Kyle Plush: Changes recommended for Cincinnati’s 911 center

Kyle Plush: New recommendations for Cincinnati’s 911 center
Published: Oct. 19, 2021 at 4:46 PM EDT
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CINCINNATI (FOX19) - When the city of Cincinnati agreed to pay $6 million to the family of Kyle Plush to settle a wrongful death lawsuit earlier this year, the city pledged to make more improvements to its 911 center.

The settlement specifies $250,000 for improvements to the 911 call center. The funds are to be used to hire outside experts to review the city’s 911 operations.

The oversight will last five years and the experts’ recommended improvements must be made.

“This settlement is about improving the safety of the citizens of Cincinnati,” said Al Gerhardstein, lawyer for the Plush family.

”I can tell you on behalf of the Plush family that the family is very satisfied with the city’s cooperation with the expert team. If there is a real commitment to the mental health of the staff if they’re given really good procedures to follow then our 911 center will rise and be one of the best in the country.”

Those three experts just turned in their first report and recommendations.

A copy of their report obtained by FOX19 NOW shows that while progress has been made, many of the same issues that contributed to Kyle’s death continue to plague the city’s Emergency Communications Center (ECC).

“Location is the most important aspect of handling an emergency call for service,” the report states. “The resources that are in place in the ECC are not being used to their full extent and capability.”

Kyle died in April 2018 after he became pinned by a folding bench seat in the back of his family’s 2004 Honda Odyssey minivan parked at Seven Hills School in Madisonville.

He called 911 twice to plead for help, providing his location and a description of the vehicle, according to his wrongful death lawsuit. “He screamed, pounded, begged for help. No one helped him.”

The teen’s body was not found for hours. His father finally located him in the van when he went looking for his son after he didn’t return home from school.


City Council took prompt action following Kyle’s death and pledged sweeping changes to emergency response procedures.

They approved $454,000 to increase 911 staff and to improve technology at the 911 center as part of a 12-month action plan.

They took oversight of the 911 center away from the Cincinnati Police Department and returned it to civilian control.

“In July, when more than 29,000 calls were answered by the ECC, the number of calls answered in less than 10 seconds was 89.32. In June when 29,354 calls were answered, 88.90% of calls were answered in less than 10 seconds. These have been the only two months during the year in which the call-answering time was less than 90%,” the report states.

The city also launched a new system called Smart911 designed to make it easier for first responders to find 911 callers in an emergency.

Once people register for it, their emergency information will automatically be displayed to call takers when they dial 911.

But the outside experts note that issues remain with regard to the proper verification of addresses by 911 operators.

“Those issues include, only having the caller state the address once, not repeating the location given, not verifying the jurisdiction, and not using existing technology, such as the CAD Map, Smart911 or RapidSOS, to verify the location,” the report states.

“This is not sufficient to verify location. Dual address verification and documentation is an important function. It has been determined that many of E9-1-1 operators are not effectively verifying location. The current policies regarding address verification are well written to the minimum location verification standards, however, since it has been determined that issues exist with location verification, the team would like to see additional location verification techniques added to the policy as well as additional training provided.”


The city has made significant strides in improving working conditions and technology, both at the primary site on Radcliff and the backup facility located at Spinney Field, according to the report.

The city is still a year or more away from achieving certification from the Commission on Accreditation for Law Enforcement Agencies (CALEA).

“CALEA accreditation is a complex process that many agencies strive to achieve,” the report states.

The city has begun using PowerDMS, a policy management platform also used by agencies throughout the county.

PowerDMS has proved an effective tool to assist in the implementation of policies and tracking their implementation.

The city also is in the process of moving to a call-taking protocol system called Emergency Police Dispatching, provided by Priority Dispatch.

The system should be in place in the spring or summer of 2022. This system, the report reads, will standardize call-taking and processing of 9-1-1 calls and potentially reduce the city’s exposure to liability in the future.

“However, this system has been criticized by some as causing delays in gathering information,” the report notes.

“Some employees will resist the change, and difficulties in the implementation of scripted call processing will occur. The decision to purchase this system was made prior to the team’s arrival.

The outside experts recommend the city use tools like a caller location query (CLQ), a CAD feature, and implementation of additional location accuracy tools, RapidSOS Portal and “what3words,” that are not currently being used in the ECC, thorough initial training on new resources and refresher training on already implemented resources and address verification.

“Location is the most important aspect of handling an emergency call for service. The resources that are currently in place in the ECC are not being used to their full extent and capability.”

Staffing issues

Staffing issues such as hiring, training, retention and morale continue to be a big problem.

The ECC has moved from being a civilian operation to a part of the police department, back to a civilian operation under police supervision and, finally, back to a civilian operation, the outside experts noted.

During this time, numerous people directed the center: “Many employees reported that they have seen more directors than they have years of service,” the report reads.

The team of experts found that while the 911 center has “extremely passionate, dedicated employees, constant “change in the operation, structure and supervision of the center has led to feelings of mistrust and confusion, and been a contributing factor to many of the issues that has plagued the center for years.”

The experts requested recent exit interview documentation and concluded the main reasons employees leave their employment with the ECC are:

  • Low morale
  • Lack of communication between the administration and the floor
  • Lack of positive communication and support from administration.

Turnover and staffing remain critical problems in the ECC:

  • Last year, 17 employees left employment with the ECC: five resigned, three retired, five failed probation, three transferred to other city departments and one was fired.
  • So far this year as of early September, 23 employees have left the EC; four retired, two failed probation, four transferred to other city departments, 12 resigned, and one left for medical reasons.

“Although staffing any ECC is difficult, that should not be allowed to be an excuse for constant understaffing of the unit. Morale remains a major issue in the center, so the ECC can’t hire its way out of a staffing shortage,” the report says.

“Until it addresses the core reasons why people are leaving, the ECC will never be able to hire enough people to become fully staffed. The administration must move away from a task-and-results environment and toward a people-driven organization. Doing so will play a significant role in employee retention. In other centers, this has proved to improve morale and turn them around.

“The team was told numerous times that staffing, morale and mental health matters are the biggest issues. The ECC operations staff reported that administrators are seldom on the floor.”

Employees expressed an interest in seeing the administrators on the floor more frequently during critical incidents and daily operations. Employees also noted that decisions are not being made in a timely manner, according to the report.

Many of the current administrators were hired from outside the city and when several started their employment it took three weeks or longer for them to meet many veteran employees.

None of the current administrators have previous experience in their current roles.

“This has led to a tremendous amount of learning on the job. It appears to the team that the administrators who are dedicated to making the center better have been overwhelmed by other major projects, such as updates with technology, hiring new administrators, CALEA accretion, and the PPDS project, and they have become isolated from the daily operations.

“These are all very important projects; however, the hours devoted solely to these projects have contributed to issues in other areas. If positive transformation is the goal, then the city must begin to put employees first. They must engage all employees in an open and honest dialogue.”

Statistics-driven vs. People-driven

Many employees who have provided dedicated service to the city are actively looking for opportunities to leave the ECC. Many of these employees hold the keys to turning the center around, but they must be engaged, and their knowledge and passion must be reignited for the center to turn around. The unions must begin to put short-term goals aside and work together to be part of the solution.

“Turning the center around won’t be easy and will take time, but it is something the current employees and leadership are capable of doing,” the report states.

“The team recommends that the administration immediately shift focus from a statistics-driven organization to a people-driven environment.

“The primary focus of the administration has been on call-answering times, and accreditation and protocol implementation.

“Although these goals are important, they can not be accomplished without a highly motivated workforce.”


The team makes several recommendations including:

  • A review of minimum staffing numbers be conducted to maximize service to the city’s residents and visitors while minimizing mandated overtime when possible.
  • Priority focus be placed on mental health. This includes, but is not limited to, the implementation of a standalone ECC Peer Support Program. “Many employees of the ECC are struggling tremendously. If these employees don’t get mental health resources in place sooner rather than later, with already low staffing will be detrimental to the city.”
  • Hire a second operations manager to allow for quicker decision-making when it comes to daily decisions
  • More formal training for ECC staff on new policies: “The team recommended the ECC begin to assess the most pressing training needs and immediately seek ways the expert team can assist them in meeting those needs.”
  • Overtime in the ECC is an issue. “The team recommends the city continue to meet with all stakeholders to determine the best path forward to meet the needs of all.”
  • Continuing education be provided on such topics as suicide intervention, behavior/personality, mental health and crisis intervention.
  • Review of the use of the 9-1-1 call/administrative call-only positions.

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