Fire Department data shows high re-engagement after overdose responses; officials say residential treatment capacity is lacking

At the San Francisco Fire Commission's Dec. 13 meeting, assistant deputy chief Simon Peng (community paramedicine) told commissioners that city data show good initial connection rates but high re-engagement within 72 hours among people the department treats or transports after overdoses and crises.

"People aren't staying connected to care," Peng said, summarizing findings from the annual treatment-on-demand hearing. He said transfer points, intake wait times and multiple handoffs create opportunities for people to disengage and that, in the departments view, greater residential-treatment capacity for people experiencing homelessness would likely produce better outcomes.

Deputy Chief Sandra Tong described EMS operational preparations for APEC, including extra ambulances, strike teams from the state and enlisted overtime coverage; the department reported that roughly 23% of EMS calls during the multi-day event were handled by strike teams. Tong also highlighted the 99-10 EMT internship program and MCI (multi-casualty incident) drills that train trainees and staff on triage and coordination.

Commissioners pressed for more data and expressed support for cross-agency cooperation; several acknowledged the difficulty of creating bed capacity and improving transitions from field care to longer-term treatment. No policy votes were taken; commissioners asked staff to continue refining data displays and to follow up on treatment pathways.