CESSA - Region 2 Standards & Protocols Subcommittee Meeting Approved Minutes 11/20/2023

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

Meeting Minutes- November 20, 2023- 1:00-2:00 via Teams

Meeting Minutes - Approved by Members 12/13/2023

  • Call to Order/Introductions
    • Call meeting to Order by Dennis Duke at 1:01PM
    • Attendees
      • Via MS Teams: Dennis Duke, Brian Murphy, Zachary Gittrich, Ryan Beck, Latricia Seye, Darren Gault, Jamal Simington, Michael Lau proxy for Sarah Scruggs, Julie Lewis, Travis Noyd, Rhonda Flegel, Jodi Mahoney, Matthew Jackson Brandon Gus-Miller, Sarah Stasik, Michael Daley, Anthony Walraven
    • Absences
      • Michael Barr, Todd Noe, , Donald Miskowiec, Christopher Watkins, Jake Herbert, lmad Khan, Chris Rogers, Meghan Moser, Wayne Gallops, Allen Haeffner, Steve Delis, Luke Tomsha
    • Guests:
      • Bobby Leebold, Brenda Hampton, Trisha Anderson, Jessica Gimeno, Susan Schafer, Pooja Nagpal,
  • Open Meetings Act - Read and notified meeting is being recorded.
    • Zachary Gittrich inquired if everybody on the absence list still a member of the Region 2 RAC.
      • Angie Clark responded since the regrouping of membership during the break of meetings-who is on the membership list currently are the members.
  • Approval of Minutes
    • June 14, 2023 Minutes -were approved.
      • Motion by Member Rhonda Flegel, second by Member Jodi Mahoney
      • Motion Approved by all members present
    • Next RAC Region 2 meeting will be December 13, 2023 at 1:00 PM
  • CESSA Revisioning Work
    • Dennis Duke provided an update noting the state had a pause on our CESSA work due to a lot of questions and issues to think through. The pause from the state provided an opportunity for the state, SAC and the RACs to look at what this work looks like for us going forward. Outcome of the in person revisioning meeting, we are tasked from now until June 30th to look at how we can deflect as many of the 911 calls and 988 to the 988 programs or the 590 response as possible. In order to accomplish the task we have to determine how to apply the level one risk matrix to the 176 PSAPS across the 11 regions of which we are comprised of. We are asked to assess the readiness of our communities that sit in our regions to deflect level one calls from 911 to 988 and the readiness can be measured by local leaderships commitment to this process, resources and vendor types at the PSAP level that are ready to make these necessary changes or other considerations that may be identified. To do this as a region, we were asked to identify what a plan would loolike to operationalize this goal in communities that we would assess to be ready. We are focusing in on the revisioning of the new deliverables of working to deflect as many 911 calls to the 988 or 590 response as possible. In order to do this we will need to understand what PSAPs have Power Phone in our region.
    • Brenda Hampton reported Region 2 has one vendor with Power Phone, total response which is McDonough/Schuyler County Communications Center. This is the only vendor that has total response in region 2.
      • Darren Gault reported he reached out to McDonough County to get them connected with Dennis Duke. Unfortunately, they're experiencing some leadership crisis and does not have a Director right now, but are in the hiring process. We may need to give them some time to get their leadership team on board before engaging them in this type of a project. Chief Gault will work to get them connected with the RAC Leadership team.
      • Dennis Duke reported we identified one (McDonough County) and another possibility if we had an independently developed protocol system.
      • Brenda Hampton responded Region 2 does not have independently developed system. We started with Power Phone but that does not negate all of the PSAP vendors. We are at a point in time where we're folded into the process. We started with Power Phone because they were most amenable to the discussion of change and incorporating the change in their protocols. Then there would be funding implications, so it's not we're just starting with Power Phone and no other PSAP would be involved. They are amenable, meeting with partners now and talking through how to make this a reality.
      • Dennis Duke Inquired if the work with thevendors will provide changes to be implemented by the PSAP.
      • Brenda Hampton responded yes, Standards and Protocol will be working with them to do that.
      • Zachary Gittrich inquired what is meant by independently developed protocol system. Do they already have protocols set up for working with mobile crisis response teams,
      • Brenda Hampton responded no, example provided is Will County 911 is independent (homegrown) vendor that has a direct relationship with Silver Cross Hospital in New Lenox. They use Power Phone technology for their platform, but because they are independent, they can write their own script. They are not reliant on a script from a vendor.
      • Dennis Duke asked for clarification - we have one Power Phone PSAP in our region. So will we be expected to work with that PSAP or identify another criteria.
      • Brenda Hampton responded you will work with that PSAP because they have total response and all the elements that are needed to make changes. McDonough/Schuyler County would be who you would work with.
      • Brian Murphy clarified we have 12 PSAPs who use Power Phone in our region, but only one that uses total response system. The eleven others use the platform maybe just not integrated.
    • Dennis Duke in order to move this plan forward, we will work with PSAP administration on scripting changes and we'll need PSAP representation. Obviously, we'll have McDonough/Schuyler County but would anybody else like to participate in a working group to help move this work forward. Law enforcement would be involved and would open it up to anybody else on our committee to step forward.
  • RAC Project Plan Discussion
    • Dennis Duke discussed as a region, we need to come up with a draft plan. Of the 11 regions we were one of the four who submitted a draft plan. I worked with law enforcement leadership Chief Gault on the plan which is divided into four areas:
    • Community Survey and Recruitment: Identify PSAPS meeting Power Phone - Total Response System criteria; Interview and recruit eligible PSAPS to participate in project to deflect Level 1 Risk Matrix call from 911to 988/590; target rural and urban PSAPS; determine potential funding needs for PSAPS; recruit PSAP managers beyond those selected for project to form and participate in working group; interviews with law enforcement, EMS, 590 Ambassador group to include members of law enforcement, EMS, and P.SAPS. Law enforcement and PSAP representation has been identified.
    • Project Training: provide Risk Level Matrix training with focus on Level 1 for tele-communicators(PSAPS) 30-days prior to scripts changes go-live; provide training to 988 ec II center on available community resources throughout the region and referral pathways. Need to determine who will be accountable for designing and providing training.
    • Data Collection and Reporting: assess data collection abilities of reporting entities including PSAPS, 988 call centers, and 590 providers; identify data points that align with project success outcomes; develop standardized data collection, submission, and reporting protocols; utilize data to assess performance, measure progress, provide for ongoing communication,and identify opportunities for improvement. Identify potential supports needed for data management including UIC Crisis Hub.
    • Communication Plan: monthly meetings with Ambassadors and PSAP working group...focus on problem solving, performance review, improvement opportunities; project implementation and performance review will be a standing RAC meeting item.
  • Dennis Duke requested feedback of who would be best to design and provide training- would it be the vendor to assist with or the vendor plus members from our RAC.
    • Brenda Hampton responded the UIC's Crisis Hub training component is developing training for 911.
    • Zachary Gittrich inquired about 30-days prior to the scripts changes going five, when the script changes are to go live - June or July.
    • Dennis Duke responded that is currently being negotiated with the state and uncertain of any updates.
    • Brenda Hampton responded from the $AC meeting held on Monday, there is nothing definitive. Cindy Barbera-Brelle said anticipated timeline was August 2024 for Power Phone.
    • Darren Gault provided some background noting why the 30 days before going live as the dispatchers needto get training relatively close to the go live time as we do not want to give them training too far away from being able to change their protocols or too close to going live. From consultation with PSAP managers who felt 30 days was where they wanted to be at to provide the training. Second thing this is a significanculture shift for a dispatch center. Currently, dispatchers do not triage calls, instead they gather the information and dispatch the call so this will be a heavy lift to train dispatchers on a new process. We need to give them the proper tools and education to make those determinationsby following the scripts that are developed by the state and accompanied with the training that they're going to receive from UIC.
    • Dennis Duke commented on 988 noting there's a lot of concern/question about the ability of 988 to move that referral on appropriately. It'll be important for them to understand what the resources are and the pathways to making those referrals are so that we're connecting the individuals presenting through the process.
    • Anthony Walraven inquired regarding the script - are you referring to something similar to a medical protocol where certain questions are asked and based oh the way those questions i:)re answered, appropriate level of dispatches is selected.
    • Dennis Duke deferred to Brenda Hampton to respond.
    • Brenda Hampton responded she cannot speak to the content of what 911 does. I would ask one of your 911 PSAP administrators to responda Anthony Walraven if there's going to be a protocol that's followed to determine and we're going to be transferring to 988...you're talking about a script and reference to, it sounds like the phone provider and scripts like that in our PSAP in Peoria are developed between our Medical Director and the Academy of Medical dispatching. I'm asking is this something similar to a medical protocol where a person presents an issue.
    • Brenda Hampton responded any changes to the protocol or the script has to be vetted by the EMS Medical Director for the PSAP and it will then have to go up to the Illinois Department of Public Health for confirmation verification, stamping approval. Whatever the charges are, they have to be vetted by the EMS Medical Director, who is in charge of how those decision points are made by the 911 telecommunicators.
    • Dennis Duke commented your Medical Director has ultimate approval.
    • Brian Murphy responded we're referring to the protocol scripts. The state has a draft project going with Will County using their medical direction and will have to be approved by local medical control.
    • Zachary Gittrich commented it sounds like the person who's going to be accountable for designing and providing training is coming from UIC.
    • Brenda Hampton responded the UIC Crisis Hub is also writing a training UM curriculum, not a curriculum. Training categories for the 911 PSAPs I think would be the decision of the PSAP administrators, Administrator Cindy Barbera-Brelle as well as adtninistrators for the PSAP that occurs with the training. The Hub is writing training topics and training categories.
    • Zachary Gittrich commented seems the person who is to be held accountable is either one of our PSAPs on here or the standards and protocol subcommittee, and we can create a working group.
    • Brenda Hampton responded I do not get the impression that each RAC is going to do their own training. There's going to be standardized training because it has to be consistent across the state.
    • Zachary Gittrich inquired is it our responsibility as the RAC to determine somebody that's going to design and provide the training.
  • Brenda Hampton responded no, it would be too incongruent. The training needs to be consistent across the state, not by individual RACS.
  • Dennis Duke noted getting to our project plan the UIC Crisis Hub will be accountable for the designing and actually providing the training to our PSAPs. There is another element to the training that I don't think UIC can provide regarding 988 call centers. Our region has 7 different 590 providers and each of the providers will have a responsibility ensuring 988 call centers understand the services available throughout the region.
  • Brenda Hampton responded there are six coming on to the 988 call center statewide There has to be continuity in terms of training for all those seven 988 call centers so they are hearing the same information the same way due to variability in terms of who the 590 providers are statewide. There may be opportunity either through writt n or participation in the trainings to share information about specific 590 providers, but we have written guidance where 988 in terms of their relationship with 590 and how it flows between the two of them.
  • Dennis Duke responded the opportunity for calls to be misdirected or not refer appropriately isa risk and the more information and education we can do of the services available throughout the region will be helpful for 988 to be successful. The next item is Data Collection - you really know what's happening if you can collect the data, identify important data points, and ability to report it out. Type of reporting would be person of successful call transfers from 988 to 590 or other service providers. Uncertain what everybody's data collection reporting capabilities are so this will be part of the interview process to identify how we collect the data and report it out. The data collection will help measure our progress, communicate it and know what our opportunities are for improvement. Last item is the communication plan and we will have monthly meetings with the ambassadors and the PSAP working group. Ambassadors can be 590 providers, law enforcement and EMS. Our focus in those meetings will be problem solving, reviewing our performance and what opportunities are for improvement.
  • Zachary Gittrich responded for data collection stating it would be a gooitem for Technology and Data Management subcommittee to work on and suggested to get arranged for January and requested to get the data from the landscape analysis from those who responded.
  • Brenda Hampton commented that RAC 2 is the only RAC that has subcommittees as the other RACs have working groups. Suggestion made was to move forward with working group. Further noted work groups still have a restriction in terms of the number of committee members that can honor a work group.
  • Dennis Duke shared with data collection reporting there will be support needs for the data management and maybe the analytics and questioned if that is something UIC can do. It was discussed with Chief Gault the possibility of a potential university level resource to assist and questioned if this is an opportunity to explore in terms of support that may be needed for data collection, analytics and reporting.
  • Zachary Gittrich stated there are only 3 members in the data management subcommittee and have only had two meetings so far.
  • Dennis Duke inquired if a resource separate from UIC Crisis Hub is possibility regarding data collection.
  • Brenda Hampton responded if that question was in writing, she would take it back to get an answer.
  • Anthony Walraven inquired about tracking the calls being either miss dispatched or miss transfer or if they should have been transferred - would that be done by going back and listening to the calls.
  • Dennis Duke responded we need to have an understanding of what the data collection capabilities are and what was mentioned may be one of the tactics and hopeful will be less working hours associated with this. It will be part of the interview process to determine.
  • Anthony Walraven commented the only experience he's had was when his area switched to a different software they had support who listened to every call by taking batches of them and providing feedback which was very labor intensive and cannot respond to another way to report.
  • Brian Murphy shared on the PSAP side use existing Quality Assurance or Quality Control methods would be most efficient way to provide, however PSAPs may not have existing Quality Assurance or Quality Control in place. This may be another conversation for a working group as the available tools by PSAP will change with the different card vendors. It may be different methods of gathering data depending on Metro area, urban agency or smaller rural area.
  • Zachary Gittrich requested to obtain the information from the landscape analysis.
  • Brenda Hampton will follow up on this request.
  • Risk Matrix Approval
    • Dennis Duke presented the Risk Level Matrix that was worked on by the Standards & Protocol Subcommittee for work on Level's 2 and 3. After discussion will look to approve the final document from members. Dennis Duke asked Zachary Gittrich to walk through the highlighted changes made to Levels 2 & 3.
    • Zachary Gittrich shared first item discussed was lights and sirens at the scene based on history or call details. It was noted there was a lot of concern from law enforcement partners and ultimately removed "non­ uniformed" as it is not feasible in our region and made note that the language is only a recommendation from PSAPs and understand law enforcement and EMS have their own protocols in place and will make those decisions in the field. We discussed item in Level 2 regarding response type listed as co-responder model but feel it would be better to have Mobile Crisis Teams and if they feel law enforcement or EMS is needed, they can request them to be dispatched. This change was for an alternative non-police response. Noting there are not many co-responder teams where law enforcement and mental health workers are working together as one team with a co-response. Meaning law enforcement and mobile crisis teams that work separately are dispatched at the same time and they arrive on the scene as far as the response time based on the data for Level 2 up to 60 minutes. Otherwise, law enforcement/EMS gets dispatched immediately in Level 3 and mobile crisis team is given up to 30 minutes to respond. Further noted in Level 3 if an individual is being transported to the hospital or CSU it is understood that mobile crisis team would be a follow up response. It was noted to remind people the way thelaw is written in Level 2 if mobile crisis team is unable to respond in 60 minutes, the dispatcher can immediately send somebody else out.
    • Brenda Hampton responded regarding Level 3 dispatcher noting it is fodispatching 911. It gives the appearance 911 operator is dispatching 590 provider and they are not. Need to be very cautious how this is presented.
    • Zachary Gittrich responded this was a decision the Standards and Protocol meeting made last week that they're going to have it so only 988 is dispatching the mobile crisis team.
    • Brenda Hampton responded exactly, in your region, the interim risk level matrix is statewide. There will not bea regional interim risk level matrix. Regional what is already established do not disregard. This is a statewide document.
    • Zachary Gittrich responded this was a decision that was recently made that only 988 is going to be responding to mobile crisis response team. There was never a vote on it. If there are any RAC members that have questions/concerns about this let me know.
    • Brandon Miller-Gus responded he was on the presentation that IDHS provided the PSAPS for CESSA on October 23rd and questioned the difference in Interim Risk Level Matrix that is presented against what he pulled up from the IDHS posting.
    • Zachary Gittrich responded there were changes made that didn't have any voting decision at any of the recent Standards and Protocol meetings and has never been matriculated down to the regional level or at the CESSA coalition. Noting there is some definite communication problems between the SAC and getting it to the regional levels.
    • Dennis Duke responded we are trying to seek approval but it sounds like we need some language modifications to the dispatch and that's on the table. Also, noting the discussion earlier regarding opposition related to the sirens and looking for approval.
    • Brandon Miller-Gus responded he provided a snip it from what the state posted back in October that was given to the 911 PSAPS for members to review.
    • Zachary Gittrich shared a post in the comment they believed the 590 language is 90 minute for Level 1. This was provided from the state. If they changed that, we were not given that. We were supposed to look at the dispatch response times for Levels 2 & 3 for deliverables,
    • Dennis Duke inquired hearing no comments related to the sirens and lights, is that something that remains or is that an issue from law enforcement perspective.
    • Jamal Simington responded from the items listed in the matrix, there's no issue for Level 2 - no internal siren and no issue with Level 3.
    • Ryan Beck responded there is no issue with the language as far as no lights and sirens. We're going to use them when we have to use them, but we'll certainly take into recommendation if it's going to exacerbate the situation and we cannot use them.
    • Zachary Gittrich shared an item to bring forward to communicate with the SAC is that have at least 1590 team and maybe a couple that also handles juvenile crisis and it seems the current state is they are going to handle juvenile crisis separately. We w111 need more feedback on how the 590's that handle both adults and minors are going to be able to do that with theresponse time because they had concerns about the response time in Level 2 and because of this, we ended up approving the 60 minutes. We would like to make sure that question/requestfor clarification is submitted,
    • Anthony Walraven commented on someone who would react adversely to lights or sirens noting a need to think about improving the communication between PSAPs and 590 providers regarding people they're already aware of because that information can be flagged about an address for safety concerns for fire department (example when house was COVID positive people-they would flag address). The information is usually provided by 3rd party and so if 590 group is already aware of people maybe improving communication between the two agencies so that 911operators know when they look at an address their aware individual has mental healt,issue that lights and sirens exacerbated.
    • Dennis Duke inquired of the 590 providers regarding Level 3 mobile crisis response up to 30 minutes. What is the capability of our 590 providers throughout the region - in Level 2 its 60 minutes.
    • Bobby leebold responded he didn't feel it is realistic given the geography and some of the processes that go into an MCR response.
    • Zachary Gittrich suggested a possible change in Level 3 to keep up to 30minutes, but then we change it and/or follow up if taken to emergency room etc. and we want the mobile crisis team to be able to follow up when they have that availability. Zachary Gittrich would make that motion to change if that would be more amenable to our 590s.
    • Dennis Duke responded and or follow up with individual in crisis. Does anybody have a suggestion for the language change with regard to the dispatch in Level 3. Does anyone want to propose a language change related to dispatch in the comments made by Brenda so that we are aligned. Dennis Duke will touch base with Zachary Gittrich offlineIt was noted we are close to approval with after language change to reflect the discussion.
    • Zachary Gittrich responded he would be willing to make a motion to approve and send to the state and if they want to communicate further changes, we can handle that in this subcommittee and bring back to the RAC. Zachary Gittrich inquired if anyone wanted to second the motion or if it is appropriate to make.
    • Dennis Duke responded because 911 isn't going to be actually doing the dispatch, if we could change the language to reflect discussion, it would move us into alignment with what information is out there from the state perspective. Recommendation to the RAC was to modify the language to 1'30 minutes and or follow up with individual in crisis1' and submit to the state for approval.
    • Brandon Miller-Gus shared concern as a PSAP leader regarding the significant differences oh this matrix compared to what he shared that was presented by the state 911 coordinator, Further noted he isn't comfortable approving something and sending it to them when it seems as if they've communicated via different channels, different messages to different groups.
    • Dennis Duke responded he will follow up with Brenda Hampton to ensure we have the correct document for people to view, therefore unable to approve it today. We'll follow up on this and have a meeting before ounext RAC meeting in December for approval.
    • Zachary Gittrich suggested to table this and send it back to Standards and Protocols subcommittee to have the changes made.
    • Dennis Duke responded the goal is to get whatever changes are not reflected here in our hands prior to December 13th RAC meeting.
    • Brenda Hampton shared she is trying to get the latest version so you have the most current one.
    • Dennis Duke commented to be clear on the deliverables we were asked to look at responses for Level 2 and 3 which is what we've been discussing to seek approval for our risk matrix and the additional recommendations were provided from the work highlighted in each of the levels 4, 3, 2 and 1. Noting a lot of work and recommendations have gone into this and want to remind everyone that this is an interim risk level matrix and will continue to evolve and that evolution will also likely include some language changes.
    • Dennis Duke inquired if this document could be submitted to the SAC for review of additional work.
    • Brenda Hampton shared the document has been submitted to the SAC on Thursday to the Standards and Protocols Committee with considerable discussion. It has been entered.
    • Zachary Gittrich noted to be clear the document that was submitted which is almost identical to this was from the CESSA coalition.
    • Brenda Hampton responded that is an issue because you presented it. It came out of your Standards and Protocol Committee for region 2.
    • Zachary Gittrich responded no it did not from the Standards and Protocol subcommittee. It was submitted by the CESSA coalition as there were numerous emails that were sent it and indicated he was at that meeting representing the CESSA coalition. The document was similar as he worked on both documents. tt was placed into a filing cabinet for possible changes in the future.
    • Dennis Duke noted the document has moved to the SAC for review and will remain in a filing cabinet for future consideration. The document will be kept in the cabinet at the RAC level as well to recognize the work that has been put into it. We will focus on getting the deliverables approved for Levels 3 & 2 response. Is that agreeable.
    • Zachary Gittrich agreed and as soon as the most up to date interim matrix is obtained please send to him and members.
  • State Updates:
    • Brenda Hampton shared Dennis Duke had done a good job folding in the October meetings and the direction provided both by the SAC and the region in terms of the project plan. Also working on the General Assembly report that is due by the end of December as well as the 988 Workgroup report-due around that time.
  • Committee members open discussion - Questions/Answers
    • Dennis Duke inquired of any other questions/discussion.
      • Zachary Gittrich sent out an email and would like PSAPs and/or mobile crisis teams to respond regarding proposed change being made that only 988 would be able to dispatch mobile crisis response teams as that was mentioned at the Standards and Protocol Subcommittee further noted many of our PSAPs have long term existing relationships with their PSAPs. One member had responded and were very concerned about it.
      • Dennis Duke no further comments noted - we'll be in touch prior to the December 13th meeting to get the Risk Matrix approved.
  • Schedule Remaining RAC Meeting
    • Next RAC 2 Meeting Date: December 13, 2023
  • Open for Public Comment - none noted.
  • Meeting was Adjourned at 2:00 PM by Zachary Gittrlch, seconded by Jamal Simington