HART: Holistic Assistance Response Team
From 500 calls in its pilot year to 25,000 annually. Housed in public health, endorsed by the sheriff, backed by 88% of county residents after learning about the program. Now transitioning from contractor to in-house staffing to solve turnover — and building toward a "fourth pillar" of emergency response alongside police, fire, and EMS.
Harris County is the third most populous county in America, with over five million residents and one of the most ethnically diverse populations in the country. Since March 2022, HART has dispatched unarmed behavioral health teams to more than 25,000 mental health-related 911 calls.[1]
“We Are Sending The Right Experts To Solve The Right Problems.”
A young woman in Harris County, Texas took a bottle of pills out of her mother’s medicine cabinet and locked herself in her bedroom. The woman’s mother called 911 because she desperately needed help, but she also feared what would happen when the dispatcher sent a sheriff’s deputy to her home. She worried that the presence of an armed law enforcement officer could inadvertently escalate an already volatile situation.
Fortunately, in Harris County, there is a mobile crisis response program called HART — the Holistic Assistance Response Team — which is based in the county’s public health department and composed of healthcare experts, crisis intervention specialists, and case managers. The 911 dispatcher sent HART to help the young woman, who ultimately left the bedroom and got the care she needed, preventing what could have been a tragic death.
This is about which expert should respond to a 911 call. When it’s a robbery in progress, or a shooting, then obviously we need to send an armed sheriff’s deputy. But if we are talking about a person sleeping on a sidewalk, or a teenager who is suicidal and swallowed pills, then we need a behavioral health expert to respond. That’s the kind of crucial work that HART’s crisis intervention specialists do everyday, and this is what it looks like to fully fund public safety in Harris County — we’ve got law enforcement, we’ve got mobile crisis response, and we’ve got community violence intervention. We are sending the right experts to solve the right problems.
The Numbers: From 500 Calls To 25,000
HART launched as a pilot in March 2022. Within five months, the team had responded to its 500th call.
~5 months
500 calls.
~1 year
Nearly 2,500 calls. Program receives a $2.6 million budget boost to expand its coverage area. (Houston Chronicle)
~2 years
11,500 calls diverted to mental health providers. (Houston Chronicle)
Permanence vote
More than 15,000 calls that “normally would have been directed to law enforcement”; nearly 1,000 residents connected to social services. (Houston Landing)
Most recent
More than 25,000 calls since March 2022; 2,834 residents provided on-scene care; 4,500+ non-violent calls diverted from law enforcement; 2,100+ deputy hours freed. Program approved to “serve all parts of unincorporated Harris County… including Houston.” (Community Impact; Houston Public Media; Ellis newsletter, Dec. 2025)
Remaining gaps: Call volume breakdown by type (the most specific figure — from a political opponent — claims “only four percent involved a mental health issue,” but this is politically contested and HCPH declined comment). Resolution rates. Repeat caller reduction data. Published average response time and on-scene duration (tracked internally but never released).
What The Team Does — And What Happens After
HART currently operates with approximately 21 field-ready teams, each composed of one crisis intervention specialist and one licensed EMT. The teams are unarmed, “trained in behavioral health and on-scene medical assistance,” and respond to calls related to mental health, substance abuse, homelessness, welfare checks, and nonemergency health or social welfare concerns.
Dispatch Protocol
A formal, published protocol governs dispatch. HCSO Policy 419 (“Alternative Responses to Calls for Service”) allows a call to be routed to HART only when all three conditions are met: no credible threat of violence or evident display of violent behavior; no known history of violence at the location; and no weapons known to be present.
Critically, HART also has independent access to the Computer Aided Dispatch (CAD) system and can self-identify eligible calls and dispatch its own teams without HCSO involvement. Commissioner Ellis’s December 2025 newsletter reported that 88% of HART’s calls came directly from 911, “meaning the team is meaningfully reducing the burden on other emergency service providers in fire, EMS, and law enforcement.”
HART can and does transport. Each two-person team includes a licensed EMT, which provides the medical authority for transport to emergency rooms and psychiatric facilities as warranted.
HART is getting people the help they need when they need it most, decreasing our jail population, helping clear court backlogs and lessening the DA’s case logs, freeing up time for law enforcement and EMS for true public safety and medical emergencies which they are better equipped to handle.
Connecting people to the support they need, not booking them in our already overcrowded jail.
HART’s crisis intervention specialists de-escalate conflict and stabilize people in the throes of an acute mental health crisis. The team helps people get to a safe space and connects them with additional support services. Then, in the days and weeks after the initial response, HART’s case managers follow up with people who need more help. Commissioner Briones reported a 228% increase in service linkages after bringing HART in-house.[4]
We meet people on the worst days of their lives, and we stay with them through the journey. We’re there for the crisis and we’re there for the recovery.
Public safety is a law enforcement issue but public safety is also a public health issue. By addressing the underlying mental health and substance use needs that led to the 911 call in the first place, HART can resolve the immediate situation, get the person the help they need to stabilize their life, and make it much less likely the person requires an emergency response in the future.
HART really is allowing our residents to get the help that’s needed, but also allowing our law enforcement partners to dedicate more time to the more violent calls that are going on in the community.
What HART Means At The Human Level
Harris County resident Mia Hernandez described her son’s mental health crisis at home in summer 2023 during Commissioners Court testimony.[3] “Officers calmly responded while the unarmed mental health professional engaged my son. He assessed him and recommended that [my son] be taken to [Harris County Psychiatric Center] not to jail.” When her son experienced another crisis two months later and a HART team was not available, Houston police arrested him and he received a felony charge. The contrast between the two responses speaks directly to the program’s stakes.
Steven Wu described a family member in Louisiana who experienced an acute mental health crisis. His family didn’t want to call 911. “My family doesn’t live in Texas; they live in Louisiana. There is no such thing as a Holistic Assistance Response Team in Louisiana,” Wu told Commissioners Court. He described family members standing between his sibling and officers, “imploring that he is not dangerous.”
In an April 2025 case described by the Precinct 4 blog, a resident experiencing a family disturbance called 911. The HART team was able to de-escalate, conduct a needs assessment, provide mental health services, and assist the resident with employment.
Remaining gaps: No traditional ride-along journalism has been published. Response times are tracked internally via CAD timestamps but have never been published. Follow-up timelines (24 hours, 48 hours, 30 days) are not publicly documented. Resolution rates — the core outcome metric — are absent from the public record.
Law Enforcement
Harris County Sheriff Ed Gonzalez has said that many of the functions handled by HART — including the mental health mobile crisis response program — should “not be a part of law enforcement.”
HCSO Director of Special Projects Mike Lee — who helped develop HART — stated it “freed up [hundreds of] hours of law enforcement time to respond to other calls” and acknowledged “police officers, although we are very proud of the training we have done, we’re not the best equipped to handle that” regarding mental health calls. Lee’s call to the Harvard Government Performance Lab in 2020, telling them the moment was primed “to get creative” about diverting quality-of-life calls from police, helped launch the program.
Commissioner Adrian Garcia, a former Harris County Sheriff, said HART is “a program he could have utilized during his tenure as a county sheriff.”
The DOJ COPS Office interviewer in the April 2023 podcast offered an indirect signal: “I had a conversation with [the Harris County Sheriff’s Office] previously about a totally different issue, and they talked about this HART program with a lot of pride… They talked about it in glowing terms.”
Safety Record
No news report, government document, or program communication documents an injury to a HART responder across more than 25,000 calls. HCSO Policy 419 spells out the escalation protocol: if a HART unit “determines the scene to be potentially unsafe, they will request backup from an HCSO unit.” Internal documentation of backup requests exists — but the aggregate count has never been published. This is a critical gap: a formal “zero serious injuries” claim comparable to Minneapolis BCR or Durham HEART has not been made, though no incident has been reported.
Remaining gaps: No on-the-record quotes from rank-and-file patrol deputies. Aggregate backup request count has not been published. No standalone HCSO data release on workload impact.
From Pilot To Permanent
Since launching as a pilot program in 2022, the HART team was housed within the Department of Public Health but relied on contractors from a private company for staffing. That meant the first responders on the HART team were not county employees, were not hired by county employees, did not get county benefits, and did not answer on a day-to-day basis to a county agency head.
Local leaders said that this arm’s-length arrangement can decrease a local government’s ability to hire and retain the best people, and to exercise a granular level of accountability over a vital public safety program.
So Harris County made two moves at once. As McKenna Oxenden reported for Houston Landing, Harris County Commissioners voted to make the successful pilot program permanent, eliminate the current geographical boundaries so that the program operates countywide, and transition to an in-house model — making HART’s first responders county employees.[5]
All but one of the Harris County Commissioners expressed clear support not only for extending the pilot program, but also expanding and strengthening it.
The pilot was staffed by DEMA Consulting & Management (Disaster Emergency Medical Assistance Consulting and Management), a California-based firm. The vendor relationship collapsed in mid-2024 amid billing controversies. On December 10, 2024, the Commissioners Court voted 3-1 to move HART in-house.
Key operational changes in the transition: HART responders became Harris County Public Health employees (county benefits, accountability, career ladder); direct HCPH oversight replaced contractor management; hours shifted from 7 a.m.–10 p.m. to 6 a.m.–10 p.m.; and collaboration with HCSO, EMS, and community partners was formalized. Commissioner Briones reported a 228% increase in service linkages after the transition.[4]
Staffing And Qualifications
Crisis Intervention Specialists: Bachelor’s degree in social work, public health, human services, psychology, or related field; at least 3 years of experience in crisis intervention or mental health services; bilingual preferred (Spanish, Chinese Mandarin, Korean, Vietnamese, Hindi).
EMTs: Graduate of accredited EMS training school; EMT certified in the State of Texas; at least 2 years EMS experience preferred with experience responding to mental health crisis calls.
Salary: The only specific figure found is approximately $27/hour (~$56,160 annualized) for Crisis Intervention Specialists. No official salary figures for EMTs, supervisors, or the Medical Director were published.
Budget
Under the DEMA contract, total spending on HART was approximately $6.6 million. The initial pilot was funded with a $5 million county budget allocation developed with the Harvard GPL. The August 2025 countywide expansion (16 new positions) was described as a “budget-neutral item” funded through reallocation within HCPH. The total current annual operating budget likely falls in the $9–12 million range post-expansion, but a definitive published figure does not exist.
The Bigger Vision: A “Fourth Pillar”
No formal proposal to create a standalone “Community Safety Department” was found in any published government document. What exists is Commissioner Ellis’s “fourth pillar” framing from the August 2021 Commissioners Court vote approving HART’s creation, when he described HART as eventually becoming “a fourth pillar in Harris County’s first responder system, which currently consists of EMS, law enforcement, and firefighting.” Former HCPH Executive Director Barbie Robinson used similar language, describing HART as “a fourth responder to our 911 system” and “a fourth response branch on that tree.”
The actual organizational trajectory has placed alternative response programs within HCPH’s Community Health and Violence Prevention Services (CHVPS) Division, directed by Lupe Washington, which houses two programs: HART (mobile crisis response) and RISE (Relentless Interrupters Serving Everyone, absorbing former gun violence interruption and hospital violence intervention programs).
What Harris County Voters Think
Harris County is also among the “purplest” of America’s most populous counties, with 52% of voters supporting Kamala Harris in the November 2024 election. A poll conducted by Gydence Research asked Harris County residents about HART.[6]
of residents believe HART is “effective” at making Harris County safer — by a 56 percentage point margin (78% to 22%). Support is bipartisan: 84% of Democrats and 83% of Republicans say HART is effective.
of residents said HART is “making communities like Harris County safer” after exposure to arguments both for and against investing in the program — a ten percentage-point jump.
of residents say mobile crisis response units are “effective” at “making Harris County safer” when asked about the concept more broadly.
Most Persuasive Arguments For Investing In HART
86% found convincing: “Medical professionals know how to recognize signs of acute mental illness, de-escalate fraught situations involving mental illness, and get people in acute mental health crises the help they need. Police officers, no matter how compassionate and skilled, simply don’t have this level of medical expertise and training.”
82% found convincing: “Letting medical professionals handle mental health-related calls for service lets police officers focus on more serious public safety threats like solving robbery, rape, and murder.”
78% found convincing: “Police officers showing up to a mental health crisis with sirens blaring, lights flashing, and a gun can unintentionally escalate an already traumatic situation. By contrast, mobile crisis response teams rely on medical professionals who are trained to de-escalate incidents like these, preventing the situation from turning violent.”
These results largely mirror a national survey of 2,503 registered voters conducted in 2024, in which 80% said that mobile crisis response units are “effective” at “making your community safer.”
On The In-House Question: Voters Weigh In
of Harris County residents said HART should be staffed by county employees and run by a county agency.
Most Persuasive Arguments For County-Staffed Model
78% found convincing: “Keeping the public safe is the most important job the government does. Whether you are a sheriff’s deputy or mobile crisis responder — all first responders responsible for public safety should be public employees working for a county agency.”
75% found convincing: “Making mobile crisis responders public employees will lead to higher-quality recruits. That’s because would-be employees know that private contractors are subject to minor shifts in budget situations or political administrations, whereas public jobs tend to be more stable.”
74% found convincing: “Public agencies are harder to eliminate when political administrations or budget situations change. Public safety priorities such as responding to mental health emergencies need the solid political and financial footing that comes with being housed in a public agency.”
Technical Assistance
The Harvard Government Performance Lab’s involvement is extensively documented.[7] The relationship began in 2020 when GPL’s assistant director of criminal justice, Gabriela Solis Torres, received a call from Harris County chief deputy Mike Lee, who told her the moment was primed “to get creative” about diverting quality-of-life calls from police. Lee and his team had been studying Oregon’s CAHOOTS model.
The GPL provided five specific forms of technical assistance: facilitated interdepartmental working groups between HCSO, HCPH, and the Justice Administration Department; informed the initial program budget and RFP using results-driven procurement; drafted job descriptions for prospective HART responders; analyzed 911 data and identified eligible calls for HART response; and drafted updates to 911 call center protocols for call screening and triage.
Former HCPH Executive Director Barbie Robinson praised the partnership: “The GPL played a critical role by bringing together county partners to help build consensus and support for the development of our alternative response model. We couldn’t have accomplished this without their leadership and support.” Lupe Washington stated in August 2025 that “Harris County’s HART Fourth Response Model is unique and is continuously being called upon by the Harvard Kennedy Government Performance Lab to use as an example for other jurisdictions.”
The GPL also published “Essential Metrics for Alternative Emergency Response Programs” (March 2024), a free tool with 29 actionable metrics informed partly by Harris County’s experience.
Sources
[1] Commissioner Rodney Ellis December 2025 newsletter; Community Impact; Houston Public Media.
[2] Harris County Commissioner Rodney Ellis, Houston Public Media.
[3] Mia Hernandez, Harris County Commissioners Court testimony, 2023.
[4] Commissioner Lesley Briones: 228% increase in service linkages after in-house transition.
[5] Houston Landing, McKenna Oxenden: Harris County HART permanence vote and in-house transition.
[6] Gydence Research poll of Harris County residents.
[7] Harvard Government Performance Lab, Harris County technical assistance documentation.