S.F. Fire Department reorganizes street teams, reports improved hospital offload times and Narcan data

Deputy Chief Simon Pang told the San Francisco Fire Commission on May 14 that the department is consolidating its street outreach and overdose response work to meet rising demand and a constrained budget.

Pang, who leads EMS and Community Paramedicine, said all five neighborhood street teams became operational the week of May 12 and that, beginning July 1, the Street Overdose Response Team will be demobilized and its members merged into broader street crisis response units. The department will reassign three EMS‑6 captains to support the neighborhood street teams and will later retask three additional EMS‑6 captains for a total of six captains working with the mayor’s neighborhood model, Pang said. He emphasized the change responds to increased call volume and limited hiring resources.

Pang said ambulance dispatches (both public and private ambulances) in April totaled 11,364, with San Francisco Fire Department ambulances dispatched on 7,912 calls. The department’s ambulance patient offload time (APOT) averaged 39.6 minutes in April, short of the statewide benchmark of 30 minutes but showing improvement, he said. Pang credited sustained hospital coordination and a streamlined APOT alert process that now allows a phone call to trigger re‑routing when a hospital backlog is confirmed.

Pang also presented overdose and treatment data. In April, 224 individuals received naloxone (Narcan) in San Francisco; about 30% of those were recorded as unhoused and unsheltered, 8% as unhoused and sheltered and 29% had unknown housing status. Pang said the department is tracking individuals who survive repeated overdoses so outreach teams can connect them to care.

On advanced prehospital care, Pang described increased use of intraosseous (IO) access and other advanced interventions. The department performed IO procedures 41 times in April; Pang highlighted one case in which prompt IO access and rapid transport contributed to a patient having a pulse on arrival at a trauma center. In April the department attempted 24 resuscitations; 10 patients had return of spontaneous circulation on arrival at hospital.

Pang described training and community outreach, including a mobile training unit that delivers short, 15–20 minute modules at stations and hospitals to reduce time and overtime costs for in‑person training. He also noted community CPR instruction at elementary schools and continued work with the Core committee, NERD volunteers and other affinity groups.

The deputy chief said neighborhood street teams are aligned to police districts and that fire department captains will be dispatched to higher‑acuity incidents to provide medical and behavioral triage and link people to services. He said the sixth Street mobile triage center’s work was scaling down as other city agencies and contractors take on expanded roles.

Commissioners thanked Pang for the new report format and asked follow‑up questions about bystander CPR rates, APOT improvements and how the department will sustain outreach work with constrained resources. Pang answered that the department will continue partnerships with hospitals, the local emergency medical services agency and other city departments to improve throughput and maintain field services.