Fire chief outlines hospital coordination, calls surge and community‑paramedicine pilot

Chief Janine Nicholson told the commission that since the July meeting she has been meeting with clinicians at San Francisco General and with the city’s Department of Public Health to address a spike in homelessness‑related 911 calls and hospital overcrowding. "We are so intertwined with the hospitals in terms of our homelessness call volume," she said, and named meetings with Dr. Susan Ehrlich, Director Grant Colfax and Dr. Colwell to explore joint responses.

Nicholson described several options the department is studying to reduce transports and hospital waits, including pop‑up triage tents, a community paramedicine van staffed with paramedics, a physician assistant and a social worker, and other diversion models used in other cities. "EMS 6 is sort of a small slice of community paramedicine," she said, describing EMS 6 as a pilot that currently focuses on frequent 911 callers. The chief said state legislation is under consideration that would broaden community paramedicine authority.

Commissioners asked about the legal and funding framework for expanding the pilot. Nicholson said some changes depend on state approval and that EMS 6 staff have been testifying in Sacramento. Commissioner Ken Cleveland said the approach would help reduce hospital transports and lessen long waits for crews; other commissioners called for the department to provide comparative data on call volume, transport rates and outcomes to guide next steps.

The chief said additional interagency meetings and data‑sharing with DPH and emergency department leaders are planned in coming weeks. No formal action was taken; commissioners asked staff to return with data and proposals for how a larger pilot might be funded and governed.