CESSA Statewide Advisory Committee Meeting Minutes 07/11/2022

Approved by Committee Members 08/08/2022

Community Emergency Services and Support Act (CESSA) Statewide Advisory Committee

Meeting Minutes - Monday, July 11, 2022 - 1:00-3:00 pm via WebEx

Call to Order/Introductions
- Meeting called to order at 1:01pm by Secretary Grace Hou
- Attendees:
  - Via WebEx: David Albert, Ashley Thoele, Cindy Barbera-Brelle, Shelley Dallas, Brent Reynolds, Andrew (Drew) Hansen, Alice Cary, Jim Kaitschuk, Blanca Campos, Emily Miller, Pooja Nagpal, Curtis Harris, Christopher Huff
  - Absent - Erika L. Freeman
  - Richard Manthy, Jr. joined at approximately 1:31pm
Approval of Minutes & Proposed Meeting Schedule
- No comments/corrections to 06/03/2022 Minutes
- Proposed meeting schedule of 2nd Monday of every month from 1-3pm, virtually
  - Motion by Member Drew Hansen, second by Member Brent Reynolds
  - Motion Approved by all members present
  - Note: Spelling errors noticed of two Members names (Richard Manthy and Ashley Thoele) after minutes approved. Spelling corrected in Minutes for posting.
Proposed Motion on Rules for Public Comment (Barbera-Brelle)
- 15-30 minutes will be reserved at the end for public comment
- Raise hand feature will be utilized for WebEx; phone lines will be unmuted for those joining via phone
- All comments should be relevant, limited to 1-2 minutes, and respectful
- Public comment can be offered after the meeting by emailing DHS.DMH.CESSA@illinois.gov
- Questions:
  - Christopher Huff: What's the thought process around the time limit for public comment?
    - It will range based on discussion on a proposed agenda item but will be between 15-30 minutes.
- Motion proposed by Member Cindy Barbera-Brelle, second by Member Shelley Dallas
- Motion Approved by all members present
- State Updates:
  - There was a survey for interest in serving on the regional committees and results currently being internally reviewed
  - 988 launch
    - Now a staff of about 100 people
    - Routed all counties in state to the call centers operating in Illinois
    - 19% answer rate jumped to 88%
    - Continuing weekly meetings with PATH
    - Program 590 moving forward
    - Questions/Comments:
      - Brent Reynolds - Just to confirm, are the "texts from Illinois" texts from Illinois area codes or based on location?
        
        It is area-code based.
      - Blanca Campos - Will one 590 provider co-chair each of the regional committees, and what is the timeline to start the regional meetings?
        
        Yes, the intention is still to have a 590 provider to serve as a co-chair. As far as the timeline, all of the nominees will hopefully be moved through the process this month.
      - Christopher Huff - Everyone is at various stages of capacity for the mobile crisis units. What parts of the state have the highest capacity?
        
        There were some that already had some mobile crisis response services. They are farther along than providers that are brand new. It has more to do with the history of the provider than an area of the state.
      - Christopher Huff - Can you describe the work being done to ensure that people have support services through the mobile crisis units?
        
        The program 590 grants are one program that a provider operates, but that is not the entirety of services. There are other types of services and supports available that they can be referred to. The vision of a continuum is anticipated to take 5 years.
      - Emily Miller - Is there a plan in place or what would happen if an organization decided to no longer be a part of 590?
        
        The 590 program is a grant from DMH meant to support the capacity of services. It does not restrict crisis services being provided by another provider.
      - Curtis Harris - As far as people going to hospitals, we need to let people know that there is the living room option.
Proposed Charter
- Charter clarifies group's objectives, boundaries, and restraints
  - Statement of purpose, goals and objectives, committee members' roles, etc.
  - 9 components, four technical subcommittees
  - Questions/Comments:
    - Christopher Huff - There needs to be captioning at these events for people with disabilities.
      - There is captioning available by pressing a button in the bottom-left corner. An announcement at the beginning will be made going forward.
    - Blanca Campos - Are we able to participate in more than one subcommittee and will those meetings be public as well?
      - Yes to both. They will be subject to the Open Meetings Act.
- Motion to Approve Proposed Charter made by Member Drew Hansen, second by Member Curtis Harris
- Motion Approved by all members present (including Richard Manthy via chat who had joined at this time but had Microphone difficulties)

Technical Subcommittees
- Protocols & Standards Deliverables
  - Questions/Comments:
    - Jim Kaitschuk - One of the problems is how do we define a "serious weapon"? They are all pretty serious. It does not seem very clear cut.
      - That is the work of this group. Those are the discussions that will have to take place.
    - Blanca Campos - How are kids going to be a part of this? How are we going to address kids' needs?
      - The statue says that all ages should be considered.
    - Shelley Dallas - 911 call centers typically get the call from a 3rd party caller with not a lot of information.
    - Alice Carey - There is a lot written about what the police should not do. There needs to be adjustments to the language.
    - Jim Kaitschuk - With regards to some of the activities and horrible events that have happened recently, there is an expectation that law enforcement officers have background on people. We need to be careful how we navigate this process. The expectation is that we know.
- Technology, Systems Integration and Data Management Deliverables
  - No Questions/Comments
- Training and Education Deliverables
  - No Questions/Comments
- Communications, Information Sharing and Public Messaging
  - No Questions/Comments
- Members will be polled for their preference on which Subcommittee(s) they would like to participate in

Expert Consulting Group
- Do's, Don'ts, and other Rules of Engagement shared
- Designated Experts present on call introduced themselves including:
  - Scott Block, Jennifer Wooldridge (on behalf of Keith Calloway), Lia Daniels, Stephanie Frank, Jennifer Gentile, Ginny Kennedy, Kathleen McNamara (also introduced colleague Eileen Molloy Langdon who was not present), Kristine Herman present but unable to unmute
No further questions from Committee Members

Public Comment
- Larry - Someone mentioned about the providers dropping out. Will there be regulations about this process? I see a lot of children having mental health issues that aren't attached to any adults. Will there be connections to DCFS? How is the connection going to work?
- Cosette - People with 2 weeks of training are making calls. I think we should focus on individuals with lived experience. There should be building upon these two weeks. Additionally, it should be specified how 988 and its implementation won't leave out community based organizations that already have direct crisis hotlines.
- No Public Comment from any Call-In Users
- Appended Public Comments via Email:
  - Steve Nikolaisen EMT-P,FP-C, Anderson EMS System Coordinator - I would like to ask the committee to be open as to how actions taken by committee will effect EMS. Having functioned in Illinois EMS for 37 years, I am positioned well to add some perspective as to how mental services have impacted EMS over the years. Early in my career, there were many state run mental health facilities. It was only on a rare occasion that EMS would be requested for these services. Typically, we would respond and then transport these patients "back" to these facilities and not have any further request for services for that individual for months and many times years. It was clear that to be "released" from these facilities, the patients had to demonstrate a capacity to be compliant with the prescribed care plan as a condition of their release. Over the years, there has been a notable "push" to try and manage these patients in a community setting versus an institution. With that "push", there has been an "overwhelming" increase for request to respond to individuals suffering from a mental crisis. Just the same as law enforcement, EMS providers are not effectively trained to manage individuals suffering from a mental health crises. During law enforcement training, out of the required 600 plus hours POST training, approximately 16 hours are dedicated for dealing with a mental health crises. When you consider EMS training, the situation is even worse. Out of the 1200 hours of training we require for an EMT to become a paramedic, only 20 hours are dedicated to clinicals and class training. There has been a nationwide "outcry" that more law enforcement training is required, yet if you look at subject percentages, EMS receives even less training than law enforcement. There is a strong argument that should be made that law enforcement and EMS receive training that barely meets the threshold of "awareness" level. Yet, we continue to require police and EMS personnel to function in situations for which they have not received proper training and quite often with poor outcomes. I would like to share with this committee that responding to a mental health crises is the least favorite of all conditions that our providers will typically respond to. Pediatrics would be a close second. This doesn't mean that our providers dislike individuals with mental health challenges or children, it simply means that they are often uncomfortable in situations where they lack the training and experience to effectively perform their duties.
    - Law enforcement and EMS have been forced into an untenable position for years when being asked to effectively manage persons suffering from a mental health crises. Thankfully, HB2784 recognizes the importance of having "trained" 590 responders to answer the call for aid and assist with someone in crises. We now will have the opportunity for 590 responders who have been trained at the "operational" level to be dispatched to make contact with those in "crises" versus responders with only "awareness" level training being requested to respond.
    - My concern is that this committee will allow or direct via protocols for EMS providers to continue to respond for a "crises" when there is no condition that requires medical treatment. I have reviewed the awarded 590 grants for 2023 and it would appear that there may not be adequate funding to provide for 24 hour/ 7-days/week coverage to meet the crises response demands for Region 4. To expect EMS to respond as "back-up" for a non-medical "mental crises", would be akin to asking a 590 team member to treat a drug overdose, again both have awareness level training for both events, but only each of the other has the "operational" level of training to effectively treat the respective conditions.
    - Moving forward, I would ask that the committee stay true to the spirit of this legislation, which was to remove individuals who lack the appropriate "training" from responding to individuals suffering from a mental health crises. It is clear that EMS has even less training than law enforcement in this area and as a nation, we have witnessed the repercussions of the lack of training. Elijah McClain's death was a heartbreaking example of how undertrained EMS can be even more dangerous than undertrained law enforcement. There is a great opportunity for you as a committee to set-up a statewide mental health crises response model if provided with adequate funding, With adequate funding, it should even be possible to include 590 responders with transport capabilities using the same strategic placement of assets and effective mutual aid agreements as we currently utilize for EMS. Upon the implantation of a model that allows for individuals to access 509 responders who are trained in the management of a mental health crises, EMS's role should then be limited to providing treatment for those suffering from a medical condition while in crises, anything services beyond that are not within the scope for which our we currently train our providers.
Next meeting will be August 8, from 1-3PM
Meeting adjourned at 2:47pm by Secretary Grace Hou