CESSA Statewide Advisory Committee Meeting Minutes 09/11/23

Approved by Committee Members 10/16/2023

Community Emergency Services and Support Act (CESSA) Statewide Advisory Committee

Meeting Minutes - Monday, September 11, 2023 - 1:00 pm-3:00 pm via WebEx

This meeting was recorded

Call to Order/Roll Call  

  • Meeting called to order by Secretary Grace Hou at 1:02 pm. 
  • Approval of August Minutes:  A motion was presented by Brent Reynolds to approve minutes, seconded by Cindy Barbera-Brelle. Minutes approved by all present members, unless listed as "abstain" below.
  • Members Present: David Albert, Bobby Van Bebber (Designee for Ashley Thoele), Cindy Barbera-Brelle, Brent Reynolds, Shelly Dallas, Drew Hansen, Jim Kaitschuk, Blanca Campos, Emily Miller, Pooja Nagpal, Candace Coleman, Curtis Harris, Rick Manthy (abstain)
  • Members Absent: Alice Cary
  • Lee Ann Reinert reviewed procedures around the Open Meetings Act and meeting logistics.   

State Updates, Secretary Hou / Lee Ann Reinert  

  • Announcement: the current Deputy Governor for Health and Human Services is moving to a new position. Grace Hou will transitioning to Deputy Governor in October.
  • David Albert will take on the role of chairing SAC meetings.
  • Dulce Quintero is being appointed Acting Secretary of the Department of Human Services.
  • Lee Ann Reinert: We do not have any public comment questions or statements this month.
  • Alice Cary is resigning from her position at the University of Illinois. She was appointed by the police chief association. They have made a recommendation for the next appointee and are currently in the vetting process.

CESSA Challenges and Opportunities, Lorrie Jones

  • New runway to July 2024
  • Design opportunities:
    • Medical Director responsibilities
    • PSAP engagement and fiscal needs
    • Limitations in MCR as a singular solution to police involvement
  • Medical Director responsibilities, Lee Ann Reinert / Bobby Van Bebber
    • Feedback from Medical Directors: The time commitment has extended beyond the initial timeframe agreement. There is no compensation for Directors. Concerned there is not enough forward movement for them to be engaged on a monthly basis. This has become an immense time commitment from them.
    • What are our options? We don't want to work counter to the legislation, but understand the concerns of the Medical Directors.
      • Consider a statutory change that removes them from their administrative responsibilities and join the expert consultant group instead. CESSA updates would then be a part of their quarterly meetings.
        • Brent Reynolds: The time commitment and obligations for all of these CESSA meetings and subcommittee meetings take a lot of resources and time. The frustration is palpable, but in the last couple of meetings we have seen more participation. It is going to take a lot from all of us to make this work.
        • Candace Coleman: I would suggest after the visioning exercise, find out where certain entities need to be engaged and maybe have a timeline for each entity to make decisions.
        • Dr. Matthew Jordan: I understand the process and my group has been fairly functional. I have no issue continuing the process.
        • Director Albert: What is the time commitment at this point? Are there things we could be doing to address the lack of compensation / lack of support side of this?
          • Lee Ann: The meetings are a couple of hours. There is additional prep. Participation in SAC.
          • Matthew Jordan: I would say it's 3 or 4 hours per month. Virtually we are able to connect more and attend more.
          • Director: I really don't know whether there is a role for us to play, for anyone that participates in this work and is not supported by their employer. I'm glad we are talking about his.
          • Candace: Whichever regional Medical Director: has the regional committee had conversations about support?
          • Eddie Markul: I think Dr. Jordan is underestimating the time a bit. I think it is more like 6 - 8 hours a month. I think the issue of compensation is important. I think it would be an incentive for others to participate more.
        • Curtis Harris: If the Medical Directors can't do an effective job, I'm fine with the fire department.
        • Brent Reynolds: I feel like we are spending a lot of time talking about this specific topic, and I don't think it's exclusive to medical directors. I don't know that anyone needs to be compensated further than their current employment. If we see some progress, we may get people more involved.
        • Blanca Campos: Is the goal with these discussions to come up with potential solutions to make changes to the legislation? I think you're recommendation on who can be the co-chair would be good.
        • Lee Ann: I do think that we need to further explore some areas where the legislation may need some revision. If we provide more flexibility to the Regions, we would need to I believe. I think this needs to be further discussed, but we should probably start a list of legislation challenges to get to our goal.
    • PSAP Engagement and their fiscal needs, Lorrie Jones
      • The PSAPs do not have the same protocol vendors. Each vendor has specific requirements, including fiscal requirements for changes.
    • Once the protocols are changed and recommended, their computer systems need to change. About 14 different CAD providers. All requiring fiscal needs that are essentially unfunded by the statute.
    • Significant responsibility in change implementation. Small percentage are actually members of the regional committee.
    • What do we need to do to fully engage the PSAPs?
    • What should happen with this information?
      • Shelley Dallas: As far as PSAP engagement, the PSAPs throughout the state are following it and engaged. Some of where we are right now in the state is a little convoluted. We have had a couple members pledge to speak with non-responsive protocol vendors, and they have agreed to be more engaged. We are trying to push the issue as far as vendor engagement and PSAP engagement. We are encouraging PSAP engagement.
    • Blanca: I was wondering if there was any flexibility in this process? Federal monies we can tap into?
    • Brent: 911 funding is already stressed for the PSAPs. We don't have money in the 911 funds to do this.
      • Lee Ann: We have put a lot of grant funding into the crisis capacity system across the state. We are hearing from some agencies that staff was really excited about the MCRT aspect of the job, but there is not enough engagement at the moment and some agencies are losing staff members because of this. We are investing a lot of staff resources into funding out 590 system as much as we can. Even fully staffed, program 590 may not be enough at any one time.
      • Brent: My concern is we get everything up and running, then we get to a path where the MCRTs are not available. I think when talking about money we should make sure we are funding MCRTs.
    • Curtis Harris: I believe that we want the fire department to send to emergency for mental health crisis instead of police.
  • Limitations of MCRT and the broader systems change: We have full state coverage (MCRTs assigned to every county). It's unlikely that MCRT can be available for all responses in a reasonable time. We also cannot fund MCRTs to be able to respond within the 'reasonable time'. We know MCRT is a viable response to the lower levels of the IRLM. Should we think about amending the statute to not be so prescriptive and not only rely on MCRTS and look at other alternative response models that can reasonably be part of the solution?
    • Blanca: I think I would agree with that. We know that this is one solution to the lower needs individuals. Response times in certain situations cannot be this long. Community agencies partnering with their local law enforcement and doing co-responder models. Expanding this has challenges including funding. We've heard a lot of co-responder models and presentations. MCRT is one response to a greater problem we all have.
    • Jim Kaitschuk: Overall for how we are dealing with crisis management as a whole is one size does not fit all. Different models are helping in different areas. The reality is LE will be the responder in certain circumstances (for those will long response times). Sometimes we are the only people on the clock.
    • Shelley: I think we are talking about funding and resources and a lot of big issues, but the biggest issue is identifying what type of incident it is when the (911) call comes through. The initial information received is typically very vague. The PSAPs scramble themselves trying to find out the nature of the call. It's really difficult to determine the cause until a first responder is on scene.
    • Rick Manthy: My understanding is the IRLM are static and cannot be changed, however the response can be adjusted by the region level. (Correct - Lorrie Jones)

Oral Presentations from SAC Members

  • Jim Kaitschuck: We are training more and more in LE about de-escalation, as much as we do scenario training, everything can turn on a dime. There is a lack of services that are currently available in some locations. How soon, if at all, is this type of model going to be available in my area? We need to look at different locations with different levels of services available to them.
  • Brent Reynolds / Shelley Dallas: The major strengths of the system is that 911 is an immediate response. It's been in place for decades. Major challenges: most of the 911 professionals do not have behavioral health training, the lack of resources that are readily available, lack of ability to integrate with 988. If a PSAP transfers a call to an agency that is not public safety, we need to make sure that the agency can transfer the call back to 911 if need be.
    • When we talk about our EMD protocols, each one of the different providers has a different level of complexity. The one provider that may appear to be less than cooperative is due to difficulties in changing the system, not the change itself.
    • Consequences of the inadequacy of the system: The responders and those experiencing the crisis are the ones at risk.
  • Rick Manthy / Drew Hansen: Encompassing mental and physical health emergencies. We have a wealth of knowledge and experiences. Being able to be present and provide the services to people in need. Vast majority of the membership I represent, the large portion of firefighters live in the neighborhood they support. Being there and being part of the community. We have a very robust documentation system for the EMS. Issue: There is a large use of the EMS system and 911, but it limits our time on task. We have an obligation to the community outside of just the single emergency we are on. The vast majority of our EMS only transport to a hospital. The lack of flexibility in response is an issue. Safety to fire/EMS and 590 providers needs to be looked at.
  • Pooja Nagpal / Curtis Harris / Candace Coleman: Major strengths of the system: relational support where people can have control of their care, possibility of deescalating a crisis before expensive alternatives happen. The misunderstanding of how to process mental and emergency room This system was designed to map out what we have available, then create what needs to fit in there. Overarchingly, we have to switch the narrative around BH/MH crisis and response. We need to not tie the mental health crisis system and the legal system. Could use better dialog across each level. Especially in regions, because we do not want to stress any one organization out. We hope to find a shared realization that not every MH crisis does not need a police response as well.
  • Blanca Campos / Emily Miller: Strengths of the system are staff / providers with longstanding relationships with the community. We have seen a large amount of increased investment in the crisis system. This allows a large number of individuals to receive contact when needed. Inadequate, there seems to be confusion around who to call when. Difficulties with the makeup of the state and what resources are available where. With continued education and awareness of what is happening here. Our children's crisis response remains separate. Consequences: Our kids system, without coordination families may be subject to multiple assessments. Thoughtful development of the "place to go" is so important. Perhaps we need to involve specific legislators. In terms of helping the evolution of the process, it might behoove us to invite the legislators to join us.

Public Comment:

  • Jim Mouldenhaur: I got an email stating that Region 8 will be on hold. Is this the same across all of the regions?
    • Lorrie Jones: There have been issues with attendance. There has been so much focus on completing the Landscape Surveys, IRLM, and vacations. We think this is why attendance is so low. Co-chairs asked us to sunset the meetings until after the visioning. The regions are on pause until after the visioning. Moving forward we will have detailed agendas set up ahead of time, so that they will know exactly what they will be doing.
    • Jim: A lot of calls are going to come in through the 911 centers, and this will be on the dispatcher. If we are receiving calls from 911 or crisis centers, a lot of the time these calls are vague and we cannot get enough information. If there is any discussion regarding funding for this board, I think it should be put towards training for telecommunicators, especially with levels 2 and 3.
  • Alyssa Morero: I think it would be useful to consider existing resources that have already been invested. Like police and 590 working together. If there is funding coming it could go into training. If we do this together instead of siloing this out, we may be able to work together better.
  • Corrine Swiatek: In the very early stages of CESSA legislation, the interim matrix was represented as an interim. Is this now a be all end all and we should take the 'interim' out of it? I think we may be spending a lot of time working on a temporary solution in place of a permanent solution. Can we remove interim or is that something we can all look at?

Adjournment: Meeting adjourned by Secretary Hou at 3:06. No opposition.