CESSA Subcommittee for Technology, Systems Integration & Data Management (TSIDM)
March 04, 2024, 2:00 pm - 3:30 pm 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 2:03 pm.
Brent Reynolds reviewed procedures around the Open Meetings Act and meeting logistics.
Roll Call:
Present by phone or video: Brent Reynolds, Lee Ann Reinert, Jim Kaitschuk
Absent: Richard Manthy, Robert Van Bebber, Cindy Barbera-Brelle
Minutes: No quorum. Previous meeting minutes from February 20, 2024 were not approved
State updates: No updates
Updates to and from other bodies: No updates
Planning and updates on subcommittee deliverables: Mary Smith
- Task H would require an integrated platform referral system to meet CESSA goals that includes the capability:
- (1) to effectively and efficiently gather information regarding individuals experiencing behavioral health crises to determine referral type
- (2) to transmit information for consumers requiring mobile crisis team response to a central dispatch center that maintains real-time information
- (3) to provide a shared service referral information system component to know where the provider is, geographically, to be able to make the referral and provide services
- Question for the committee: What elements and capacities would such a system as this
require to monitor and evaluate system integration and interconnectedness?
Discussion:
- Brent Reynolds: When we talk about central dispatch center, would it be regional or statewide? How many?
- Lee Ann Reinert: In other states, it's one. We as a group should discuss what we think is a best practice for the state. We need to make sure that wherever the dispatch center is, it knows where the mobile crisis response teams are and can figure out the appropriate response for the person who needs help.
* Jim Kaitschuk: The other thing we have to evaluate is call volume. One of the things being evaluated in many places, is that we have a number of dispatch centers throughout the state but as crisis on dispatch units and boards and networks and radios continues to grow, there continues to be conversation about looking more regionally for some of the dispatch centers that do exist today.
- Brent Reynolds: I am focusing on how the mobile crisis teams will be dispatched. We need to make sure the solution is expandable with interoperability from one center to the next.
- Mary Smith: In terms of best practices, the SAMHSA toolkit recommends a centralized dispatch statewide. We've talked about how that follows an air traffic control model. We're talking about mobile crisis response but also other services in the crisis continuum that we'd want to exchange information with to connect the person to the appropriate services.
- Brent Reynolds: Who are the consumers of this information? I think as a 911 center, understanding that these mobile crisis response teams are out there having this information, to know where they are, the 911 center knows where they are. We may want different layers of permission. We don't need to know the name of the person experiencing the crisis if we're monitoring it tactility but if there's an emergency, then having the name and info of the person would be helpful for the responders. It makes sense if we have the information to share it with all parties involved.
- Mary Smith: That's true. We know we have around 145 [corrected to 176 in the chat by Lee Ann Reinert] PSAPs across the state. Do we want them to call a different dispatch center No. Do we want a small number of dispatch centers that can take the information and then link the person to the appropriate service and make sure there's follow up? Do we want one center to provide some efficiency of scale? It's not enough, of course, to have just the dispatch center. You have to have this data system that's going to collect and integrate data from multiple sources.
- Mary Smith: I think our recommendation [for what the system could do] would be regardless of the number of dispatch centers. We are not talking about 911 dispatch, but the 911 calls that go to the dispatch center. That center would have the capability to generate what kind of services are available, to dispatch mobile crisis response team in real time based on where providers are located, and to provide a referral instead of mobile crisis response if that was the disposition.
- Lee Ann Reinert: It is important to consider economies of scale as we make sure the needs of the whole state are covered. Reduce duplication without hindering response time.
- Most mobile crisis response teams don't have access to GPS-enabled technology. If we were trying to link 911 call center to MCRT, we'd have to purchase technology 176 times for each PSAP and for each mobile crisis response team which is cost prohibitive. A centralized dispatch potentially solves some of those problems.
- With CESSA, 911 is a customer. A 911 telecommunicator gets a call, determines mobile crisis is needed, and now needs a way to get in touch with mobile crisis. DMH is simultaneously developing a system where individual callers call 988 and they need a higher level of care than 988 can provide, then the 988 center needs a way to assist that person with getting connected. There's nothing that says what we develop for CESSA needs to match what we develop for 988 but in my mind, we shouldn't make two, we should have one system that responds to the needs of all customers.
- Brent Reynolds: 911 centers have been around since the 80s or 90s and have struggled with interoperability, with communicating across county or municipal lines. Just this year, we are within a grant period within Cindy's office. Many of us are purchasing a CAD system that can communicate with another CAD in a neighboring community to know what resources are available. One idea is for the CAD system where we get calls for service and track resources to respond to integrate the mobile crisis response teams in that software that allows you to track personnel with GPS through automatic vehicle location (AVL). Staff on their smart phone can change their status, we can see where they are at, and they can hit a button on their phone and signal us that it's an emergency. I don't think anyone has done this on a state level. So thinking about economies of scale, you wouldn't need to go out and buy a whole new system
- Mary Smith: The AVL system sounds great but what I struggle with is how to connect to the rest of the system. With AVL, we could track where mobile crisis response teams are but the system we need is much broader, the whole crisis continuum.
- Brent Reynolds: Law enforcement records management (LERM) system and electronic patient care and reporting integrate in. Most of the systems that collect information for reporting and referral, those systems don't usually have the option to track personnel so we may be talking about 2 or 3 different solutions.
- Jim Kaitschuk: LERMs is not equally applied to all the CAD systems throughout the state.
- Brent Reynolds: There's fewer CAD systems but there's so many LERMS and electronic patient care reporting systems. I'm sure there's software solutions for integrating the systems here in Illinois.
- Lorrie Jones: I don't know if any other jurisdictions have done anything like this. Mary's point is well taken that the central dispatch systems that we've seen are for the crisis continuum, they have tied into bed registries. Are the EMS and hospital record systems interoperable or are they just linked?
- Brent Reynolds: Rich isn't on, but he could explain it better. The electronic patient care reporting is when the fire department and EMS responds to the call, they have a tablet or a laptop, or even in some cases paper, they track all the times, dispatch times, arrival time, patient contract time, gathers patient information, reporting solution for them. Before they leave the accident, they need to get a signed release if the patient is refusing further services. All that information is uploaded into the EMS system and then the EMS system does reports.
- Lorrie Jones: So how are these systems tied to the CAD systems?
- Brent Reynolds: In some areas. The integration is basically taking the initial call for service and populating it into their reports. That document lives in a different platform but they enter the information and pull the data over from the initial call.
- Lorrie Jones: So, it's more of data integration than interoperability.
- Brent Reynolds: There are other systems out there, Chicago, maybe Baltimore. I'd be curious about getting into the weeds with them about what they're doing. I would hate to limit our creativity, but we also could shorten our discovery period down if we talk to these other programs about their software solution.
- Lorrie Jones: The one we saw was Phoenix, Arizona which is the most sophisticated. It's tied to patient records and issues a patient identifier. It's just a phone call to ask what extent they are interfacing with their 911 and first responder systems. They have a central dispatch that address the full crisis continuum with a bed registry but whether or not they have a front end with the first responder?
- Susan Schafer: We have an integrated justice system where it had RMS, JMS, and CMS were all together and now we are updating it and it's 3 different vendors. It populates lots of things but to make the connections, we have to do that ourselves through our own IT. The other locations, like Phoenix or Baltimore, are they all unique, homegrown connections or was it contracted?
- Lorrie Jones: They've contracted with vendors to create these. They are all unique but also the vendor in Arizona is from Oklahoma so actually Oklahoma is looking to contract them to build something similar.
- Mary Smith: We've also seen Virgina. It's pretty integrated. It has the ability to collect bed registry information as well as the ability to look at schedules of providers to make follow up appointments, as well as being able to link electronic health records.
- Mary Smith: The system Brent described is really interesting. One of my hesitations from the work with the vendors and protocols, is that there are a lot of CAD vendors [over 40].
- Lee Ann Reinert: Perhaps what we should focus on in this discussion is our wish list, what we think should be required to be included, because we probably are talking about some type of procurement which means there are rules around that on the DMH side. So if this group could say, for example, we need interoperability with 40 plus CAD systems, or GPS tracking that includes interface with cellphones.
- Brent Reynolds: I don't believe in the CAD system but just brought it up to explain what we could do with it. A purpose designed system makes sense. But I brought up the CAD solution because of timeliness. We're working on bringing the CAD systems together. Once this is in place, a solution that can provide units and their statuses and their location, if the 911 centers already have this interoperability hub, then whatever solution with come up with, we'd want it to integrate with the 911 PSAP CAD systems. We wouldn't necessarily use CAD for this, but we'd use the interoperability with CAD to gather the data so 911 centers would know the resources available in their area. I'd want it to do it integrate with the CAD to CAD hubs that are being built in Illinois. There are many members of the subcommittee not here. We have at least one more meeting date to discuss this.
- Mary Smith: The hubs are interesting. How do you see addressing point 3?
- Brent Reynolds: When you talk about a shared service referral system, does that have to be available at the 911 center if they aren't dispatching mobile crisis?
- Mary Smith: No, that's the purpose of having a central dispatch. 911 does the thing they are excellent at, but there's all the other crisis continuum services, so we need a referral system that links those.
- Mary Smith, Brent Reynolds, Lee Ann Reinert agreed it would it be helpful to review the Phoenix and Virginia systems.
Next Meetings:
Monday, March 18, 2024 2:00-3:30 pm
Monday, April 1, 2024 2:00-3:30 pm
Public Comment:
Jessica Gimeno: I appreciated the comment about matching the level of acuity to the level of service to meet the individual's needs. Are there states whose make up, geographically or racially is similar to Illinois? Perhaps we could look at them? Are there states in the Midwest?
Brent Reynolds response: I'm not sure there's states in the Midwest that have an established program like this, but we can take that under advisement.
Adjournment:
Meeting adjourned by Brent Reynolds at 3:06 pm.