Executive Summary

Scope of the Problem

Across America, at least 240 million calls are made to 911 each year.^[1] Many of these result in timely responses from a dedicated group of 911 professionals^[2] to medical emergencies, fires, and serious crimes in progress. This everyday excellence—24 hours a day, 365 days a year—is a remarkable, often lifesaving accomplishment. Indeed, 911 professionals are true first responders. At the same time, the majority of calls to 911 are for issues that fall outside the scope of emergency calls, ranging from noise complaints to minor traffic collisions or mental health crises.^[3] These calls do not require a police, fire, or medical response, and people impacted by the criminal justice system,^[4] along with 911 professionals and police officers, have been arguing for years that something needs to change in the 911 system.^[5]

And what a time for change it is. The world is reeling from a global pandemic, and many cities are experiencing rates of violent crime, especially gun crime, that have not been seen in decades.^[6] The recommendations being put forth by Transform911 in this blueprint support the increasing demand for 911 professionals and police, fire, and EMS department responses that are the consequence of these disturbing trends. These recommendations are not in contradiction of these new realities. In fact, they help increase the time that police and 911 professionals can dedicate to responding to violent crime, as other elements of the first responder ecosystem can take responsibility for calls that need not involve police, helping to prioritize scarce public resources more efficiently and equitably to where they are most needed.

The levels of systemic complexity are typically hidden from public view and consideration, as is the dedicated 911 professional workforce; 911 doesn’t enjoy the broad public recognition that other first responder systems have; it is often conflated with policing.^[7] As we will describe and offer solutions for, that 911 is under the radar screen has impacted research, reform, funding, staffing, and evolution of the system. This has profound implications for 911 delivering on its promise, impacting the health and wellbeing^[8] of people across America.

America’s 911 system exhibits many opportunities for improvement in effectiveness, efficiency, and equity. The lack of common minimum standards for workforce training and support, data collection and reporting, and technology interoperability, combined with the lack of federal funding to address these challenges, means that while the emergency number people call is constant, the response’s appropriateness is highly variable. This inequity in system responses almost universally disadvantages those in small, poor, or otherwise marginalized communities, and it undermines public safety and public health.

This need for change is compounded by the fact that virtually every system in the US, including 911, must reckon with structural racism to be equally accessible and effective for everyone. We must contend with these challenges now to set a solid foundation upon which to build a 911 system that is adequately resourced to respond to the complexities and emergencies of the future. In short, 911 is not a reliable pathway to health and wellbeing for everyone in America.

Starting in July 2022, the new 988 suicide prevention and mental health crisis hotline will begin implementation nationwide. Individuals who call or text 988 will be connected to a trained counselor who will listen and provide support and connections to needed resources. The 988 hotline offers opportunities to decouple care and support from enforcement and is long overdue. Of course, implementing 988 will require us to address many strategic and operational details. Many of the recommendations from this blueprint should also be applied to the new 988 system.

Further complicating the changing landscape for 911 is the burgeoning innovation in technology as it applies to almost every aspect of the system: calls coming in, call handling, and information processing to and from dispatch. For example, NG911^[9] is poised to change the nature and type of information that can be shared with Emergency Communications Centers (ECCs),^[10] to include video and text, as well as offering cloud-based data systems that enable information sharing across ECCs. These changes come at a financial cost in terms of meeting technology needs and increased staff training, and a cost to the workforce, as a barrage of traumatic visual content can be expected to affect 911 professionals’ wellbeing.

Defining 911

Transform911 defines 911 as the system that, when working at its full potential, provides members of the public who are facing acute threats to their wellbeing^[11] with appropriate, equitable, relevant, immediate, and around-the-clock access to relief from distress. 911 is a complex system requiring expertise, communication, coordination, resources, and trust to span

• the diverse cultural, historical, linguistic and other realities across and within America’s communities;
• the methods by which users initiate the request for assistance—be that by way of a telephone call, text, or other defined mechanisms;
• the call-taking, call-handling, and dispatching procedures; and
• the response–be that by virtual or on-scene traditional (i.e., EMS, fire, or police) and/or other sectors of the first responder ecosystem.

We have also compiled an extensive glossary of relevant terms that may provide additional context, which can be found in Appendix A.

Origin of Transform911

Transform911 was launched to chart a path towards a 911 system that equitably and reliably increases access to wellbeing for those who need emergency assistance, the professionals who staff 911, and those deployed to respond. This initiative builds on years of foundational work by members of the University of Chicago Health Lab, and other practitioners and researchers, and where research did not exist, we highlighted opportunities for further exploration and generated information through our collaborative workgroup process.

Though this blueprint is informed by existing research,^[12] we recognize that this field is lacking evidence, so we also capitalized on the expertise of our community of practice. The Transform911 effort brought together relevant research and over 100 critical stakeholders with diverse experiences and perspectives in a two-year-long process to develop a blueprint for needed change. Stakeholders in this community of practice included experts from across the country, including 911 professionals, academics, community advocates, government agencies, public safety leaders, people impacted by the criminal justice system, and technology specialists to develop unified recommendations for a transformed 911. The blueprint is a culmination of this work and is a consensus document outlining a vision for a 911 system that lives up to its immense potential and the actions we must take to arrive there.

Our efforts were divided into six workgroups, headed by dedicated co-chairs as listed below. For our complete membership roster, see Appendix B.

911 Professional Career and Supports
George Rice, Managing Partner, Skyhawk Global
Lora Ueland, Executive Director, Valley Communications Center 911, Kent, WA

Alternative First Responders
Sean Goode, Executive Director, Choose 180
Gabriel Rodriguez, Chief of Police, Camden, NJ

911 Hotline Alternatives
Jasmine Desiderio, Deputy Director of Albuquerque Community Safety Department, Albuquerque, NM
Moki Macias, Executive Director, Policing Alternatives & Diversion, Atlanta, GA
Mary Naoum, Crisis Response Design Consultant, Policing Alternatives & Diversion Initiative, Atlanta, GA
Mariela Ruiz-Angel, Director of Albuquerque of Albuquerque Community Safety Department, Albuquerque, NM

Emergency Communications Center Operations
Edwin F. Huellstrounk, RN, BSN, NREMT-Paramedic, ECRN, TNCC, CEN, Emergency Room Nurse for Edward-Elmhurst Hospital in Naperville, IL
Chad Kasmar, Chief of Police, Tucson, AZ
Tyrell Morris, Executive Director, Orleans Parish Communication District, New Orleans, LA

911 Governance
Jerry Clayton, Sheriff, Washtenaw County, MI
Stephanie Olson, Strategic Planning & Performance Manager, Raleigh, NC
Jeanne Milstein, Director for Human Services, City of New London, CT

911 Technology and Infrastructure
Michael Cowden, Director of Solutions Engineering, Code for America
Evonne Silva, Senior Director, Criminal Justice, Code for America
Meredith Horowski, Senior Director, Network, Code for America (former co-chair)

Over the course of eight months, these workgroups met biweekly via zoom to discuss 911 professionals, alternative hotlines, alternative first responders, ECC operations, governance, and technology as they pertain to the 911 system. In addition to those engaged formally in the workgroup efforts, we reached out to those with specialized interest and expertise in 911, including people who critically challenged the vision that we were proposing, and engaged them in the process through presentations, opportunities to serve on workgroups and weigh in on their formation, invitations to share feedback on draft recommendations, and other aspects of the initiative. These stakeholders served as reactors, educators, and collaborators. Ultimately, the Transform911 team synthesized this collaborative and constructive feedback, including some strong critiques, and developed this blueprint with seven essential recommendations to transform 911, described below.

Following this overview, we provide a chapter for each recommendation with more discussion and detailed, deeply considered action steps necessary to advance that recommendation, reflecting the culmination of each workgroup’s efforts, as well as national feedback and input.

For any given reader, some of these recommendations and action steps may feel resonant, others less so. You may even initially disagree with some of them. This blueprint serves as an invitation for leaders and other interested parties who recognize the importance of 911 in their communities to join us in aiming for Transform911’s north star, through considering and working to implement the following recommendations.

Transform911’s Seven-Point Plan:

1. 1. (Re)Introducing 911
      Everyone knows the number, almost no one knows how it works.
   2. Putting the People in 911
      Community partnership is essential to an optimal 911 system.
   3. Advancing the Workforce
      There’s no 911 without a recognized, supported, professional workforce
   4. Making 911 Independent and Equal
      ECCs that are independent and equal to other local first response systems help improve equitable outcomes.
   5. Ensuring the Right Response at the Right Time
      A diverse ecosystem of responses reduces our reliance on the police by default.
   6. Strengthening Data and Tech Standards
      Reliable and ethical data and tech improves responses.
   7. Securing National-Level Support (for 911)
      Effective, equitable emergency response locally requires unequivocal support federally.

Next Steps

The goal of this blueprint—and the related convening—is that it will immediately be acted upon by the developers themselves and will not be a report that sits on the shelf. We intend for the recommendations to be adopted by the existing Transform911 community of workgroup co-chairs, members, partners, and advisors and for this community to expand to include a wider group of adopters and interested parties. This effort is truly “co-owned” collectively by the Transform911 workgroup co-chairs and members who developed the content and provided the ambition and expertise necessary to establish the recommendations presented here. The Transform911 workgroup co-chairs and members have and we expect will continue to serve as vital ambassadors and leaders for the work and will help push for the implementation of the Transform911 Blueprint’s recommendations in their communities.

On June 29, 2022, this blueprint will be released publicly during a third Transform911 convening. The one-day public event will be hosted both virtually and in person in New Orleans, in partnership with the Orleans Parish Communications District Emergency Communications Center.^[13] The convening will be open to the public and all Transform911 stakeholders, funders, members of the media, and federal and state representatives and staff. The event will unveil this blueprint, showcase relevant early examples of applied recommendations, and present plans and opportunities for implementation. The recording and other related materials for the event will be available online on the Transform911 website, under the convenings page. This blueprint marks a milestone in the transformation process, invites others into changes that are already gathering steam via the workgroup’s consideration process, and to also raise the profile of the work.

^[1] National Emergency Number Association, “9-1-1 Statistics,” accessed November 22, 2021, https://www.nena.org/page/911Statistics.
^[2] The term ”911 professionals” is used to include operators, call takers, call handlers, dispatchers, and managers in Emergency Communications Centers (ECCs) throughout the blueprint. Workgroup co-chairs and members chose this term to emphasize the professional nature of these jobs.
^[3] S. Rebecca Neusteter et al., “Understanding Police Enforcement: A Multicity 911 Analysis,” Vera Institute of Justice, September 2020, https://www.vera.org/publications/understanding-police-enforcement-911-analysis; Cynthia Lum et al., “Can We Really Defund the Police? A Nine-Agency Study of Police Response to Calls for Service,” Police Quarterly (2021), https://doi.org/10.1177/10986111211035002.
^[4] This includes people who have experienced an arrest and/or period of incarceration as well as their families and immediate communities.
^[5] Neusteter et al., “Understanding Police Enforcement.”
^[6] https://www.npr.org/2021/09/27/1040904770/fbi-data-murder-increase-2020
^[7] The dearth of reports and research on this issue is a testament to the lack of attention paid to the 911 system as separate from policing.
^[8] The recognition that transformation of the 911 system is an essential element in increasing equitable access to wellbeing is what led Transform911 to partner with the Full Frame Initiative (FFI) on this effort. FFI has developed and works with systems and communities to operationalize an evidence-informed framework for wellbeing, which FFI, and by extension this effort, defines as “the set of needs and experiences universally required in combination and balance to weather challenges and have health and hope” (for more information, see fullframeinitiative.org). There is a discrete set of these needs and experiences, which all humans are “hardwired” for; they include social connectedness and belonging; safety; stability (predictability and familiarity); influence, purpose, and a correlation between efforts and outcomes; and meaningful access to relevant resources such as food and shelter. While all people are driven to meet their needs in these domains, racism, sexism, and other “otherings” create differential social, contextual, and structural access.
^[9] For resources on the NG911 effort, see https://www.ng911institute.org/resources and https://www.nena.org/page/NG911_Project.
^[10] These entities are often referred to as Public Safety Answering Points (PSAPs). However, a diverse array of other entities, including 911.gov, the National Institutes of Health, APCO International, the IJIS Institute, and many local emergency centers also use the term ECC. At the request of Transform911 co-chairs and members, this blueprint uses the term Emergency Communications Centers (ECCs) throughout.
^[11] We define wellbeing as “the set of needs and experiences universally required in combination and balance to weather challenges and have health and hope.” An extensive body of research demonstrates there is a discrete set of these needs and experiences, which all humans are “hardwired” for; they include social connectedness and belonging; safety; stability (predictability and familiarity); influence, purpose, and a correlation between efforts and outcomes; and meaningful access to relevant resources such as food and shelter. For more information, see fullframeinitiative.org.
^[12] For a review of the research that informed this blueprint and the Transform911 process, see Transform911: Assessing the Landscape and Identifying New Areas of Action and Inquiry, https://www.transform911.org/resource-hub/transforming-911-report/.
^[13] The Orleans Parish Communications District ECC is the 911 Center that serves New Orleans, Louisiana.