TRANSFORM911Implementation Case Studies


San Francisco: Street Crisis Response Team (SCRT)


  • City: San Francisco, CA
  • Population Size: 881,549
  • Jurisdiction Size: 46.87 sq miles


  • 0 – SCRT

CIT (Crisis Intervention Training) Requirements

  • Have a CIT program/training- but not all officers are CIT trained

Model Components

  • Staffing Structure
    • For SCRT- All ride in the same vehicle – 1 clinician + community paramedic from FD + peer
  • Staff Training/Qualifications
    • Masters level or above but not all licensed clinicians need to be able to initiate involuntary holds
    • Hired an outside trainer to specifically design training-focus on team building, institutional racism, health equity through this program
  • Dispatch Structure
    • Respond to 911 calls + police can refer to the team

Operating Structure

    • Operations
      • First team in 2020, currently 7 teams
      • 12-hour shift 7 days a week- staggered so there is 24-hour coverage
      • Respond to lower-level priority calls (not A level) no weapon/violent calls
      • Works collaboratively with other crisis teams
    • Funding Mechanisms
      • Started with funding for an entire city-wide team, but staggered ramp up
      • A proposition is bringing in money for homelessness + legislation that allocates funding
      • RWJF funding for evaluation
    • MOUs/Contracting
      • Unknown
    • Management Structure
      • Co-owned by FD and DPH
      • Community based organizations staff clinician and peer on team
    • Supplies/Equipment
      • Van
      • Must call ambulance if transport is needed to hospital

Data Systems & Collection

  • Data Systems:
    • Avatar EHR, Epic EHR, CAD System, Encounter log      
  • Data Collection:
    • Full scale evaluation – external team is contracted
    • Robust data collection – tracking call origin, the calls team accepts vs rejects, service utilization, call date, etc.
    • Tracking BH data
  • Highlighted Statistics/Outcomes:
    • 60% of pilot calls were handled safely and the individual remained in the community without any transport (others included ambulance to emergency or team taking them to a service provider)

Key Takeaways

  • Focus on institutional racism, health equity through this program

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