CESSA - Region 9 Committee Meeting Approved Minutes 12/19/2022

Community Emergency Services and Support Act (CESSA) Region 9 Advisory Committee

Meeting Minutes - December 19, 2022 - 2:00-3:30 via WebEx

Meeting Minutes - Approved by Members 01/09/2023

Call to Order/Introductions
- Dr. Matthew Jordan called to order at 2:02pm
- Attendees: Jennifer Brothers, Andrew Kunstler, Amanda Teachout, Bernadette May, Christiane Harding, Jason Kern, Karen Bush, Frances Baker (Lore), Ryan Lettieri, Aimee K., Deputy Chief Mathew Mannino, Jim Sowizral, Joseph Kreul, Daphne Sandouka, Grace Hong Duffin, Ariana Kitty, John Knebl, Lorrie Jones, Anthony Rigano, Matthew Fishback, Rosa Gonzalez, Leonetta Rizzi, LaToya Marz, Stephanie Hanson, Joe Schelstreet, Richard Neumann, Jeremy______, Joe_______, Patrick______
- Guests: Theresa (Tiki) Schulte
- Absences: J. Pacini, Dalila Alegria, Robb Cagann, Mohammed Sabit, Faizan Shakeel, Arthur Proust, David Hassard

Approval of Minutes
- No previous meeting minutes to approve

Regional Advisory Committee Agenda review & discussion
- OMA
  1. This meeting is being held under and is subject to the Illinois Open Meetings Act.
  2. All members are asked to complete the OMA training.
  3. Register at the first link, and then the training link will be visible on the left-hand side. There is also an FAQ at that site.
  4. OMA Notices - Read verbatim

Roll Call & Introductions
- Members are invited to introduce themselves

DMH Crisis Continuum
- DMH has responsibility to coordinate Mental Health services in Illinois, so CESSA falls under DMH.
  - Someone to Call (988 Regional Crisis Call Hub Services) 6 Lifeline Call Centers funded by Programs 400 and 401. SAMHSA Goal: 90% of individuals with access by end of 2023
  - Someone to Respond (Mobile Crisis Team Services) Program 590 is expanding capacity of crisis services within the community 66 providers in 83 locations. SAMHSA Goal: 80% of individuals with access by end of 2025
  - Somewhere to Go (Crisis Receiving & Stabilization Units) 21 Living Rooms (not 24/7/365) and 11 Crisis Residential Programs (not available in most parts of the state). SAMHSA Goal: 80% of individuals with access by end of 2027

Current Crisis Response System
- The current crisis response system is complex and supported by many kinds of organizations, including the Lifeline Call Centers that answer crisis calls, the mobile crisis response teams across the state, and the 911 centers, who currently answer most crisis calls.

CESSA Introduction
- Also known as the Stephon Edward Watts Act
- DHS is mandated to lead this work
- Requires development of a Statewide Advisory Committee and Regional Committees within each of the 11 EMS Regions
- Committees are charged with coordination of emergency responses of the 911 and PSAPs with plans for 988 addressing
  1. Protocols and Standards
  2. Training
  3. Communications
  4. Mobile Crisis Response Teams
CESSA First Responders
- Public Safety Access Points (PSAPs) must coordinate with Mobile Crisis Response (MCR) teams DMH has developed through its Program 590 to provide a "community-based" response to low-level and low-risk behavioral health crises.
- Law enforcement must be integrated into processes so that individuals involved in low-level non-violent misdemeanors can be diverted to the mental health system.
Crisis Complementary Parts
- The Crisis response system in Illinois is made up of many complementary parts. There are many different responses possible to crisis, though the majority of them currently go through the 911 system and generate a law enforcement or EMS Response
  1. 179 911/PSAPs and dispatched emergency service providers (map to the left)
  2. 66 Mobile Crisis Team program grantees
  3. 877 Law Enforcement Entities
  4. 1300+ Local Fire Departments, county/fire-dept based and privately operated ambulances
  5. Six 988 Call Centers
  6. Advocates and People with Lived Expertise of Crisis
A continuum of police and community response
- CESSA envisions a continuum of possible responses, where the response is appropriate to the level of crisis.
  1. Innovative law enforcement and behavioral health collaborative models are already being tested and implemented across Illinois and nationwide
  2. The CESSA legislation envisions a continuum of responses based on the conditions and potential lethality of each crisis call
  3. 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 Regions
- The DHS Secretary shall establish 12 Advisory Committees:
  1. 1 Statewide Advisory Committee
  2. 11 Regional Advisory Committees to assist with the execution of this legislation.
- Regional best practices will be developed by the Regional Advisory Committees consistent with the physical realities of various locations.

CESSA Timeline
- This is the timeline based on the actual legislation, which calls for final recommendations from the SAC and RACS by January 1, 2023.
- This will have to be revised if the deadline is extended.
- In the meantime, no changes will be made to the system until the statewide and regional CESSA process is complete.
CESSA Structure

Mission of Regional Advisory Committees (RAC)
- Make recommendations to the Regional EMS Directors to make changes necessary to 911 call protocols and recommend new protocols following SAC guidance.
- Identify recommendations to address changes in standards in 911, law enforcement, EMS, and behavioral health mobile crisis services to meet the guidance of CESSA.
- Recommend changes to SAC and IDPH Division of EMS regulating professional work in law enforcement and fire departments.
- Recommend regional training and technical assistance needs to SAC.
- Recommend data collection needs for coordination and improvement of 911 and 988.

CESSA Regional Advisory Committee Membership
- It is defined by the CESSA legislation
  1. EMS Director (the designated Chair of the RAC)
  2. A 590 Provider Executive (the designated Co-Chair)
  3. Law Enforcement Entities
  4. Advocates
  5. EMS Provider representative
  6. EMS Union representatives
  7. Law Enforcement Representatives
  8. Mental / Behavioral Health providers
  9. 708/Government Entity Representative
  10. 911 PSAP Representatives

Region 9 map (displaying 988, 911 PSAPs, EMS)
- Reviewed and discussed.
- Map seems to be outdated.

Introduction to CESSA Charter
- Responsibilities and Deliverables
- Decision-making process
- Possibilities of RAC Sub-Committees
- How to handle public content *To be discussed and ratified at next RAC meeting

Select Deliverables
- There are four sets of deliverables. The most important are the regional standards and protocols.
  1. Protocols & Standards
    - Approval of vendor scripts and protocols
    - New matrix(ces) for risk attribution for incident types and dispatch priorities based on national best practices
    - New data informed dispatch priorities given jurisdictional realities including availability of Mobile Crisis Response Teams
    - New data informed dispatch protocols when responding to person in crisis involved in non-violent misdemeanors
    - New data informed standard response times for incident types and correlate with dispatch priorities and matrices
    - List of any local agencies, boards/commissions with regulatory oversight for appropriate interfacing
  2. Technology, Systems Integration and Data Management
  3. Training and Education
  4. Communications and Public Messaging
Additional decisions in RAC Charter
- Discussed decision making process
  - Consensus when possible; majority vote if not
- Possibility of RAC Subcommittees
- Management of Public Comment

Member discussion
- Lorrie Jones confirmed Region 9 map was outdated
- Is there a vision to merge 911 & 988?
  - We don't know and right now we'll work on integrating them. The 2 represent complete different entities.
  - 911 ->? makes rapid decisions-triage
  - 988?-> goal is to keep people on the line to assess crisis (average call time is 20 min).
How do we make the choice effectively and ensure that we're measuring this process properly?
What kind of training is needed?
Is there room to add more representatives within this Region's counties?
- Yes, these are open meetings. More representatives can be invited to attend future meetings.
Next steps
- Regional monthly meetings
- Statewide meetings

State Updates by Lorrie Jones
- General Assembly passed legislation for the implementation of the CESSA act to July 1st, 2023. There are improvements being made to the bill but has been difficult to speed up the process to reach its completion. They decided to extend the implementation date. Protocols & standards need to be set and ready to go as well as the trainings. It won't be approved until these requirements are met.
- Lorrie suggested breaking into subcommittees since meeting once a month as only one committee may not be enough.
- Lorrie commented on the participation of entities from other states that have been sharing different models that may be worth looking into and studying.
- The state will continue to develop toolkits to provide guidance to all committees.
- All meetings have to be public domain, even as breaking up into subgroups.
- An expert advisory group (non-voting members) can be invited.

Next meeting
- All the dates for our future meetings need to be posted from January through June of 2023
- We will meet every 3rd Monday of the month at 2:00pm
- Our first meeting of 2023 will take place on January 9th at 2:00pm
Meeting adjourned at 3:01pm by Dr. Matthew Jordan