STAR: Support Team Assisted Response
Denver's STAR program launched on June 1, 2020 with a single van and two responders. Five years later, it operates eight vans citywide with a $7.2 million budget, has responded to more than 25,000 calls without a single arrest, and has become the most studied alternative crisis response model in the United States.
Denver’s STAR program launched on June 1, 2020 with a single van and two responders.[1] It now operates eight vans citywide with a $7.2 million budget and has responded to more than 25,000 calls without a single arrest.[2]
“Put Out As Many STAR Vans As Police Cars As Far As I’m Concerned.”
That’s a quote from a Denver resident interviewed by researchers from New York University Law School’s Policing Project.[1]
of the study’s participants believe that “transforming first response” in Denver is a “high priority.”[1]
How STAR Was Created
STAR emerged from at least eight distinct forces converging over several years — not a single catalyst.
The financial foundation came from the Caring for Denver ballot initiative in November 2018, which Denver voters approved with 70% support, creating a 0.25% sales tax generating roughly $35 million annually for mental health and substance use services.[1] Colorado State Representative Leslie Herod championed the measure. A $208,141 Caring for Denver Foundation grant directly funded the STAR pilot.[1]
The operational model came from a delegation trip to Eugene, Oregon in June 2019, where community advocates, city officials, law enforcement, and nonprofit representatives studied the CAHOOTS program, which has operated since 1989 through the White Bird Clinic.
Local organizing had driven the concept for years. The Denver Alliance for Street Health Response (DASHR), co-founded by Vinnie Cervantes, was “founded as a group explicitly trying to bring this kind of CAHOOTS program to Denver.” The Denver Justice Project, co-chaired by Roshan Bliss, had been “publicly talking about the program — or elements of it, at least — in 2017.”
Denver-specific deaths of people in mental health crises during police encounters were explicit motivators. Michael Marshall, a 50-year-old Black man with schizophrenia, died in the Denver Detention Center in November 2015 after deputies restrained him during a psychotic episode. Denver paid $4.65 million to settle. Roshan Bliss stated that if mental health workers had been sent to the motel where Marshall was accused of trespassing, “he could have avoided the Denver jail where he was later killed.”
Police Chief Paul Pazen’s receptiveness was essential — advocates began talking to him when he was a commander in 2017; when he became DPD chief in 2018, “he was primed to help get the ball rolling.”
And the data case: heading into 2020, Denver Police data showed mental health-related calls for service were up 17% over the three-year average.
The pilot launched on June 1, 2020 — the sixth day of Denver protests following George Floyd’s murder on May 25. The NYU Policing Project documented that STAR had been in development since at least 2019, with the Caring for Denver grant and the Eugene delegation trip preceding Floyd’s death by over a year.[1] The protests intensified political support for expansion.
Political Durability
The program has enjoyed broad political support. During Denver’s mayoral election, three of the top candidates voiced support for STAR’s expansion. Kelly Brough, former chief of staff to then-mayor John Hickenlooper, said that while “sworn officers have a critically important role to play in resolving serious and violent crime, it is neither efficient nor effective to rely only on police response for the myriad of community safety issues.” City Councilmember Debbie Ortega pledged to “allocate more resources towards Denver’s [STAR] Program so qualified mental health professionals can resolve nonviolent scenarios and police can focus on keeping us safe.”
The Stanford Study
Dee, Thomas S., and Jaymes Pyne. “A community response approach to mental health and substance abuse crises reduced crime.” Science Advances 8, no. 23 (June 8, 2022): eabm2106. Published in the peer-reviewed open-access journal of the American Association for the Advancement of Science. The study used a preregistered, quasi-experimental design with 432 precinct-month observations across Denver’s 36 precincts, covering December 2019 through November 2020.
In neighborhoods where STAR operated:
drop in low-level crime in STAR areas.[3] “There were fewer citations, and people were less likely to reoffend because they got the help they needed.” The study estimates 1,400 fewer criminal offenses in Denver because of the pilot program.[3]
Violent crime rates in STAR areas remained steady — the crime reduction was entirely in the low-level offenses that STAR handles.
cheaper than the criminal justice system.[3] Cost per STAR offense reduced: approximately $151. Average direct criminal justice cost per minor offense: $646 (in 2021 dollars).[3]
And the safety record: police have never been called for backup during STAR interventions.[4]
Many of the people who get proper treatment from these programs have fewer run-ins with police moving forward, as well as fewer detentions and hospitalizations.
In its first year, STAR diverted 748 calls — representing 3% of all 911 calls for service. The six-month pilot results: 748 incidents responded to, zero arrests, zero calls requiring police backup.
What STAR Looks Like On The Ground
Each STAR van deploys with one behavioral health clinician (employed by WellPower) and one paramedic or EMT (employed by Denver Health). Teams wear plain clothes and carry no weapons or restraints. Vans carry Narcan (naloxone), fentanyl testing strips, weather-appropriate clothing, hygienic products, snacks, water, fidget spinners (added for the I/DD community), and blankets. Newer vans feature a trauma-informed interior design with modified seating for more comfortable conversations.
Seven call types are STAR-eligible: Assist, Intoxicated Person, Suicidal Series, Welfare Check, Indecent Exposure, Trespass/Unwanted Person, and Syringe Disposal. The eligibility criterion across all call types: no evidence of criminal activity, weapons, threats, violence, injuries, or serious medical needs.
During the pilot, the median on-scene time was 24.65 minutes — compared to 34.08 minutes for a traditional police response to the same call types. STAR provided transportation in 41% of calls — most commonly to shelters or homeless services, the walk-in crisis center, and hospitals. As of December 2024, 30% of clinical encounters included transport. STAR Program Manager Stephanie Van Jacobs noted: “Transportation is crucial because oftentimes it can be the main barrier stopping someone from accessing a resource.”
Follow-up care is coordinated through Servicios de La Raza under a $2.3 million contract. When a STAR team encounters someone interested in continued care, they send a referral for longer-term behavioral health services, acute case management, and resource navigation. Of roughly 12,000 clinical encounters through December 2024, approximately half received referrals to community care.
It’s really about meeting the needs of the community and making sure we are sending the right experts, so we can actually solve the problem.
I kinda see public safety as a puzzle… it has many different interlocking pieces that all come together to form one picture. You have dispatch and call takers. You have police. You have fire. You have medical. You have your fourth responders — your clinicians, your STAR vans, and things like that. And then you have your community in need. It’s just having the availability of resources to make a functioning and healthy community.
What STAR Encounters Look Like
The Denver Post described a concerned passerby calling 911 about a sobbing woman on a downtown curb.[5] The same article covered a woman experiencing homelessness who undressed in an alley because she couldn’t find a private place to change, and an unhoused woman stranded in an unfamiliar neighborhood on a blazing hot day who was given a snack and water and asked in surprise: “Who are you guys? And what is this?”
MSU Denver RED published five cases from clinician Chris Richardson.[6] A man whose wheelchair broke was connected to Veterans Affairs, which had been searching for him — he is now housed and receiving VA benefits. A man reported his wallet stolen, and the STAR paramedic noticed a life-threatening hand infection that led to two weeks of hospital treatment. An inebriated person transported to detox called his STAR clinician the next day asking for help getting sober.
Of roughly 12,000 clinical encounters through December 2024, only 3% resulted in mandatory psychiatric holds.[2]
What Police Officers, Dispatchers, And Municipal Workers Think
The NYU Policing Project report provides an unusually detailed window into what the people inside the system think about STAR.
Having the ability to send out police, fire, medical, and now “the fourth responders” to address issues of mental health, homelessness, and addiction contributes to public safety.
I don’t know that I would call somebody having a health crisis a policing issue. Although, by default, in this country, it tends to be a policing issue, unfortunately.
Municipal workers “agreed with the importance of having alternative responders without ‘lights and sirens,’ ‘uniforms,’ and ‘guns’ as essential to protecting people from harm and creating public safety.”
Community members told the researchers that armed police officers should focus on “really dangerous situations” and “high stakes cases” such as “carjackings, assaults, and murder”; “domestic violence or gunshots”; “murder cases or rape”; “children being kidnapped”; and “DUIs.”
Both community members and municipal staffers indicated that a clear benefit of STAR is “freeing up police time [so that] police could respond to other more pressing ’emergency’ calls/matters.” The “‘appropriate’ scope of police work often was described as responding to and solving ‘violent crime.'”
American Police Beat Magazine profiled Denver STAR as “a leading example” of the civilian crisis response approach.[4]
The Dispatch Challenge
Despite operating 8 vans citywide, STAR answers only about half of eligible calls — roughly 25,000 out of an estimated 60,000 eligible calls over five years.[1] The NYU researchers found that dispatch rates vary significantly by call type: “welfare checks received a STAR response nearly half of the time… [while calls related to] encampments and suicides received a STAR response much less frequently.”[1]
Barrier: Dispatchers Sometimes Simply Forget
Researchers found that “911 operators and front-line workers [have] overwhelming appreciation for STAR [but also, at times] … forget to utilize this new ‘fourth option.'”
I don’t think there’s a lot of hesitancy in terms of, “Oh gosh, I don’t want to add STAR to this,” it’s more of a, “Oops, I forgot,” because it’s just newer, so it takes time to adjust to everything. But I think as the STAR program expands in Denver, that’ll kind of resolve itself in time.
To combat this, STAR “program managers are working to educate dispatchers and call takers on the skills STAR responders have in order to make them more comfortable with utilizing the program.”
Barrier: Dispatchers Worry About Sending Unarmed Responders Into Danger
Researchers found “significant hesitation from dispatchers to send unarmed responders out in the field.”
For me, in the chair, if STAR can’t protect themselves, I’m not sending them by themselves… It’s a liability that falls on us, as the dispatcher. “Why did you send them there? Now they’ve gotten hurt. Now it’s your fault”… You really need to go with your gut for what’s risky, that you never want someone to get hurt.
This dispatcher told researchers that on intoxication calls — which according to protocol STAR technically can handle alone — she always wants to add police as cover as an extra precaution. She also adds police cover to all suicidal calls, which are similarly STAR-eligible. In her mind, preserving the safety of first responders is the primary concern of 911 operators.
“Send Them. We Got This.”
I had a dispatcher the other day who was like “God, I just hate sending STAR to an apartment or house because it’s… like you’re going in and all this stuff could happen.” I’m like, “We’ve delivered groceries and medications and picked people up. We’re used to going into people’s homes. We’re used to meeting people in alleys. We’re used to meeting people in parks.” Send them. We got this. You have our back. You know where we are. We’ll call for help if we need it.
The NYU researchers explain that this is a widespread sentiment among STAR responders: “STAR clinicians told us that they feel very comfortable going inside apartments and houses with individuals in crisis largely because they have done so many times in previous job positions.”
Scale, Budget, And The Medicaid Breakthrough
STAR currently operates 6:00 a.m. to 10:00 p.m., seven days a week, citywide with 8 vans. At full capacity, the program fields up to 16 behavioral health clinicians and 16 paramedics/EMTs — roughly 32 field staff — plus administrative roles. Clinicians are WellPower employees (not direct city staff); paramedics are Denver Health employees. The program is administered by the Denver Department of Public Health and Environment (DDPHE).
Budget Trajectory
2020 (pilot): $208,141 Caring for Denver grant. 2021: ~$2.4M. 2022: ~$3.9M base budget. 2023: ~$5M. 2024: ~$7.2M total (city + Caring for Denver). 2025: ~$7.2M. 2026: ~$5.9–6.4M (initially proposed with ~$1.5M cut; Council restored $500K).
Staffing And Compensation
STAR clinician compensation ranges from roughly $65,000/year (pre-licensure, Master’s level) to $78,200/year (fully licensed LCSW/LPC/LMFT), with a $1.00–$2.50/hour language differential for bilingual clinicians. The standard clinician schedule is three 12-hour shifts (10 a.m.–10 p.m.), paid for 40 hours weekly; program operating hours extend to 6:00 a.m. through additional early-shift coverage. Program managers earn $80,000–$100,000/year. Clinicians need a Master’s degree and current Colorado licensure or licensure-track status; WellPower provides free licensure supervision.
Staffing growth: 2 staff at pilot launch → 14 by early 2022 → 20 with 5 vans by mid-2022 → 32 with 8 vans by fall 2023.
The Medicaid Breakthrough
According to the Government Finance Officers Association (GFOA)/Safety Reimagined report: “For their STAR program, 96% of costs were billable to Medicaid.”[7] This is possible because Denver partners with WellPower, which has institutional Medicaid billing capability. Not all STAR calls generate billable encounters — only those where “the services that were delivered were substantial enough to create a medical record” qualify.[7]
of STAR costs are billable to Medicaid (GFOA/Safety Reimagined).[7]
The Expansion Gap
The long-held goal is 24/7 operations — but this has not been achieved. Mayor Johnston’s budget proposal stated in October 2025 that “2026 is not going to be a year in which the program could expand.”[8] Advisory committee member Vinnie Cervantes responded: “Other cities across the country have been able to fund their program at much higher rates, smaller cities than Denver, and we are still at a point where we’re not even close to full funding.”[8]
Remaining gaps: Specific training curriculum hours. Quantitative staff retention rates. Precise federal Medicaid match rate Denver receives for STAR encounters.
Sources
[1] NYU Policing Project Report on Denver STAR, 2024.
[2] Denver STAR program data; Denver Department of Public Health and Environment.
[3] Stanford University, Thomas Dee and Jaymes Pyne, Science Advances, 2022.
[4] American Police Beat Magazine: Denver STAR profile.
[5] Denver Post, STAR program coverage.
[6] MSU Denver RED, clinician Chris Richardson case studies.
[7] Government Finance Officers Association (GFOA)/Safety Reimagined report.
[8] Denver city budget coverage; Vinnie Cervantes, STAR advisory committee member.