CESSA - Region 2 Standards & Protocols Subcommittee Meeting Approved Minutes 05/02/2023

Community Emergency Services and Support Act (CESSA) Region 2 Advisory Committee

Meeting Minutes- May 02, 2023 - 1:00-2:00 via Teams

Meeting Minutes - Approved by Members 06/06/2023

  • Call to Order
    • Meeting Called to Order by Zachary Gittrich at 1:01 PM
    • Attendees:
      • Present: Latricia Seye, Ryan Beck, Rhonda Flegel, Brian Murphy, Zachar Gittrich, Dennis Duke, Eileen Williams proxy for Jodie Mahoney
      • Absent: Allen Haeffner, Jodie Mahoney, Jamal Simington, Sarah Scruggs
      • Guests: Gabriela Vo, Brenda Hampton
  • Open Meetings Act - Read and notified meeting is being recorded.
  • Debate & Approve Charter
    • No charter necessary.
    • Select co-chairs
      • Allan Haeffner resigned as Chair.
      • Latricia Seye nominated Zach Gittrich as Chair.
      • Zach Gittrich accepts nomination.
    • Review deliverables
      • Not necessary
    • Establish public comment rules
      • Not necessary
  • Review of Interim Risk Matrix and Toolkit
    • What can we agree on?
    • What needs to be changed?
    • What should response look like?
      • Zach Gittrich opened meeting up to open discussion on Risk Matrix & Toolkit
      • Zach Gittrich: This risk-matrix is for PSAPs to know who to dispatch in what situations.
        • Ryan Beck: How does response time work for moderate risk where LE/EMT is immediate by MCRT is a specific time? Is LE/EMT supposed to wait? Concerned EMS will be tied up waiting for MCRT.
          • Zach Gittrich: The law states the RAC is supposed to determine MCRT response time. If MCRT cannot respond in time, then LE can respond as normal.
        • Brian Murphy: Does 988 know the estimated response time?
        • Gabriela Vo: We do not have technology to track 590 teams on the map. We remain in contact with 590s though. If 590 cannot respond in time and 988 cannot deescalate, 988 would escalate to LE response.
        • Rhonda Flegel: 911 is the only one who can dispatch LE/EMS.
        • Brian Murphy: Will 988 still be on the call and just transfer info over to 911? *
          • Gabriela Vo: Yes.
      • Zach Gittrich: Should we collapse level 2 & 3 into one on our Risk-Matrix?
        • Ryan Beck: If we collapse levels 2 & 3, we should move several of the situations to Level 4.
        • Dennis Duke: Our work is to use the SAC's recommendation. We could use only 3 groups moving forward. But until anything changes, our work is to operationalize the four categories. We could request from the state to consolidate 2 & 3 down, but I do not believe we can make that change as a region.
        • Brenda Hampton: Dennis is absolutely correct. The RAC cannot change the amount of categories.
          • Zach Gittrich: And this is DMH's recommendation?
            • Brenda Hampton: It's not DMH's recommendation. It is the SAC's working document.
            • Zach Gittrich: CESSA state's regional committees have more power than State committee. CESSA coalition has spoken with head of DMH verifying this.
            • Brenda Hampton: That is incorrect. Changes will invariably occur. But the RAC cannot change amount of levels. However, modifications can be made between two levels.
            • Zach Gittrich: Can you show in the CESSA legislation where it say that?
            • Brenda Hampton: I will get something for you.
      • Zach Gittrich: Focusing on 1 & 2, we should specify in the dispatch type what the protocols are. E.g., no lights, sirens, uniforms for people in autistic crisis.
        • Brian Murphy: Regarding dispatch protocols, we attempted that and the pushback from fire/ems was very strong. This is something that might have to be discussed with the responders themselves, and not in the PSAP risk-matrix.
      • Rhonda Flegel: Brian is correct.
        • Gabriela Vo: How would something like no-uniform work with LE?
          • Zach Gittrich: Many co-responder teams, the officers respond already in plain clothes. However, many places don't have co-responder models and co-responder models are more expensive, so what co-responder will look like is LE and MCRT will show up separately at the same time.
          • Rhonda Flegel: We dispatch for a lot rural areas where co responder can't get too. We'd then have to rely on CIT officers and many rural LEA don't have officers in plain clothes.
          • Dennis Duke: FYI, many MCRT have their own uniforms to identify themselves.
        • Brian Murphy: Clarification on terms is necessary: florid psychosis.
          • Gabriela Vo: Florid psychosis means hallucinations, delusional beliefs. Psychosis where someone is not intoxicated but may seem intoxicated. Many people believe those experiencing psychosis are dangerous but that is not true.
        • Dennis Duke: We need to identify training needs. Also, not clear that 988 is able to dispatch at all. So, we may need to remove that 988 is a dispatching entity.
          • Rhonda Flegal: 911 dispatchers hold licenses through state for Emergency Medical Dispatch (EMD) and Emergency Fire Dispatch (EFD). PSAPs have very specific scripts that they must follow.
          • Brenda Hampton: The risk-matrix is a high-level document. There will need to be scripts and training created. Furthermore, 988 does not dispatch 590 providers. They do a warm transfer.
        • Zach Gittrich: I recommend we add to Level 1: a) behaviors that effect those with autism that may seem violent, but are forms of self-harm like yelling, hitting oneself, being on the ground, and b) someone specifically requests MCRT.
          • Zach Gittrich: Also, how do PSAPs define the word "emergent"? *
            • Rhonda Flegel: Emergent depends on what is going on in the moment. Normally 2nd or 3rd party call. If there's aggression/weapons/danger to life or self is more emergent than someone just needing someone to talk too.
          • Gabriela Vo: if someone has a pocket knife is that a LEA response? *
            • Rhonda Flegel: It could. But it depends on the intent of use.
            • Zach Gittrich: Reminded everyone the story of Stephon Watts, who was shot because he had a butterknife even though he was not using it in a threatening manner.
        • Ryan Beck: What are we expecting of EMS providers?
          • Brian Murphy: Intent of CESSA is diverting from hospitalization. So we may be expecting EMS to wait for MCRT.
          • Zach Gittrich: So EMS couldn't take them to a crisis stabilization unit (CSU)?
          • Rhonda Flegel: No, EMS cannot.
            • Dennis Duke: CSU is not available everywhere. In some situations it will be a default to EMS transport to hospital.
            • Ryan Beck: We should only send EMS when we are okay with transporting someone.
        • Brian Murphy: Why are we setting a time limit for MCRT's for moderate risk?
          • Dennis Duke: Changing that time limit in the moderate risk sounds like a good thing to bring to our RAC.
          • Ryan Beck: Once EMS is dispatched we have a duty to stay with that patient.
  • Next Meeting Date: Tuesday, May 23rd, 2023. 1 PM.
  • Public Comment
    • No public comment given.
  • Adjournment - Meeting was adjourned by Zachary Gittrich at 2PM.