City Fire Department addresses high call volume from frequent callers needing treatment

The City of San Francisco held a government meeting on July 4, 2025, focusing on the challenges faced by the fire department, particularly in relation to emergency medical services (EMS) and community paramedicine. The meeting highlighted the significant strain on resources due to a small percentage of the population, often referred to as "frequent callers," who require extensive support but frequently refuse treatment.

Commissioner comments underscored the frustration experienced by EMS personnel, who dedicate considerable time and effort to assist individuals with complex needs, including mental health and substance abuse issues. The discussion emphasized the importance of addressing these challenges to reduce the number of emergency calls and improve outcomes for those in need.

A key point raised was the need for additional community paramedics. The department is in the process of hiring and training 35 new paramedics, but there is recognition that even more personnel will be necessary to meet the growing demand for services. The current recruitment process is separate from the general hiring of EMTs, with a new exam scheduled to identify eligible candidates.

The meeting also touched on the collaboration with the conservatorship office, where EMS personnel support the administration of psychiatric medications but do not directly administer them. This partnership aims to encourage compliance among clients who may be resistant to treatment.

Concerns were raised regarding the availability of treatment beds for individuals in need of care. While specific numbers were not provided, it was acknowledged that the demand for treatment options far exceeds current capacity, particularly as outreach efforts increase.

Additionally, the meeting noted that approximately 35% of individuals the street crisis response team attempts to assist are not present at the location when help arrives, highlighting the unpredictability and challenges faced by EMS teams.

In conclusion, the meeting underscored the ongoing challenges within San Francisco's EMS system, particularly regarding resource allocation, the need for additional personnel, and the complexities of engaging with a vulnerable population. The discussions will inform future strategies to enhance service delivery and address the pressing needs of the community.