CESSA - Region 4 Committee Meeting Approved Minutes 05/16/2023

Community Emergency Services and Support Act (CESSA) Region 4 Advisory Committee

Meeting Minutes- Tuesday, May 16, 2023 - 10:00-11:30 via Zoom

Meeting Minutes - Approved by Members 01/16/2024

• The May meeting was called to order by Co-Chair Julie Brugger at 10:01 a.m.

• Julie Brugger read the Open Meetings Act

• Progress on developing RAC recommendations for the Interim Risk Level Matrix

• Questions we are considering today:
  • Do we have the right people working on this? Do we need to or can we devote extra resources to it? Do we need to develop a working group to get it started or to move it forward? What help do we need from the UIC crisis hub? Do we have other issues or concerns? Are there any other people who you feel like need to be involved in the meetings? Are there other individuals who want to ask questions about the different specific areas?

• • Q: Deborah H - the number that had completed the survey, only seven of the twenty-three responded; is that representative of who is attending the meetings or do we have those 23 that are also part of this? Or they didn't have to do the assessments but are they a part?
    • A: Julie B - not so far. I've reached out and I know that Cindy Barbera-Brelle, who is the statewide administrator of 911 is working towards getting the other the remaining PSAP's to respond to do these landscape analyses.
  • Q: James H - Who are you missing in Madison County?
    • A: Julie B - Granite City, Madison, Venice, Pontoon Beach and Troy. I am also missing St. Clair, Washington, Bond and Monroe counties.
    • A: James H - Madison and Venice I believe are no longer going to be PSAP's by the 1st of June because of consolidation. Also, SIUE will no longer be a PSAP as of the 25th, we will be taking their calls. You can remove Troy from your list also.
  • Q: Julie B - do you know how many CIT officers they have from the landscape analysis?
    • A: James H - I can find that out.
  • Q: Deborah H - Is there a subcommittee that's looking at this?
    • A: Julie B- yes, the Standard Protocols Technical Subcommittee through the Statewide Advisory committee. They are the ones who created this Interim Risk Level Matrix and the ones who identified the different risk areas, the different recommendations for response type and response time.
  • Q: Deborah H - it's not any of us at this meeting? None of our local people have given feedback to that?
    • A: Julie B- what we've done so far is send the worksheets that we complete about the our recommendations for our area to the state so they can hear those and begin to see if these are patterns of questions or is it only our region that has these questions. The Standards and Protocols meetings is where these decisions are getting made to begin with at least; that's where the recommendations are coming from. It's not actual decisions because the Statewide Advisory Committee itself will have to make those, but the recommendations for that are being made by that committee.
  • Q: Deborah H - Is there a subcommittee that's looking at this?
    • A: Julie B - yes, the Standard and Protocols Technical Subcommittee.
  • Q: Deborah H - I'd be interested from the input from the people who have feet on the ground, the people that know how these systems work best in terms of making recommendations like the mobile crisis teams? I think hearing from them, at each of these levels; what they feel the appropriate responses are as well as the PSAP's and having them give us direction. Hearing from these groups would be important in how these responses should work. I think that would be what we would want to share upward. I just think the recommendations should originate from them and then our group could visit those and to make our recommendations based on what the feedback is.
• State Updates - None
• Committee Discussion:
  • C: Julie B - about the Standards and Protocol meetings, any of us are welcome to attend. We would be members of the public for that meeting, so we would have to hold our questions till the public comment section. We can attend those and become more knowledgeable about what they are considering. One of the things that they're considering is rewording some of it. The term "florid psychosis" appears and that there have been enough people who have expressed concerns about that, that people want it described "behaviorally" as opposed to a term like that, in order to seek guidance and clarity.
  • C: Julie - I think in terms of issues and concerns, part of it is the questions regarding 988, because at present, they're only responding to situations where the clients calling for themselves; is that going to change? Do we feel like the level 4 sort of low risk situations that it's okay to wait for mobile crisis response to respond, recognizing that they'll always get there as quickly as they can? As it could take as little as 15 minutes, but could take as long as an hour and a half depending on where they are. Do we feel like that that is an acceptable way to do this? Because certainly part of CESSA was predicated on the idea of that mobile crisis response teams in the community could deal with some of that. We've been talking more about the levels two and three, the risk levels of two and three recognizing that in risk level, in the highest risk or the most urgent risk level, that it always needs to be an immediate response and therefore always requires law enforcement, but that in the least risk level, do we feel like that it's okay for mobile crisis response teams to respond as quickly as they can?o 
• Next Meeting Date: June 20, 2023
• Public Comment/Questions
  • Comment: Gabriela - a question that the committee brought up was some clarification on my ability to dispatch specifically related to cases with third party and I want to clarify that as of right now, as a 988 representative, do not dispatch. When a situation requires that we escalate the intervention, we will need to contact the 590 team or 911 to debrief them on the situation and have them make the decision to dispatch or not. We handle those call with the first party caller, we cannot dispatch but we do process those calls. We do assess as much as we can from the third party account and support them through the through the process of how to best provide support for this person as well as provide them resources with 590 team contact or advise them to reach out to 911 and provide them with the number to contact 911 in case dispatch is needed.
  • Q: Julie - are you giving them numbers to the local crisis teams as well or are you only giving them 911?
  • Comment: Gabriela- only to the specific local PSAP call. With third party, they will provide us with the zip code and we can look it up via our database, we provide them with the closest resource possible.
  • Q: Julie - Those are transferred to the local MCRT as well as 911? And are you transferring calls to the local MCRT for situations where you feel like the person needs additional needs, additional support and may need a team to come out; then are you sending those calls to the mobile crisis response teams or just giving the person the mobile crisis response team number to call themselves?
    • A: Gabriela - that's for the third party, that's for the people who are not in direct crisis. For the first party call, with the person who is experiencing the crisis, we use our established report to work with this person on transferring it on; we call this a "conference call". We have the 590 team to be there so that we can stay on the line with the person in crisis until we are sure that there is some kind of intervention coming in.
  • Comment: Joe) a couple of concerns. One was with the response time issue. We are in the position where we have the contiguous counties of Missouri that abut our area, we have St Louis and St Louis County. Being that Saint Louis County is so huge, the 90 minute time frame might be an issue. Also, the other thing I guess I'm a little confused about, we're now advertising 988 is the mental health crisis phone number. I'm not sure how the public knows it, but it seems like there could be a delay in care. If somebody calls and is one of those floridly psychotic people that has weapons ready to hurt themselves, I call 988. They have to transfer to 911. It seems like that slows down a process. Also, the other piece of that is, with the 988 that Gabriela talked about, they do talk to these third parties and kind of guide them through the process. But I'm wondering even with that, if they're talking, there's these issues going on, are we getting a timely response? I'm kind of wondering did we, are we trying to fix something that wasn't broke to begin with? It seems like the 911 system, everybody knew that number and we kind of figured it out and now we have this ambiguous, "I don't know who to call".
  • Comment: Gabriela - Joe pointed out, what happens if we have a caller who is in an active psychosis? We have a system where the crisis counselor who received the call will continue the intervention while they're passing all information for different crisis counselor. That counselor will place a call onto PSAP or 590 whichever is appropriate for the situation, that way there's no interruption in the continuing the quality of care. It is not disrupted by this transfer and obviously we'll walk, we will work with the caller through the call being transferred to the 590 team. Also, about a third party, where with the third party caller we did our best to assess from the third party point of view. Most of the time those calls come from somebody who's concerned and is kind of a distance away from the caller, so the person in crisis might not even be in the same state for the situations because usually the people who are there in the middle, close by the people who are experiencing crisis, usually they know to contact 911 as that is the system that everybody is familiar with.
  • Comment: James - to make a comment on what you two were just talking about. I think there's a messaging issue, of which route people need to go. If we, as a group or as the state keeps pushing 988 as for mental health emergencies, I think it needs to be very clear that when it's appropriate to call 911, I think that's important. Gabriela, if you would be using a work phone line and were to transfer call to my PSAP in Edwardsville, IL, what's the number that your 988 people are going to call? I'm interested to see we provide information to state on where these calls are supposed to be transferred to.
    • A): Gabriela- I have the number 618-656-2131.
  • Comment: James - that is not the phone number we provided the state to provide to 988; which is fine. We've created a special line that comes in and it alerts my dispatches that this is a 988 transfer. The second issue to this is 62025. This is the zip code for the City of Edwardsville, but it's not completely serviced by the City of Edwardsville Police Department, there could be places that are serviced by the county. What my concern is, in the world I work in seconds matter, location matters. My only interaction with 988 is when 988 tried to give me information on a call and there was zero information, they just didn't have anything to provide us. This is my concern with this 988 system does. It does not have the power and the capability the 911 system has with automatic location and automatic number information so I can get the correct responders to the right place. This is our concern with people sitting in the chairs that answer the phone line every day that we're not getting good information and we're going to be delaying our responses.
  • Q: Julie - James, is that specifically location information or is there additional information besides location itself?
    • A: James- the 911 system obtains automatic location information, which could be from a landline, it could be from a cell phone and it also comes with a number of information. There's other software that we have through Rapid SOS that might provide us, if it's an Apple cell phone or additional information. Somebody might provide the Apple with an emergency contact information, things such as that. Unfortunately, 988 systems are not built like 911 and we are losing service because it's going to a different line.
  • C: Gabriela - yes, we do not have the ability to pin the locations like 911. We do deescalate for low and medium risk level and even highly priority case using the training for crisis counseling and interventions. For those other cases that we do reach out to PSAP'S, it's usually cases where it's not that we couldn't deescalate, it is that there's very limited information. It could be the person calling and saying "I have a thought" or "I took something" and that's it, they end the call.
  • C: James - please understand, the problem is they've called 988 because that's what the state of Illinois is telling them to do; they're calling 988 for help. We no longer have location information. We don't have good information where an ambulance can be sent and they've now disconnected with you. With this, we are way behind, and trying to go backwards in trying to find information. I'd have to ping a cell phone, if they'll even let me ping it because the call wasn't made to 911, to try to find location information to send someone, this is where the struggle and problem is. I can appreciate what 988 is attempting to do, very much so. 988 would take a lot of calls of people that maybe don't need 911. I'm just afraid that we're driving people to the wrong location.
  • C: Julie - This will be one of the concerns that we send off, that I send off to the state.
  • C: Brittany - I have that same concern for Centerstone. We've had very few 988 referrals. One of the calls that we did receive was definitely a call that should have been sent to 911 or should have been a 911 call; hopefully from the beginning because location was really needed, we did not have that or even which Police Department to contact.
  • Q: Julie- James do you know if a call gets forwarded to you from 988, will you have that location from 988 itself?
    • A: James - No, that information has never been obtained because it comes via a landline, a seven-digit line. Information was never obtained or "grabbed" because it didn't go through the 911 system where it dips and collects that data.
  • Q: Julie - there's no way to get that information if the client can't tell you themselves?
    • A: James - there is a way to obtain it by a pinging the cell phone, but that is a court process. Example, a person called because loved one was missing suicidal. If that came in via 911, I can immediately ping that information from the cell phone company without legal process because it's emergent. If I do it when it doesn't come through the 911 system, we can still do it but now we're delaying because we have to complete paperwork and get all that is needed to clear legal in order to get the information.
  • C: Joe - one of the things I thought about and I think we kind of talked about this a little bit, it seems like to me there is a disconnect in the definition of crisis, or at least it seems that the system is, to me is looking at the people who are calling are just depressed and need to talk to somebody. 99% of the calls we get are not that. 99% of the calls that we get are the people who are actively suicidal, homicidal, having acting out behaviors. I haven't seen a statistic how many calls we get statewide that are the ones where someone is depressed and needs someone to talk to versus situations where it's life threatening. I think it's very problematic as James was just saying, we're losing seconds where seconds count. The fact that the 988 system doesn't have that location device, is really problematic. We have had one where not enough information was supplied to us to really react in a helpful way.
  • C: James - I think it just comes down to messaging and directing. 988 is good for what it needs to be there for, and then 911 is really good for what it needs to be there for. It's just a matter of education and messaging of which route people need to take when they do come across something, when to call what line.
  • C: Nathan - I'm another representative from 988. I don't disagree with what anybody's saying, but CESSA's goal from the state is something we're trying to keep in mind and stick to. There are problems considering we don't have a locator but we're trying to maintain the least invasive intervention possible because there are a lot of people as mentioned calling in being depressed and needing to talk to somebody. The right place for them is 988, not 911. That being said, there are a lot of individuals out there who call in genuinely with the belief that they are going to kill themselves. We at 988 are able to successfully deescalate those calls and provide the least invasive intervention, whereas in the previous system they might end up calling 911 when there was an option for a lease invasive less invasive intervention.
  • Q: Julie - Nathan, do you have any statistics on how many calls come in who can successfully be deescalated that way or even through mobile crisis response, but something that wouldn't necessarily require the immediate intervention of law enforcement or EMS?
    • A: Nathan - I don't have exact statistics in front of me. The last that I heard, the statistics we got from Vibrant, that the system that 988 routes through, about 85 to 90% of the calls were able to handle within 988 eight system without escalating to a PSAP or EMS. In saying that, it doesn't mean that 85 to 90% of those calls are just people calling and looking to talk because they're depressed. A lot of those calls come in very much presenting suicidal, having a plan in place, being pretty certain about carrying it out and we're able to deescalate from there.
  • C: Gabriela - I think what I'm getting from this conversation is that we're looking at different risk level and when does 911 come in to the situation and when does 988? Right now the system we're using per Vibrant recommendations is to divide by emotional support, low, medium or high and then in progress. I'm hearing a lot of concern related to that in progress piece where it's like we're losing valuable time if it is an in progress, when the caller is already doing something, concerning their safety. It seems to me that the consensus were getting to is raising that as a concern, for that specific level, because that's the one per James and Joe's point, that need very immediate locations and pinpoint.
  • C: Julie - basically what you're saying is the people who are in progress need to call 911 versus if there's a chance to deescalate on the phone, they call 988? I think the messaging problem with that for the community though, is going to be helping people in the community understand when to call what.
  • C: Gabriela - Yes, I agree. We have had a situation where the caller had a noose around their neck, but we are able to deescalate. So that would be sorted into high lethality versus an in progress, like they only took a pill, correct?
  • C: Nathan - What's difficult about some of those situations is if we have an in progress, where somebody has already attempted an overdose when they call us or has already slit their wrists or something like that we're not going to be inclined to let them go and tell them to hang up with me and call 911. We need to ensure that they are safe and that they get the proper care they need. Often times in a lot of those situations, we're able to stay on the line with those callers; this is where we as 988 operators are coming from. We will immediately find the appropriate EMS and try to obtain as much information from the caller as we can for EMS; often times that's just not the situation. We do have people who call in who genuinely just want to talk to somebody in their final moments and don't have any interest in receiving medical attention or assistance. Often times those individuals are very resistant to sharing identifying information. However, our goal is always coming at it to obtain as much as we possibly can and keep them on the line while we send somebody out to them. The truth is though, there have been cases where we have very little information.
  • Q: James - how many callers do you have that just want to call in and talk to someone before their final moments and then what do you guys do after that?
    • A: Nathan - again, that's pretty rare I don't have the numbers in front of me like percentage wise, but that has certainly happened. Again, our angle on that is to try to keep them on the line, try to keep them awake and alert, and try to gather as much information as we possibly can to pass them off to the correct EMS. We do have a tracing system on our end that tells us the town they are in, and that's about as much as we can get. Past that, we need to work with the caller to get more information from them.
  • Q: Julie - Nathan, does that give the information of the town that they are in as they call you? Or does that tell you the towns included in the area code that they're calling from or the phone that they're calling from?
    • A: Nathan - I believe that tells us where they're currently calling from but that can be as broad as Chicago. I's not very precise and ideally we're never going to call EMS or a PSAP with that little information. We're always trying to probe and use our training to get as much as we can.
  • C: James - I don't know how to explain it without coming across poorly. I've had calls like that. I've had 911 calls where people want to talk in their final moments, and a call where a woman happened to slit her throat, but we were able to get EMS there and save her life. This is where I see a problem with that and when you say you're "going to send EMS". I dispatch for police, fire and EMS; if you called my EMS, they are not going to go without police. Again, it's the messaging of when people need to call and which direction they need to call.
  • C: Gabriela -. I want to clarify on the procedure when a person is calling and states that they want to talk in their final moments, as they had a knife or like a means. We will immediately initiate that system where the crisis counselor receiving the call continues the interaction, as well as having another crisis counselor immediately start looking into that. The goal is to try to be as timely as possible with the system that we're using. Possibly the caller may have said that they've made up their mind but just want someone to talk to in their final moments. We still use skills and technique in crisis interventions to try to find that point to deescalate, but also to subtly gather information that can identify the location. That is how a call of that nature would be handled, and how we pass on the information if we are successful in at least gathering even some information. Because otherwise, we don't have enough information to even pin or anything of that sort because we don't have that system.
  • C: James - based on the matrix, if you had a call or a call in that's threatening harm, it is a level 4 and that should go directly to 911. It wouldn't be a matter of just trying to talk to them, it would be a call that needs to go to 911 so there can be an immediate response.
  • C: Gabriela - absolutely. Even if we are able to like deescalate it, we are still going to work on maintaining their safety level and contacting who we need to.
  • C: James- in going by the Level 4 Risk Matrix, it lists immediate threats to life, whether it's an active situation, weapons present, to dispatch response law enforcement and or EMS until scene is secured and via 911; so that doesn't have anything to do with 988. My concern is if 988 are holding calls where someone's immediate life is at risk and you're not transferring it to a 911 center, that's a problem.
  • C: Nathan - I just want to reiterate, when we do have a life threatening situation like that, we're absolutely grabbing as much information as we possibly can so that we can pass it off to PSAP's. As you stated, if we transfer that call to you, you're not going to be able to grab the location because it's coming from our line. You're not going to be able to trace that. Our role is the least invasive intervention possible. We're going to be gathering as much information as we possibly can, but we're also going to be working to deescalate. Example, if somebody has a knife in their hand and they're ready to use it, but we're able to deescalate, talking them into taking a minute, going outside to get some fresh air while they are talking to us and from there we are able to safety plan and deescalate with them. We don't want to erode that trust with them. Obviously we are going to escalate if it's necessary but our position that's been directed by the state is to assess for lethality. If a call comes in presenting as high lethality and we're able to deescalate that call was never high lethality.
  • C: James - it states in level 4, immediate threats to life, active situation with weapons evolved, dispatching entity is 911. I'm at a loss and a confused. Where you would be dealing with it in the 988 world, which is fine if it doesn't meet a level 4. If it's level 4, it should be 911. This is the problem that I'm seeing. I have no problem when 988 are able to deescalate situations, but if someone is presenting with a knife and it's an immediate life threat, we are now being put way behind of getting help to someone.
  • C: Gabriela - I want us to consider the perspective of when a person calls in and they say a word that lets us know we need to assess first; because the person can make a statement that they are going to kill themselves. Where's the legality level at? Because the caller may say that and "that the knife is in the other room and I have people in the house". We can't just transfer right away because that wouldn't meet the Level 4 Matrix? The other thing is we also cannot do a cold transfer because the person calling in, is only looking to talk to someone. If we tell them "you're at level 4 risk, we're going to transfer you to 911". We can make sure that this person has reached 911. What if they hang up?
  • C: James - if someone calls 988 and says "they're going to kill themselves and their family members" and they decide they don't like what you have to say and hang up; then we have nowhere to go. I'm just trying to point out issues and holes in the system that we have, that we are tasked with at this point. I'm trying to point out the problems, we're tackling this in two different fashions and thought processes, I guess.
  • C: Gabriela- the approach that we run by Vibrant and the state is based on crisis interventions from a mental health standpoint. Our technique and our assessment of that is related to how crisis is deescalated from a mental health side. We also are very much aware of the immediacy of the situations and I'm not disagreeing or denying that this is what is happening, but for those situations, I just want us to consider we cannot transfer right away. Example, if the person calls in to 988, that it is very much increasing their risk, if we don't intervene and attempt to give them the best scenarios to be transferred to 911. So it's the goal in our intervention isn't to like take over for Level 4 situation for 911. Our goal is to set it up so that the person can be transferred and we want to make sure that the transfer is complete, that they are getting help.
  • C: James - Gabriela, I really liked when you pointed out that you guys are taking a team approach, where you have another person trying to reach out to the PSAP'S. I do appreciate that and if that could be a standard that would be wonderful.
  • C: Julie - I do think that the point that the system still has holes and it still has gaps, and that is the truth. As we look at state update, I know that there are some updates regarding CESSA; that the state has identified. One of the things that they shared with us in meetings last week, was there will be a vote in the General Assembly in this legislative session because we are coming quickly upon July 1, which is technically our implementation date right now. Where the bill they will be voting on is to push implementation for a year. DMH is expecting it to pass; that would give us more time to develop the systems that we really need to have in place to be able to do this meaningfully. So I think that you know a lot of a lot of people are very hopeful that. I think that having meetings exactly like this is kind of the purpose to point out where the gaps are and where that the pieces are in this that perhaps weren't thought of as they were creating the law or as they were trying to come up with the different things that the law includes. I appreciate those from 988 being on the meeting with us today because I didn't realize that 988 isn't dispatching at all at this point. I knew that Chestnut hadn't received any calls in that way, but I didn't know that that was the truth all across. I think that that was an interesting piece of information, as has been this whole conversation regarding where these gaps are and I think that this also identifies the need to educate the public on which number to call in which kind of situation; not to make it overly complicated. It is really important that we help the people in our in our areas know how best to get the help as quickly as possible that they need. Nathan identified in the chat, "hopefully long term 988 will have the ability to ping".
  • Q: Julie - are there any other thoughts regarding the idea of us continuing to move forward with this process and figuring out where the gaps are and then hopefully how to address them? I do think that one thing that's coming from having these meetings between the 590 providers and PSAP representatives is that we're getting to know each other a little bit and getting to understand everybody's role in the situation and to help the communities that we all serve. I think that that's extraordinarily valuable as we continue to move forward.
  • C: Cindy- I would just say just to reiterate what was, I think it was very good conversation but I believe education is very important, but also to be made aware. The legislative end of it needs to be made aware of the challenges. As we're educated here on this call, I feel that perhaps, some of them could be educated as well as to the depth of these challenges too. So I agree with everything that was said on the call.
  • C: Julie- there are some big gaps that got identified today that are really important. The idea of how to begin to fix that on not only are small scale basis for our region, but overall. I'm sure a lot of the same gaps that other people are finding as well.
  • C: James - I very much appreciate Nathan and Gabriela for spending their time with us, for us to help make some changes, identify some problems that hopefully we can move forward from.
  • C: Julie - yes, and to give us information about their system that we didn't know.
  • C: Nathan - We appreciate your thoughts. It's important to see all aspects of this. Thank you.
  • C: Gabriela- thank you for having us here and having this discussion. 590 is not the fix all, and we don't go into it thinking that way. We always know that we're here to work with 590 and PSAP because that's just the continuum of care. People are going to be in different level of risks and would need different level of interventions. Hopefully we can address these holes.
  • C: James- and unfortunately none of our work worries about the other real problem, and that's the other end after we've all done our work and got them somewhere for care. What happens after that?
  • C: Julie - thanks so much for joining us and absolutely join us every month if you can. I think the more people we have working on this, the better we're going to going to do in terms of identifying gaps and then identifying bridges to cover those. I think the more of us working on it and working toward it, the better it's going to be.
  • Q: Joe - thoughts on the technical subcommittee, do they have people from the various regions, from the state involved?
    • A: Julie - not that I'm aware of. What I understand about that technical subcommittee is that those are members of the Statewide Advisory Committee. What they have done if they feel like they've needed them, they've requested membership from other people in the community. They call them expert consultants in the community; so if they know someone in their community that they can reach out to, who they feel can offer some information or input, then they've involved them if they were willing to be involved. An every two week meeting format is pretty intensive and I think that not everyone is able to make a 90 minute meeting every two weeks. But I think in terms of looking at that, anytime that we can join, it's going to be better because we need to be aware of what's happening in there, and if for nothing else, we can put in our opinions. We can offer the problems that we're finding, the gaps that we've identified, and the concerns that we continue to have so that they're looking toward having the big, full picture.
  • C: Joe- makes sense. I think one of the reasons these committees are around the state is because there are so many different things that are done so differently.
  • C: Julie, yes, and different areas have different needs. The needs of our area are probably pretty different than the needs of the people in Chicago. Any other questions, concerns, any other comments either from the committee or from the public?
  • C: Peter- I am the IDPH Regional EMS coordinator. One thing I do know from the other meeting that there is an e-mail address that questions can be sent before a scheduled meeting and they will try to answer those questions at that meeting.
  • C: Julie - I will look that up and send it out to everyone.
  • C: Peter- when you join as a member of the public, you usually get to ask your questions or state your concern, but they won't answer you at that time, but at the next meeting.
  • C: Julie - thank you for sharing that. Thank you all so much for your time and attention to this and for your perspectives because the more people involved in this, the better our ideas are going to be. I definitely appreciate everybody's input.
• Adjournment:
• Julie- vote for adjournment is not required as not enough members in attendance; ending meeting at 11:26.