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Kempe Foundation

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Children's Hospital Colorado -




The more we share our research, findings, expertise and experience, the more we can empower others to help children in need.

What is START?

A service of the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, START is a Multidisciplinary State And Regional Team (START) of Expert Consultants. START provides interdisciplinary case consultation for highly complex, protracted or difficult child abuse and neglect cases. The consultation team can involve experts from many disciplines including but not limited to medicine, medical toxicology (adult substance abuse and drug exposed child), nursing, behavioral health addiction treatment, law, ethics, psychology and clinical social work. Financial arrangements can be made with the Kempe Center to secure this service. See our national START Brochure​.

Who can refer a case?

  • State and County Departments of Human Services
  • Law Enforcement Agencies
  • Legal Professionals (District Attorneys, County Attorneys and Guardians ad Litem)

Instructions to submit START referral: 

1.    Before completing the referral form, please gather the following documents (must be saved as PDF). Information should be organized in the following categories not to exceed 150 pages total (not including medical records). Please do not send entire case files.

a.    SACWIS (TRAILS) and other DHS/CPS documents: E.g. Referrals to child protection, assessment summaries, evaluations, and treatment plans; family history, occupation of caregiver(s), education, parent involvement with CPS as a child, psychiatric history, etc. Do not include reports of contact unless directly relevant to purpose of START consult.

b.    Third party evaluations and assessments (psychological evaluations, Parent-Child Interactional, IEPs, treatment reports, etc.)

c.    Law enforcement reports and criminal history.

d.    Legal status/court involvement. Court reports and current court orders in both civil and criminal courts.

For medical review, if applicable:

e.    Medical records; past and present medical history, name of physician, pediatrician, specialists consulted, etc.

f.     If applicable: Digitized x-ray films, CAT Scans, MRIs, lab results, toxicology testing results, and/or other relevant medical information/tests. 

2.    Once all documents are gathered and scanned/saved to your computer, you will be ready to fill-in the START Referral Form. 

3.    Once you have submitted your files online you will get a message confirming your files have uploaded successfully (you may close your browser at that time). You will also receive an automated confirmation email from with subject line: Case Last Name Referral within 5-10 minutes of successfully submitting your files. If you have not received it, please check your junk mail folder. If you still are unable to upload your materials, do not receive this confirmation, or need to send information by mail (i.e. medical record discs), please contact the START Coordinator at KempeSTART@UCDENVER.EDU

Overview of the START Process:

1.  Submit START Referral:

  • Referring Party accesses START Referral Form to submit referral and pertinent documents via online HIPPA compliant system.

2. Coordinate:

  • We will make sure we understand your referral and that we have received all pertinent documents and information.
  • We may contact you via phone or email to discuss the referral in more detail.

3. Schedule START Consult:

  • The START Coordinator will schedule consultants from appropriate disciplines.
  • START Consults are one hour in length.
  • Referring party may invite other service providers to the START Consult.

4. START Consult:

  • The START team and referring parties will meet in person, or by video conference/phone.
  • The focus of this consultation is to address the questions that were submitted in the referral.

5. Post START Consult:

  • After consultation, the referring party will receive a report with recommendations.
  • This report will be sent to the referring party only; the referring party distributes the report at their discretion.