Boulder Pilots Alternative Response Program to Emergency Calls

Some 911 calls will now result in a mental health response rather than a police presence

The City of Boulder launched in December an alternative response pilot program, Community Assistance Response and Engagement (CARE), to respond to dispatcher-triaged 911 and non-emergency line calls that do not require a police response.

The CARE pilot program is part of the city’s effort to create an alternative to police response for 911 calls that are not criminal in nature, do not present safety concerns, and may be more appropriately addressed by health care and behavioral health professionals. The CARE team consists of a behavioral health clinician, a paramedic, and includes intensive case management. This program aims to better assist community members with complex needs.

“The City of Boulder takes pride in its emergency medical services for the community,” said Michael Calderazzo, Fire Chief. “Boulder Fire-Rescue additionally appreciates the great value of partnering with Housing and Human Services in providing advanced level care and preventative medical assistance to those here in need.”

Wendy Schwartz, Human Services Policy Manager, said CARE is patterned after the STAR program in Denver.

STAR is a partnership between the WellPower, Denver Health, Denver Police Department, Denver Department of Public Health and Environment as well as community stakeholders like Caring4Denver and more.

Photo by Jonnica Hille, via Unsplash

STAR provides person-centric mobile crisis response to community members who are experiencing problems related to mental health, depression, poverty, homelessness, and/or substance use issues. Before the STAR program began, Denver’s 911 system was limited to addressing 911 calls through traditional ways, like sending police. Calls for health and safety issues were routed one of two ways; either they went through the police or the health/hospital system. STAR created a third option.

When someone calls 911 for something like a mental health crisis, substance use issue or even something like homelessness or poverty, their call can now be routed to STAR. STAR sends a behavioral health professional and a paramedic to the person in distress.

“Our city council was very interested in this type of a program, and we put together a team to look at planning this in Boulder and went through a process, did some ride-along with STAR, did research on other programs, did some analysis of what was going on here in Boulder. That’s how we put together the program here in Boulder in a cross-departmental partnership,” Schwartz said.

During the first phase of the pilot program, the CARE team is only available Monday through Thursday from 9 a.m. to 7 p.m.

Schwartz said in the program’s early months city leadership will continue to assess the success of the program and how it is meeting the needs of the community. As staffing increases and the program makes improvements based on lessons learned during the pilot period, CARE will expand its operating hours.

Boulder is the first community in Boulder County to implement this kind of alternative response program.

Schwartz said city staff will work with a professional evaluator to review success metrics of the CARE pilot program and make improvements as the program evolves.

“We have hired an independent external evaluator to really follow along with us this first year in evaluating and looking at the data, looking at what’s happening,” she said. “After the first year of the program, then the evaluator would be working on a report to assess the information, and that report will certainly be made public. We do check-ins on a monthly basis on how the program’s going as well.”

CARE responds to calls involving concerns about a person’s wellbeing. Calls may involve concerns about anxiety, depression, thoughts or statements about suicide, substance use, minor medical issues, or a person who is experiencing a decline and not receiving appropriate care. CARE does not respond to calls with a report of criminal activity, threats of violence, physical disturbance, weapons, injuries, or major medical need.

“Our goal is that every community member gets the response that best meets their needs at the moment,” Schwartz said. “With licensed behavioral health clinicians and paramedics evaluating appropriate cases in the field, we have one more tool to help people connect with the right services at the right time.”

Through the CARE pilot program, the city aims to:

Help people feel supported and able to manage complex challenges while staying in the community.
Increase positive health impacts for community members served by CARE and reduce future emergency services calls for those individuals through connection to ongoing community services.
Better use police and fire-rescue resources by diverting calls that could be more effectively served by an alternative response.
Achieve cost savings from reduced emergency services by reducing unnecessary ambulance rides.

The CARE team complements the Crisis Intervention Response Team (CIRT), which responds to higher acuity calls than CARE. Through CIRT, clinicians respond with police on calls involving a behavioral health crisis. Other outreach and alternative response groups in the city include the Homeless Outreach Team, Urban Park Rangers, Downtown Ambassadors and Nurse Navigator Program.

CARE now offers an additional approach to helping ensure community members’ diverse needs are met with a compassionate and effective response with the CIRT team, otherwise known as the CIR team. And that’s licensed behavioral health clinicians that respond with police to situations that seem like they might have a behavioral health component.

“There’s a dispatch protocol and we modeled this, we used information from Denver and STAR program to see how they were doing this where they really look at the information being provided in the call and do an assessment of which type of response might be most appropriate,” Schwartz said. “If it is something that really seems like it has roots in a behavioral health or low-level health issue and there’s no indications about violence, weapons, et cetera, then that would be a candidate for a CARE response.”

Schwartz said the Care clinicians are HHS employees and the paramedics are from the Boulder Fire Department.

“We also have case managers as part of the program. After the initial crisis is deescalated, then case managers who are HHS employees can work with those individuals to help them connect with ongoing community services,” she said.

Schwartz said the CARE program is paid for through allocated city funds.

“The funding is part of the city’s budget. It’s city funding that’s been allocated to the departments of Housing and Human Services and the fire department to support the program,” she said.

Schwartz said Boulder hasn’t been immune to economic, social, and crime concerns among residents.

“In Boulder is what people have been experiencing across the country, which is really increased concerns about behavioral health and wellness after the community experienced since the pandemic here in Boulder,” she said. “We had the King Soopers shooting, really a lot of stress for the community.”

Schwartz said she hopes the CARE program brings people together to help those in need.

“I think that what we would hope to see is that people are getting connected to community care, different resources that exist for ongoing care in the community so that whatever brought them to that crisis point, that situation can be addressed so that they don’t have to continually be in crisis,” she said.

For more information about the CARE program visit https://bouldercolorado.gov/services/community-assistance-response-and-engagement

Colorado Crisis Services and Mental Health Partners clinicians and support specialists are available 24/7: