79 frequent 911 callers cost Sacramento Fire $12.5M over five years

# Overview

# Scale and cost Those 79 people accounted for an average of 12% of the city's EMS time each year while amounting to about 0.014% of Sacramento's population. The cumulative financial toll over fewer than five years was calculated at $12.5 million. At the same time, budget constraints recently left as many as eight fire engines out of service, reducing surge capacity.

# Who are the high utilizers Most of the frequent callers were people experiencing homelessness with complex medical, mental health, or substance use challenges who lack access to ongoing care or medically capable shelter. A subset were housed seniors with mental health needs and limited social supports. City officials and frontline health workers framed the issue as a failure of the broader care and shelter system rather than a moral failing by callers.

# Operational impact

# Department response and alternatives Fire Department staff are developing an alternative response program that coordinates medical care, behavioral health support, and social services to address root causes and reduce repeat 911 calls. Officials said several of the high utilizers have since moved into more stable environments as a result of those efforts. The program is described as data-driven and focused on connecting people to the right provider at the right time to reduce future emergency calls.

# Policy proposals and legal options

# What this means for public safety Repeated emergency responses to a small group of people are consuming measurable EMS resources and contributing to slower response times for other residents. Sacramento's approach combines an operational alternative response model with proposed legal and partnership changes aimed at enabling compulsory treatment in narrow cases and improving coordination between medical, behavioral health and shelter systems.

# Bottom line The situation links emergency services strain to gaps in outpatient and shelter capacity. Sacramento is testing an on-the-ground alternative response program while pursuing legal and intergovernmental changes intended to reduce repeat 911 use and free up emergency resources for time-sensitive incidents.