The campaign’s premise was simple: For nothing more than a modest sales tax increase, Denver could create a $45 million a year stream of grants to nonprofit mental health and drug treatment programs.

“This initiative will give us the capacity to get everybody who needs help into a place where they can get the help that they need,” said Dr. Carl Clark, the president and CEO of WellPower, the city’s largest mental and behavioral health provider. 

“It's the type of thing that is a gamechanger.”

Voters enthusiastically bought into the concept. And after six years and more than $170 million in tax dollars granted, a year-long review by CPR News found that the game has indeed changed, but perhaps not in the ways supporters and voters envisioned.

Caring for Denver has funnelled millions of dollars from Denver taxpayers to programs — some of them outside the city — with no history of providing behavioral or mental health resources, who also have no staff licensed by the state to provide professional counseling or drug addiction treatment. Other nonprofits appear to have misrepresented their partnerships with city and state agencies.

Millions more has gone to programs run by convicted felons, in some cases with prison stints that had barely ended before their ideas were funded by Denver taxpayers. One anti-violence nonprofit received nearly half a million tax dollars despite a history of domestic violence alleged to have been committed by its executive director, who now sits in the Adams County Jail awaiting trial for first-degree murder.

“This is disturbing information for me,” Denver Auditor Timothy M. O’Brien said after being briefed on CPR’s findings. “The oversight of the grants and contracts is poor at best.”

At the same time, Caring’s most attention-grabbing campaign promises have not come to pass.

“We have the power to end overdose,” said the founder of the initiative, State Rep. Leslie Herod, on the campaign trail in 2018.

That has not happened. Not even close.

A record 598 people died of overdose last year in Denver, the most ever recorded. The suicide rate in the city rose to the second highest level in two decades last year — the highest rate in the metro area. Surveys conducted by the Colorado Health Institute show that the need for mental health care in the city of Denver has never been greater, yet access to services has never been harder to obtain. 

It is difficult to measure the effectiveness using citywide metrics of any mental health and substance abuse program during a pandemic and amidst an influx of dangerous drugs like fentanyl, but other counties without Caring for Denver money, like Adams and Jefferson County, experienced a decline in the suicide rate and fatal overdoses in 2023. 

Larimer County passed a mental health sales tax of exactly the same rate in the same year as Denver. They built a facility for acute mental health care in Ft. Collins and grant about $3 million a year to a variety of governmental and nonprofit groups. Every grant is approved by the county board of commissioners in public hearings. There, the suicide rate has declined substantially, down 28 percent since 2018.

Herod made her comment about the power to end overdose while visiting Denver’s Harm Reduction Action Center on the campaign trail for Caring for Denver and her own state House seat in August 2018. She made no promises about mental health, but said that through programs like harm reduction — directly engaging with drug users — lives could be saved and overdoses ended. 

“If I've overstated that Caring for Denver could solve all of Denver's mental health problems, then I overstated that,” Herod said in an interview with CPR. “I don’t believe that I did.”

Caring for Denver was the creation of State Rep. Leslie Herod, who said she was inspired by a similar tax in Seattle. With funding from the Mental Health Center of Denver, now called WellPower, the coalition of providers and advocates collected enough signatures to place the Caring for Denver concept and accompanying tax on the 2018 ballot in Denver.

The campaign ran no commercials, but relied on telling personal stories through social media, emphasizing that almost everyone is affected by suicide or drug addiction in some way. With no organized opposition, the campaign resonated with voters, who approved it with 70 percent of the vote. The tax, which amounts to 25 cents on a $100 purchase, is applied to most retail sales and services in Denver. Based on its winning margin at the polls, it is among the most popular tax initiatives ever in Denver.

After the initiative passed, the backers set up a nonprofit also called Caring for Denver Foundation to distribute the tax money. Denver’s Department of Public Health and Environment determined it was the only qualified entity to manage the money. No bids were sought. Meinhold, who helped write the ballot initiative, became the executive director, and by 2020, Caring for Denver was pushing millions of tax dollars to an array of nonprofits and government agencies.

There were a few restrictions. Among them: the money must be spent solely on Denver residents, at least 10 percent would have to be granted back to city departments for use in behavioral health, and Caring could spend no more than five percent to administer the grants.

Almost immediately the non-profit drew scrutiny from the auditor’s office.

O’Brien, who acknowledges that he has never been comfortable with the concept of turning tax dollars over to an outside entity with limited oversight and considerable discretion over how the money is spent, dinged Caring in a 2020 audit for failing to spend the millions that were flowing through the agency.

“Caring for Denver should be using its large fund balance to move these programs ahead, as the voters intended,” said O’Brien in an Oct. 2020 statement included with the audit.

Caring started moving money out the door. Today, supporters point to Caring’s success stories. But even some of those come with asterisks. 

One of the most high profile grants from Caring for Denver is for the STAR program, a small fleet of vans jointly staffed by Denver Health paramedics and licensed therapists from WellPower. The vans go to people in crisis and try to get them connected with help. STAR’s management says it has helped 6,500 distinct individuals since 2020, which would represent about one out of every 11 people among Denver’s population of 716,000. 

Hart Van Denburg/CPR News

But the effectiveness of even that highly-touted program is uncertain. One Stanford University study found that certain nonviolent crimes fell in and around downtown Denver during the pandemic (December 2019 to November 2020) where STAR vans operated, but it was hard to ascribe that entirely to STAR. An ongoing report from the Urban Institute has not been completed because researchers acknowledge they are struggling to obtain surveys from people who received STAR services, with only 18 responses returned.

Still, backers point to STAR as an example of what can be accomplished with the tax money.

“People's lives are being saved because of the investment in mental health and substance misuse services in Denver,” said Herod, the board chair of Caring for Denver. “We are the model. We have been a model for national grant makers in health to talk about where we are funding and how comprehensively.”

Caring has provided a lifeline to some long-standing non-profits with a history of taking on Denver’s toughest cases. They have used the money to plug gaps in their coverage of those with mental and behavioral health problems, and say they could do even more if their slice of the now more-than $40 million annual pie was just a little bigger.

“Caring for Denver has been a major proponent in keeping us vital,” said David Barnes, who runs Heartland Mental Health, which is registered with state health regulators as a clinical care facility, has licensed staff, and has a track record going back decades providing services in Capitol Hill. His organization received nearly $600,000 through multiple grants from Caring for Denver. The grant goes to fund a drop-in center with a food bank, community meeting space for mental health services and group therapies.

Another group, Para Ti Mujer, in southwest Denver, got just less than $1 million over three grants. The group contracts with licensed clinicians to provide mental health care and wrap around services to Spanish-speaking communities, focusing on women. 

“It’s been so successful it has a waiting list,” said Miriam García Romero, director of programs for Para Ti Mujer.

But it’s not clear whether Denver voters understood everything they were buying when they voted to tax themselves for Caring for Denver.

There is not much debate about the need for expanded mental and behavioral health services in Denver.

Even before the pandemic it was not uncommon to see drug use on the streets in Denver, or the occasional person in crisis screaming or talking to themselves.

It’s the same in most cities, partly because the government can’t force individuals into treatment and partly because treatment is expensive and difficult, with outcomes uncertain.

Less visible are the people with mental or behavioral health challenges who want help and have the means to pay for it, but just can’t find it. Like Phoebe Bawmann. 

Bawmann grew up in an upper middle class household that nevertheless struggled to find her care as she dealt with severe mental health issues stemming from childhood trauma. 

“What grew from that took many different shapes and forms that I could call PTSD, I could call depression, I could call anxiety. I struggled with pretty severe anorexia in my early adulthood that actually nearly cost me my life on several occasions,” said Bawmann, who is open about her family’s struggles with mental health. Her father died by suicide in 202

Yet even for her family with means, getting care created a financial strain. 

“I have memories of my parents being on the phone with our insurance company, I mean for hours, for days on end and pleading with them like ‘she's gonna die,’” Bawmann recalled.

Surveys in Denver indicate an inability to pay for services is among the top barriers to receiving care.

Enter Caring for Denver. The foundation granted tax money to many traditional programs, with licensed staff and a long history of working with patients, like WellPower, Stout Street Foundation and Step Denver.

The money provided for new programs in city agencies, like the Sheriff’s Department, District Attorney’s Office, health department and courts. 

“I think the work that Caring for Denver has been doing is great,” said Denver Sheriff Elias Diggins, who has received $1.3 million for case managers and medication-assisted treatment in the jails. “I would not criticize them in any way. To the contrary, I would compliment them for stepping up and filling the gap.”