CESSA - Region 2 Standards & Protocols Subcommittee Meeting Approved Minutes 06/06/2023

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

Meeting Minutes- June 6, 2023 - 1:00-2:00 via Teams

Meeting Minutes - Approved by Members 07/11/2023

Call to Order

  • Called to order by Zach Gittrich at 1:02 PM.

Open Meetings Act

  • Read and notified meeting is being recorded.

Roll Call & Approval of May 2nd, 2023 Minutes

  • Present: Zachary Gittrich, Ryan Beck, Sarah Scruggs, Rhonda Flegel, Meghan Moser, Brian Murphy, Jodie Mahoney, Latricia Seye, Luke Thomsha
  • Absent: Allen Haefner, Jamal Simington,
  • Guests: Angie Clark, Brenda Hampton, Gabriela Vo
  • Luke Thomsha asked to formally join the subcommittee.
  • Quorum Achieved.

SAC Updates

  • The legislature did provide a year extension for CESSA implementation.
  • Risk-Matrix levels: DMH stated at the May 8th SAC meeting that the RACs cannot reduce levels from 4 to 3 for the time being.
  • 590 Dispatch: Currently, 988 is not able to dispatch 590 teams in Region 2. However, according to DMH at May 8th SAC meeting the goal is that 988 will be able to dispatch 590s. Current obstacles are technical and logistical in nature.

Proposed Changes to Risk-Matrix

  • Review of CESSA Law
    • Prohibition on Law Enforcement involvement:
      • Section 30.a: Law enforcement responsibility for providing mental and behavioral health care. In any area where responders are available dispatched to respond to an individual requiring mental or behavioral health care unless that individual is (i) involved in a suspected violation of the criminal laws of this State, or (ii) presents a threat of physical injury to self or others.Responders are not considered available for dispatch under this section if 9-8-8 reports it cannot dispatch appropriate service within the maximum response times established by each Regional Advisory Committee under Section 45.
      • 30.a.1: standing on its own or in combination with each other, the fact that an individual is experiencing a mental or behavioral health emergency, or has a mental health, behavioral health, or other diagnosis, is not sufficient to justify an assessment that the individual is a threat of physical injury to self or others, or requires law enforcement response to a request for emergency response or medical transportation.
      • 30.a.2: If, based on its assessment of the threat to public safety, law enforcement would not accompany medical transportation responding to a physical health emergency, unless requested by responders, law enforcement may not accompany emergency response or medical transportation personnel responding to a mental or behavioral health emergency that presents an equivalent level of threat to self or public safety.
      • Section 30.a.3: Without regard to an assessment of threat to self or threat to public safety, law enforcement may station personnel so that they can rapidly respond to requests for assistance from responders if law enforcement does not interfere with the provision of emergency response or transportation services. To the extent practical, not interfering with services includes remaining sufficiently distant from or out of sight of the individual receiving care so that law enforcement presence is unlikely to escalate the emergency.
    • Section 55. Immunity. The exemptions from civil liability in Section 15.1 of the Emergency Telephone Systems Act apply to any act or omission in the development, design, installation, operation, maintenance, performance, or provision of services provided by this act. This specifically applies to our Mobile Crisis Response Teams.
  • Review of proposed Risk-Matrix
    • Zachary Gittrich explained he drafted risk-matrix is based on conversations with RAC members and the interpretation of the law. Explained differences between state recommendation and RAC 2 draft. It will be up to the committee to democratically make all final changes. One of the subcommittee's goals is to turn risk-matrix from a high-level document to a low-level document for our PSAPs. Risk level two of the matrix was changed to a non-police response involving EMS & MCRT working together with a response time of 60 minutes. Risk Level three is the co-response model involving law enforcement. Risk level three has an immediate response for LE/EMS and 30 minute response for MCRT. Risk level 4 has Law Enforcement response with MCRT response if requested once scene is secure. The one thing all risk levels share is there is a mental, behavioral, and/or developmental crisis occurring.
    • Ryan Beck - EMS is not holding calls. How do we coordinate with MCRT? Usually, when we get a call, we send EMS immediately, we don't wait. Currently, all coordination between EMS, Fire, and LE is through PSAPs. If there's not immediate need for EMS, why would we even respond unless requested by MCRT?
    • Zach Gittrich - Other alternative responder models often have medics as part of their response.
    • Ryan Beck - EMS operates under a medical director's license. We are limited in the care we can provide in the field. Person's with high intoxication: there's little MCRT can do besides transport them to drug rehabilitation center. EMS can only give fluids and/or transport to hospital.
    • Meghan Moser - Agree with Beck. I don't know why we would need EMS present in Risk level two. It's far more likely I'm going to have a safety issue and need LE than EMS.
    • Jodie Mahoney - In our area, whenever EMS is requested, LE is responding first. LE arrives prior to EMS. Once an EMS request is made, there is no way to cancel that request. I don't know if we can tell police not to show up or not to respond with lights & sirens. It's part of their protocols and they are responding to secure the scene.
    • Zach Gittrich - The CESSA law changes that. LE are prohibited from responding to incidents where we determine they are unnecessary. The law will require police to change their protocols.
    • Ryan Beck - There will be providers who deem it necessary for law enforcement to be present if they don't feel comfortable.
    • Meghan Moser - It's going to be rough to change those protocols. My worry is how often are we going to be able to make it in the time period allotted.
    • Zach Gittrich - If any responders do not feel comfortable, the law does not prohibit them from requesting LE back-up.
    • Zach Gittrich made a motion to change Risk Level two response from "EM Response w/ Mobile Crisis Response Team" to "MCRT Response (EMS if requested)"
      • Ryan Beck seconded motion.
      • Voice vote: unanimously in favor. Motion is approved.
    • Brian Murphy - I think we need more time to review matrix and review with our teams.
    • Brenda Hampton - As a reminder, whatever this subcommittee decides, will have to be approved by the Region 2 RAC.
    • Ryan Beck - In Level three risk "Active suicide attempts w/out lethal weapon" allows MCRT up to 30 minutes. If someone has taken four bottles of pills and we have to wait 30 minutes for MCRT we're going to find bodies not people.
    • Zach Gittrich - In that situation, transport to hospital would be appropriate and MCRT will follow-up at hospital.
    • Ryan Beck - I think a lot of these situations will be MCRT will follow-up.

Next Meeting Date: July 11th, 2023 @ 1 PM.

Public Comment

  • Matt Fish - Works for Cook County Sheriff's office. Asked how our draft matrix was developed? Asked where does 988 fit into our matrix?

Adjournment at 1:52 PM.