CESSA - Region 4 Committee Meeting Approved Minutes 01/16/2024

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

Meeting Minutes- Tuesday, January 16, 2024 - 10:00-11:30 via Zoom

Meeting Minutes - Approved by Members 03/19/2024

  • Welcome & Call to Order
    • Call meeting to Order by Julie Brugger (Co-Chair) at 10:00 am
  • Attendees
    • Via Zoom: Breona Hawkins, Patrick Feldhake, Jane Nesbit, Kelly Ann Jefferson, Layla Simons, Chief Steven Johnson, Dave Fellows, Joseph Harper, Brittany Pinon-Becker, Randy Randolph
  • Absences
    • Jeff Shafer, Deborah Humphrey, Megan Black, Timothy McClain, Cindy Wagner, James Hengehold.
  • Guests:
    • Asantewaa Darkwa - UIC (HUB)
  • Open Meetings Act
    • Julie Brugger read and notified meeting is being recorded.
  • Approval of Minutes
    • December 19, 2023 - Approved by all Members present.
    • May, June, July, November 2023 - Approved by all Members present.
  • State Updates: Asantewaa Darkwa
    • We have been meeting with PowerPhone to begin implementation and with Priority Dispatch as well; after that, we are going to work with APCO and independents.
    • The next SAC meeting is in February, it is an in-person meeting and I believe they will still host the Zoom meeting as well. We had asked all the regions to work on a project plan to begin implementation in their region.
  • Progress Plan RAC 4
    • Julie Brugger- PowerPhone is who the State started with because they were accessible and amenable to making some protocol changes to their computer aided dispatch system to create an opportunity to transfer calls out of 911 into 988 for level 1 low-risk callers. There are going to be changes in the protocol questions that our PSAP answerers are gathering; questions they ask to determine what type of response gets dispatched, police, fire, ambulance, etc. PowerPhone people are working actively toward changing those protocols to create a way to transfer those low risk calls out of 911 into 988, to be managed through 988 instead of the 911 system. PowerPhone will also be working towards implementing the Illinois Risk Level Matrix recommendations for responses for the other levels of callers as well. The most sweeping changes will happen to those level 1- minimal risk callers because those will be mostly responded to by mobile crisis response teams and 988 instead of anyone who would be dispatched through the 911 system.
  • Julie Brugger- We have been working toward strengthening relationships between our 590 programs, local law enforcement and PSAPs. The Program Coordinator from the Chestnut Health Systems 590 Program has been in contact with police departments for Fairview Heights and Collinsville to offer our crisis response teams; to reach out to up to five community members each week that are identified specifically by the Police Department. These people may be heard from often or that might have had interactions with people our local law enforcement may be concerned about and feel they could use behavioral health resources. For these occurrences, the crisis team checks on them as they can throughout the week, between other crises that they may be currently responding to. Additionally, reporting back at the end of each week via e-mail. We are letting the community know that we are here in the community to help. We have been informing our partners in law enforcement and PSAPs, (our public safety answering points) as well. We are going to be creating meetings as Priority Dispatch is having talks with the State. We are going to be having meetings with local PSAPs to talk about the changes that they would like to see. All changes must be approved by the EMS medical directors before any changes can be implemented to those protocols. By the end of January, I will reach out to schedule meetings with our PSAP representatives that sent the landscape analysis information.
  • Julie Brugger- I will identify new members for participation in our RAC. Our recent meetings we have not been able to achieve quorum. We have minutes back to May to be approved, due to not having quorum to be able to approve.
  • Julie Brugger- Training programs that are underway for our PSAP answerers as well as our 590 programs. The statewide Communications and Technology Subcommittee is underway creating a feedback system between 911 and 988 and for transfer of calls for all to be on the same page; making sure that everyone is aware of what is happening and when. Ultimately, the goal is making the 911 system less burdened while at the same time making sure that everybody in the community recognizes all the different services that are available to them.
  • Committee members open discussion - Questions/Answers
  • Chief Steve Johnson- Chestnut reaching out to the police departments and our sending you information about our calls for those that could use mental health services worked very well, it is a great partnership. One thing that we struggle with is so many of these people do not have a way to be contacted. For us to be able to send this information has been beneficial, and successes have been made. The Metrolink ends at 1:00 AM. At the Fairview Heights location there are anywhere from 5 to 30 unhoused individuals that must get off at that time. They will call for ambulances every night to be transported to the hospital once leaving the Metrolink for non-threating problems. For several nights, every ambulance in the region was tied up transporting to a St. Louis area hospital; we had a citizen who was choking on the other side of town and no ambulance was available. Chestnut is making attempts to be there at 1:00 AM to help these individuals with services. This continues to be a huge issue in Fairview Heights, not only the unavailable ambulances, but some are going into neighborhoods committing crimes and other things. Any help that we can use to mitigate this and not tie up emergency services is huge. Progress on that is being made, I just wanted to thank Chestnut for how you reached out for us.
  • Julie Brugger- We are glad to help, and we want to offer the services to our community who can best benefit from them. We do have some plans to reach out in other locations as well. It can be complex logistically to figure out because it must be in between being called out for an active crisis in the community.
  • Joe Harper- Comprehensive opened our drop-in center back in April and we are hoping this is having an impact on some of the people in our area. We have served 3400 people so far. It is open just during regular business hours. People can come in and get food, they can shower, and can get clothing. We have a peer specialist that can help people deal with several different issues that they need help with; we try to link them to services. We just opened our living room program earlier this month, we have had about forty clients so far. We are near the Metrolink, so we have some of those riders later at night. It is a place for those who are in crisis, they can come in 24 hours a day, a very relaxing environment. The Peer Specialist will identify what the crisis may be, and they spend time talking with them about that. People can stay up to 23 hours. If a person in crisis is at a point where they need a higher level of care our crisis team can assess them and arrange for that.
  • Randy Randolph- I am excited to see that that engagement with the community police departments is long overdue. It is going to be exciting to see what comes out of this.
  • Steve Johnson- In looking at the threat matrix, my caution and concern with 988 is sending them to what is thought to be a low-level call; finding out once arriving, it is not. 988 do not have the equipment, training, and backup for instances like this. I suspect that is the same concern throughout the entire state.
  • Julie Brugger- that is an especially important piece to this, it is impossible to predict human behavior. We are just not going to be able to do that successfully 100% of the time. Even in asking every question possible, we are still not necessarily going to know what happens next. This is a complicated issue; those on my crisis team have the same concerns. Are they going to a place expecting one thing and then it becomes something far outside the realm of what they can do or becomes a huge safety issue?
  • Joe Harper- I share those sentiments. We have had a couple of situations where it was the thought that it was going to be at a lower level, then when arriving on scene it was not, turning into a very frightening situation. When this happens, there is a delay in being able to get law enforcement to respond. In our community especially because of the lack of officers on duty. This is a very genuine concern, and I am not sure that it was clearly thought out when some of these decisions were made about how to separate these. We have a protocol that we follow, we ask lots of questions about weapons, etc. but that does not always prevent the escalation.
  • Julie Brugger- it is a difficult and complicated question, and looking at how do we create the safety that we need? We have thought about utilizing different services that act like panic buttons. However, all of that depends on Bluetooth connection and other things that that are not always able to be depended on completely. Also, the possibility of some escalated situations, just the fact that you are trying to push a panic button may cause the situation to become more violent. It is hard to develop a plan for how to keep everybody safe.
  • Joe Harper- The things I have thought about lately is most of the crisis positions are entry level positions in our field. These are people that have not necessarily had a lot of experience in terms of violent situations or de-escalating situations. They do get training, but the model was not set up or funded to put people out there who have a high skill level in doing this. A couple of meetings ago we talked about that, and it sounded like people were surprised that these are entry level positions. I have been in this business for thirty plus years and they have always been entry level positions. I am not sure why that was surprising, but it may be something that needs to be considered if we are determined that this is the model we are going to follow. Do we need higher-level skill set personnel that deal with violent situations to be part of these programs, because that is not what is being funded?
  • Julie Brugger- that is an excellent point. I wonder about the different training that is offered. There is much situational awareness regarding safety as well as escalation, the warning signs of violence and behavioral precursors. I do not have the knowledge to be able to give. I am not able to teach my clinicians to respond with the same level of awareness and risk mitigation that police can. We do not have that kind of training. I love the idea of a co-response kind of model. Unfortunately, it is impossible to staff because again, we must have clinicians working out of every single Police Department twenty-four hours a day, seven days a week and we just do not have that kind of funding. Even if I could find clinicians, with the current workforce shortage there is no way to fund it.
  • Chief Steve Johnson- I had a conversation with a leader in the mental health community, he had mentioned that were changes coming forward and he wanted to get some of his personnel trained. He wanted me to come to their meeting and have training on de-escalation due to teaching this nationwide. I offered. However, he wanted me to do this in roughly a half an hour time limit. I informed him that de-escalation training is at a minimum two solid weeks and then sixteen weeks of FTO field training. He thought possibly he could obtain spare ballistic vests in the department that they could use. I explained that they had all expired in the past five years, so a waiver would need to be signed, so as if anyone were shot and passed away, there would not be an issue of being sued. He then inquired about Taser training. I informed him, this is literally Police Academy training; there is no way to effectively lessen that initial training and say that it truly is the training. I agree with what is being said, a co-responder model is really the safest direction in many ways. How do you staff it? Where do you go from there? We had a discussion before about Belleville, Swansea, Fairview, Collinsville along the 159-route, having a co-responder response unit for mental health issues along there. The problem is there could be ten calls at once and then there could be no calls for four hours. How do you manage that in between?
  • RAC 7 Zoom meeting dates for the Calendar year 2024:
    • February 20, 2024; 10:00 am-11:30 am
    • March 19, 2024; 10:00 am-11:30 am
    • April 16, 2024; 10:00 am-11:30 am
    • May 21, 2024; 10:00 am-11:30 am
    • June 18, 2024; 10:00 am-11:30 am

Open for Public Comment

  • John Nowack- I am interested in becoming a member.
  • Julie Brugger- Thank you John, I will get that process started.
  • Rachel Lair- I know you are currently working in Fairview Heights and within Collinsville. If there is another community that continues to have issues with lower number of individuals, is there a possibility that there could be a call for service for those outliers? Is this something that is looking to be expanded to other communities soon?
  • Julie Brugger- We want to be available to reach out to the people who need us. If you have some ideas on who we need to reach out to, let me know and I will see if we can get somebody out to see that person. I think that the more services we can offer, the better our community is going to respond. Also, the more often that my teams can be out there, the more that the community is going to recognize that there are other ways to get services besides an emergency room or the police and for ambulance services. We do intend to reach out to other police departments within a couple of months.
  • John Nowack- I want to share some numbers that were ran last week from just MedStar within Region 4. We ran 47,113 calls last year, 16,411 were marked as some kind of psychotic or suicidal or some kind of crisis. 16,000 calls are just us, just MedStar. I see it every day, my crews thinking they are walking into a very low-level call. Unfortunately, they have had guns pulled on them or at the scene someone makes a wrong comment, and it turns it into a very violent situation. We do have an emergency button that we can hit; however, in some instances, reaching up for that button, that microphone, stating that the police department is needed, can create an issue. It is helpful if we have previous information; people move to another residence, and we are not picking up the same individual at the same address every time. If we could still have some of that information on a resident and make it possible to notate in our CAD if we if it has been a violent situation before
  • Julie Brugger- There are 590 Mobile Crisis Response Teams that have radios directly into law enforcement and 911 that their crisis teams carry. Unfortunately, we cover such a wide expanse of space that it would be twelve different police departments that would need to be covered, that would not work. People are producing ideas on how to make that work; it is a challenge in addressing that safety. We want people to be excited about doing this work. We need that energy and enthusiasm; that goes away quickly when people start feeling unsafe.
  • John Nowack- I can share information at our next meeting about the Cahoots co-responder model in Chicago. They were given $38 million of funding for the 988 programs. They have put together an MCRT that resembles an ambulance. They are non-emergency vehicles; they have eight or ten on the streets currently. It has a paramedic, two crisis workers as well as someone that is affiliated with law enforcement. They made the step up where one of the individuals from the crisis team has attended a semester or two of distinct types of mental health approaches; of course, de-escalation is another thing. The program was launched around April of last year. In of the SAC meetings, someone from that organization did a presentation on it. Again, they were funded an exceptionally large amount of money, this is not something happening in Southern Illinois, and this is one of the biggest problems.
  • Julie Brugger- I will certainly bring up the idea of really needing help creating that safety as we continue this and are out in the community increasingly. Hopefully, we can get that across to our State Representatives as well, that there are other programs that need that kind of funding too.

Meeting was Adjourned at 11:08 AM by Randy Randolph, seconded by Joseph Harper