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San Francisco’s Terrifying Ambulance Situation and More Good, Bad and Ugly Grades for City Services

Written by Maryann Jones ThompsonPublished Dec. 06, 2022 • 12:00pm
Illustration by Lu Chen

Editor’s Note: Every month, The Standard’s “State of the City” analyzes the outlook for San Francisco by monitoring data on the city’s economy, health, crime, housing and other key performance indicators.

It’s never easy to grade yourself. And given the post-pandemic challenges San Francisco is experiencing, an honest self-assessment is that much more difficult.

But that’s just what the Office of the Controller released yesterday: a full audit of the city’s performance for 800 different service areas, from street cleaning to law enforcement to homelessness to library circulation.

The Annual Performance Results report is produced by the City Services Auditor, the internal analyst and independent auditor for SF’s $14 billion budget. The group works with all city departments to set quantitative benchmarks for success and then monitor progress toward those goals.

The 78-page document details how the city performed during its 2022 fiscal year, which ran from July 1, 2021, to June 30, 2022. Translation? Most of the data is nearly six months old—a lifetime ago in today’s San Francisco. But the report provides a citywide look at a specific point-in-time on the full spectrum of SF operations. (The most recent data for dozens of key indicators can be accessed on the CSA’s online Performance Scorecards.)

Don’t have time to read the entire volume? Here’s the SparkNotes.

The ‘Great’ of San Francisco Public Services

Given the extraordinary challenges SF is having as it adjusts to post-pandemic reality, it’s fair to point out where the city is far exceeding its own goals. These strengths hold up the many reasons why residents love living in the city: captivating libraries, world-class parks and a geography blessed by fresh air.

The city deserves to pat itself on the back for its high marks in health care for residents. Its health networks are well-subscribed and show increasing patient satisfaction. And though not part of the official audit benchmarks, SF’s response to managing both the Covid and MPOX outbreaks was outstanding.

The ‘Good’ of SF Public Services

There are many areas where San Francisco’s services have recovered from the pandemic and now meet or exceed goals that were in place prior to Covid. In the transportation safety arena, Muni drivers have decreased accidents, and law enforcement has increased citations for the most dangerous types of driving in the city.

The city also helps its citizens tread lightly in terms of their environmental footprint. San Franciscans have not increased their usage of water or landfills and continue to increase their recycling and composting.

The ‘Bad’ of SF Public Services

It’s no surprise to San Franciscans that the city is missing the mark in providing key services to residents. The Controller’s Office says problems with many of these departments stem from chronic understaffing: Job vacancies for roles across the city stands at 9%.

As of the end of June 2022, requests for street cleaning have increased a whopping 20% over the prior fiscal year. It comes as no surprise that the city cannot keep up with the need for service, dropping its response rate by a full 10 points.

Auto theft and other types of property crime have jumped significantly over the past fiscal year, which covered the majority of the pandemic. Though any increase in crime is bad news, the good news is that property crime has not quite reached pre-pandemic levels—though it is darn close.

Finally, Muni continues its struggle to return to pre-pandemic service, significantly missing its on-time and service-hours goals.

The ‘Ugly’ of SF Public Services

Most sadly, the city still cannot take care of the citizens who need its services the most: Residents in need of emergency care and individuals in crisis or living on the street. Human lives are on the line if the city can’t urgently address these critical issues.

Ambulance response and 911 call answering times continue to miss their marks, in many cases due to staffing shortages. However, the report says the SF Fire Department recently completed the hiring of 60 additional full-time employees that were allocated during the last budget cycle, which may improve this mark in the months ahead.

Only 86% of ambulances arrive within 10 minutes to life-threatening emergencies. And when patients make it to Zuckerberg SF General Hospital, the beds run at an average of 102% occupancy—a mathematical impossibility that is supposed to clock in under 95%.

Despite the Safe Streets program Vision Zero’s goal of zero traffic fatalities, 2022 had already hit 30 at the end of October, more than 2021’s tragic total of 27.

Violent crime also jumped during the last fiscal year. Though, as with property crime, its levels have not yet reached pre-pandemic numbers, violent crime is always a major concern. 

Finally, the city continues to fail its unhoused population. The city’s goals for the number of direct exits from homelessness were not met—and neither were its targets for substance abuse and mental illness treatment. Despite increased spending and many new initiatives, the sad reality of homelessness continues to vex San Francisco.

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