'We Are Bleeding': San Francisco's 9-1-1 Dispatch Struggles amid Staff Shortages

The 9-1-1 call came in the day before Thanksgiving. A person had been found in a bathroom, unconscious — maybe dead. It looked like a drug overdose, and 9-1-1 dispatcher Valerie Tucker was trying to figure out how to save the person's life, if it wasn't too late.

Tucker — now nine and a half hours into an 11-hour shift — had been juggling dispatches to fire department engines, ambulances and crisis response teams inside San Francisco's 9-1-1 call center since 4 a.m.

She had volunteered to come in three hours earlier than scheduled so that she wouldn't be mandated to work overtime in the short-staffed center on Turk Street.

Tucker consulted her counterpart from the fire department on who to send. Not only was the dispatch center short on staff, but the fire department faced similar challenges.

"We're low (on) medics," he said.

Tucker wanted to send an ambulance immediately, but sometimes they have to wait to drop off a patient at city-run San Francisco General Hospital, she said. In the meantime, she dispatched a fire engine with a paramedic on it.

"The whole city is so low on city staffing," she said. "We are bleeding here."

It was just a typical work day for Tucker, whose high-pressure job has only intensified in recent years because of a lack of dispatchers and other first responders. Understaffing at the 9-1-1 dispatch center is so bad that officials internally lowered the city's long-standing goal for answering calls — from picking up 90% of calls within 10 seconds to only 85% last year.

The city's 9-1-1 dispatch center is one microcosm of what officials and workers say is a staffing crisis in San Francisco government, which currently employs more than 32,000 people. Vacancy rates for temporary and permanent positions have more than quadrupled — from 2% in June 2019 to 9% today — according to human resources.

At one of the hardest-hit departments, the port, 27% of positions sit empty. In the much larger health and transit departments, a roughly 10% vacancy rate translates to hundreds of unfilled jobs each.

The city, like others nationwide, is struggling to recruit police officers, sheriff's deputies, nurses and others in a tight labor market. But where San Francisco uniquely struggles is quickly hiring them — taking an average of 255 days.

Mayor London Breed called the timeline "incredibly frustrating" in a blog post Thursday.

The city has recently implemented some common-sense reforms to the arcane civil service process, like letting applicants take required tests on demand online instead of having to show up in person at a scheduled time. Human resource officials have also proposed more changes to the process that they hope will cut the timeline by at least half. The civil service commission will consider approving changes in a Dec. 19 meeting.

Breed wrote, "this is just a first step in what we need to do" and pledged to do more.

But while officials and workers in 9-1-1 dispatch said civil service changes will help, they won't fix all the issues. Chronic understaffing means burnout for front-line employees who often must work overtime to keep critical services running. It also means lower quality services for residents because the city is failing to meet standards for 9-1-1 call response times.

"We're already so short-staffed that when we answer 9-1-1, the first thing that person says is, what took you so long?" Joan Vallarino, a dispatcher for 18 years, told the civil service commission during a meeting last month along with Tucker. "It's really scary."

Robert Smuts, deputy director in charge of 9-1-1 dispatch emergency communications, said he goes to sleep and wakes up thinking about trying to strike a balance between maintaining standards and not burning out hard-working dispatchers.

"That is not an easy call to make," Smuts said.

The issue isn't unique to San Francisco. Oakland's underfunded and understaffed center responded to an even lower percentage of calls within 15 seconds, a recent report found.

In San Francisco, staffing at 9-1-1 dispatch has been a chronic issue. The situation got so dire in 2017 that the state sent a warning letter to the city about call response times, Smuts said.

By that time, the city was already on its way to onboarding more dispatchers and improving call times, but progress backtracked during the pandemic. The city froze hiring for two years and lost about eight employees who did not comply with the city's vaccine mandate, Smuts said. When the city started classes again, it was only able to half fill them, and he expects only half of those will make it through training.

The department wants to have 160 fully-trained dispatchers, but only has 123 now.

"There's nobody clamoring to be a 9-1-1 dispatcher," Vallarino said over the phone on her lunch break during a 16-hour shift the day after Thanksgiving. "We're getting fewer applications. We're hemorrhaging employees."

To help, the department hired a recruiter focused on dispatchers in late October, and since then has already seen a "significant increase" in applications, Smuts said. It still takes a year to train a dispatcher.

Even though the number of 9-1-1 calls hasn't risen to pre-pandemic levels, there are fewer people who must work more hours to keep up.

If no one volunteers for overtime when the center is short-staffed, dispatchers can be required to stay for extra hours, though they can't be required to work more than 12 hours in total, Smuts said. If they can't work extra hours, they receive a written warning that can escalate to suspension in very rare cases, he said.

Tucker, a mother of two, said she once got a written warning when she couldn't stay because she didn't have childcare.

Before last year, Smuts could normally fill staffing with voluntary overtime, but because of "a high number of leaves, quarantines, and some understandable burn-out," he had to start depending on mandatory overtime in August 2021.

To ease the burden, he internally lowered the city's more than two-decade-old standard for answering 90% of 9-1-1 calls within 10 seconds to 85%. The city is still failing to meet that new metric.

The city has also failed since 2019 to meet a separate state mandate to answer 95% of calls within 15 seconds, except for when call volume dropped during the peak of the pandemic.

The longest Tucker has seen an emergency call wait is four minutes. Lower-priority emergencies for complaints about drugs, homelessness or mental illness can wait up to half an hour, she said, leaving her frustrated.

Long hours take their toll, leading to shot nerves, hot tempers and body aches.

"By the end of the week, I run out of the room," Tucker said.

Smuts said dispatchers are taking more leaves than before the pandemic — which workers said was necessary for mental health. Tucker is finishing up two weeks off and Vallarino is taking one day off a week to spend time with her nephew, whom she just started raising, while pulling extra hours on work days.

Mary Ellen Carroll, the emergency management department's director, called dispatchers "some of the most dedicated city workers I have ever met." She tries to connect dispatchers with city resources such as therapy dogs and counseling.

"I will lose more people if I can't also ensure that they are safe and relatively healthy in this job," she said.

Carroll said her department is looking at compensation related to recruitment and retention. A dispatcher's salary starts at just over $100,000 a year.

Dispatchers also said a game changer would be if the city reclassified them as public safety workers who are eligible for early retirement. A recent state law would allow the city to do so, but it would still require a change to the city charter and a significant and yet unknown price tag, Carroll said.

So with change still slow and conditions difficult, why do city workers stay?

Tucker, a native San Franciscan, feels purpose in public service. Vallarino wants to make it to 20 years to secure medical benefits when she retires and help city residents.

At a civil service commission's meeting in November, she asked for support to do just that.

"Please help us help the people that are in this city," she said.

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