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Fire Commission reviews department operating budget as medical calls surge
Summary
Deputy director Mark Corso told the San Francisco Fire Commission the city faces a roughly $260 million shortfall and asked departments for 2.5% reductions per year; commissioners pressed officials on rising medical calls, ambulance replacement costs and the need for grant-writing capacity.
The San Francisco Fire Commission heard detailed budget projections and operational plans at its Jan. 24 meeting as department officials described growing demand for emergency medical services and limited budget flexibility.
Mark Corso, deputy director of finance and planning, told the commission the city is facing an approximate $260,000,000 budget deficit over the next two years and that all departments are being asked to make a 2.5 percent general‑fund reduction in each year. For the fire department, Corso said that reduction equates to roughly $1.5 million per year, or about $3 million cumulatively in the second year. He said the mayor’s office requested “no net new positions.”
Corso outlined the timeline for budget work: department submittals due around Jan. 21, the mayor’s balanced budget is due by charter deadline June 1, and Board of Supervisors hearings occur in June and July. He also highlighted a recent transition to a new citywide financial and procurement system that has changed account coding and reporting, creating temporary limitations in the department’s standard packet documentation.
The presentation emphasized staffing and fleet assumptions. Corso said the department plans a March 26 academy and anticipates three additional academies over two years to keep staffing levels up; the budget includes backfill for academy-related vacancies and equipment and fleet replacement that are part of years three and four of a five‑year plan. Corso said the department finished last fiscal year with “just under 150,000 incidents” and that monthly medical calls recently exceeded 10,000, trends that have driven demand.
Commissioners pressed on EMS specifics and possible operational responses. Commissioner Joe Alioto Veronese asked whether the increase was primarily medical calls; Corso replied that medical calls were the main driver of the overall increase and that the trend supports exploring quick‑response vehicles to get to patients faster. Corso also flagged a pilot of smaller ambulances that could reduce per‑unit cost from about $170,000 (current model) to roughly $90,000–$100,000 if adopted.
Commissioners raised grant‑writing capacity as a budget lever. Veronese urged adding a grant writer, and Corso said a grant‑writer position is included on the department’s needs assessment and will be communicated to the mayor’s office as part of the budget committee’s recommendations.
Corso described EMS revenue and write‑offs: gross ambulance billings are about $135 million with roughly $106 million in contractual adjustments and write‑offs, leaving net projected revenue near $28–29 million, largely driven by payer mix and contractual rates.
On overtime and transfers, Corso said departmentwide general‑fund overtime is approximately $31.2 million per year (as approved previously), with an airport overtime line of about $6 million that has been relatively consistent. He said some transfers reflect federal agreements, equipment funds, and other technical reallocations.
Corso closed by noting continued work with division heads, a reconvened internal budget committee and the possibility of an extra commission meeting before final submission if unresolved issues remain. The commission directed staff to return with additional detail on specific items, including a comparison of ambulance models and grant‑writing staffing options.
The commission’s budget discussion will continue at the department budget committee meeting and at future commission sessions ahead of the February submission deadlines.
