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Fire Department presents one-year update on EMS 6 outreach unit
Summary
Medical director Dr. Clement Yeh told the Fire Commission that EMS 6 made 2,244 encounters in its first year and reached 467 unique clients; presenters said the unit helped steer frequent 911 users into sobering, detox and housing services and joined a state community paramedicine pilot.
Dr. Clement Yeh, the San Francisco Fire Department’s medical director, told the Fire Commission on March 8 that the EMS 6 outreach unit has completed a busy first year of operations and appears to be reducing repeated 911 use among a subset of clients.
"Since January 2016 we’ve had 2,244 unique encounters," Yeh said, presenting program metrics. He added the unit has recorded 467 unique clients and averages about seven encounters per 12‑hour watch. Yeh said extended on‑scene evaluations and coordinated follow‑up let crews offer alternatives to hospital transport in some cases: "If there are around 60 avoided ambulance transports and 911 encounters, that amounts to about a $100,000 worth of largely unreimbursed charges," he said.
Paramedic Captains Simon Pang and April Bassett described case studies in which repeated callers were connected to detox, sobering and supportive‑housing resources. Pang described patients who went from dozens of 911 calls a year to single‑digit use after coordinated outreach, sobering‑center referrals and case management. Bassett described one client who completed detox, entered a treatment program and obtained supportive housing, and another who was reunited with family after medical coordination.
John Brown, medical director with the Department of Public Health, praised the initiative and emphasized training and evaluation: San Francisco joined the California community paramedicine pilot as one of 13 sites and completed a 150‑hour course that produced 10 community paramedics. Brown said UCSF and the California EMS Authority will participate in program evaluation and that results could inform statewide standards of practice.
Jim Wagner, director of the San Francisco Homeless Outreach Team (SF HOT), told the commission his agency is assessing workforce and programming and pledged continued partnership. Wagner said HOT uses the city’s Homeward Bound relocation resource when appropriate and offered to provide counts and follow‑up data requested by commissioners.
Commissioners asked operational questions — busiest hours, coordination with Project Homeless Connect and sobering‑center capacity. Dr. Yeh said the team’s busiest period begins at noon and runs into the evening when outreach and bed‑coordination work is most active; captains explained that outreach work can extend over multiple contacts and weeks, not always within a single encounter. Dr. Brown and other presenters said the San Francisco Sobering Center (12‑bed capacity) functions as an EMS destination for selected intoxicated patients and can reduce hospital wall time when used as an alternate destination.
Yeh and presenters acknowledged limitations: several high‑use clients, particularly those with severe mental‑health conditions or repeated relapses, remained difficult to stabilize despite persistent outreach. Yeh asked the commission to support an initial analysis and oversight to guide any expansion, saying the pilot has philanthropic support (California Healthcare Foundation) and state evaluation but that operational funding is not centrally provided by the state. He recommended further data analysis to determine which elements of the model drive success.
Commissioners and the chief thanked the team for the year’s work and requested a hard copy of the presentation and follow‑up data on Homeward Bound usage and other program metrics. No formal action was taken; the commission moved on to the chief’s report at the end of the presentation.
