CESSA - Region 3 Committee Meeting Approved Minutes 12/15/2022

Community Emergency Services and Support Act (CESSA) Region 3 Advisory Committee

Meeting Minutes -  December 15, 2022 - 8:30-10:30 via Teams

Meeting Minutes - Approved by Members 01/17/2023

  • Call to Order/Introductions
    • Diana Knaebe called the meeting to order at 8:30am.
    • Member Attendees: Matthew Johnston, MD, Diana Knaebe, Jessica Douglas, Trenda Hedges (Nominee), Olivia Mefford, Christopher Mueller, Devron Ohrn, John Simon (Nominee), Katrina Moseley
    • Public Attendees: Taylor Davis, James Doss, Matthew Fishback, Tara Hamann
    • Excused: Scott Pasichow, MD, Mark Schmitz, Andrew Wade
    • Absences: Andrew Dennis, MD, Chad Dooley, Scott Hough, MD, Raymond Hughes, MD, Sara Rolando, Amy Toberman
  • Meeting Logistics/Open Meetings Act
    • Open Meetings Act site at the Office of the Illinois Attorney General
    • Meetings are recorded. You may choose to turn off your camera.
    • Minutes will be posted at the Illinois Department of Human Services Division of Mental Health on the Open Meetings page.
    • Minutes will be posted after they have been approved at the following RAC meeting.
    • Please remain on mute during the meeting unless you want to have some discussion. If you would like to speak, please raise your hand to get the presenters attention.
    • Only appointed members may contribute to the discussion at any point during the meeting. Members of the public will be able to speak during the "Public Comment" session of the meeting.
  • CESSA Legislation
    • https://www.ilga.gov/legislation/publicacts/102/PDF/102-0580.pdf
    • Division of Mental Health has been charged with coordinating the Continuum of Crisis Services.
      • Someone to Call
        • 988 Regional Crisis Call Hub
        • Currently 6 in the State.
        • Memorial covers 7 counties (Sangamon, Menard, Scott, Morgan, Logan, Mason and Christian).
        • In Bloomington/Normal, PATH Inc. is the statewide Call Center for anyone who is not covered under one of the current Lifeline Call Center regions.
        • PATH Inc. is also back up for Memorial and 4 other agencies, if they are unable to take a call
        • SAMHSA (Substance Abuse and Mental Health Services Administration) has given the state the goal of 90% of individuals receive access by the end of 2023.
      • Someone to Respond
        • Mobile Crisis Response (590 Grant)
        • Trained individuals who present to client's homes during a crisis.
        • 66 providers in 83 locations.
        • Memorial is not responding in person 24/7. In the rural areas, Memorial is responding virtually.
        • SAMHSA goal is that 80% of individuals have access to Mobile Crisis Response by the end of 2025.
      • Somewhere to Go
        • Crisis Receiving and Stabilization Units
        • 21 Living Rooms, not 24/7/365.
        • 11 Crisis Residential Programs, not available in most parts of the state.
        • In Springfield, Memorial has both a Living Room at the 8th Street location and Crisis Residential at the West Lake location.
        • SAMHSA goal is that 80% of individuals have access by the end of 2027.
  • CESSA Structure
    • Community Emergency Services and Support Act
    • DHS is mandated to lead CESSA.
    • DHS requires the development of a State Advisory Committee and Regional Committees within each of the 11 regions.
    • Committees are charged with coordination of emergency responses of the 911 and PSAPs with plans for 988 addressing:
      • Protocols and standards
      • Training
      • Communications
      • Mobile Crisis Response Teams
    • PSAPs (Public Safety Access Points) must coordinate with Mobile Crisis Response (MCR) teams that DMH (Division of Mental Health) has developed through its program 590 to provide community based response to low level and low risk behavioral health crisis.
    • Law enforcement must be integrated into processes so that individuals involved in low level, non-violent misdemeanors can be diverted to the metal health system.
    • The Crisis response system in Illinois has:
      • 179 911/PSAPs and dispatched emergency service providers
      • 66 MCR team grantees
      • 877 Law Enforcement Entities
      • 1300+ Local Fire Departments, county/fire-department based and privately operated ambulances.
      • 6 988 Call Centers
      • Advocates and People with Lived Expertise of Crisis
    • Continuum of Police and Community response
      • Innovate law enforcement and behavioral health collaborative models are already being tested and implemented across Illinois and nationwide.
      • The CESSA legislation envisions a continuum of responses based on the conditions and potential lethality of each crisis call.
      • CESSA does not prohibit law enforcement from participating in resolving certain situations and co-responder models and CIT training remain valuable assets in the continuum.
    • CESSA has 12 Advisory Committees:
      • 1 Statewide Advisory Committee
      • 11 Regional Advisory Committees
        • We are Region 3
      • Looking at best practices being developed here within this committee, consistent with the physical realities of the various locations.
      • Some ability to be able to have the protocols and standards that we set up in this region, be specific to the resources that we have in this region.
    • CESSA Original Convening and Implementation Timeline
      • Became a law in 2021
      • In the first quarter of 2022, the Statewide members were identified and confirmed.
      • Between quarters 2 and 3, the Statewide Advisory Committee was launched and the regional group members were identified and invited.
      • Quarter 4, the Statewide Advisory Committee and the Regional Advisory Committees are to meet, deliberate and develop recommendations.
      • Final recommendations will be delivered by the end of December 2022 to the statewide group and then reported on the state level in January 2023.
    • Mission of the Regional Advisory Committees (RAC)
      • Make recommendations to the Regional EMS Directors to make changes necessary to 911 call protocols.
      • Recommend new protocols following the state advisory committees' guidance.
      • Identify recommendations to address changes in standards in 911, law enforcement, EMS and MCR to meet the guidance of CESSA.
      • Recommend changes to the SAC and to the Illinois Department of Public Health Division of Emergency Medical Services regulating professional work in law enforcement and fire departments.
      • Recommend regional training and technical assistance needs to SAC.
      • Recommend data collection needs for coordination improvement between 911 and 988.
    • CESSA Regional Advisory Committee Membership
      • EMS Director - Dr. Matthew Johnston (Co-Chair)
      • 590 Provider - Diana Knaebe (Co-Chair)
      • Law Enforcement Entities - Devron Ohrn & Olivia Mefford
      • Advocates - Andrew Wade
        • 1 Request is out and 2 invites have been sent out.
      • EMS Provider Representatives - Chad Dooley & Sara Rolando
        • 1 open slot, request is out.
      • EMS Union Representatives -
        • 2 open slots
      • Mental/Behavioral Health Provider Representative - Mark Schmitz & Co-Chair is representing.
      • 708/Government Entity Representative -
        • Waiting on a response from to see if the State's Attorney or a representative from the State's Attorney office could be represented.
      • 911 PSAP Representative - Amy Toberman, Christopher Mueller, Jessica Douglas
      • EMS System Agency -
        • Memorial - Co-Chair is representing
        • St John's Hospital - Dr. Scott Pasichow
        • Blessing Hospital - Dr. Scott Hough
        • Jersey Community Hospital - Dr. Raymond Hughes
        • Trinity Medical - Dr. Andrew Dennis
    • Region 3 has different providers in our region.
      • Transitions of Western Illinois
      • Locust Street Resource Center
      • Memorial Behavioral Health
    • CESSA Charter (Need to be ratified at the next RAC meeting)
      • Responsibilities and deliverables
        • Related to protocols and standards
        • Approval of vendor scripts and protocols
          • The SAC has had different vendors come a talk about what they can offer to the areas.
        • New matrixes for risk attribution for incident types and dispatch priorities based on national best practices.
        • New data informed dispatch priorities given jurisdictional realities including the availability of MCR teams.
        • Looking at new data informed dispatch protocols in responding to persons in crisis who are involved in nonviolent misdemeanors.
        • New data informed standard response times for incident types and correlate with dispatch priorities and matrices.
        • List of all local agencies, boards, commissions with regulatory oversight for appropriate interfacing.
        • Additional deliverables are related to technology, systems integration and data management; training and education; and communication and public messaging.
      • Decision making process that we want to follow
        • Would prefer a consensus when possible, but can do a majority vote if not.
        • Understand that some members specialize in certain areas and that we should defer to their expertise.
      • Possibilities of having sub-committee
      • How to handle public comment
  • Member Discussion - Questions and Answers
    • Dr. Matthew Johnston - Where do we want to attack first? Have had some discussion with Chris Mueller on PSAPs and their availability to do some of these secondary triage. Is that one of the sub-committees to stand up first?
      • Chris Mueller - PSAP protocols are my hot button. We need to figure out how we are going to wrap this and how we are going to send these calls. That is probably the trickiest part.
      • Dr. Johnston - Have the national companies got those protocols in place? I know that they were working on them in September/October.
        • Chris - No, they have not been finalized.
    • Diana Knaebe - After protocols, I would think that we would want to bring on training and education sub-committee. Who is already trained? Who is going to do that training? There will be statewide guidance, but regionally, how do we want to make sure that we operationalize that?
    • Diana - Communication and public messaging is a twofold. Communication is part of internal communications of those protocols and what is going on in time frames. And then the other part is for the public to know what is happening in our areas and what happens when they call 911 or 988. Training & Education and Communication & Public Messaging may need to go parallel with one another.
      • Jessica Douglas - I concur that those two do intersect because with my staff, they need to be trained on something, but they also need to understand the education behind it. They need to know the why behind it. Not only to know this is how we are moving but this is the reasoning and the why behind it.
        • Diana - Could possibly communicate with teams early about what we are working on and how it will impact them. Have some people working on that while others are looking at protocols and standards. Start thinking about talking points.
    • Dr. Johnston - Are we mandated timelines for all these and implementation? Or are we just working towards those goals?
      • Diana - From what I understood during the SAC the other day, because CESSA is just now being pushed out, there are no specific dates out there. The goal is by the end of the 2023 calendar year, these things are accomplished.
    • Diana - As word gets out, people may start sending in emails and/or get information to our RAC and we would want to put that in a public comment section for later meetings and then make determination as to whether those are things that need to get added to our list of things that need to be considered as we look at protocols and communication. So I think that public comment needs to be a big part of and can drive some of these pieces as we pull them together.
  • Determination of Day/Time for Subsequent Meetings
    • Determined that the third Tuesday of every month at 8:30am via MS Teams.
  • Public Comment
    • Matthew Fishback - Wanted to let you know that the deadline for CESSA is July 1st. There could be some more modifications done in early/late spring.  The State recognizes that the integration of all these networks has a long way to go. During that period, the existing emergency response network should operate as it always has. No changes need to be made until all of these elements are fulfilled:
      • The Statewide Committee has negotiated protocols and 911 operator script adjustments with the contracted services providing these tools to 911 PSAPs operating in Illinois.
      • The Regional Advisory Committee has completed design of the specific 911 PSAP process for coordinating activities with mobile crisis response providers.
      • Mobile crisis response is available in the jurisdiction.
  • Dismissal
    • Motion to adjourn by Dr. Matthew Johnston.
    • Second by Jessica Douglas.
    • Motion carried, adjourned at 9:31am.