San Francisco Launches New Street Crisis Team to Support People Experiencing Homelessness

The new team will serve the City’s unhoused community experiencing non-emergency and non-medical issues as part of the City’s broader street response
May 30, 2023

San Francisco, CA – Mayor London N. Breed today announced the City’s launch of a new pilot program that will serve as an alternative to law enforcement response for non-emergency calls involving people experiencing homelessness in need of a higher level of care. The new Homeless Engagement Assistance Response Team (HEART) is a community-based team made up of Urban Alchemy practitioners.   

Under the direction of the City’s Department of Emergency Management, HEART will provide rapid, compassionate, and structured responses to targeted, non-medical, non-emergency 911 and 311 calls involving people who are experiencing homelessness. Historically, the San Francisco Police Department (SFPD) has responded to all calls, but as part of the City’s work to divert certain types of 911 calls, HEART will replace law enforcement responses.    

This new team will broaden the City’s comprehensive street response effort. Existing street response teams may differ in specialty and mission with teams consisting of mental health clinicians, medical staff, community paramedics, EMTs, social workers, and peer counselors. For example, the Street Crisis Response Team responds to emergency behavioral health calls for this in immediate crisis. HEART will work in coordination with those teams under the coordination of DEM.    

“The new HEART team is part of our work to further build out our street response effort to help those struggling on our streets,” said Mayor London Breed. “Addressing homelessness isn’t just about adding new shelter or housing – it's also about meeting people where they are to get them connected to those resources. This is hard work, but it’s how we will make a difference in people’s lives and in our neighborhoods.     

San Francisco has a variety specialized teams that work in coordination to address mental health or substance use crisis calls, medical health and wellness, and street-condition-related matters. These teams are extensively trained in trauma-informed care, motivational interviewing, cultural competency, and de-escalation.    

DEM will oversee HEART field operations together with Urban Alchemy, including routine collaboration to identify system and program needs, and to ensure integrity and consistency of services being delivered to the unhoused community. The team will operate seven days a week: Monday through Friday, 7 a.m. - 7 p.m. and 7 a.m. - 3:30 p.m. on weekends. Currently, HEART has one-time funding of $3 million, which was allocated in the FY 22-23 for a one-year pilot.    

“San Francisco is a national leader in developing and implementing alternatives to law enforcement, and it is essential that we invest in compassionate responses to people experiencing street homelessness,” said Mary Ellen Carroll, Executive Director of the San Francisco Department of Emergency Management. “We look forward to piloting the HEART program over the next year as we continue to work to reduce the need for police to serve as the primary responder for people experiencing a crisis on the street.”  

"Urban Alchemy puts those who have experienced trauma front-and-center to support our most vulnerable populations. Our model uses empathy and compassion to make our streets safer while providing services and support to those most in need,” said Dr. Lena Miller, CEO of Urban Alchemy. “Community-based safety has been the missing piece to the puzzle, and we are proud to expand our partnership with the City to lead this pilot program to better support San Francisco’s unhoused community.”   

HEART practitioners are first required to complete specialized training prior to deployment as part of the team’s focus working with those in the unhoused community that need a higher level of care, including:  

  • Trauma Informed and Strength Based Care  
  • Cultural and Gender Awareness  
  • De-escalation  
  • Harm Reduction  
  • Self-Care and Wellness Safety  
  • CPR and First Aid  
  • Naloxone Training  
  • Needs & Engagement Assessment  
  • Services Linkages  

What will HEART do?  

HEART will view experiences of homelessness through a trauma informed, compassionate and strength-based lens that will work to integrate a range of motivational and empowering strategies with a goal of building trust and productive engagement. Services include:  

  • Client Engagement  
  • Assessing and helping clients meet their immediate needs (shoes, clothes, wheelchair, etc.)  
  • Documenting longer term service linkage needs  
  • Coordinating with other San Francisco’s specialized street response teams and other city services that result in greater stability and safety for the client 

HEART will consist of four practitioners and one supervisor per team that will respond to citywide non-emergency calls. The pilot program will begin with four teams. Dedicated HEART care coordination services will provide longer term linkage support with other support providers. The practitioners will be required to respond to a minimum of 100 tickets per week, and DEM and UA will review call needs & outcomes within the first 30 days of the program’s launch and adjust call completion expectations accordingly.  

As part of the pilot program, a monthly data report will be produced that aggregates call volume, types, completed needs assessments, call dispositions/outcomes, and response time, and data re: requests for assistance from public safety, fire/medical/SCRT, and HSOC. The information will be segmented by neighborhood. A narrative section of the monthly report will summarize progress, success and challenges. The City will work with Urban Alchemy to review these reports during routine check ins, spotlighting opportunities for improvement.