CESSA - Region 1 Committee Meeting Approved Minutes 02/02/2023

Community Emergency Services and Support Act (CESSA) Region 1 Advisory Committee

Meeting Minutes- Thursday, 02/02/2023 - 2:00 PM

Meeting Minutes - Approved by Members 03/02/2023

  • Open Meetings Act
    • These meetings will be subject to Open Meetings Act.
    • A copy of the agendas and meeting minutes will be posted to the Illinois Department of Human Services/Division of Mental Health Open Meetings Page.
  • Call to Order/Introductions
    • Meeting called to order at 2:02 pm by Patrick Phelan.
    • Previous Meeting minutes approved by motion of Dr. Erin Rigert, seconded by Heather Butler. Approved unanimously.
    • Attendees:
      • Via web-based Teams: Patrick Phelan, Dr. Erin Rigert, Synthia Jones, Lynn Akker, Chris Baldwin, David Lohse, Brenda Hampton, Jason Holcomb, Matthew Smetana, Samuel Jones, John Girone, Deanna Cada .
      • Absent- Danielle Angileri, Christopher Scroll, Brandon Lieber, Tessa Lohse, Jason Leverton, Joshua Lewis, Colette Mickelson, Joan Lodge, Jennifer Fey.
  • Overview: The Continuum of Law Enforcement/Behavioral Health Responses
    • The state envisions a continuum of responses based on the conditions and potential lethality of each crisis.
    • CESSA does not prohibit law enforcement from participating in resolving certain situations and co-responders' models and CIT training remain valuable assets in the continuum.
    • A diverse set of innovative law enforcement and behavioral health collaborative models are being tested and implemented across Illinois and nationwide.
    • A decision tree of who gets deployed in a crisis is working its way through a statewide subcommittee. This decision tree should be ready for the committee to review by our next meeting in March.
  • CIT (Crisis Intervention Team) /Crisis Intervention Team Model
    • Partnerships with other first responder agencies, community providers, advocates, family members, and persons with lived experience of SMI.
    • Single point of entry to emergency psychiatric care.
    • 40-hour CIT training for specialist officers.
  • What evidence says about CIT
    • There is strong evidence that CIT training improves officer knowledge, attitudes, self-efficacy, and use of force preferences.
    • Just the training itself has an impact on the officers' overall attitudes towards the work.
    • There is good evidence that CIT training/program implementation increases linkages to care.
    • Evidence related to use of force and arrest in unclear.
    • Availability of mental health resources is critical.
  • Co-Responder Teams
    • Some communities have set up co-responder programs. The goals of the co-responder model are to reduce arrest, increase safety, reduce ED transports and hospitalizations.
    • Significant variation exists within the model.
      • There are models where responders ride together, arrive together, or provide telephone support.
      • Hot calls vs. secondary response or follow-ups.
      • Often not 24/7.
    • Patrick Phelan indicated that Sinnissippi Centers has started a model with the police department in Dixon, if they are responding to a call, they may call Sinnissippi for support. Sinnissippi workers may come out to the call, or we will respond with a telephone call.
    • Evidence regarding co-responder teams
      • They are generally more acceptable to our stakeholders.
      • Improve collaboration between police and mental health.
      • In some communities, may reduce officer time on scene.
      • May reduce ED transports, but with that may increase admission rate for those transported.
      • May reduce immediate risk of arrest.
      • Are preferred over police alone approach by service users and family members.
    • Conclusion
      • CRT responses may reduce short-term incarceration risk but not long-term EMS demand or risk of justice involvement.
      • Follow-up services are critical.
      • The findings suggest that co-response police-mental health programs can improve the management of people showing suicide-related behaviors.
  • Alternative Response Model, which leverages Mental Health Response Teams
    • Ultimately what CESSA is aimed at is a model that is an alternative response model.
      • Designing the model so that we can assign the appropriate protocols to the appropriate situations.
    • Mobile Crisis Response Teams
      • Teams of clinicians that can be accessed or deployed without any law enforcement involvement.
      • Offer triage, screening, assessment, de-escalation, crisis resolution, peer support, coordination with behavioral health services, crisis planning and follow up.
      • May respond at the request of crisis line or law enforcement.
      • May request law enforcement assistance when safety issues are identified.
      • Typically, not dispatched directly via 911 system.
      • 66 MCRT providers in Illinois (funded by DMH Program 590), most with 501c3 designations.
      • Limited research on Mobile Crisis.
      • The wait time has been an issue, we are working on trying to improve the wait time statewide.
  • Early conclusions regarding the community response models
    • We recognize that no one approach is going to necessarily be completely effective. We are going to have to have a multi-faceted approach that is tailored to our communities.
    • Variability across the community response models: How dispatched/assessed, who responds, transport options, where is service housed.
  • Questions and Answers
    • Jason Holcomb noted that the discussions are focused on law enforcement, but in reality, EMS responses play a huge role in that continuum. Jason encouraged the committee to remember the EMS role. Winnebago County's mental health board has funded a mobile crisis team with a psychiatric nurse that can be dispatched with law enforcement and EMS.
    • Matthew Smetana commented and agreed with the question Jason Holcomb inquired about regarding EMS.
    • Heather Butler commented and discussed that in Dekalb County, they have been having meetings for the last six months with their 590 provider. Heather commented that they also have a lot of unanswered questions with 911 calls regarding crisis.
    • Patrick Phelan commented that there are many 590 providers across the state with unanswered questions as well.
    • Brenda Hampton commented and said that while many 590 providers do no transports at all, some may transport in voluntary non-volatile situations. If someone is aggressive or hostile, or their behaviors are unpredictable, the 590 providers do not have means to secure or restrain. Committee task: Understanding local resources for alternative response.
  • Discussion regarding who is providing alternative responses in our region.
    • Jason Holcomb discussed:
      • Winnebago County Mental Health Board has funded a co-responder program that includes three law enforcement jurisdictions: Winnebago County Sheriff's Department, City of Rockford Police Department, and Loves Park Police Department.
      • New 911 software upgrades that will be added in to allow for better screening of mental healthcare calls and direct dispatch for a co-responder team or am EMS team with a psychiatric nurse. A dedicated team screens 911 call transcripts when they are not answering crisis calls for potential follow-up.
    • Patrick Phelan discussed:
      • Noted again that there is a collaboration in its infancy with Dixon Police Department.
      • In Lee and Whiteside Counties Sinnissippi has engaged in Crisis Prevention teams with law enforcement and the hospitals to proactively co-respond for individuals before they reach crisis or as a crisis follow-up.
    • Deanna Cada discussed:
      • For the last five years Dekalb County's Mental Health Board has embedded a clinician within the Dekalb Police Department, Sycamore Police Department, and now working toward Dekalb Sheriff's Department. These clinicians also review 911 transcripts. Many 911 operators are CIT trained. It has been a huge advantage to be able to bring training local for CIT. Would be willing to share some great data they have regarding their model.
    • Patrick Phelan discussed:
      • How can we reach out to all stakeholders and determine who is engaged in any of these models.
        • Patrick will poll stakeholders in Lee, Ogle, Carroll and Whiteside Counites.
        • Jason Holcomb will assist with Winnebago County.
        • Deanna Cada agreed to assist with DeKalb County.
        • Need volunteers for Jo Daviess, Stephenson, and Boone Counties.
      • Data collection-The UIC Crisis Hub is developing a toolkit to help do a quick survey of the different responses available in our region. Tool kit will go out to the committee when it comes out.
    • Brenda Hampton discussed:
      • Pulling information together once these toolkits come out will be vital to make this work. It will look different across all the regions since everyone has different resources. This is information that the state does not have.
  • State Updates
    • Brenda Hampton stated the Standard and Protocol Subcommittee is working on a matrix to triage responses. This committee will discuss the matrix at the next meeting.
    • Brenda Hampton provided us with the link for the Standard and Protocol meeting in the chat section on Teams.
    • Brenda Hampton let the committee know that the Governor announced that on May 11th the public health emergency will end. This will likely require an in-person meeting with a virtual option.
    • Brenda Hampton discussed the 2023 CESSA Sprint at a Glance: Calendar of Deliverables. These are deliverables that need to be met in order to submit the recommendations on CESSA.
  • Public Comment:
    • Chris Baldwin let the committee know that he is the Database Director for the 988 Path Crisis Center. Chris is happy to answer any questions the committee has.
    • Matt Smetana asked for more clarification on EMS transportation. The December 21st, 2022 memo stated: "non-Police responders are not authorized to transport individuals to mental healthcare who are objecting to such care." Matt let the committee know that the customary practice in Region 1 has been to routinely transport individuals by EMS. Matt wanted to clarify that despite of what the memo says, EMS as a responder is allowed to transport patients involuntarily.
    • Brenda Hampton said that she knows this is a confusing statement and that DHS recognizes that this is a confusing statement. Nothing at this time has changed. Brenda will try and find out before the next meeting or sooner some clarification on this matter.

Next Meeting: Thursday 3/2/2023 at 2:00pm. Subsequent meetings will be held at 2:00pm on the first Thursday of each month and are scheduled through June 2023.

  • Dismissal: First motion to adjourn the meeting was from Jason Holcomb. Second motion to adjourn the meeting was from David Lohse. Meeting was adjourned at 2:05pm.