Community Emergency Services and Support Act (CESSA) Region 3 Advisory Committee
Meeting Minutes - April 18, 2023 - 8:30-10:00 via Teams
Meeting Minutes - Approved by Members 06/20/2023
Call to Order/Introductions
- Diana Knaebe called the meeting to order at 8:32am.
- Member Attendees: Matthew Johnston, MD, Diana Knaebe, Chad Dooley, Jessica Douglas, Brenda Hampton, Olivia Mefford, Mark Schmitz, John Simon, Andrew Wade, Katrina Moseley
- Public Attendees: Phil McCarty, Nathan Shotton, Gabriela Vo
- Excused: Kristen Chiaro
- Absences: Andrew Dennis, MD, Trenda Hedges, Daniel Hough, Scott Hough, MD, Raymond Hughes, MD, Christopher Mueller, Devron Ohrn, Scott Pasichow, 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.
Approval of Minutes from March 21st, 2022 Meeting
- Due to Region 3 not meeting quorum, the March 21st meeting minutes could not be voted upon and will be voted on at the May 16th meeting.
Landscape Survey and Risk Matrix Toolkit- Diana Knaebe
- We are still missing about half the PSAP landscape surveys. We have received Christian, Shelby, Montgomery, Brown, Quincy, Adams, Sangamon, Scott and West Central Joint Dispatch. We have not received Logan, Cass, Hancock, Henderson, Macoupin, Mason, Havana Police Department, Menard or Pike County. We have relayed to the state the counties that are missing and Cindy Barbera-Brelle is supposed to be sending a reminder to all the PSAPs to get those sent in. It will be difficult for us to complete our piece without everyone's information, but we will work with what we have.
- For the 590 providers:
- Transitions of Western Illinois has Adams, Hancock, and Pike counties and has recently taken on Schuyler and Brown Counties.
- Memorial Behavioral Health has Christian, Logan, Mason, Menard, Morgan, Sangamon, and Scott counties and has recently taken on Cass County.
- Montgomery County Department has Montgomery County.
- Locust Street Resources has Green and Macoupin counties and shares Calhoun and Greene Counties with Chestnut Health Systems.
- Expected deliverable is to have an inventory of available mental and behavioral health crisis response alternative services by PSAP jurisdiction.
- Dr Johnston met with a group on April 12th to discuss the Risk Level Matrix. Minutes from the meeting have been shared with the group. If you have met with a group to discuss the Risk Level Matrix and would like to share those minutes, please send those to Diana or Katrina to share with the group.
- There is currently still a concern with Risk Level 2 & 3.
- Trenda Hedges brought up that she would like the Warm Lines to be included in Level 1.
- Dr Johnston - We all agreed that we did have 1 or 2 concerns. One was the "non-lethal weapon". Everything is a non-lethal weapon until it is not. If we know someone has a weapon, even if it is non-lethal, I have a concern for safety of our providers. I think that there has to be a co-response on level 3. Level 1 is mostly handled over the phone. A lot of the level 2's can be done by the warm line but MCRT does goes on some of those. We did talk about scene safety. I know that if Sangamon County, if a patient does not answer, law enforcement will go with MCRT.
- Dr Johnston - The other concern is response time. In the Quincy area, response time could be an hour and half from the main location. Who is going to stay on the scene with that patient depending on what level they are at? Levels 1 & 2 can wait on the phone for someone to respond in person, but what about Level 3? If law enforcement is busy and EMS is swamped, who is going to wait with these acutely ill patients? Our concern is that we need a second set of eyes on things, whether it be temporary or not, to make sure it is safe for our members to go out into the community.
- Mark Schmitz - Would like to add onto the response time. We are covering a really large geography. I think about the size of EMS districts. They do not tend to be very big or they have stations scattered throughout the area so that they can meet the response times. There is an expense to that. I worry that the response time, whatever the number, that it is a number that the provider is going to be held accountable to. If I am going from the center of our service area takes an hour and half to get to the furthest point in our area. If driving from the northernmost point to the southernmost point, it is almost 3 hours. If the ultimate outcome is the 30 minute standard, we would have to put active MCRT ready to respond in 30 minutes across the whole service area, but there is not funding for that right now. It would take a dramatic increase in funding to meet that. So with response time, does it get translated into a provider expectation that DMH is going to say that this level requires this response time, so you are expected to have staffing so that you can respond in that amount of time. I don't know how we would do that unless there was a dramatic increase in funding. Also looking at it from a taxpayers standpoint, I think people would be mortified about how much downtime the state would be paying for staff who are just waiting to respond to a call. So I am not sure it is a great use of our resources. So when it says response time, is that aspirational or is that a performance standard.
- Dr Johnston - Also in Level 2 there was a law enforcement with behavioral health/MCRT. Wondering if we need that response in level 3 as well.
- Olivia Mefford - The co-response via telehealth with MCRT, what is that going to look like for law enforcement? A majority of the individuals that we encounter do not have cell phones or do not have that capacity. Many of the time the officers use their own personal phones. Is that going to then require officers to stay at the scene, to maintain that connection with MCRT through the telehealth app? IOs there going to be iPads? Same question about co-response via telehealth.
- Diana - I would think that would depend on the different providers on what can be offered. The issue is, if the MCRT is not going out, then the iPads at someone's house without anybody having it. If there is no phone, how did they contact 988 or 911 to begin with? If there is a phone, then you can just do a telephone session so it is not virtual in the sense of just being telephonic. With the virtual piece, it is nice on a smartphone so that they have the ability to have face to face with MCRT.
- Olivia - We have individuals in our area who feel that their phones have been bugged . We need to think about the other barriers that we have come across.
- Mark - We have to keep in mind that organizations like Memorial are able to provide things that organizations like Transitions are not able to provide.
State Updates - Brenda Hampton
- Nanette Larson, Deputy Dir of Wellness and Recovery Services for DMH gave a powerful presentation to the Co-Chairs and SAC meetings last week on the importance of recognizing that people who have mental illness or people who have developmental disabilities, bring to the table expertise from their journey. We recognized that everyone in the SAC and maybe some individuals in the RAC really do not understand the population. We take it for granted that everybody understands individuals with mental illness, but people bring to the table their own stereotypes and their prejudgment and their biases about people. We have six of the most common stereotypes, but when you add to that a person who has a mental health disability, those stereotypes are magnified. When you hear of an occurrence, like a man shooting, the first thing that is said is "Oh, that person must have a mental illness." That is not a majority of the situations. When you bring to the table those stereotypes that we hold about a certain population and then make assumptions, that is very damaging, that is very detrimental. For some individuals who even participate in the RAC/SAC, they hold those prejudgments.
- Myths that Nanette wanted to bust about mental health:
- Mental health problems are rare.
- 1 in 4 Americans are affected by a diagnosable mental health condition every year.
- People with mental health problems are violent.
- People with mental health problems are no more likely to be violent than anyone else.
- Only 3-5% of all violent acts can be attributed to people with mental health problems.
- People with mental health problems are over 10 times more likely to be victims of violent crime than the general population
- People with mental health problems are "crazy".
- People with mental health problems need help and support for their condition. Derogatory, stigmatizing terms like "crazy" can cause people to avoid getting the help they need.
- People with mental health problems never recover.
- Research shows that people with even the most serious mental illnesses can and do get better. Many recover completely and go on to lead successful, productive lives.
- CESSA was built on the actions that occurred with a young man named Stephon Watts, who had autism, which falls under the category of developmental disabilities. Because of that these are the myths that Nanette wanted to bust about developmental disability:.
- Developmental disability is a mental illness
- Developmental disabilities are lifelong conditions that affect a person because of damage or change in the developing brain.
- There is no treatment for people with developmental disabilities
- There are treatments and interventions that can improve a person's symptoms and ability to function.
- People with autism cannot feel or express love or empathy.
- Autism does not make a person unable to feel emotions. It affects the manner in which the person communicates feelings.
- People with developmental disabilities function best in institutions.
- Research shows that individuals moving from institutional to community settings consistently develop their daily living skills to a higher level than their matched peers who remain institutionalized.
- Sprint to July 1st. We are making a lot of accomplishments in channeling and changing where we are with the deliverables. Will we have everything accomplished by June 30th, probably not, but that does not mean that DMH and the crisis hub are not continuing to plan for how do we do this work after July 1st. We are starting to get information back from the RACs as they start teasing out aggregate data that they have gotten from the landscape analysis. The training component has started, there have been 3 trainings so far.
Next Meeting on May 16th, 2023 at 8:30am.
Public Comment
Dismissal
- Diana Knaebe adjourned the meeting at 9:16am.