been working in the field as community health workers, as social workers - going into people's home, making that their living for a really long time already. That is already happening. Now with this program, they have a police radio and people know where they are, so it's actually - in some sense - a little bit safer.

[00:27:33] Stephanie Van Jacobs: I would just add to turn to your community - listen to the needs of your community and involve them in these conversations that are being had in the early stages of these program ideas.

[00:27:45] Crystal Fincher: And in the time that you have had the STAR response, have responders needed to call for backup or found themselves in a situation that they weren't able to handle?

[00:27:56] Evan Thompkins: For the most part, no. There are reasons a STAR team will call for backup. Sometimes that can just be a general assist if there's someone on the side of the highway that we're meeting with - just having a police officer there to kind of help with traffic or something like that. Sometimes if STAR team shows up and it's a more acute need that needs a higher level, or if maybe there is a safety concern - they might call in co-responders to hand that call off to a co-response team.

[00:28:26] Stephanie Van Jacobs: I would just add that safety is a priority - and so the idea is that we keep the individuals in the community safe, we keep the clinicians and paramedics & EMTs safe. And so if we need to call for support on that, we can. Oftentimes though, STAR is able to operate independently and safely.

[00:28:44] Crystal Fincher: So what is next for STAR? If you're looking at expansion, if you're looking at addition of services within your current portfolio - what are the greatest needs that you would like to, or are planning to respond to?

[00:28:57] Evan Thompkins: There's definitely a lot of different needs. To start with, we want to keep expanding until we can meet the needs of the city of Denver. Right now, we're only meeting about 50% of STAR-eligible calls. So again - more STAR vans, more STAR staff, EMTs & paramedics. But then also thinking about how do we increase our follow-up care network with our community partner, Servicios de la Raza. How can we have more case managers for them? How can we make sure there's even more culturally appropriate services through community partners, that we can tap into this network so we can really build a tapestry of resources that work for people? We want to move to 24-7, so thinking about what kind of services that would inquire. We've had thoughts, too, of - sometimes shelters are full or if it's after-hours, there's not an option for that person. So in the future, could we have a STAR walk-in center where people could access services 24-7? Could we have beds to house individuals there? We currently house our vans with Denver Health and Hospital Authority, but at some point we're going to need our own space to house vans. So could we have our own building to centralize all of the STAR program together? So there's definitely been a lot of different dreams that we're looking to in the future. Thinking about how we respond too - right now, we have behavioral health clinicians and EMTs & paramedics. But could we have different models where those people - the teams we have now - are going to some of the higher-acuity mental health calls we respond to. And then we have other teams - maybe of a peer support specialist and an EMT & paramedic - who can assist in a different way. Sometimes people respond better to someone with lived experience who can talk to someone more as that middle ground of - I'm not a therapist, I'm not your friend, but I'm in-between - and saying, Hey, you know, me and you aren't the same, but I've been in the same ballpark and here's steps I've taken to move past this situation. Here's a path forward. Let's help you determine a way forward as well.

[00:31:09] Crystal Fincher: I'd like to discuss a little bit about the impact that you've seen in the community, but with a broader question - what do you think is the most useful way to evaluate the effectiveness or usefulness of programs like STAR? And what has the impact been, or what results have you seen based on what you're tracking in your community?

[00:31:32] Evan Thompkins: I think there's quite a few different ways you can look at that - qualitative data and quantitative data. So tracking through systems at 911, at Wellpower, at Servicio - really looking at the data to show a story of where we are and areas we can improve in. We also work with an organization called Urban Institute, and we've tasked them to do some third-party evaluations of the program. So this year, we're having them do a cost study and an evaluation of how we can continue to expand the STAR program. Quantitative - I think it's really important to try and get firsthand feedback from some of the people we serve. That can be pretty difficult to do sometimes, especially if someone's in the middle of their crisis - they probably don't want to necessarily fill out a form about how they were feeling with the STAR interaction. But I think firsthand information can be very beneficial.

Also really involving your community too - we have a Community Advisory Council - different members of the community who run different organizations, who are members of color, who really have their ear to the ground of what's happening in the community. And looking to them to provide some evaluation with their experiences of the program. One of the things that came from that is this push to have this follow-up network of care through Servicios de la Raza. They really wanted this network to focus on having culturally, linguistically, and geographically services available to people in a way that really met the actual needs of that person and could probably get them into care a little bit sooner. I think some of our other data points that we've collected can really speak to why we need to continue expanding and then just points of improvement that we can point at through our data sources.

[00:33:26] Stephanie Van Jacobs: I would just add - we see the impact daily by the relationships that we're building within the community. Having community members speak about STAR, having individuals utilize the STAR number, having individuals call the STAR number more than once is really showing the trust that we're building in the community. And I really look to the future with excitement of how we'll continue to evolve that trust - so that STAR is just a household name alongside 911 and these traditional responses.

[00:33:58] Crystal Fincher: Excellent. And just as we close our conversation today - are there any surprises that you've encountered since starting this program, or things that you've learned along the way that maybe you thought - Hey, the community has this need and we're going to solve it this way and it turned out that meeting that need was best done in a different way? Looking at this in a context of advice to other cities or lessons that you've learned.

[00:34:24] Evan Thompkins: I can speak to lessons learned. Really trying to involve the community from the get-go. We did not do an adequate job of that here, and so we've definitely had to pay the consequence for that. I think a lot of times - as government, we just assume what community needs and provides that to community, instead of understanding that community can tell us what they need, and we can just be a conduit to provide those needs. So really listening to your community, really making sure the programs that you create are things that is going to be beneficial for the community and serve them in a way that they want to be served. Something else that came up is - throughout the past in STAR, there were times people called in for STAR and said - Hey, I want a STAR response. It met the STAR protocol - no safety concerns, no major injuries, fell within the guidelines of working with STAR. But STAR wasn't available. So then two or three hours, a police officer showed up - which is exactly what that person didn't ask for. So we now have developed a STAR-only response, where a person can call in, say - I want STAR-only. The call taker will confirm - Just so you know, if STAR is not available, we're not going to send anyone. Is that okay? And then if they say yes, they won't send anyone - they'll give them a call back and let them know if that's going to be the case. But they'll also tell them - Hey, you can call us back if you do want a traditional police response. So that's definitely been beneficial.

[00:36:00] Crystal Fincher: Stephanie, anything you would add?

[00:36:03] Stephanie Van Jacobs: Just continued collaboration. I think the STAR program will continue to evolve and will acclimate as the community's needs change. And so those relationships with our 911 communications, with Denver Health DDPHE, our community coalition, and WellPower - it's incredibly crucial to continue that collaboration, continue having those conversations, and then turning to the community to make sure that STAR is setting out and doing what it said it was going to do and really actually meeting the needs of the community. So being flexible and able to shift and move as the community changes.

[00:36:40] Crystal Fincher: Well, thank you both for your time today. Certainly enlightening learning from your experience in Denver and look forward to following how it continues to expand and unfold. Thank you so much.

[00:36:52] Stephanie Van Jacobs: Thank you.

[00:36:53] Evan Thompkins: Thank you.

[00:36:55] Crystal Fincher: Thank you for listening to Hacks & Wonks, which is produced by Shannon Cheng. You can follow Hacks & Wonks on Twitter @HacksWonks. You can catch Hacks & Wonks on every podcast service and app - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get the full versions of our Friday week-in-review shows and our Tuesday topical show delivered to your podcast feed. If you like us, leave a review wherever you listen. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the podcast episode notes.

Thanks for tuning in - talk to you next time.