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Gathered through a series of semi-structured interviews and a review of court documentation, we outline the processes, discussions, victories, and challenges of starting STEP Court in Multnomah County. We outline how the passage of Oregon’s short-lived drug decriminalization law, Measure 110, created an opportunity to think differently about certain types of offenders. We outline the pre-existing relationships, structures, and specialty courts in the county that created trust and fostered the political will needed to start the court. We highlight some potential pitfalls and challenges and how they navigated them to get the court started.