Blueprint for Action

The Transform911 Blueprint for action born of this work is described below. First, however, it is important to ground our recommendations in several key considerations of Transform911 itself: Transform911’s north star, operating definition of 911, and what we mean by the language of “community.”

Transform911 North Star

Transform911 envisions a 911 system that equitably and reliably increases access to wellbeing for those who need emergency assistance, the professionals who staff 911, and those deployed to respond. We build on the extraordinary and positive innovations in the field to address the challenges and inequities that are within our reach and control, recognizing that the change we envision cannot happen without shifts in the systems and communities that 911 serves.

Defining 911

The definition of 911 is “a telephone number used to reach emergency services, [such] as the police, the fire department, or an ambulance.”^[1] This definition is currently employed by 911 and other emergency crisis professionals. Transform911 has employed a broader definition, one that is more in line with the general public’s perception of 911. Transform911 defines 911 as the system that, when working at its full potential, provides members of the public (who are) facing acute threats to their wellbeing with appropriate, equitable, relevant, immediate, and around-the-clock access to relief from distress. 911 is a complex system requiring expertise, communication, coordination, resources, and trust to span

• the diverse cultural, historical, linguistic, and other realities across and within America’s communities;
• the methods by which users initiate the request for assistance—be that by way of a telephone call, text, or other defined mechanisms;
• the call-taking, call-handling, and dispatching procedures; and
• the response—be that by virtual or on-scene traditional (i.e., EMS, fire, or police) and/or other sectors of the first-responder ecosystem.

How We’re Understanding Community

For the purposes of this work, there are several distinct and overlapping communities. Diverse community members who access 911 and related services and the people who are impacted by them nationwide are a discrete community for which Transform911 has sought intentionally to include through workgroup membership, recommendation development and reaction, and as the beneficiaries (i.e., they have something to gain or lose by way) of the recommendations. Other communities that have a vested interest in Transform911 specifically and 911 more broadly are 911 professionals, traditional and alternative first responders, healthcare professionals, and policymakers. Throughout this work and this blueprint, the call for inclusion, partnership, and power is particularly salient for those communities that have been historically marginalized, the most impacted, and closest to the inequities and harms of our systems.

Transforming 911

The reality of 911 in many communities is far from achieving these definitions. We find ourselves with a 911 system that is

• under-resourced;
• under-staffed;
• not understood by the general public;
• not well positioned to nimbly adapt to future needs; and as a result
• often ill equipped to adequately triage and deploy resources to ensure the right response is dispatched at the right time.

911 is also situated in a larger context of systems that have historically responded to people very differently based upon personal characteristics and geographies.^[2] Differences in responses and outcomes have contributed to, and in some instances resulted in, some people and communities fearing 911 and opting not to use this system no matter how dire the crisis may be.^[3] Transform911 and this blueprint are working to identify these challenges and offer practical solutions toward addressing them. These efforts work to solve the challenges facing the 911 system by simultaneously recognizing and building on the passion, knowledge, and infrastructure already in place, while also taking a clear-eyed look at where the current system is insufficient or even counterproductive to addressing community needs. We weave this together in the recommendations that follow.

The current 911 system holds many tensions. It is a highly personal, nationwide resource. It is ubiquitously known and simultaneously completely misunderstood as one unified national system and universally as part of the policing system. Recognizing and building upon these tensions is at the core of transforming 911.^[4] In doing so, this blueprint operationalizes seven essential recommendations to transform 911 for public health, safety, and justice.

Taken together, these recommendations outline seven essential tenets to support both the 911 system and the communities it serves today and in building for the future. In transforming 911, it is essential that 911 services operate independently from and equal to other public safety agencies and that any person be able to access immediate help through 911 at any time and in any place. To achieve this essential state, we must support, elevate, and invest in the workforce; provide more responsive services that are transparently explained to callers in real time; advocate for the implementation of national minimum standards, practices, and procedures; use data more effectively, and invest in robust resources that respond to community needs.

The time to transform 911 is now. Our nation’s equitable and effective access to wellbeing hinges upon prioritizing the seven recommendations outlined in this blueprint. The recommendations are not stand-alone provisions; they are designed to be implemented in unison and with fidelity. They require an investment of critical resources, most importantly the time and attention of community members, practitioners, stakeholders, and policymakers, who are all needed to transform this critical system. The recommendations in this blueprint respond both to the current as well as the future state of 911.

The Future is Now

The Transform911 Blueprint attempts to be clear-eyed about the current limitations of our nation’s 911 system—which in many ways is antiquated and inadequately resourced—while advocating for the recommendations that are necessary to support the rapidly changing conditions that drive needed changes and required investments. We must also acknowledge where and how our nation’s 911 system can be improved to enhance access to wellbeing today and to set the system up for success in the future.

For example, as demographics and populations change over the next few decades, the 911 system must strive to respond to that new cultural landscape. For example, the US population is aging,^[5] which will likely result in increases in calls for both 911 and 988 services as elders are more likely to fall and experience health crises related to chronic illnesses such as heart disease and dementia that can lead to crises. Furthermore, the US population is becoming more ethnically and racially diverse,^[6] which may increase the need for non-police responses such as peer- and community-based crisis response and mental health treatment. The reason for this is that some immigrant populations, Black people, and other people of color may be fearful of police and law enforcement institutions and thus less likely to call 911 for mental health and other crises.^[7],[8] The 911 workforce is predominately white; as the population becomes more diverse, the 911 system must respond by seeking to become more inclusive and diverse.

Climate change will also impact the nature and type of calls 911 receives. For example, pandemics will be more common^[9] as the planet continues to lose biodiversity, the climate will become hotter,^[10] and we will experience more flooding as sea levels along the coastline rise.^[11] With these projections in mind, the need for fire and rescue services will increase alongside the need for immediate medical assistance.

And finally, the future of work itself will change substantially as technology continues to drive innovation. In many locations, as much as 80% of calls to 911 come from cell phones, representing a major technological change. In the near future, text, the internet of things, wearables, and other technology are expected to expand the types of data flowing to and through the 911 system.^[12] 911 systems in many communities are not well equipped to handle these different inputs effectively. Furthermore, augmented intelligence, automation, and more will eliminate whole classes of jobs—potentially including elements of the 911 system—and create the need for whole new workforces.^[13] According to the Bureau of Labor Statistics, the 911 workforce alone is expected to grow by 8 percent from 2020 to 2030, with an average of almost 10,000 openings projected each year, over the course of the next decade, not factoring in the areas of the 911 system’s larger workforce ecosystem, such as 988 and other hotlines, as well as growth in the traditional and alternative first responders fields. This larger first responder workforce ecosystem is explored in greater detail in chapter five of the blueprint.

The impacts of technology changes go beyond workforce challenges. For example, NG911^[14] will change the nature and type of information that can be shared with ECCs, to include video and text, as well as offering cloud-based data systems that enable information sharing across ECCs and other agencies. These innovations increase data vulnerability^[15] and affect caller privacy.^[16]

Seven-Point Plan to Transform 911

The 911 of the future—the 911 that America needs and deserves—is within reach but will only happen through the concerted efforts of the general public, policymakers, and the deeply committed 911 professionals who are the backbone of the system.

In charting a course toward this vision of 911, we have built on the evidence base, promising practices, and the wisdom of a growing group of deeply invested stakeholders. We have taken economics and history into account, as well as where there is tremendous strength and momentum to build on. We have also worked hard to prune away a host of important, but perhaps less impactful, tactics and recommendations.

We are calling for seven mutually reinforcing strategies, or “recommendations,” essential for reaching the vision of 911 we put forward:

1. (Re)Introducing 911
2. Putting the People in 911
3. Advancing the Workforce
4. Making 911 Independent and Equal
5. Ensuring the Right Response at the Right Time
6. Strengthening Data and Tech Standards
7. Securing National-Level Support (for 911)

Below, we introduce all seven recommendations and the rationale for each. Following this overview, we provide a chapter for each recommendation with more discussion and detailed, deeply considered action steps necessary to advance that recommendation, reflecting the concluding work of each workgroup and national feedback and input.

For some readers, one or more of these recommendations and action steps may feel obvious, others less so. You may even initially disagree with some of them. This blueprint serves as an invitation for leaders and other interested parties who recognize the importance of 911 in their communities to join us in aiming for Transform911’s north star through considering and working to implement the following recommendations.

1. (Re)Introducing 911

Everyone knows the number, almost no one knows how it works.

What are we calling for? We are calling for a multipart national outreach, education, and visibility campaign to reintroduce 911 as a system and as a profession that is an essential gateway to the care infrastructure of America.

Why is this essential? While 911 is ubiquitous, what 911 does and how it operates is not well known. As is so often the case, perception often becomes reality, such as 911 being perceived as an enforcement or policing response. Too many people think 911 is just a switchboard not meriting particular skills or expertise by call handlers.^[17],[18] It’s everywhere, and when it doesn’t work, the general public assumes that’s the fault of the people who work in the system, rather than a symptom of systemic failure or disinvestment. System failures include inadequately resourcing response options to ensure the right responder can be deployed at the right time, to technological system failures that can result in deploying responders to the wrong address, or to not having a reliable address to deploy a response at all. The result of people not knowing how the 911 system works, along with knowledge in terms of its functioning and vulnerabilities, is that the 911 system is misunderstood by a broad swath of America.^[19],[20] This recommendation reflects the need to clarify what 911 is and isn’t, and to build the constituency, visibility, political will, and enthusiasm needed to realize and sustain a highly effective and imperative system that contributes to public health and community wellbeing.

2. Putting the People in 911

Community partnership is essential to a 911 system that works for everyone.

What are we calling for? We are calling for structures and practices that create deeper and more transparent partnerships between Emergency Communications Centers and the communities^[21] they serve, with particular attention paid to demographic or identity communities who may have differential experiences and understandings of emergency response systems (including but not exclusively 911). We are calling for intentional, integrated community voice and leadership at critical points in the system to facilitate shared, though inherently not equally weighted, responsibility in system outcomes.

Why is this essential? 911 is a vital resource for the general public, but its operations and outcomes are often experienced as opaque by that same public, who may not know exactly how to get the data and information they seek. This results in a 911 system in which accountability and transparency currently aren’t consistently available to the public. Ensuring that 911 is equitably accessible, effective, and responsive requires partnering with the people and communities who are served by the 911 system to help each caller achieve wellbeing and relief from distress for themselves and for those around them.

Focusing on community is a full recommendation because designing and implementing by, for, and with community is deeply countercultural in many systems in America, including 911. Distributing power and accountability with the broader community, particularly those communities currently less likely or willing to call 911, will not happen without purposeful, sustained effort. Even with the best of intentions, such efforts can flounder and create whole new harms when sprinkled on to existing practices. Community members are true assets; they are resources and serve as supports to each other and can be to public safety agents through trusting alliances. Building alliances with the public involves educating the community about how the 911 system works and engaging the community, particularly marginalized community members where disparities are prevalent. Seeking out and listening to the expertise of people about their lived experience and engaging that expertise and insight to continuously examine relationships, practices, policies, and structures allows for the development of a relevant, accountable, effective, and curative emergency response system.

Those who have been adversely impacted by a system have a unique and critical perspective on what would heal or help. Likewise, 911 professionals who have expertise in response protocols and processes are well positioned to make decisions about these elements. However, both group’s experiences have historically been left out, resulting in ECCs that are not reflective of and appropriately responsive to the people who serve in and are served by ECCs. ECCs must therefore adopt mechanisms that allow for community voice and accountability to the people served, as well as to 911 professionals.

3. Advancing the Workforce

There’s no 911 without a recognized, supported, professional workforce.

What are we calling for? We are calling for 911 professionals—who are critical to the functioning of the entire 911 ecosystem, from call-taking to field responses—to have access to high-quality, consistent minimum training, wellbeing support, compensation, and career paths, commensurate with the reality that they are professionals and the first, first responders. This requires reclassifying 911 professionals from “administrative support” to “protective service” and addressing local and regional barriers to recruitment and retention, including factors that impact attracting and retaining diverse staff reflective of the communities they serve. This also requires building response networks to understand and fill out the ecosystem of needed responses, including hiring people with lived crisis experience and preparing them adequately for the work.

Why is this essential? The wellbeing of the public requires that their calls to 911 be handled by trained professionals who receive support in equitably handling the tremendous traumas of the profession and whose compensation and benefits are reflective of the requirements of the position. 911 professionals make consequential decisions under highly stressful conditions; their decisions have ramifications across the entire response ecosystem. Compensation and clear opportunities for advancement in the field are essential to minimize turnover and support strong agency culture. Other first responders in the ecosystem are under-resourced and require similar considerations: needed minimum training and standards, parity in pay and benefits, and support for experienced trauma. Currently, however, few of these elements are in place, which significantly compromises the entire first response system.

Moreover, Emergency Communications Centers nationwide are facing staffing shortages, with many below 50% of optimal staffing levels.^[22] Retaining staff through ongoing support and even retraining will save money over time as turnover is reduced and the need to conduct costly recruiting and training of new staff is minimized. First responders—including 911 professionals—deserve respect, safety, support, and a living wage. Building up a 911 workforce that is dedicated, compassionate, prepared, and supported by internal leadership and the public alike will set us on a path to wellbeing for public safety workers and the communities they serve.

4. Making 911 Independent and Equal

ECCs that are independent and equal to other local first response systems help improve equitable outcomes.

What are we calling for? We are calling for local 911 Emergency Communications Centers to be independent and equal public safety departments equipped to tap a diverse range of responses to best match the response to each emergency. This requires removing the default to police or another system common in many communities when ECCs are housed within law enforcement or another emergency response agency.

Why is this essential? The mission and function of ECCs across the nation have transformed from simple information transfer stations to critical points in the public safety incident life cycle where resource deployment and tactical decisions are made. The leaders of these agencies need autonomy to address issues that affect the greater public safety mission of a jurisdiction that has proven practically and politically difficult when ECCs are in a subordinate position (usually within or to police and/or fire).^[23] An experienced emergency communications professional should be in an equal position to fully inform elected officials, governing bodies, and the public without fear of recourse or concerns about being minimized or questioned by other public safety agencies.

5. Ensuring the Right Response at the Right Time

A diverse ecosystem of responses reduces reliance on the police by default.

What are we calling for? We are calling for significant investment in a diverse ecosystem of response options so that callers can be met with the right response at the right time. These response options can and should include the availability of experts in triaging crises in ECCs as well as connections that enable 911 professionals to transfer calls to hotlines or virtual and on-scene responders skilled in managing a host of community needs, including homelessness, mental health crises, substance use crisis, and domestic violence.

Why is this essential? People call 911 for a wide swath of reasons, ranging from noise complaints to mental health crises to requests for information and much more, and though only a small fraction require a law enforcement response, nationwide 911 professionals do not have a diverse ecosystem of responses to deploy. For this reason, it is critical that the 911 system move away from police as the default response by tapping into a more robust, relevant ecosystem including, but not defaulting to, police. This transformation is essential to ensure that 911 can provide access to a full range of appropriate immediate responses around the clock to support callers’ wellbeing and relief from distress when their social networks and the people and resources around them are not sufficient to address the crisis appropriately.

6. Strengthening Data and Tech Standards

Reliable and ethical data and tech improves responses.

What are we calling for? We are calling for uniform 911 minimum data standards and improved data collection practices, as well as the development and maintenance of transparent, consistent policies on the ethical use of technology and data in emergency response. This covers data privacy and algorithmic transparency for software systems built around emergency response data. Furthermore, we are calling for the adoption of clear and specific guidelines for standardizing, sharing, and making available emergency response data across the nation.

Why is this essential? Variances in data collection and transparency processes across jurisdictions, and the lack of a national 911 data collection effort, have hampered our ability to leverage data in the current state of things. Innovation and rapid, nationwide systemic improvements are made possible when data on emergency calls, responses, and outcomes are made available.

While we hold data transparency as a core value, we also recognize that emergency call data does include a host of highly sensitive and personal information. Callers to 911 must have the peace of mind that their wellbeing will not be undermined through the sharing of information that they assumed was private. Ethical and transparent communication and methods around getting caller consent for response and sharing information is essential.

Modern emergency management relies on the deployment of modern technology, not only to manage the response to emergencies, but to ensure that the public is able to access emergency services through technological means that work best for them. Ethical deployment of tech includes increasing equity in 911 coverage, as much as possible, for example, by using things like tele-response in rural and tribal areas.

The future will bring further developments in augmented intelligence, but as more and more information produced by automated systems is used to guide decision-making, it is essential that the algorithms employed are transparently developed and examined for inequitable outcomes. In short: if automated systems are guided by the inequitable decision-making processes of the past, inequity will be further baked into our systems.

7. Securing National-Level Support (for 911)

Effective, equitable emergency response locally requires unequivocal support federally.

What are we calling for? We are calling for federal, executive branch leadership to embrace and advance the transformative changes outlined in these recommendations. Specifically, we are calling for the president to create a time-limited 911 center and directorship by December 31, 2022, along with a federal interagency taskforce—to also include the relevant federal agencies, as well as local 911 and other related field leaders—and a National Academy of Sciences (NAS) panel. The emphasis on time limitation is made because a permanent federal home for this center should be carefully examined and ultimately recommended by the NAS panel to establish where it can best be located to serve the needs of callers and the workforce; to coordinate complex processes among the many federal, state, and local partners; bolster federal support; and weather political leadership changes. There are many considerations for 911’s long-term success that will need to be carefully considered before this center should be established.

While we strongly believe that federal leadership and guidance are critical for the transformation of 911, we emphasize that we are not calling for the federalization of the 911 emergency response system. Provision of services and authority to deploy them so should remain at the local, regional, or state level. We are calling for federal guidance and resources to support local leadership (see chapter nine on national support), to promote more direct connections to the community (see chapter four on the people), and to make a significant financial investment in this long-overlooked aspect of the emergency response system.

Why is this essential? Our nation’s 911 system currently functions through a patchwork of thousands of locally operated ECCs, with oversight and support split across many different federal, state, and local agencies. Local control and relevance are essential (see chapter six on independent and equal 911). But without national minimum standards to align operational procedures and ensure communication and coordination among jurisdictions, the possibility of transformation on a national scale is reduced. For example, depending on the jurisdiction, 911 emergency calls may be handled by staff who are highly trained in a variety of emergency responses or by staff who have not even been trained to help a caller administer cardiopulmonary resuscitation or who lacks access to certified language translation services. This inequity in system responses almost universally disadvantages those in small, poor, or otherwise marginalized communities, and it undermines public safety and public health.

The federal government is uniquely suited to convene stakeholders to build constituency, tap expertise, and set minimum standards for training, data, and technology. Without federal involvement, standards are not only optional; they are largely unfunded. Federal incentives, coordination, adherence monitoring, and resourcing has the power to galvanize the adoption of innovative practices and technology across geographical and operational lines—from our most rural communities to the densest urban centers.