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Key Takeaways -- Public safety agencies are examining how changes to 9-1-1 call-taking and dispatching can improve police responses and help accomplish the goals of police reform. -- Innovations include:
Assistant Chief Kevin Hall, Tucson Police Department: Clinicians in Our 9-1-1 Center Have Improved Our Response in Many Ways A couple years ago, we decided to put mental health clinicians into the 9-1-1 center, hoping to get real-time triaging of crisis calls and engaging people in crisis over the phone, rather than sending cops out to handle that. We thought this would be better than a crisis line, which is the most common form of crisis intervention. We had and still have a crisis line, but we thought it would be better to have them in the 9-1-1 center triaging calls and making an informed decision as calls come in about whether it’s somebody who can be de-escalated or stabilized over the phone. These clinicians have access to the different databases of our mental health system. With a name and date of birth, these clinicians can tell what the person’s diagnosis is, who they’re seeing, their case history, and the medications they’re on. They can engage these folks in conversation over the phone, sometimes completely avoiding a call for service from being generated. In the call center, clinicians can look at the calls on their screen, and they know who is taking the call. They can plug in with the call-taker, listen in and talk with the call-taker. One of the most common situations where we use these clinicians is when someone calls in expressing suicidal ideations, but doesn’t have a weapon or a plan, and can probably be stabilized over the phone. The crisis clinician can dispatch a mobile crisis team, which is made up of clinicians, not police officers, to go out and either pick up the individual to take them to the crisis center or stabilize them in the field. Or they might contact the person’s case manager or set up an appointment the next day at the crisis center. Because we’re a Medicaid expansion state, we don’t have to pay for the clinicians. This is an agreement we make with this service provider through our regional behavioral health authority. It’s an extension of the crisis line that they’re already paying for. These folks are at least bachelor’s-degree level clinicians with crisis line experience. This was all ramping up before COVID. When COVID hit, the parent company that oversees this service provider pulled the clinicians out of the 9-1-1 center to protect their health. It took a little while to make it work, but we’ve now enabled them to remotely go into our CAD system and see our calls. They’re now doing the exact same thing they did before, but they’re doing it from their homes. Criteria-based dispatching: Criteria-based dispatching is something we started looking at a couple years ago. Basically call-takers are given “cards.” For example, if a call involves a shooting, a “shooting card” will pop up with a script for them to read, so that they know exactly what questions to ask. That electronic card immediately goes to dispatch. It reduces the time needed to get information and makes the questions more consistent. We looked to Washington, D.C., because they have perfected this. The system is built so that call-takers can skip questions if they’re not relevant, and there’s also a free-form box, so if the situation doesn’t fit the questions in some way, they can type into the free-form box and that goes into the call text. Rebecca Neusteter, Executive Director, University of Chicago Health Lab: Criteria-Based Dispatching Makes the 9-1-1 Response More Consistent A couple years ago, I started trying to understand what was driving the demand for police services in communities. The best way to measure that, and the best way to understand how officers are spending their time, is through calls for service. I had the privilege of working with the Tucson Police Department and Camden County, NJ Police Department to study their CAD data and understand what was driving their calls for service. We found that the vast majority of calls for service didn’t involve a crime at all. And when they did, it was rarely a crime of violence or a serious crime in progress. We started asking whether the police are the most appropriate responders to those calls, recognizing that many of the calls involve underlying causes or symptoms that go far beyond the mission and resources of most police departments. Police dispatch switchboards really define what the workload of officers looks like in a community. But those are often some of the least understood and least appreciated forms of data in policing. Tucson and Camden have implemented reforms in call-taking over the past few years. Tucson’s most recent change relates to criteria-based dispatching. This is quite common on the fire side of call-taking and dispatching. It presents call takers with a more formalized logic model and decision tree, so that there is a more consistent set of questions asked of callers when they dial 9-1-1. It has a set of scripts that call-takers follow. So if two call-takers take the same type of call, criteria-based dispatching offers a greater probability that the calls will be processed in a similar manner. Without that script and logic model in place, we see a great deal of fluctuation in how call-takers prioritize and classify calls, partly because some jurisdictions have very large numbers of codes for how calls can be classified. We know that makes it more difficult to determine which buckets to put them in. Criteria-based dispatching and call-taking should ensure greater uniformity. For example, without criteria-based dispatching, questions may be asked in any order, based on how a call taker’s conversation with the caller is going. That may result in a more organic conversation, but important questions may not be asked, or they may not be asked in an order that allows for a heightened priority level. And there can be a lack of uniformity in collecting information and making sure the information is being captured in the CAD system. If information is left out of the CAD system, it puts the responding officers at a huge deficit and sometimes in danger. In terms of reducing police use of force, there are a handful of improvements we can make to the system, such as highlighting the most salient pieces of information on the screen. 9-1-1 systems often don’t make the most important information stand out to officers. We also default to sending the police to anything that isn’t a fire or medical issue. We should think about the response mechanism, and whether or not police are always best-equipped to de-escalate an incident. Laurie Flaherty, Coordinator, National 9-1-1 Program: IP-Based 9-1-1 Systems Are More Flexible The part of Next Generation 9-1-1 that gets the most attention is the ability of the system to receive, process, and share multimedia information. Right now, the 9-1-1 system is limited to voice and, in some cases, text messaging. That changes when you move to a digital Internet Protocol-based model. If it’s digital information, it’s possible to share that with the 9-1-1 center and then out to the field. That has the potential to add relevant, actionable information that could be used to make the response more efficient, more effective, and safer. States are at varying levels of implementation of the components of Next Generation 9-1-1. No jurisdiction has completely implemented it, with both the infrastructure upgrades and the applications that would run on that infrastructure. Before the advent of Next Generation 9-1-1 and an Internet Protocol-based model, none of the 9-1-1 centers could connect to each other. They all had to be independent operations. That resulted in a very decentralized structure, and that means there’s wide variability in terms of Computer Aided Dispatch (CAD) and their protocols and operating procedures. Only with the advent of Next Generation 9-1-1 have 9-1-1 centers realized that if they’re going to share data, it makes sense to do things much more consistently and in a collaborative manner. We don’t have a hard number, but there are somewhere between 50 and 200 CAD vendors, and there’s no standard for how CAD is built. That builds wide variability in the system, including what information it is possible to enter into the CAD system. During COVID, we’ve seen alternative responses for different reasons. Technology is being used to redirect non-emergency COVID calls to alternate responses, such as telemedicine or nurse triage lines. So the technology is there, but it requires changing 9-1-1 centers’ standard operating procedures and training their staffs. A lot of places have done that on the fly during COVID. It’s entirely possible to put alternative response plans in place if you have the right people to figure it out.
The PERF Critical Issues Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.
PERF also is grateful to the Howard G. Buffett Foundation for supporting this work.
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