Exploring Innovative Emergency Responses with CAHOOTS

A new collaborative online learning opportunity for cities and community stakeholders committed to implementing innovative models for public safety

What Works Cities


Alternative Emergency Response: Exploring Innovative Local Approaches to Public Safety is a learning opportunity for cities and community partners to learn from peer cities committed to implementing programming to improve emergency response and public safety.

These cities will share their own experiences, and hear from practitioners in the field such as the CAHOOTS program of White Bird Clinic in Eugene, OR, Portland Street Response in Portland, OR and Support Team Assisted Response program (STAR) in Denver, CO.

Read on to learn more about challenges that cities and first responders face, the emerging evidence-based strategies to address these challenges, the objectives of this sprint, and who is best suited to join from the city and/or the community.

  • Registration due by: Thursday, April 8, 2021
  • Start Date: Thursday, April 15, 2021
  • Duration: 8 weeks on Thursdays at 2:00PM ET/11:00AM PT from Thursday, April 15th to June 3rd

[Update: Registration is now closed. If you are interested in learning more, please contact CitySolutions@results4america.org.]

The Issue

Traditional emergency and public safety protocols consist of a call to 911 and, in most circumstances, first response by police officers who are dispatched to the scene. Given the wide range and variety of calls to 911, however, not all require the police to serve as the first responders, especially in non-violent situations where there is no imminent threat to public safety. Officer-led responses to these types of situations can overburden already stretched police forces, and unfortunately, in some cases — particularly those related to poverty, behavioral health, addiction, or individuals experiencing homelessness where police officers may not have been trained — have endangered the safety of the individual in need of support.

In fact, approximately 10 percent of police responses involve people affected by a mental illness, and in some cities can account for a quarter or more of emergency calls. Or, consider this study published in the American Journal of Preventive Medicine, which estimates that at least 20 percent of fatal encounters with law enforcement involved an individual with a mental illness.

Recognizing these facts, practitioners and experts are exploring gaps in the traditional approach, including the time needed to dedicate to the individual, the knowledge and skills to appropriately engage, the ability to transport individuals from a potentially unsafe situation, and the ability to immediately enter an individual into a continuum of care. A multifaceted, layered approach is required to more appropriately and holistically address the challenge, to produce better outcomes for all, and to address the root causes of community and individual crises.

With this in mind, cities are asking, what are the emerging evidence-based strategies to adequately support residents and better deliver emergency services for a safer community?

Cities from Portland, OR to Orlando, FL are looking to data to innovate around public safety approaches to non-violent 911 calls for more appropriate care and better outcomes for residents. In concept, it is a simple idea — when a 911 call comes through a dispatch center that is non-violent, non-criminal, and involves a behavioral health, addiction, poverty, or homelessness situation — send a behavioral health expert. The idea is not to replace police officers, but that there are alternatives to using law enforcement as first responders in these situations.

By partnering with trusted community service providers and partners, cities are reimagining emergency response by incorporating pre-existing knowledge and expertise from the community to work in coordination with traditional first responders, like police and fire departments. The goal is to deploy right-fit resources, close gaps in comprehensive care and free up time for officers to respond to calls within their expertise.

Alternative Emergency Response: Emerging models for reimagining public safety

Medics talking with a person who needs a place to stay. Image courtesy of The Atlantic.

In the City of Eugene, OR, the local police department has implemented a model called CAHOOTS — Crisis Assistance Helping Out On The Streets — for more than 30 years, in partnership with White Bird Clinic. By dispatching a “mobile crisis response” team composed of a mental health provider and medical professional, CAHOOTS diverts 5–8 percent of crisis calls, taking a substantial load off of Eugene Police Department at a low cost: the CAHOOTS budget is only 2.3 percent that of the Police Department budget and saves the City an estimated $8.5 million annually in public safety spending.

CAHOOTS staff and the police work in coordination in this model; when responding to a call, either police or CAHOOTS can be sent solo to a call, sometimes both respond simultaneously, and if needed they call on one another for back up. The approach is fluid and adaptable — not linear — providing multiple options to ensure appropriate care for residents in a vast range of situations.

Additional cities are implementing and piloting alternative crisis response programs including Denver, CO; Portland, OR; Olympia, WA; and San Francisco, CA. Denver, CO launched their Support Team Assisted Response program (STAR) in collaboration with the Denver Police Department and community partners in June 2020. A six-month evaluation report showed that with STAR, nearly 30,000 calls could be reassigned to an alternative responder, thus reducing the burden on police who have been tasked with over one million calls annually. Based on these early successes, Mayor Michael Hancock and the Denver City Council approved $1.4 million to fund the program in 2021.

Funding support for alternative models is building at the federal level as well. In 2020, Oregon’s Senators proposed the CAHOOTS Act. The bill would offer states enhanced federal Medicaid funding for three years to provide community-based mobile crisis services to people experiencing a mental health or substance abuse disorder related crisis.

The outcomes that may not yet be quantifiable could be the most significant: the number of situations that were diffused, arrests and injuries avoided, individual and community traumas that never came to be, because there was an additional service available to help that was not accessible before. The model being presented in this sprint seeks to ensure that medical and behavioral health care are integrated from the onset of intervention and treatment, adding to the efficacy of the model for alternative public safety responses.

Sprint Overview

As part of its City Solutions work, What Works Cities is partnering with Everytown for Gun Safety and White Bird Clinic to offer a small cohort of cities an opportunity to learn more about alternative models of emergency response and how to advance the implementation of such models.

In addition to learning sessions facilitated by White Bird Clinic, participants will hear from practitioners in Portland, Denver, and expert researchers in the field of public safety, as well as have the opportunity to develop connections with others experiencing similar challenges and exploring similar solutions.

After the 8-session online learning opportunity, participants will:

  • Have a firm understanding of the history, available research, and research needs around behavioral health, addiction, poverty, homelessness, and equity in public safety and alternatives to police response for mobile crises;
  • Be able to identify and analyze dispatch data to better understand how policing affects residents in their city;
  • Be able to build a working group to explore alternative emergency response models, including non-law enforcement mobile crisis program;
  • Understand the necessary steps to develop and modify public safety infrastructure to support alternative teams like mobile crisis teams as first responders; and
  • Understand the necessary concrete next steps to implement alternative emergency response models including mobile crisis response.

Sessions for the sprint will cover the following topics:

  • Introduction to the Cohort and Building a Cohort Charter
  • Racial Equity and Effects of Over-Policing
  • What Does the Evidence Show?: Analysis of Mobile Crisis Response
  • Case Studies and Testimony: Lessons from Crisis Alternatives and Consumer Voices
  • 911 Dispatch: The Gatekeepers
  • Community-Informed Design
  • Making Decisions with Data
  • How Does this Really Work? Risk Mitigation, Responder and Patient Safety, Vehicles, and Logistics

*Changes and additions to these topics may occur.

Sprint Details

  • When: Thursday afternoons at 2:00 PM ET/11:00AM PT, April 15 through June 3
  • Where: Weekly 60 to 90 minute webinars and/or cohort discussions delivered via an online learning platform

Who should participate

Cities are encouraged to bring together a team of key, diverse stakeholders in order to maximize the opportunity and establish a foundation for long-term success.

Participating members of the sprint project team could include, but are not limited to, leaders and staff from:

  • Mayor’s Office and/or City Council
  • Police and Fire Departments
  • 911 Dispatch Center
  • Health and Human Services Department
  • Neighborhoods and Community Engagement Departments
  • Local and trusted health care and mental health providers
  • Local community-based nonprofits and organizations
  • Community foundations and other local funders

Participation requirements

  • Sprint team has demonstrable progress towards exploring and/or implementing alternative emergency responses
  • Demonstrated leadership support and commitment to sprint objectives
  • At least one city government staff member on the sprint project team
  • Have submitted a What Works Cities Assessment (If your city has not, please submit an assessment by June 30, 2021)
  • City’s mayor is a member of Mayors Against Illegal Guns (If the mayor is not currently a member, he or she can join here)
  • Complete an application form by April 8, 2021

Participating cities are expected to actively participate in all 8 sessions, complete all assignments and readings, and engage in earnest with advancing the objectives of the Sprint.

Sprint Facilitators

Weekly sessions will be led by White Bird Clinic. Speakers will include experts and practitioners with deep experience in this issue, including Portland Street Response, Denver STAR, and Vera Institute for Justice.

Important dates

  • Registration deadline: Thursday, April 8, 2021
  • Sprint begins: Thursday, April 15, 2021
  • WWC Assessment must be completed by: June 30, 2021


Email CitySolutions@results4america.org with any questions.

What Works Cities, a Bloomberg Philanthropies initiative launched in 2015, helps local governments across the country drive progress in their cities through the effective use of data and evidence to tackle pressing challenges that affect their communities.

Through its City Solutions work, What Works Cities partners with cities, community organizations, and other local and national organizations to accelerate the adoption of programs, policies, and practices that have previously demonstrated success in helping cities solve their most difficult challenges.

Everytown for Gun Safety is the largest gun violence prevention organization in the country with nearly six million supporters and more than 375,000 donors including moms, mayors, survivors, students, and everyday Americans who are fighting for common-sense gun safety measures that can help save lives.

White Bird Clinic is a non-profit health center based in Eugene, Oregon that “helps individuals to gain control of their social, emotional and physical well-being through direct service, education and community.” White Bird Clinic is a key agency in the continuum of care for the community, and leads the CAHOOTS (Crisis Assistance Helping Out On The Streets) the Mobile Crisis and Medic response team for Eugene-Springfield’s Public Safety System.



What Works Cities

Helping leading cities across the U.S. use data and evidence to improve results for their residents. Launched by @BloombergDotOrg in April 2015.