>> hello everybody. i'm san francisco mayor london breed. i'm here at the 911 center with a number of our public safety leaders in the city including

director of the department of emergency management, mary ellen carol, dr. grant colfax, our fire chief jeanine nicholson. and chief deputy lizar and we're here just to talk with a number of our dispatchers here at the 911 center and i just want to thank the dispatchers and the people who are part of this center because i think what people don't realize is every single day, 24 hours a day, the people who work in this building, they are fielding calls on a regular basis of people that sometimes sadly are experiencing one of the worst times in their lives and they're looking for help. and these folks in this building who show up time and time again for us despite the pandemic, despite everything

that's been going on in this city for the past year and a half. they've been here. they are wearing their mask and doing their jobs and they're showing up for san francisco. so i want to that our 911 dispatchers and their hard work and commitment to san francisco. we just heard back from a number of things they, of course, want to see change and they want the public to be aware that when they call and you call 911, they hear a lot of calls and they know what is available and what's important for everyone to know is i know folks are asking i want a paramedic or a want a police officer or i want the street crisis response team. well, ultimately, they need to understand what is going on in the scene to the best of their ability. and they are able to make decisions baseded on what they hear from you. ultimately, it's about public safety and they can't just send

anyone into any situation without making sure that they understand what's going on and often times our police department are the first line of defense around issues that involve public safety and when you're able to dig a little bit deeper sometimes, they recommend the street crisis response team or a paramedic. ultimately, the men and women who work here every single day, they've heard a huge range of things and they as far as i'm concerned are the experts and the best judge of what is most appropriate to send when you call 911. so trust them. many of them have been working here for 10, over 20 years and have heard a number of calls from a number of people and so we are here to express our pre-for their hard work and ask the people of san francisco when you call 911, please respect and trust our

dispatchers. today, we're also celebrating one year of our street crisis response team and so i know simon peng and others are here with us and the behavioral health teams from the department of public health, i mean this was what some considereded a crazy idea bringing all these city agencies together to respond to the crisis that sometimes people are having on our streets. and the fact is there's not a one-size-fits-all. there are people suffering from schizophrenia. there are people who suffer from behavioral health issues and substance use disorder and it's complicated and sometimes people are violent, sometimes they're not. i went on a ride with the street crisis response team and, you know, it took about an hour to even get to a point where we could actually get that person over to general hospital. we had to unfortunately do a

72-hour hold, 51-50 that individual because of their behavior and even if they didn't have a weapon and weren't going to harm themselves, going in and out of traffic where a car could potentially hit them or that person in the car who hits them could be harmed themselves with a real problem and so they have to use their own expertise, their own judgment to decide what is best for the individual they are trying to serve. and this program came about in trying to find a nonpolice response to things that don't require a police response. we have a lot of challenges in san francisco and we truly appreciate and value our police department and the work that they do to serve and protect the people of this city. but we also understand that there are some calls that they are not necessarily needed and so my preference is that when

the dispatchers get the call, they make the decision sometimes for there to be the street crisis response team or a police officer or a paramedic depending on the situation. and so this program has been in existence for years. they've answered thousands of calls. they helped divert people to some of our behavioral health beds which you all know. we have expanded significantly and there's a commitment from this past year's budget to increase the number of beds by an additional 400. we're already over 200 additional behavioral health beds and we plan to do more. the goal is to make sure that when we engage with members of the public who are struggling and having challenges, behavioral health related issues, we are able to have a place for them to go and sometimes that's not always the emergency room. so we know there are complex problems and complex solutions and other challenges that our

city as a major, as a major city, that's a very dense city, we know there are problems and challenges we have to face, but i've got to say, i'm so very proud and grateful to all of our public safety officials who are doing the work on the ground to try and keep people safe. i'm grateful to them for showing up and despite dealing with some of the most challenging of circumstances every single day, they still show up. so when you see our firefighters, our police officers, our paramedics, anyone wearing a city uniform in any way, just give them a smile and thank them for their service because they are doing the hard work day in and day out to deal with the challenges that exist in this city. so thank you again everyone for being here. we celebrate and we're grateful to our street crisis response team. we're grateful to our police officers and our firefighters and our department of public

health officials, our doctors, our nurses, our clinicians. all of the people who were extraordinary and helped us through this pandemic. we are so fortunate to have so many extraordinary public servants in this city. and now, with that i'd like to introduce the director of the department of emergency management mary ellen carol. >> thank you mayor breed. i really appreciate the fact that you took time to come in today. we got some feedback on the implementation of the skirt teams and some of the other teams and we're super grateful for that. i just want to thank my colleagues, dr. colfax, chief

nicholson, of course, deputy chief lizar for your support and commitment to developing alternatives for people in crisis. the role of emergency management is to provide coordination and there is no significant crisis than what we see of the the tragedy happening on our streets. this includes overseeing multi-department operations. we need to unify all of these different groups to figure out are we doing this most efficiently. are we getting the results that we need and ultimately our goal is to improve the conditions on the streets and the sidewalks and our conditions. just to reiterate, we have increasingly more resources at

our disposal to aid people working on the streets. again, to echo the mayor, we need to trust their expertise. please do not hesitate to call 911 or a nonemergency if there's an emergency and provide the information that these trained professionals are asking for. they care deeply about this city and they want to get the information out and the help out and their frustrations they indicated is they're going to have to get into these arguments to call in to get the information. we want to get the help to the persona needs it as quickly as possible. and so that starts with calling 911 and responding to the prompt so we can get that help out quickly. the emergency management side of d.m., we are drawing on our

experiences. the development of all the relationships that we've had and the expertise that we developed to help our department partners here really effectively utilize the resources and work towards those common goals and outcomes. san francisco is a leader in developing and implementing ultimate response teams for people in crisis. and we at the department of emergency management are honoreded to be able to help coordinate these efforts and bring our best outcomes for the people of san francisco. right now, are i'd like to introduce my colleague, dr. colfax, the leader of the department of public health. >> good morning everybody. thank you director carol. hi, everyone. it's great to be with you here today and i want to thank mayor breed for her tremendous

leadership. san francisco is fundamentally changing how we serve people in crisis and leading the nation on how we respond to health care needs with health care response. and thank you, mayor breed and partners for helping us do this. i want to thank director carol and the 911 dispatchers to ensure they apply the most appropriate and compassionate response is provided to people in need and this includes people experiencing nonviolent mental health or substance use disorders to the best response the street crisis response team. our community paramedics, mental health with lived experience together have a range of specialty skills to engage in crisis and address a person's immediate needs for care, treatment, and shelter. skirt is truly a collaboration. as you know, staffing comes from the department of public health and, of course, fire as

well as our wonderful community partners health right 360 and rams. and the first year, skirt responded to over 5,000 calls. those 5,000 calls in emergency visits a decrease in ambulance rides and a decrease in law enforcement responding to nonviolent calls and most importantly, an opportunity to connect san franciscans with those most appropriate services. skirt is supported by a dedicated followup team within 24 hours of the initial encounter. nearly a third of all people are successfully reengaged with followup care such as being connected to a provider or treatment facility. this is really about meeting people where they are and tailoring our response. if you have a person on the street in a skriesz, even the skirt team to wrap around that

person, that's an important step. you don't want to crowd that person. so the pier counselor will go out and engage that person one on one saying i've been here before. i have that lived experience. how do i share my experience and engage the broader team. they can transport that person to places like humming bird, our low barrier care. that low barrier care. getting that person off the street, linking them to care. skirt is part of our larger effort to bring our response to the community. our community based teams like skirt and overdose response team are removing access to care, treatment, and services. and i want to make one more plug, if you see someone in crisis, please call 911 to describe what you are seeing and somebody will be there. now, it's my pleasure to introduce a great leader, partner, and collaborator in this response, chief nicholson. thank you.

>> thanks, dr. colfax. yes, i just want to say thank you, mayor breed for trusting us in the fire department to take on this critical role with the department of public health and others. as you may have heard, street crisis response team, we also call it "skirt." i want to give a shout out to some of the people here on the street crisis response team. we have a community paramedic that has more training than a regular paramedic. they're trained in de-escalation. they can redirect people to other services and a mental health professional from public health and as dr. colfax said, a peer support person. in terms of the 5,000 calls we

have gone on and of the folks we have gone out to help, 40% of them have accepted help and transport to a psychiatric facility. that does not include people that we have had to 51-50. but this is an extremely successful program. we're working out all the creaks. but we look forward to it. chief simon peng, if you have any specific questions, he is here as well. thank you all for being here today and, again, a big shout out to our street crisis response team and i would like to introduce our partner of safety, deft chief lazar. >> thank you, chief nicholson.

what else can be said? first on behalf of chief scott and the entire san francisco police department, i want to thank our mayor london breed who back in 2020 was looking at policing and looking at the role of police. and really, it was her vision that said, you know, we need to take this important issue of helping and assisting the mentally ill more away from the police and more towards professionals who are trained and go to school and are prepared to deal with the challenges on our streets and that's involved to what we see today. we have a lot to celebrate in one year and as you can hear, that's 5,300 calls to police who are sometimes there, but we're not there to do the intervention and to help people. and so that is a lot to be

unlike other cities in america, the police and fire like each other and we're friends with each other and and maintains the building. and the last thing i want to say is i want to thank our san francisco police officers. just like mayor breed has shown tremendous support. i want to thank them as well on behalf of the chief and the department for what they do every day working to help and serve the public and provide public safety in the city. thank you very much. >> i want to thank paul miamoto, but the people who

secure i want to thank them for their services as well. with that, i want to open it up to any questions. >> i believe this was a week before thanksgiving. i'm curious if there are plans to services and how they. >> well, i think what we've been doing around deescalation for the most part has been working and our police officers have a job to do when they're called to protect public safety. the chief last week showed the video and provided input. it's an ongoing investigation. there will be an independent investigation, but it appears that, you know, the training and what the officers learn to do around deescalation were implemented in this particular

case. and so there's an ongoing investigation in this case but at the end of the day, i'm grateful for the work that we have done in san francisco around deescalation and around the ability to identify and work towards a solution in most of these situations and this was an unfortunate situation that occurred, but i think that our officers handling themselves appropriately. >> reporter: [inaudible] >> i think it's hard to say because people have struggled with mental illness since the beginning of time. and the fact is we as a

society, as a city, as a state, as a country, we have not handled it very well. we are doing the best that we can within the laws that we have. but one very important law that is missing in order to really see and feel the difference has everything to do with force and that means forcing someone into treatment, forcing someone into some cases, you know, a locked or unlocked facility based on what their issues are. and so there's a huge push around we don't want to take away someone's rights and i totally understand it. i'm going to tell you right now. i see elderly people on the streets who have dementia. who have no family members. who have no one making decisions for them and then when we take them into our care and we try to get them help and support and make sure they're not outside doing things that they would not normally do if they didn't have dmen can. as soon as they say, i want to go. i don't want to be here we have

to honor that and so the system is broken as a whole and needs to be changed. and so we don't necessarily unfortunately have the local jurisdiction to make those changes. we need a change in state law and we need a change in this country about how we address mental illness whether it's those suffering from substance use disorder or dementia, schizophrenia and all these other ailments that may impact the mind in a way. my hope is that what we are trying to do is we're trying to manage the situation as best that we can within the laws that we have. we can't force someone to stay in our care. we can't force someone to stay in a treatment bed. we cannot force someone to behave in a certain way. there's a number of layers that go into that and so we are still missing the most

important layer to see in a real difference a lot faster in our city. you mean sheriff. >> reporter: [inaudible] >> work off duty in the private sector. i think at the end of the day, it's a sad state of what we're living in terms of what we are

seeing with these mob style robberies and a number of other the burglaries, the car briek-ins, all of the things that and the people in this city want to change they're not coming back. so it's going to impact our bottom line and the ability to pay for all of these problems to help homeless and mentally ill. it's going to impact our city as a whole. so that line of defense with our police department, our sheriff's deputies is going to be critical. a critical piece to helping to maintain safety. that's just what it is. yes, we have our ambassadors. yes, we have different responses to calls that people make to 911. yes, we are trying to make the reforms and to ensure that the appropriate interactions take

place with law enforcement in san francisco. but at the end of the day, people want police officers, they want to make sure that our streets are safe and we're going to do everything we can to make sure that they are. and that's part of it. and by expanding the ability for sheriff's deputies to work off duty at these various locations, that's only going to enhance public safety and i am fully in support of that. >> reporter: [inaudible] >> i'll let dr. colfax talk about that. we probably won't be able to relax right away. . it means that we don't know just like with covid when it first happened, we didn't know specifically the impacts. we don't know yet, we don't know when it will be in san

francisco. but the likelihood it will be here is likely but we are paying for close attention to this. we are working with a number of health experts all over the country and ultimately what has been said time and time again, get your vaccine and do everything you can to make sure you are protected. even if we see this is worse than the delta variant, you do have a layer of protection with the existing vaccine, but there may be more needed as well. so we just don't know what we don't know, but as soon as we know, our plan is to make sure the public knows everything that we know. dr. colfax, did you want to add to that?

last question. good. >> reporter: [inaudible] >> yes. first of all, let me just say i'm a big supporter of night life and going out in san francisco. and there are rules and number of regulations put in place in a number of establishments. number one, you have to have a mask. number three, when you go to the restroom, you have to have a mask and i was in a private area with my drinks, with the people i was with enjoying myself at a venue and i had a great time and i followed the appropriate protocols, and, yes, i was dancing, and, yes, i was drinking and having fun and at the end of the day, i am doing everything i can to follow the existing protocols and i think sadly sometimes

these videos are taken out of perspective. i took pictures who wanted to take pictures with me. i am out there in the public not just supporting night life, but out there at our restaurants, shopping at various locations doing what i feel as mayor i should be doing but also as a human being who's been through a global pandemic who did everything i could to make sure that the people of this city were safe which is why it's no coincidence we not only have one of the lowest death rates in any major city in the country. so i'm doing my job and i am following these protocolonel colonels. what i've said to people time and time again that we need to do our very best. in a room full of vaccinated people. so that's what i have to say about it. i'm going to continue to support our night life and go out and enjoy myself as someone who is a single woman living in a major city who is having fun,

but i want to be clear, i'm not out there making the rules and then not following them. so it is just not fair to try and take a snip of a video which i knew was done by somebody who was at my table and use that as a way to indicate it's something other than what it is doing exactly what i would expect anyone else to do when they're out at a night life venue drinking and dancing and partying and having a good time. thank you.

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