Interdepartmental coordination is genuinely difficult — nobody should pretend otherwise. But this is a fixable problem, and fixing it well would do more than repair what's broken: it would put San Francisco at the forefront of alternative crisis response.
See the seven recommendationsThe Collaborative Framework is a set of seven recommendations for how San Francisco can run its Street Crisis Response Team well. City leaders already have an 80+ page version of this — give them your thoughts after you read through them yourself!
None of these are radical. Most are the kind of housekeeping that never gets done because it sits between three departments and belongs to none of them. Taken together, they turn a program that was assembled in an emergency into a permanent, professional part of the 911 system.
Each one is written here the way you'd explain it to a neighbor. The full booklet, with the detail and the sourcing, is at the bottom of this page.
Right now the people doing street crisis work are employed by different organizations, which means different pay, different training, different rules, and different computer systems — on teams that are supposed to work the same call together.
Pick one employer for all the peer staff, and build it around the expertise already embedded in the 911 system. The peers running these calls today hold institutional knowledge no job posting can recreate — which streets, which shelters, which people, which approach works at 3 a.m. Keep everyone's database access intact so they can actually help someone on scene, and structure it so the City can bill Medi-Cal for this work instead of leaving that money on the table.
Why it mattersOne team should feel like one team — and the state will help pay for it.Peer support spans everything from a warm line to a 911 call, and street crisis response sits at the very top of that range — the highest-acuity work in the profession. It should be treated that way. Prior peer counseling experience belongs on the job requirements for this truck; it is not an entry point into the field, and it never should have been staffed as one.
Create clear levels a worker can climb, with training that arrives in tiers rather than all at once, and real first-responder training attached to each step: the crisis responder academy, EMT certification, and crisis intervention training alongside police. New hires start on the new standard immediately; people already doing the work get a fair runway to meet it.
The field is writing these standards as we speak — SAMHSA's national model standards for peer certification, and California's own competencies for peer services in crisis care, published this March. San Francisco can build a tiered standard while that work is still taking shape and help define it, or wait and spend the next several years catching up to a benchmark someone else set.
Why it mattersThe hardest peer work in the field should carry the highest standard — and the city that gets there first helps write it for everyone else.Shifts overlap — there's a window each day when every unit is on the board at once.
Use it. Run drills, walk through real cases together, practice hard scenarios. Training happens on the clock without pulling a single unit off the street.
Why it mattersBetter-trained teams, zero loss of coverage, no new money.Cities all over the U.S. are building alternative crisis response programs right now, and they are learning things — some of them the hard way.
Meet with those colleagues twice a year, every year. When the research shows something works, adopt it. When it shows something doesn't, stop doing it.
Why it mattersSan Francisco shouldn't have to relearn lessons other cities already paid for.This sounds trivial. It isn't. Crews need one reliable place to pick up and drop off their vehicles, with basic facilities — a bathroom, somewhere to sit — at the start and end of a twelve-hour shift.
Sign a written agreement for a local secure lot, or otherwise designate a single fair location.
Why it mattersSmall logistics failures are what actually burn people out.Peer counselors are on contracts. A permanent 911 resource shouldn't be staffed by people whose jobs can quietly disappear — which is precisely what just happened.
Reserve the language now for a permanent civil service classification, paid on par with a Health Worker IV, that lets workers rotate through different parts of the care system over a career.
Why it mattersPermanent roles mean accountability, retention, and a workforce the public can count on.Everyone has an opinion about whether this program works. Almost no one has data, because nobody agreed in advance on what to count.
Spend six months establishing a baseline, then collect eighteen months of data, with the Controller's Office or an outside university checking the work. Design it so the answers land in time to shape the 2029 budget season.
Why it mattersDecisions this big should be settled by evidence, not by whoever is loudest.These recommendations only matter if the people who make the decisions hear from the people who live here. Build a message in a couple of minutes and send it to the offices that decide.
Tell them what you think → Opens the message builder on the home page.Page 7 of the Collaborative Framework, as circulated to the commissions in July 2026. Prepared in individual capacity.