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Supervisors press city officials to map, coordinate dozens of street-based teams before scaling new alternatives
Summary
A lengthy hearing on June 9 examined how proposed street crisis, wellness and overdose response teams would coordinate with existing outreach. Supervisors and community members warned the city risks duplication without a functioning Office of Coordinated Care and more data and dispatch pathways.
Supervisor Hillary Ronan convened a lengthy hearing on coordination among multiple street-based response teams proposed or active in San Francisco, urging clarity on how teams will share data, triage calls and link clients to long-term care.
City presenters from the Department of Homelessness & Supportive Housing, the Department of Emergency Management, the Fire Department (community paramedicine / EMS 6) and DPH described a layered system: SCRT (street crisis response) for acute behavioral health crises, a Street Wellness Response Team for well-being checks and outreach in public spaces, and a Street Overdose Response Team that can initiate low-barrier medications such as buprenorphine immediately after an overdose reversal. Departments emphasized shared leadership, connected databases (including AVATAR and Epic), staggered team hours and plans to expand teams to reach 24/7 coverage.
Community speakers and the Mental Health SF Implementation Working Group said they were not consulted on all proposed teams, asked for an inclusive mapping of existing programs, and recommended expanding scope, improving dispatch protocols (an alternate non-911 number) and scaling mediation with community-led CART (Compassionate Alternative Response Team) proposals. Eric Simon Peng (Fire Department) and EMS staff underscored the clinical and medical triage capability of community paramedics and the need for paramedic involvement in overdose response.
Supervisors repeatedly pressed for: a clear diagram of which team does what, how databases are shared, supervisory structures, funding sources, and whether new teams duplicate existing ones. Departments conceded gaps and committed to follow-ups: scaling pro-bono legal and mediation support for negotiations, enhancing the Office of Coordinated Care to be the backbone for referrals, and returning with dispatch/pathway plans. Supervisor Ronan moved to continue the item to the call of the chair so staff and stakeholders could prepare additional mapping and coordination work; the motion passed unanimously (4 ayes).
Public commenters, including providers and unhoused advocates, urged a community-led approach (CART) and asked for more language-accessible outreach and investments targeted to hardest-hit neighborhoods. The committee continued the matter to allow further analysis and stakeholder engagement.
