CESSA - Region 4 Committee Meeting Approved Minutes 02/20/2024

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

Meeting Minutes- Tuesday, February 20, 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 10:03 am

Attendees
- Julie Brugger, Patrick Feldhake, Kelly Ann Jefferson, Megan Black, Layla Simons, Brittany Pinon-Becker, James Hengehold, Erin Hazen, JoAnn Russell-Baum.
Absent
- Jeff Shafer, Breona Hawkins, Deborah Humphrey, Timothy McClain, Steven Johnson, Dave Fellows, Joe Harper, Cindy Wagner, Randy Randolph.

Guests:
- State representative Brenda Hampton - UIC (HUB)

Open Meetings Act
- Julie Brugger read and notified meeting is being recorded.
Approval of Minutes
- January 16, 2024, Minutes - not approved; Quorum not met.

State Updates:
- The Statewide Advisory Committee (SAC) meeting was Tuesday, February 13, 2024, at Glenview. SAC Members had an opportunity to visit a 911 call center after the meeting. Three things were presented in the SAC meeting in terms of legislation. CESSA is being extended through 2025. Secondly, they are going to expand the role of the Chair for the SAC as written in legislation; the Chair role must be assumed by an EMS Medical Director, who in most cases is also an emergency room physician. There have been challenges over the course of the last year and a half with medical directors being active participants in the planning processes. The legislative change will allow another person, likely to be public health regional staff, to sit in and serve in the role of the Regional Advisory Committee Chair. Third, it was agreed is that its ability to push the planning down to what they are calling the "hyper local level" at the local community level.

System Integration and Data Management Updates:
- The System Integration and Data Management has been working on developing operational procedures for communication between 911 and 988 and for communication between 988 and Mobile Crisis Response Teams. They are also deciding what data to collect to find whether efforts to create the changes mandated by CESSA are successful.
Standards and Protocol Updates:
- The Standards and Protocols Committee in their talks with the dispatch vendor PowerPhone, has identified fifteen protocols they can apply to behavioral health crises and have added at least one question to each of those. With the dispatch system, Priority Dispatch, the State will use that same information to offer suggestions for updates to protocols. Priority Dispatch has shared their protocols #25 and # 41, which are mental health and suicide, respectively. The State will take some example cases from Illinois to go through those protocols shared by Priority Dispatch to see how the dispatch decisions fit in with the Illinois Risk Level Matrix in terms of risk areas and risk acuity. Local customization will surround dispatch decisions based on available resources such as law enforcement, EMS, Mobile Crisis Response. Sometimes depending on the locale, it could be fire that is helping. The State is planning to begin talks with CAD vendor APCO. Training plans are being developed for 911, 988 and 590. Protocols are being developed for call transfers from 911 to 988 and for mobilizing MCRT from 988. Protocols are being discussed to decide how misdemeanors will be managed in crisis situations.

Training and Education Updates and Discussion:
- In the Training and Education Subcommittee, updated training plans have been proposed. There are training plans for 911 answerers, 988 answerers and for the 590, which is the Mobile Crisis Response Teams (MCRT). The projected courses that the Training and Education Subcommittee are suggesting is one on CESSA, the Emergency Telephone Systems Act and on sexual assault, specifically legal concepts related to those.

RAC Project Plan Updates:
- In the recent meetings with our 911 telecommunicators, I learned that the protocols used are through the computer aided dispatch of Priority Dispatch. These are specifically the EMD protocols and medical protocols. The other protocols, law enforcement and fire protocols are based on local guidance from the 911 system. We are still building and strengthening relationships with local law enforcement by checking on community members identified specifically by law enforcement, needing some added help. We are also going out to some of the encampments that some who are unhoused have developed in the last few weeks, to offer added services. We have done some pilot programs with our Metrolink to offer services to people who are riding the Metrolink and then do not have anywhere to go at the end of the night when the train stops and trying to make sure that they've got resources and working with other community partners to see what is available.

Shared training plans for 911, 988, and 590. Committee members open discussion.

Q: Julie Brugger- Is there other training that needs to be included in this training plan statewide for 911 telecommunicators? Are there any pieces that maybe should not be needed? Is there anything that needs to be added specifically for our region, which is special or different that maybe should not necessarily be required statewide but that our telecommunicators from our region may need?
C: Brittany Pinon-Becker- I think it will depend on the feedback and that participants level of comfort after they have this training. I think asking for feedback from them as they navigate calls post training to see what added training might be useful or Lunch & Learns might be beneficial moving forward.
C: James Hengehold- it will depend too on what the State mandates and what the basic public safety talk communicator training is since they have not outlined yet as by law what the basic training is for a dispatcher. I think it will depend on how this training is delivered. The 80 hour we teach is specific to Madison County and what Madison County has to offer. It is important for any training that is delivered, that it is specific to the area that you work in. We do on the ADR that we have; we do touch on the resources that are available that we have locally. Training cannot be one-size-fits-all, specifically for the State. What they have in the Chicagoland area is not what we have here.
Q: Kelly Ann Jefferson- Is there anything on the list that supported them for debriefing or self-care; that they've handled a difficult call?
C: Julie Brugger- I think there's part of that in the Vicarious Traumatization.
C: James Hengehold- Yes, that's correct; that was recently taught in an 80-hour session for new dispatchers. We include that, a third party teaches that.
Q: James Hengehold- The training plan is this a bullet point that they have created; are these things they would like to train on or is this content already created and this training exists somewhere?
C: Julie Brugger- These are the projected courses, and the State is asking for feedback from all our regions to say if this is what we need or not?
Q: Julie Brugger- For the training plan for our 988 Suicide and Crisis Lifeline answerers, are there things that we feel like are missing from this? Is there anything about our specific area that we feel like our 988 answerers need to know about our region because of the resources available?
C: James Hengehold- It is going to depend on what resources are available that they can send out that is outside of the realm if they must have a responder and what is available to them in each resource in each area. As far as the training times listed, I find it hard when they decide to put hours without content behind it. You have an hour based on how much training this should be when you do not even necessarily know what training that is. And if the end goal is just to say we have accumulated this many hours of training, that' is kind of disingenuous sometimes, just to say that we have created this many hours of training, but you really do not have that many hours of training.
C: Julie Brugger- Agreed, not only the resources that are available in our region; not every single regional resource is available in every part of our region. It will be beneficial to have the knowledge of what is available in each hyperlocal piece.
Q: James Hengehold- Per the training slide, is there a specific part where it identifies how they interact if they need to reach a 911 center, how they need to communicate with them and engage with us? It would be necessary for how 911 dispatch centers would interact with the 988, the understanding of what information they have, what information I have, so we know how to interact with each other, effectively and quickly.
C: Julie Brugger- I do not see that listed, but all the different pieces should be included in every single interaction between 911 and 988 and how to close that communication loop once it begins.
C: James Hengehold- I can take an alarm call from a medical alarm company, I already know how it is presented. I know the information that I will receive every time and they know what they are going to provide me with every time.
We can make that interaction a very quick telephone transfer; that conversation can happen quickly and fluidly so that we can get responders out, or conversely, 988 can address the issue as they need to.
C: Brenda Hampton- There is draft document, I will call it "guidance." It talks about call transfers from 911 to 988 and conversely 988 to 911 in terms of what information needs to be exchanged and how that communication flow goes. One of the challenges right now is the technology is not there to make that happen. We are short of a landline and that may not be the most expedient way to get it done, but right now that is what exists. The discussion is on what, what technology is needed to do this? Many of the 911 call centers already have the functionality, it is the 988 vendors that do not have the resources to accept that information; that is the challenge right now, trying to figure out how to make that work. It is almost like the guidance we did for 590. It is the information that must be conveyed, the information that you must receive so that each party knows what is flowing in each direction and what happens next.
Q: Julie Brugger- looking at the training plan for our 590 Mobile Crisis Response Teams, this would be in place of or in addition to whatever each agency uses to train the Crisis Staff. It lists 4 1/2 hours of de-escalation techniques to include situational awareness and safety, and hour and a half for that. I personally feel like an hour and a half for situational awareness and safety is not enough alternatives to suicide de-escalation. Additionally, I am not sure an hour and a half are enough for de-escalation either.
C: James Hengehold- there should be more focus on safety of crisis response, those out there that are responding and situational awareness.
C: Julie Brugger- I know that is a big topic of continued learning that the staff in the 590 program that I supervise that they are consistently interested in and want to know more about, is that de-escalating to create safety. Also, being aware of the precursors of violence, the behavioral kind of things which clues us into the idea that violence may occur next. I really think this needs to be amped up a bit more.
Is there anything here that we feel like does not need to be required for everyone in the state or anything that we feel like should be more regionally specific, like the resources that James was talking about? Is there anything else that we feel needs to be regionally specific or maybe that people in our region might need that not everyone in the state would necessarily need? Will it be beneficial if people in our region know what are some of the resources that are across the river in Missouri from us in our region?
C: Brittany Pinon-Becker- I also think knowing about the Missouri petition process is helpful too. I know they have an entirely different process. Our current crisis staff have a Missouri folder in their crisis bags that have example Missouri affidavit and instructions and what that process looks like, and a general resource sheet and I think BHR info.
Q: Megan Black- Is there going to be any training that does like cross training for all of us together? From the EMS side of things, I am looking for different things or would expect different things on an ambulance versus what MCRT would do or would be looking for. The waters are going to become muddied. We might feel the situation is a 911 emergency but upon arrival, it seems it is more a Mobile Crisis Response situation. Will there be any training that gets all these groups together so we can have a shared expectation, how we' are going to manage certain situations or knowing each other's protocols?
C: Julie Brugger- Brenda, do you know if that is part of what is going to happen in these training plans, that there will there be any opportunity for 911 telecommunicators and 988 answerers plus the 590 teams to get together, whether it's physically or virtually to talk through some of those kinds of issues?
C: Brenda Hampton- I do not know but that is an excellent recommendation.
C: Julie Brugger- to James's comment, we do not want a cookie cutter computer-based training just because it checks a box. We want something that is going to be meaningful for the people who are taking part in it. Our feedback has included that we need to solicit feedback from my telecommunicators after they've completed this to see if there's anything else the participants feel like they need that We want to make sure that that these are individual treatment plan or individual training plans that don't necessarily overlap with the established training plan.
Open for Public Comment -
Q: Guest- Who will be creating the acknowledgement for training for certification, creating and acknowledging the training for certification?
C: Brenda Hampton- I do not know if I would want to use the word certification. There will need to be a way that agencies will verify that their staff have received X number of hours under the required training. I will take this question back to see if that certifies them to do Mobile Crisis Response teams.
C: Julie Brugger- Currently for us to be able to utilize Mobile Crisis Response as our service for as the name of the service that we are providing, the staff must have completed is a safety planning course, a de-escalation course, and a course on the Illinois Medicaid Crisis assessment tool. These are the specific things in addition to the trainings that each of our programs provide. Those are the specific things statewide that everybody who provides Mobile Crisis Response must complete; these things would be in addition to that, or maybe they will take their place.
Q: Guest- Is this going to be annual or one time only? You can have 20 hours of training in something but if the content of that training is not there or not relevant, who makes that decision of whether that hour and a half of training is relevant to the needs or whatever it is that you are wanting. I feel if you break this down into an hour here, hour and a half there, I think the more of a challenge it is going to be to put training curriculums together that are going to meet all the needs of what your expectations are.
C: James Hengehold- I can only speak for the 911 side. I know that the State is working their way to making a baseline training program for dispatches, which I would assume is going to include all of this eventually. It will be difficult; for me to teach a class, I must be certified to teach a class and then the class must be built and be certified by the State of Illinois. I am sure that this is going to be a long run for this to occur.
C: Julie Brugger- I think we need an annual refresher on things like situational awareness. If we are not actively practicing it, it is easy for that to not be at the front of our minds as we approach a situation.
Q: Guest- How much of what is in this training for 911 telecommunicators training plan overlaps what you do already?
C: James Hengehold- Sexual assault and TTYTDD are already state mandated. Many of these other things are extremely specific to 988, which is new. It cannot be a requirement at this point. However, this very much depends on what the State of Illinois is going to do to make their basis of a mandated, minimum standard for dispatch training, which will roll into that. CID for dispatching of itself is not a prior course at this point, but it is out there and most of our staff have gone to that training when it becomes available, when it is taught by the state or a third party,

RAC 7 Zoom upcoming meeting dates:
- 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

* Adjournment - Not enough Members present to vote; meeting ended 11:16 a.m.