Coordinated Street Response Program

Street Crisis Response Teams (SCRT)

All teams operate citywide, 7 days a week, 24 hours a day. SCRT provides rapid, trauma-informed emergency care to people in acute crisis. SCRT teams address urgent behavioral health and wellness issues. They provide access to critical resources like: 

• Urgent care
• Emergency shelter
• Substance-abuse treatment
• Mental health and medical clinics
• Residential programs

SCRT units include:

• Community Paramedic
• Emergency Medical Technician (EMT) or second paramedic
• Either a Peer Counselor or a Homeless Outreach Team (HOT) specialist

Behavioral health clinicians are also a core part of SCRT. They provide follow-up support through the expanded City's Office of Coordinated Care (OCC). They follow-up with people who got a response from an SCRT unit. Follow-up includes care coordination and connections to critical resources.

Street Overdose Response Team/Post Overdose Engagement Team (SORT/POET)

SORT and POET connect with people in the critical moments after an overdose. Community paramedics can start medication-assisted treatments to help people with substance use disorders. SORT also provides: 

• Rescue kits
• Educational materials
• Support to get into substance use treatment and shelter.

Follow-up teams include:

• Street medicine specialist from the Department of Public Health
• Peer specialists
• Behavioral health clinicians

Homeless Engagement Assistance Response Team (HEART) 

HEART provides rapid responses to targeted, non-medical, non-emergency 911 and 311 calls. These calls are for people who are experiencing homelessness when there is no sign of: 

• Crime
• Violence
• Threats
• Mental health or medical need 

Examples include blocked sidewalks or a person loitering in the lobby of a building.  

HEART is a community based team that serves as an alternative to law enforcement. The HEART pilot project is currently funded for one year. 

Homeless Outreach Team (HOT) 

HOT provides support and connections to shelter and housing for people experiencing homelessness. The team works in neighborhoods 7 days a week throughout the City. Teams with expertise on issues that are barriers to stability provide these services.  

Some individuals may not be ready to accept help. In this case, HOT continues outreach so that services are available when needed. HOT coordinates with BEST and Street Medicine teams to ensure people have access to care. 

Teams are not dispatched through 911. People experiencing homelessness can contact 311 and ask how to connect to HOT. HOT only takes requests from people experiencing homelessness. It does not respond to third-party requests. First-person calls or planned outreach have proven more effective than third-party requests.

Bridge and Engagement Services Team (BEST) Neighborhoods 

BEST provides rapid and trauma-informed behavioral health assessment, engagement, and community-based therapeutic interventions. It promotes healing, wellness, and positive community participation.  

BEST Neighborhoods works in assigned neighborhoods 7 days a week. It provides time-limited, focused, and phased interventions to help clients shift to ongoing care and support. BEST is not dispatched through 911. BEST Neighborhoods responds to referrals from street teams including:

• Street Crises Response Team
• Healthy Streets Operations Center
• SF Homeless Outreach Team
• Hospitals
• Jail health
• Street Medicine

The team also assists unhoused people with behavioral health needs in neighborhood "hot spots."

EMS 6 

Works with people who need emergency services the most. Many are experiencing homelessness and face substance use and/or mental health disorders. EMS monitors 911 calls and gets calls from caseworkers to respond to people who need help. They provide urgent care and transport people to the hospital or to shelter.  

The City’s EMS 6 team focuses on people who frequently use the 911 system. It provides intensive, wrap-around care. The goal is to break the cycle of people who rotate from the street to the emergency room and back to the street.

Street Medicine Team 

Serves people experiencing homelessness with medical, mental health, and substance use needs. It focuses on people who are not connected to care. Services include:

• Transitional primary care
• Low barrier buprenorphine

Coordination with other street outreach teams to assess the need for acute medical conditions.

A “street crisis” is challenging to define. It includes someone experiencing a mental health or substance use crisis on the street. They could be:

• Unconscious 
• Not breathing
• Threatening themselves or others

These are medical emergency situations that impact life safety.

A “street crisis” also includes non-emergency urgent situations. This includes:

• Someone with obvious wounds
• People who are lying down or sleeping
• Someone who is inadequately clothed for the weather

Together we can help people experiencing a mental health or substance use crisis on the street. If you are experiencing an emergency or worried about someone’s safety on the street, call 911. For non-emergencies, call 311.

Calling 911 is the fastest way to send lifesaving help. You can help by calling. Call 911 if you see someone:

• Someone Experiencing a mental health or substance use crisis
• Unconscious 
• Not breathing
• Threatening themselves or others

 A highly trained emergency dispatcher will send the appropriate help. 

 The dispatcher will ask you where the emergency is and what is happening. You can say “I don’t know” if you do not know the answer. For best outcomes, if you feel safe stay at the scene so you can provide updates to the dispatcher. If you need to go, you can leave the scene after you make the call.

 Calling 911 does not mean the police will respond. San Francisco’s 911 has invested in alternatives to law enforcement. This helps reduce police response to behavioral health crises.

For non-emergencies, call 311.

There is no easy answer because different situations require different responses. Many factors play into each call. The Coordinated Street Response Program allows us to substitute police response with specialized street response teams. 

Street response teams reduce police responses to people experiencing mental health emergencies. In 2022, less than 3% of calls involving the street response teams required a police response.

Calls will last anywhere from 2 to 10 minutes, depending on the emergency. When you call 911, a trained emergency dispatcher will find out what’s happening. Then they will send the appropriate help. The dispatcher will ask you where the emergency is and what is happening. You can say “I don’t know” if you do not know the answer.

For best outcomes, stay at the scene so you can provide updates to the dispatcher. Stay calm and answer all questions as best you can. Answering questions will not delay response times. If you need to go, you can leave the scene after you make the call.

Situations range in urgency and associated response times. Response times vary based on the 911 dispatcher’s assessment of a situation. For example, for a medical emergency call, the City aims for an ambulance to arrive in under 10 minutes. For a mental health or substance use call, the City aims for a response time under 15 minutes.

We never give up on someone, even if they refuse care. It may take many interactions before we can help a person in crisis. All offers are voluntary unless someone is a threat to themselves or others. Each contact is a chance for us to:

• Build trust
• Understand the person
• Offer more services and support

It depends on the situation. Individuals seen multiple times by street response teams are prioritized for follow-up care. It may take many interactions before we can help a person in crisis. Each contact is a chance to build trust and form therapeutic alliances.