CESSA Technology, Systems Integration & Data Management Subcommittee Meeting - Approved Minutes 09/18/2023

CESSA Subcommittee for Technology, Systems Integration & Data Management (TSIDM)

September 18, 2023, 2:00 - 3:30 PM

Meeting Minutes - Approved by Members 10/02/23/2023

Subcommittee members: Brent Reynolds, Cindy Barbera-Brelle, David Albert (Designee-Lee Ann Reinert), Richard Manthy, Alice Cary, Jim Kaitschuk, Ashley Thoele (Designee - Robert Van Bebber)

Expert Consultant Group (ECG) members: Peter Eckart, Chris Baldwin

  1. Welcome and Call to Order (Roll Call)
  2. Open Meetings Act
  3. Approval of the Minutes from previous meeting
  4. State Updates
  5. Planning and updates on deliverables for CESSA technology and data
  6. Next Meeting Dates
  7. Public Comment
  8. Adjournment

The meeting was opened by Rick Manthy at 2:03 pm

Rick Manthy reviewed procedures around the Open Meetings Act and meeting logistics.

Roll call:

Present: Brent Reynolds, Joe Croegaert (Designee Lee Ann Reinert), Rick Manthy, Bobby Van Bebber, Cindy Barbera-Brelle

Motion to approve minutes from Brent Reynolds, seconded by Cindy Barbera-Brelle.

Minutes from 9/5/23 approved by Brent Reynolds, Joe Croegaert, Jim Kaitschuk, Cindy Barbera-Brelle

Updates:

  • Cumberland County is updating their system from the stand alone Powerphone to their total response system which integrated to their CAD. Follow up meeting next week.

Recommended CESSA Reports:

  • Volume of calls coordinated between 911 and 988
  • Volume and referrals from other first responders to 988
  • IL CESSA Crisis Continuum
    • Focus - Service calls, referral and disposition by type of CC provider
    • Overarching goal - monitor progress toward CESSA goal of providing alternatives to law enforcement only responses to individuals experiencing behavioral health/mental health crises
    • Potential data collection elements
      • PSAP identifier, EMS Region Number, Reporting Month, Total Number of Emergency Calls, Total Number of BH/MH Emergency calls, Caller Type/Category, Incident Type, Disposition / Referral
    • Potential data collection elements for 988 Centers
      • 988 Call Center Identifier, EMS Region Number, Reporting Month, Total Number of BH/MH Emergency Calls Received and Answered, Total Number of BH/MH Calls Referred from 911, Total Number of BH/MH Calls Referred from Law Enforcement, Total Number of BH/MH Calls Referred from EMS, Call Disposition
    • Potential data collection elements for MCRTs
      • MCRT Provider Identifier, EMS Region Number, Reporting Month, Total Number of BH/MH Emergency Calls Received and Answered from 988, Total Number of 988 Referrals Resulting in MCRT Dispatch, Total Number of 988 Referrals Resulting in referral to other MH services, Total Number of 988 Referrals Resulting in referral to Law Enforcement, Total Number of 988 Referrals Resulting in referral to EMS, Total Number of 988 Referrals Resulting in referral back to 911
  • Illinois CESSA Statewide and Regional Compliance Report
    • High-level summary of all CESSA operations, including advisory / convening, referral networks, administrative support
    • Statewide and regional counts for training, communications, and data system development
    • CQI and Change Management
  • Cindy Barbera-Brelle: I just want to confirm that if I call 988 and it doesn't go to one of the state centers, it will go to the Bloomington Center first before it rolls to the national backup. Is that the case?
    • Lee Ann Reinert: That is correct for any county that does not have PATH in Bloomington as their primary. It will first ring to the primary call center, then PATH, then national backup. 3 of our 6 Centers don't work 24/7. On those times it is immediately re-routed to PATH. If PATH doesn't answer within 2 minutes, it routes to the National Backup.
  • Lee Ann: The national call centers are trained to handle crisis calls. They are held to the same kind of expectations as far as the call center operation they provide. This remains a challenge for operationalizing CESSA at this moment. The National backup centers don't have access to state developed databases that call centers at a state level may be using for a dispatch type function. Our 6 call centers have information that we have provided for them with geographic boundaries and the MCRTs that are responsible to respond to that area. There is no mechanism currently for states to share this information with the national center. These centers are essentially using Google and some SAMSHA developed tools for them to find the appropriate crisis response center. We are reducing our reliance on the National Backup Center, but there may be times that they are involved.
  • Mary Smith: I think we also have to remember that in addition to the type of data and reports that we want to create, the state is currently receiving other reports. One of those has the data on answer rate and flow to backup. There may be some other sources of data and reports.
    • Lee Ann: We receive information that we get from Vibrant. Since they control the routing, they know where they have sent that call to, whether it was answered, and whether it was forwarded on to the next center. I think it's very important that we are very clear as we move forward in this process, any time we are talking about data we don't control, it's very delineated between that and things that we can control. There are caveats we need to communicate clearly so there aren't expectations around it.

Virginia Site Visit - What can we learn:

  • What did you see that you think would be appropriate for IL from Virginia?
    • Brent Reynolds: It's an impressive solution that they're using. My concern for us is putting the cart before the horse because we don't have a great way of communicating between our sources. I almost feel like we are jumping ahead too far down the path.
      • Peter: Let me ask you the associated questions. On any of the pieces that I just presented, wehre there any pieces there that seems like IL already had some of them or the opportunity to build some of that?
      • Brent: I would say that there's the possibility of EMS having this information and the mobile response teams that are already in existence.
    • Rick: The initial risk assessment. I assume these are what the 988 call centers are going through. I'm assuming it's the call centers doing the initial assessment, is that correct?
      • Peter: For VA it's all one call center. I wonder what you think about the possibility of this is for the 911 centers. Do they not already make a determination based on some of those things?
      • Rick: The 911 Centers are going to be determined based on who they are using for their EMS protocols. I would think this is more in line with the 988 call centers. I definintely like the risk assessment matrix they are using. Like Brent said, I think the rest is putting the cart before the horse.
    • Cindy Barbera-Brelle: Initially, I was looking at this in terms of the protocols which potentially do a lot of this. Gathering based on the questions that you're asking then moving through the various slots of the protocol. I guess the key will be what types of reports can we pull out of the protocol that we want to report on.
    • Peter: How much of this can we start to equally represent at the other nodes in the system? With 911, with Law Enforcement, with 988, and with Mobile Crisis Response. What other barriers would we have to overcome to create a system that has the elements that we want in Illinois?
      • Rick: That's a loaded question. It looks like VA is dealing with 1 call center, 1 primary 988 center and PSAP. They're in the same boat as a lot of the county agencies we talk to. In IL we have so many different entities between the 11 regions and the number of PSAPs and 590 providers. I don't see us being able to bridge those gaps. If we only had 1 of each it would be one thing, but we have a lot more bridges to gap.
      • Peter: Virgina has 5 hubs. These 5 hubs are the centers for each of the areas. They have a standardized system in each of the 5 hubs. They use this software to create a standardized set of services for MCR across the state. It's not 11 regions, it's 5. And there's one crisis number that routes them to each of the reasons. It's more centralized.
    • Cindy: One thing unique about VA that we learned, they have a state employee that's responsible for that region and does a lot of the coordination. We don't necessarily have that model in place. It doesn't mean we can't do what we need to do, but they have more boots on the ground at the moment.
    • Mary: While it might not be possible to do these things now, we are making recommendations about the direction the system needs to go in. None of us expect to run out of the gate July 1, 2024 being able to do these things. I think what we are doing is laying the groundwork to develop a system that we need in IL. We have to think ahead and have a vision of where we want to go.
    • Brent: Part of my question in, to those representing 590 or 988, is this something close to what they are currently using in their operations.
      • Chris Baldwin: Our system doesn't quite look like this in the same way. We do have call forms that we can help sort through different components of risk, and we do collect the data. Our forms do not produce any recommendations, that's purely the training of the call operators. We have no geolocating. Based on the self-reported zip code our system will sort the responses to distance from the reported location. I think the biggest challenge is just going to be figuring out how to produce a system that incorporates the various stages of the process. There are protocols that go into evaluating the current risk factors. The protocols are interpreted by the operators. It's not something automatically produced by a system. When operators are making the call you have room for operator error, when the system is making the call there's not as much leeway for assessing aspects of the situation that aren't as quantifiable. I think there's room for both ways.
    • Chris Baldwin: I would love to have this real time map to just get the closest team there. It would require a slight adjustment to the 590 teams to just go to the closest call instead of having such defined boundaries. At PATH we are happy to reduce law enforcement involvement in these types of situations. I think some of the biggest challenges we've seen is a culture shift of when is it appropriate to send things to the 590 call centers or 988. Some of the work is just going to be a cultural change understanding that. A lot of the risk level discussion has been framed as how PSAPs evaluate risk. There hasn't been as much discussion of how 988s evaluate risk because it seems like the 988 risk evaluation process has been pretty stable. It's a slightly different perspective on our end.

Next Meetings: 1st and 3rd Mondays at 2:00 pm. October 2 at 2:00 pm.

Public Comment:

  • Alicia Atkinson (in chat): When looking at the system of out of Virginia, it seems like a hybrid of a 911 center's CAD system and protocol system. It may be worth determining the interfacing abilities of 911 protocol provider's system and this system (or any future 988 center system). It could be possible to have the cloud based protocol systems of 911 centers interface with a future 988/590 system to capture information already gathered by a 911 center when they receive the call transfer at 988. It may also be beneficial to research cloud based CAD systems built for 911 centers and how they can be utilized for 988 centers.
  • Craig Kowalski: My chat comment was directed to Christopher when he was speaking on the GPS coordinates of the 590 providers. They already have the emergency beacons and they are not clear across every team. Those coordinates are already being disclosed, but I don't know where they are going. It would be beneficial for the state to get a cross platform for those beacons for the MCRTs when they're responding.
  • Jessica Gimeno (Access Living): This is my first attending a Technology, Systems Integration & Data Management Subcommittee because I am new-I am the new Mental Health Policy Analyst at Access Living. I attended the 988 Suicide Hotline and Crisis Workgroup Meeting last Thursday; Virginia's system was a big topic too at that meeting. VA's system is very impressive and gives me hope, of course there are some challenges.

Adjournment: Meeting was adjourned by Rick Manthy at 3:24 pm. No opposition.