These Peers Provided Alternative 911 Responders. San Francisco Is Removing Them
After losing her job because of substance abuse, Chantel Hernandez-Wood was living on the streets of San Francisco when she saw a red van parked nearby one day in 2022. It was the city’s former Street Overdose Response Team, and she flagged them down for help.
Equipped with a peer counselor trained to connect with people in crisis, the crew drove her to a recovery center, where she received medication to assist with alcohol withdrawal and entered a 90-day recovery program. While there, she decided she wanted to do the same kind of work as the people who came to her rescue.
“It felt like I meant something to someone. They went above and beyond to help get me off the streets,” Hernandez-Wood told KQED. “I thought, ‘I’d love to do that, I want to give back.’”
After successfully finishing the recovery program, Hernandez-Wood completed training to become a certified peer support specialist, learning techniques to engage with vulnerable populations and navigate social services. She started working at the nonprofit Glide, helping people who struggle with drug use, went on to work on the city’s Street Overdose Response Team, and later stepped into her current role as a peer responder on the Street Crisis Response Team. Peer responders currently pair with fire department paramedics to respond to some calls together.
“It was so surreal, because I was working on the same type of team that helped me when I needed help the most,” she said.
But now, San Francisco is quietly shifting its emergency response networks and the roles that peers with lived experience have within them. The fire department is planning to remove peer specialists from its 911 response this summer, setting off alarms for peer advocates who say the decision is a regressive step in the city’s approach to mental and behavioral health emergencies.
“It’s just an incredible disservice to the community,” Hernandez-Wood said. “I feel blindsided.”
Fire department officials said the move to pull peers off of the Street Crisis Response Team came after “careful consideration,” and cited challenges with scheduling that made picking up the peer responders before calls difficult.
“This decision was not made lightly and reflects the evolving needs and direction of crisis response within the larger 911 system,” a spokesperson for the fire department said in an email. “We believe that by working together within the Street Response framework, SFFD can ensure those we serve continue to receive the appropriate response.”
Widespread protests against police brutality in 2020 sparked national discussions around how first responders can better serve people experiencing a mental health crisis, overdose or other behavioral health issues. In the wake of those conversations, the city did not decrease its police budget, but instead created new teams to respond to people in crisis, including the Street Crisis Response Team.
The peer responders are not fire department employees, but are contracted through the nonprofit RAMS, which the Department of Public Health administers. Others are specialists with the San Francisco Homeless Outreach Team. The Department of Public Health declined to comment on the staffing changes, saying the Street Crisis Response Team is under the fire department’s purview.
Peer responders with the Street Crisis Response Team help address issues ranging from a street-level overdose to a domestic dispute in a penthouse, offering support for de-escalation, navigating social services and sometimes bringing lived experiences to a crew of medical and safety professionals.
“Over the years, I’ve noticed that a lot of people will look to their peers for guidance or answers because we’re not in uniform,” Hernandez-Wood said. “A lot of unhoused folks that have substance use disorders, they don’t want to talk to anybody in uniform, they just feel more comfortable and less intimidated.”
San Francisco has served as a model for other cities and jurisdictions looking to improve the way that they address complicated 911 emergency calls. A 2024 report by the Policing Project at New York University found that the city’s programs “saved law enforcement resources, freeing up the police for other more pressing work.”
But the novel approach presented challenges.
According to the report, “911 dispatchers are stretched thin and struggle with the scripted protocols they must use to assess call eligibility, in particular because those protocols may not always resolve the calls they receive. There still is some confusion among frontline workers about responsibilities of each at the scene of an incident. And many community members and some call takers are disappointed that alternative responses are not solving complex social problems.”
The San Francisco Fire Department has meanwhile been developing its Community Paramedicine team, whose members have training in trauma-informed care and resource navigation, to more appropriately respond to people struggling with substance use, mental health crises, homelessness and other behavioral health challenges.
The community paramedics have more training in emergency medicine, and they arrive in uniform and steel-toed boots, unlike the peer specialists, who work in regular street clothes, a small but important detail that can signal a more relatable helper for some 911 callers.
The last day on the Street Crisis Response rigs for peer responders, who say their lived experience is central to their expertise, is Aug. 14.
Amelia Harmon, who works with peer responders on the Street Crisis Response Team, has been advocating to keep the positions within the fire department at public health and law enforcement commission meetings, as well as urging city supervisors to step in to reverse the decision.
She said it’s especially urgent after behavioral health clinicians were removed from the Street Crisis Response Team in 2023. Pulling peer responders off of 911 responses is further “chipping away” at the work that she and others have spent the last five years building, she said.
“Removing peers doesn’t cut costs, it moves costs to the most expensive part of the system,” said Harmon, a peer supervisor with RAMS. “Why would we forfeit high-quality care that has mechanisms for federal and state reimbursement in this budget climate?”
The decision to remove peer specialists from 911 responses is also drawing wider criticism from other workers in the city’s homelessness response system and public safety.
“I have personal experience with crisis, and I would rather speak to a non-uniformed peer,” said Joshua Cantero, a case manager at a San Francisco homeless shelter, in a letter to the Board of Supervisors. A peer counselor, Cantero wrote, “makes the clients feel more comfortable and assists with getting them into shelters and making them feel safe.”
It’s not yet clear what will happen next to the peer responders. They have not received layoff notices and could be reassigned to different street teams. Fire department officials said they will continue to refer people to experts with lived experience when it’s appropriate.
Harmon is desperate to keep the peer responders on 911 calls, saying she’s seen firsthand how their approach can be both life-saving and ease the burden for other first responders.
“Why would you cut out the heart and soul of the program,” she said, “and risk burning out your own people?”