Supervisors Hear Progress, Data Gaps and a June Dispatch Shift for Street Crisis Response Teams

San Francisco supervisors heard updates April 20 on a network of city street response teams designed to divert noncriminal behavioral-health and homelessness calls away from police — but officials and supervisors repeatedly flagged data gaps and capacity concerns as the city moves toward a planned dispatch change in June.

Chair Ronan opened the Budget & Appropriations Committee hearing by saying the goal is to “reduce SFPD’s role in responding to calls for service related to homelessness and mental illness,” and to make sure alternative teams are working as intended. She listed about 10 teams funded by the city, including the Street Crisis Response Team (SCRT), the Healthy Streets Operations Center (HSOC), EMS 6, a Street Overdose Response Team and a new Street Wellness Response Team; she also noted an alternative response funded by the board, CART, had not yet launched.

Fred Brusso of the Budget and Legislative Analyst’s office summarized a report focused on SCRT and HSOC and presented charts showing the changing share of 800B calls (the local code for noncriminal mentally disturbed-person incidents). Brusso said police handled roughly 85% of those calls in December 2020 but about 46.6% in February 2022, while the street team share increased — findings he described as estimates because of limitations in 911/CAD records. “The 911 call records, unfortunately, don't allow for tracking the exact number of 800B calls to which the police department responds,” the report said during the presentation.

Department officials described how the system works and why some police responses still occur. Robert Smuts, deputy director for DEM who oversees the 911 center, explained that calls are often dual-coded so both police and SCRT are notified. If SCRT is unavailable, police backfill. He said coding and the city’s older CAD system have produced artifacts (including overlaps that sum to more than 100%) and that replacing CAD is a priority to improve accuracy.

City health and emergency-management staff described outcomes and limits. Dr. Angelica Almeida of the Department of Public Health said SCRT began in late 2020 (pilot operations concentrated in the Tenderloin) and scaled to six teams with citywide coverage; she said teams both respond to 911 dispatches and proactively seek people in need. Assistant Chief Simon Pang (San Francisco Fire Department) said SCRT’s average response time improved from about 17 minutes to the mid-teens with present staffing.

Presenters summarized dispositions: across the reported operational period, SCRT transported people to some form of care about 28% of the time, identified acute medical emergencies roughly 15% of the time, and used non-hospital transports in about 13% of cases. Presenters said roughly 60% of dispositions result in the client remaining in the community after de-escalation; SCRT requested police assistance in about 3.6% of encounters (158 of 4,392 encounters shown in the presentation).

Departments and supervisors discussed a planned procedural change: beginning in June, the city intends to use Emergency Medical Dispatch (EMD) protocols so eligible calls would be processed primarily as medical responses rather than entered as police 800B calls. Robert Smuts said that under the planned change, EMS would backstop SCRT rather than SFPD, and that police “will no longer respond” to SCRT-eligible calls once the EMD triage is in place and staffing goals are met.

Supervisors pressed on key questions: whether the increase in total call volume represents latent demand (people more willing to call now that alternatives exist), whether SCRT capacity is sufficient when the city shifts to EMD, and how follow-up and case management are being measured. Dr. Almeida and OCC staff said an OCC follow-up team prioritizes people with multiple contacts; they reported that 43% of individuals had been connected to some form of case management since OCC launched and that follow-up contact rates were higher in recent months (e.g., 79% in February for one data pull).

Supervisor Safai and others highlighted an apparent contradiction between slides showing 81% of clients with a single encounter and maps and field experience showing repeat contacts. DEM and SCRT staff said identification challenges (anonymous encounters, “John Doe” entries, and imperfect chart merging) can undercount repeat contacts and promised to provide more refined data on how often teams cannot identify individuals across encounters.

The Fire Department described the Street Overdose Response Team (in operation since Aug. 2, 2021), citing 1,820 calls handled through April 16 and referencing the 2020 medical examiner’s tally of 711 overdose deaths. Officials said the team has reached about 52% of confirmed opioid overdoses during operating hours and is pursuing a state pilot to allow community paramedics to carry and administer buprenorphine (estimate: operational planning through July). Officials said current workflows often require transporting survivors to emergency rooms or clinics to secure buprenorphine prescriptions, which limits rapid initiation of treatment.

Several supervisors and public commenters also raised staffing and budget questions for DPW, noting that some calls previously routed to HSOC are now coded to DPW for street-cleaning responses. Public commenters urged independent oversight of SFPD data and stronger equity and needs assessments as the system evolves.

At the meeting’s close, Chair Ronan made a motion to continue the item to the call of the chair; the committee voted by roll call (Chan — Aye; Walton — Aye; Ronan — Aye; Member Moore absent) and the motion passed. The committee plans to monitor data-quality improvements, deployment of EMD protocols in June, SCRT capacity and the planned buprenorphine pilot.

Ending: Departments committed to returning with refined metrics and clarifications (data-cleaning and CAD replacement status, more precise counts of repeat contacts, and early evaluations). The committee continued the item for future follow-up.