Public health and social welfare fields increasingly recognize the need for preventative interventions that address root causes rather than respond to emergent problems – yet face significant challenges in designing tools and demonstrating success for such initiatives. We characterize these important, but difficult to develop and scale solutions using Dan Heath’s term “upstream work”. We then explore design solutions to support upstream work through a multi-phase co-design process to assist fire departments developing alternate EMS response programs to reduce 911 call volume. We contribute to literature on designing to support data practices in community organizations and further delineate the key challenge of these programs as upstream initiatives: demonstrating success to stakeholders. We then present our co-designed prototype, a data dashboard to visibilize and track the outcomes of alternate EMS response programs for different stakeholder audiences, and detail good practices for designing to support local and community based upstream initiatives.