Supes’ Meeting Ends in Confusion
Replacing Police response with community advocates was approved 3–0, but disquieting details persist about which agency gets the call to an emergency and how much to spend?
W hile Supervisors Gordon Mar, Catherine Stefani and Matt Haney—all three members of the Public Safety and Neighborhood Services Committee—agreed “in principle” with the resolution that would shift response to 9-1-1 & 3-1-1 “Priority C-level” calls involving unhoused people from Police duties to a more community oriented agency.
Department of Emergency Management (9-1-1) call takers receive calls or complaints that they send to a dispatcher. The dispatcher assigns a response, if the call requires a response. The dispatcher assigns an available team or unit to respond. The call waits in a queue if there are no available units. The responders report to dispatch when they arrive. Priority A-level calls occur in response to emergencies that require an immediate response such as the danger of a loss of life or major damage to property. B-level calls involve an individual in medical or mental crisis who is non-violent, has no weapon and has committed no crime. Priority C-level are non threatening behavioral complaints. Any incident could escalate to a higher priority during the response in progress. There are also 3-1-1 calls, the police non-emergency line for non-urgent needs, and calls made directly to the Homeless Outreach Team.
Reallocating 4.8 million dollars in the Police Department budget to fund the Compassionate Alternative Response Team (CART) in addition to the 2 million dollars that are already on reserve for an alternative response to policing was not clearly supported, and there was unanimous confusion about the logistics—since the services of the Fire Department and the Department of Public Health’s Street Crisis Response Team (SCRT) and its offshoot, the Street Wellness Response Team could coincide with the CART services.The Department of Homelessness and Supportive Housing also provides a Homeless Outreach Team (SFHOT), and the Department of Public Health maintains a Comprehensive Crisis Team in conjunction with SFPD. The Police are themselves trained in crisis intervention and has a Crisis Intervention Team (CIT) Program, which trains officers to respond to behavioral health emergencies. These functions sometimes, perhaps often, overlap. To the Supervisors, defining the circumstances in which a 911 or 311 call would be assigned to which of the agencies seemed, as yet, unclear.
SUPERVISOR STEFANI: I don't know how the workers in the community will be trained. Are they only responding to C-calls? How do they know they are responding to a C-call? What if someone doesn't want to call 911 because they only want to call CART? What if it's more than a C-level call?”
Supervisor Haney, introduced the resolution, noting that the SFPD responds to an average of 179 homeless complaints each day and that the Police Commission has recommended that these duties should be reallocated. “C-level” calls to 911 or 311 usually involve altercations between unhoused individuals, trespassing on private property or sanitation issues.
Vinny Eng was one of the presenters for CART, and other presenters made the case for its implementation and funding. “It is not a crime to be poor, it is not a crime to lack access to housing, it is not a crime to live under unstable conditions,” Eng said, as he explained the following slides:
Supervisor Stefani seemed unsatisfied with the vague distinctions. “I do have questions with regard to the interplay of CART and some of those response teams”—and she pushed further. “My concern is only around how it's all going to work together in terms - I just don't understand the interplay between all of it. Part of me thinks of the incredible work they do, we need more EMS-6 and more crisis response team so we can answer the calls.
“CART Has basically pointed out they're not getting the answers. Not just to allay the caller experience—who's calling in. I totally understand that. But I'm trying to get a sense of who is responding? What is the level of training? Because when you look at our street crisis response team. You look at the wellness team and everything that's proposed. These are paramedics in the field. Sorry, I'm just trying to get a sense of the difference between the two and how it would all relate?”
Chief Simon Pang, section chief of community para-medicine for the Fire Department, who has been leading its effort to build the SCRT offered a caution “I agree with all those principles. I, somehow, I feel like there's a sense of us and then the other and that's a little concerning to me. I feel like the members that are supportive of CART have an idea that they have the best way to do it and everyone else is not doing it correctly. And so it's concerning to me because I'm afraid that there may be unfortunate delays and care of someone who might really be in extremis, but the CART responder may not recognize, in the first place, that there's an actual emergency going on and then, they delay in activating medical resources because of an aversion for the institution.”
Chief Pang had a specific incident in mind. “ … yesterday, members of the San Francisco Harm Reduction Team (Glide), contacted one of the EMS 6 Captains, who happened to have an E.R. Doctor with them that day and they said “we just gave Narcan to someone,” a Narcan reversal, but the person still seems like they're not waking up. So, our EMS-6 team (SF Fire Department) recognized that the person was not fully awake, was still overdosing and the half-life of Narcan is shorter than the half-life of heroin and fentanyl, and they wanted to treat that individual, but what happened was, a police officer on foot patrol happened to walk by at that moment and said, “can I help?” And, the members of the Harm Reduction Team were so triggered by the presence of police, they came over and interrupted care and said, “why did you call police? Why did you call police here?” And the captain attempted to explain they did not call police. The police happened to be there and were not interfering, but had good intentions and were trying to help. They interfered with patient care. And, it turned out that this gentleman had lice, was still under the influence of opioids and agreed to go to the hospital, … and then the members of the Harm Reduction Team interfered again and got very upset that the police officer is there and unfortunately, this person stumbled off against medical advice. So, this is my concern about an interaction that I think is not conducive for cooperation for all the city agencies in trying to help people on the scene.”
Stefani, admitting that the situation was making her nervous said “My concern is that we have not worked out how all of this is going to work together. And investing in it with these—it sounds like there's a lot more that needs to be discussed between those good people that want CART to go forward, I know several, I love Vinny, … but I'm really nervous that tensions have not come down enough to work together because my understanding in what the Police Commission has asked, what the Board of Supervisors has unanimously asked is that we have—we want people other than the Police Department, those who show up with guns to respond—that we have our paramedics and we have our Fire Department who are not armed, who are trained, who are trained in extra layers when it comes to the community paramedic division, that they are responding. And it seems to me that, even that seems to be problematic … the situation that just occurred yesterday with the Harm Reduction Team … indicates to me there's still tension that, to put this all together seems problematic. I don't know how the workers in the community will be trained. Are they only responding to C-calls? How do they know they are responding to a C-call? What if someone doesn't want to call 911 because they only want to call CART? What if it's more than a C-level call? I think this is a very good idea, but … somebody was talking about too many cooks in the kitchen and now we're adding our own response team with what we already have?”
The resolution, sponsored by Supervisors Haney, Preston, Ronen and Walton could be heard at the full Board of Supervisors next Tuesday, pending compilation of the agenda, which will be posted tomorrow morning. Listen in.
Doug Comstock is Editor of the Westside Observer.