State Sen. Cheryl Kagan has spent the past decade working to update 911 centers across Maryland. Kagan, who represents the Gaithersburg and Rockville area, said she was driven to improve emergency response after learning that three people in her district died from 911 call response failures.

This week Kagan finished up a years-long tour of every 911 call center in the state. Following her tour, she said the biggest misconception is that no one thinks about 911 until they need it.

“They just assume that they’re going to pick up the phone, dial three digits and a well-trained, friendly person is going to be able to send the help they need,” she said. Most of the time that’s accurate, Kagan said, but not always.

“Sometimes, whether it’s in a crisis, whether it’s because too many people are calling with non-emergencies, or because a county’s 911 center is understaffed, there may be delays,” she said. “And that’s what’s terrifying, because people will die unnecessarily.”

Maryland’s original 911 system was authorized in 1979 by the Emergency Number Systems Board — now the state’s 9-1-1 Board — and was designed for landline phone use. In 2018, Kagan sponsored a legislative commission to advance NextGen 911, an initiative to reform state laws and upgrade to a more modern system.

The Baltimore Banner spoke with Kagan about surprises she uncovered during her tour and her long legislative crusade in reframing Maryland’s emergency response.

The following Q&A has been edited for length and clarity.

The Banner: What was the most unexpected thing you learned during your visits?

Sen. Cheryl Kagan: Right now, estimates have been that 25% to a whopping 50% of calls to 911 are actually not emergencies. Since our 911 centers are often overloaded and understaffed, if we could shift some of the workflows that are not emergencies to a 311 system, everyone who did have a crisis would get quicker attention.

Only Montgomery, Prince George’s, Baltimore City, Baltimore County, Anne Arundel and St Mary’s have 311 — the other 18 jurisdictions do not. So, I have been working on a statewide 311 system to make sure that we can lighten the load on all of our 911 centers.

The Banner: Did you see anything that scared you?

Kagan: There are some counties that have cut corners on public safety. There was one county with 911 specialists working in what looked like a dark small basement closet. It was terribly disrespectful and depressing with no natural light or windows. Now, that center has since been moved and improved.

The contrast is that there was one county that had a large and open space with skylights, with a decent break room and kitchen. I will not name those counties, but the respect and care that we have for the 911 specialists matters, mostly because they have to show up in person.

The Banner: What was the morale amongst specialists like at call centers?

Kagan: They are not dispatchers. They are not just call takers. They are not operators. In law in Maryland, they are called 911 specialists — and that’s really important.

These courageous women and men — and they are disproportionately women — under the headset who save lives every day tend to be invisible. They are underpaid and underappreciated. So, part of my mission has been to make sure that we are taking better care of them.

The Banner: What needs to be done to support 911 specialists?

Kagan: We want to make sure that we’re providing them with benefits that will encourage them to stay on the job. What they do is among the most challenging public service jobs out there.

I think they need more pay, better recognition and flexible hours to improve morale. They work really long hours, and obviously they work nights and weekends and holidays and all the time. Most importantly, I believe they need mental health care to make sure they can take care of themselves after after a crisis, after a trauma. I also believe they deserve workers’ compensation for post-traumatic stress disorder.

They should be considered in the same way as police, fire and paramedics. Even though they’re not on the site dealing with victims, in some ways it can be more stressful because they don’t know what the outcome was.

The Banner: Could NextGen 911 policy have made a difference in your district, potentially improving emergency response in situations where your constituents died?

Kagan: One of the cases where someone died in my district was due to the inability to locate a person who was having a heart attack on the grounds of one of the largest employers in my district. The paramedics were sent out, and they went to every office on every floor looking for him, but didn’t find him after hours in the building. Then 10 hours later, the cleaning person found his dead body in a different building on the grounds.

So, if we had had better accuracy and better technology back at that time, the paramedics might have been able to target the area they were investigating.

The Banner: Seconds save lives. What still needs to change at 911 call centers to improve response time?

Kagan: As you said, seconds can matter. Minutes can matter. There was a bill that I passed this year to provide more frequent training for our 911 specialists in telephone CPR, because it’s one thing for me to show you how to perform CPR in person. I’m guiding you, and you’re sitting right next to me. But it’s really different if you’re on the phone and I’m at home and I’m frantic, my loved one isn’t breathing, and you’re trying to keep me calm and teach me, right? There was a pilot program in Charles County that showed twice as many people survived after more intensive training. So, I passed a new law allowing funding for telephone CPR.

The Banner: What practices need to be adopted across all 911 call centers?

Kagan: I would like to see more interconnectivity. So, rather than getting a busy signal in one county, your call would roll over to a neighboring county that might have a lighter workload. For example, let’s say there’s a huge car crash in Washington County, then maybe Frederick County could pick up for them. So, we could use a little more interconnectivity and mutual support in that capacity.

The Eastern Shore has a consortium, and they do that already. I’d like to see that spread statewide.

The Banner: Was there a difference between rural call centers and ones in the cities?

Kagan: Obviously, a larger population means more 911 specialists. So, more people under the headset, more fires and more health emergencies. In Calvert County, where I just visited, there were eight people under the headset who handle all incoming calls. In some of the larger counties, they separate specialists who handle police emergencies or fire or paramedics to split up workloads.

It really just depends on local flavor. Some of them are unionized. Some aren’t. Their scheduling is different. Some have overnight bunks, in case there’s a snowstorm and they can’t go home. So, they’ve got to have a place to sleep, eat and shower, and then get back on a little bit later because the person who’s supposed to be on the next shift couldn’t make it in.

I mean, these are truly the invisible sheroes and heroes of public safety.