CESSA Technology, Systems Integration & Data Management Subcommittee Meeting - Approved Minutes 02/20/2024

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

February 20, 2024, 9:00 am - 10:30 am via Zoom

Meeting Minutes - Approved by Members 03/18/2024

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

  • Welcome and Call to Order (Roll Call)
  • Open Meetings Act
  • Approval of the Minutes from previous meeting
  • State updates
  • Updates from and to other bodies
  • Planning and updates on Subcommittee deliverables
  • Next meeting dates
  • Public comment
  • Adjournment

The meeting was called to order by Brent Reynolds at 9:04 am.

Brent Reynolds reviewed procedures around the Open Meetings Act and meeting logistics.

Roll Call:

Present by phone or video: Brent Reynolds, Richard Manthy, Lee Ann Reinert (joined at 9:08 am), Jim Kaitschuk (joined at 9:12 am), Cindy Barbera-Brelle (joined at 9:16 am)

Absent: Robert Van Bebber

Motion to approve previous meeting minutes from Cindy Barbera-Brelle, seconded by Lee Ann Reinert. Motion passed with voice vote. No opposition. Minutes from Feb. 5, 2024 approved by Brent Reynolds at 9:18 am.

State updates: Lee Ann Reinert

  • Bill filed by Access Living with the original sponsor of the bill to extend the deadline.
  • Other changes being considered are related to the Regional Advisory Committee that make sure they have sufficient support and ability to work at the hyperlocal level so bill would allow for the creation for subregional committees and the ability to have someone else appointed as a chair besides the EMS MD since some regions have struggled with availability of their EMS MD

Updates to and from other bodies: Pete Eckart

No updates

Planning and updates on subcommittee deliverables: Pete Eckert

Task A: These next 3 slides are slides you have approved, and we want to document the status. The numbers and text in bold at the top are the direct language from the law, and what's below is reframed. We need these indicators to operationalize what the law asks for.

(1) the volume of calls coordinated between 9-1-1 and 9-8-8 and (2) the volume of referrals from other first responders to 9-8-8

  • 1.1 Total calls to 9-1-1: yes
  • 1.2 Number of MH/BH crisis calls received by 9-1-1
    • Cindy Barbera-Brelle: would have to identify by incident type code so we suspect it's all over the board. We can try to get a singular type code but it may be an uphill battle. We can try to capture that but it won't be as accurate.
    • Brent Reynolds: We won't get all PSAPs to agree on the call type. The challenge is that not very call that is dispatched is known to be a mental health/behavioral health crisis call until police or fire arrive on scene and decide that especially when it's a third party caller not knowing situation of the involved party. Also, sometimes the disposition will not make it back to the PSAPs.
    • Pete Eckart: This is an iterative process. Maybe its related to resources, technology, there will be some places where this is available faster. Our job is to make the recommendations and then it will be on the statewide advisory committee and maybe the local representatives
    • Cindy Barbera-Brelle: Do the protocols keep track of a number of time that mental health protocol is used?
    • Brent Reynolds: One we get everyone off of flip cards and into integrated system, you can run reports on those.
    • Cindy Barbera-Brelle: so we could look to the protocol activity to get that information
    • Brent Reynolds: We hope that everyone has it integrated into their CAD. Priority Dispatch doesn't have automated exporting of data so education may be required
    • Mary Smith: this is what we're working towards with PowerPhone on their mental health protocol. We don't have this exact data right now, but we will eventually.
    • Sarah White: What about agencies that do not use EMD guide cards? Law enforcement only? Or Primary PSAPs that transfer to the FD/EMS - who uses the card then?
    • Brent Reynolds: if it's a medical related call, they'd send fire and EMS
  • 1.3 Number of MH/BH crisis calls received by 9-1-1 meeting criteria for transfer to 9-8-8
    • Not currently collected yet
    • Mary Smith: Working on with protocol venders
    • Rick Manthy: My understanding is that we won't have that data until 988 is more established.
  • 2.1 Total calls to 9-8-8
    • Pete Eckart: Yes, statewide and per LCC
  • 2.2 Number of MH/BH crisis calls received by 9-8-8
    • Yes- most of them are and they track that
  • 2.3 Number of MH/BH crisis calls received by 9-8-8 meeting criteria for transfer to 590/MCRT
    • Pete Eckart: This is absolutely what's intended but Mary is that happening universally or still in implementation?
    • Mary Smith: not sure
    • Emily Legner: yes, 988 center have a requirement to report on that. There is not infrastructure but there's a guidance that tells you how to report that
    • Pete Eckart: so needs confirmation on 988 by 988 basis
  • 3.1 Total outgoing calls from LE or EMS to 988
    • Are there any calls where law enforcement encounters a crisis, transfers to 988, and is it being tracked?
    • Jim Kaitschuk: I don't know
    • Rick Manthy: this comes later in the process

(3) the volume and type of calls deemed appropriate for referral to 9-8-8 but could not be served by 9-8-8 because of capacity restrictions or other reasons

  • Total number of calls: Yes
  • Number of MH/BH crisis calls referred to 988 by 9-1-1- PSAPs referred back to 9-1-1 PSAPs because response type or time was not available
    • Calls not currently being transferred
  • Number and percentage of MH/BH crisis calls referred to 988 by 9-1-1- PSAPs that were dropped or not answered
    • Calls not currently being transferred
  • Number and percentage of MH/BH crisis calls referred to MCRTs by 9-8-8 Lifeline Centers that were refused, dropped or not answered
    • Calls not currently being transferred
  • Number and percentage of MH/BH crisis calls referred to MCRTs by 9-8-8 Lifeline Centers referred back to 9-1-1 (LE and/or EMS) after contact with the crisis caller
    • Calls not currently being transferred
  • These are all subject to the new system that people like Dr. Smith are working on
  • Brent Reynolds: Some of this might not be accurate.
  • Pete Eckart: But can we satisfy the requirements of the legislation without being that specific? Brent, I am not disagreeing with that but we can evaluate that later

(4) the appropriate information to improve coordination between 9-1-1 and 9-8-8 and (5) the appropriate information to improve the 9-8-8 system, if the information is most appropriately gathered at the 9-1-1 PSAPs.

  • 1. Data identified in answer to previous questions, with monitoring of trends over time
    • If we have the data, we can start the trend analysis, but we can't start the trend analysis until we have the data
  • 2. Coordination response time - from initial call-answer to 9-1-1 to final resolution at 9-8-8 or transfer/dispatch to MCRT
    • Mary Smith: The next gen system has the ability to capture some of these things but right now there are no referrals from 911 to 988
    • 988 also does a good job of tracking the time they spend with their callers and Mary has already done one analysis of dispatch to time on scene. What we don't have is a way to knit together responses based on individual person. Keeping track of how someone moves through crisis response system - we don't have a mechanism for that yet
  • 3. Increase in number of MH crisis calls to 9-8-8 vs 9-1-1
    • We could measure this by how many calls are coming in to 911 that are related to mental health crisis and then how many calls are coming in to 988, and measure it over time to see it change. Not yet, dependent on new mental health protocols
    • Mary Smith: if we had that data, at least it would be a proxy.
  • 4. MCRT response time - from dispatch to arriving on site
    • Mary Smith: MCRT are supposed to be collecting that data and reporting that to DMH. We have some data but we probably need to work on it and make it better
    • We need to have a plan for continually updating it and making sure its being reported correctly
  • 5. Number and percentage of operators, responders and providers across the system who are trained in the new protocols and standards
    • No yet - protocols are not available yet
    • Training arm of the Hub is developing training calendars and a way to track who participates in training
  • 6. Number and percentage of 9-1-1 telecommunicators making referrals to 9-8-8 reflecting the RAC recommendations.
    • These would be based on the new protocols and standards approved by EMS MD And IDPH so not happening yet
    • Cindy Barbera-Brelle: Are we looking for the number of telecommunicators or the number of PSAPs?
    • Pete Eckart and Mary Smith agree telecommunicators should be changed to PSAPs.
  • 7. Number and percentage of MH/BH crisis calls referred to service providers reflecting the RAC recommendations (by region and type of service)
    • Not yet - still being developed
  • 8. Quality of the outcomes experienced by individual consumers - satisfaction, crisis resolution, referral to and receipt of appropriate services, follow-up, other outcomes to be determined
    • Pete Eckart: These are contingent on having the next system in place. It's not yet
    • Jessica Gimeno: I like that you added #8, Peter. It's important to understand how the individual experiences it especially since there is no mechanism for tracking an individual throughout the system yet.
  • We have good recommendations for what we will need, and that it's all contingent on getting the protocols in place but we've done what we were asked to do even if it doesn't feel like we've gotten all the way to the finish line.
  • Data currently collected by 988 programs
    • The state is paying for the services based on federal grant so state defined what data needs to be collected. Performance measures and standards are collected.
    • Substance Abuse and Mental Health Services Administration (SAMHSA) determines the performance standards.
  • Data currently collected by 590 programs: Similar to above.
  • Data currently collected by 911: We are not currently collecting any

Task G Data Collection System recommendation: Mary Smith

  • Workplan Task G: Develop recommendations for technical systems and infrastructure necessary to facilitate and automate data collection, including implementation (Based on recommendations for comprehensive operational and evaluation data metrics - Workplan Task C.)
  • The BHCH, DMH and 911 State Administrator have been working with the UIC Center of Clinical and Translation Science (CCTS), Technology Services Core (TSC), to design and develop specifications for a Provider Data System to collect aggregated crisis system data on a monthly basis from three sources:
    • 911 PSAP Call Centers
    • 988 Lifeline Crisis and Suicide Call Centers, and
    • Mobile Crisis Response Team (MCRT) Programs (Program 590)
  • We are looking at data that's already collected and what's recommended
    • For 590 providers, each has their own reporting system and they report to DMH. For 988 centers, each has their own reporting system and they report to DMH. So we want there to be a standard reporting system. Whatever system we create or recommend, we want it to be useful for providers.
    • This system only collects aggregate data so not personal health or identifying information is submitted
    • We want to also include indicators that are not being reported on yet - The 911 data elements
    • The 988 and 590 data elements we reviewed today, that are already collected, would be part of this system
  • Timeline
    • The design process has taken 2 to 3 months. It's almost finished
    • Production is about 3 months for CCTS to work on developing the programming
    • Testing and deployment is about 1.5 - 2 months
    • The timeline for development of this project is dependent upon contract signing date, funding, and resources available at time of the project signing
  • Pete Eckart: This meets a very specific need for the providers, for DMH, and the requirements of the CESSA legislation. So we expect in June that you will all say that we recommend this system will advance within the state. You'll see this again in the draft final report for your review. So with that in mind, does anyone have any questions? No questions.

Next Meetings:

Monday, March 4, 2024 2:00-3:30 pm

Monday, March 18, 2024 2:00-3:30 pm

Public Comment:

None

Adjournment:

Meeting adjourned by Brent Reynolds at 10:25 am.