CESSA Protocols & Standards Subcommittee Meeting 05/02/2024

CESSA Protocols & Standards Subcommittee Meeting May 02, 2024, 2:30 - 4:00 pm

  • Virtual meeting via Zoom

Meeting Minutes - Approved by Members 05/16/2024

Call to Order/Roll Call:

  • Meeting called to order by Lorrie Jones at 2:35 pm (via Zoom)
  • Shelley Dallas motioned for approval of 4/04/2024 meeting minutes, seconded by Rachael Ahart. All members present motioned to approve except Pooja Nagpal (Designee for Candance Coleman) who abstained. Motion approved.
  • Members Present: Rachel Ahart, Blanca Campos, Candace Coleman (Designee Pooja Nagpal), Lee Ann Reinert, Shelley Dallas, Rick Manthy, Cindy Barbera-Brelle
  • Members not present: Bobby Van Bebber, Brent Reynolds, Drew Hansen

State Updates (Lee Ann Reinert):

  • The bill with CESSA revisions was heard in committee today and passed committee unanimously. Bill includes topics previously announced, including:
    • Extension to July 1, 2025,
    • Allowance for the Division and EMS directors to appoint a different chair when needed, and
    • The ability for the RACs to organize themselves into subregional groups in order to get work done at a hyperlocal level.
  • Representative Cassidy responded to a question that there may be further amendments in the veto session, but the above changes have moved through committee and now need a vote in both chambers.

Behavioral Health Crisis Continuum Forum (Dr. Lorrie Jones):

  • We asked the regions to give us 10 individuals who they think would benefit from attending.
  • Dr. Margie Balfour is presenting alongside Dr. Brian Hepburn. We're also hearing form local experts that will be highlighting some of the work in Illinois, as well as the Meadows Institute, Alburquerque models, and advocates from around the country.
  • Breakout sessions on tackling challenges in rural areas, workforce challenges, and engaging communities.
  • SAC members, look forward to an invite in the next couple of days. We'd like you to register by May 17, 2024. We are capped at 200 people so it can't be open invitation unfortunately.
  • Question from Pooja Nagpal: Will you have lived individuals sharing their experience receiving crisis services? Response from Lorrie Jones: Yes, we will have a speaker sharing about the crisis system in Illinois from the perspective of someone with lived experience.

Update on Work with Protocol Vendors (Dr. Lorrie Jones):

  • PowerPhone: They are working on developing an Illinois specific database. Once that is done, we will work with the pilots to get them prepared to work through the changes in the database.
  • Priority Dispatch: We attended an in-person all day meeting yesterday. It went well. We were able to discuss a crosswalk with the Priority Dispatch protocols with the Illinois Risk Level Matrix. We had four representatives of PSAPs who have Priority Dispatch who were very excited to participate and were very active in the process.
  • APCO: Follow up meeting scheduled for next week. They have provided documentation for the workgroup to review. It looks like Priority Dispatch and PowerPhone will move forward first, then APCO.
  • Independents: Still planning to get to them next.

Discussion and Questions about Vendor Updates:

  • Shelley Dallas: I think there might be a bit of confusion in the regions. Some of the regions are announcing which agencies are going to participate in the pilots.
    • Lorrie Jones: There are protocol pilots and then actual pilots. The protocol pilots are working with the vendor to test out the protocol changes. That must happen before we work with the regions to implement the actual pilots. For those pilots, we must have training done and some other things. The first pilots, the protocol pilots, are a pretest of the protocol changes only, pretesting the databases only before we go through with the entire pilot.
  • Stacie Kemp: So, our workgroup was feeling hesitant about identifying someone for the pilot before we saw the protocols but then we were told we had to, but that's for the actual pilot, correct?
    • Shelley Dallas: Those two would be the secondary full-blown pilots. There would be two or three other who test the protocols first (protocol pre-testers).
  • Stacie Kemp: Do we know who the protocol pre-testers are?
    • Mary Smith: When we work with the vendors who own the protocol, we work with some PSAPS who use that protocol as part of the subject matter expert workgroup. So, with PowerPhone we worked with Shelley and MJ's PSAPs. With Priority Dispatch, we are working with four who use Priority Dispatch. As we work with APCO, it will be the same thing.
  • Stace Kemp: That makes it sound like we're even further out from the actual pilot.
    • Mary Smith: We've tried to say the process is changing the protocols first, then approved by the EMS medical directors, and then we'll be able to move forward. PowerPhone will work with each of the pilots in the region to update their software with the new database.
  • Stacie Kemp: When does the pretest happen?
    • Mary Smith: We don't have a data but PowerPhone is updating their protocols now. We hope we can have approval from medical directors and do the pre-test sometime in June. We can't control the approval by the medical directors, but hopefully the latest July.
  • Lorrie Jones: Then the pilot would follow. And at this time the other parts of the system would be getting ready, so the 590 programs would be getting their training, working with agencies to make sure they know what data they are collecting to evaluate the pilots. All that could happen while we do the pretest. Maybe we can come back with a graphic that displays this the next time.
  • Pooja Nagpal: What counties are the pre-test and the main pilot?
    • Lorrie Jones: We have some of that but it's evolving. We can share that with the group for PowerPhone and Priority Dispatch. And we have the pilots that the regions have selected. We can share that at the next meeting.

Misdemeanant Discussion (Dr. Lorrie Jones):

  • We have talked about this other part of the legislation and heard from Stephanie Frank at the last SAC meeting. We know we need to have a plan to address people who could be charged with misdemeanors and get them into treatment systems instead of the criminal justice systems. Does anyone have experience with deflection and diversion?
  • Rachael Ahart: Our team strives to do that where-ever possible, so if someone is involved in a low-level crime and there are mental health concerns, we try to prioritize the mental health treatment.
    • Lorrie Jones: Who makes that decision and how is it followed up on?
    • Rachael Ahart: There is a lot of discretion given to officers on scene and determining disposition.
      • If someone is on scene but no one wants to be a victim, that helps. There are times we take a report that includes the criminal offenses and the known mental health status or whatever is going on at the time, so we'd go on scene and do all the documentation you would if you were making an arrest or an NTA and potentially fill out a petition for involuntary admission if appropriate, transport to a hospital for a mental health evaluation.
      • Even if cases where we potentially send that information to the state's attorney's office for charging, we've also communicated at that level, requesting mental health intervention as the end goal as opposed to criminal charges for that person. So, there's several points in the process where we think about deferring.
  • Shelley Dallas: I want to stress that this would be post-dispatch once responders arrive on scene for this description.
  • Lorrie Jones: On the substance use side, there are lots of deflection use sites across the state. An officer has the discretion to take an individual to a deflection site. One of the differences between the SUPR side and mental health side is we don't have places for people to go right now. Developing places to go is the next step in the crisis continuum. So, if you don't take them to the emergency room, are there other opportunities?
  • Rachael Ahart: I think this varies tremendously by location. We have some resources available. We've had an officer bring someone to the Living Room at Rosecrance or community providers. When we have co-response teams, the social worker can do a higher-level mental health assessment on scene, and if they don't reach a level where we think the hospital would accept them, we don't take them to the hospital because then they'd be likely to be released and not likely to be connected to services. So, one goal of our program is to decrease unnecessary hospital transports, as well as unnecessary arrests. So, if they don't reach that level, the social worker will do safety planning and temporary case management and follow up to connect them to a provider.
  • Lorrie Jones: Let's talk about who should be around the table to plan how to do this? Law enforcement, because they have the discretion, right?
    • Rachael Ahart: I agree, and I don't think that there is any way at the time of dispatch you can expect anyone to know if it's a misdemeanor or felony or what level of crime. I think it would also depend on what resources and options are available in particular communities.
  • Rachael Ahart: There's also Champaign County Crisis Intervention Team Steering committee made up of mental health providers, community resources, law enforcement and state's attorney's office. Out of that has come the concern of how to share mental health needs with the jail, if the person is arrested, so that they get evaluated in jail and get the care they need. So, we worked on ways to provide mental health information to the jails and the state's attorney's office, so that wherever they go, whoever is involved, is aware that mental health is a primary goal for that individual.
  • Stephanie Frank: Do the social workers assess for substance use disorder also?
    • Rachael Ahart: They will do assessment for that as well, but in those cases, we are more likely to use a hospital in those situations.
    • Stephanie Frank: I think that's similar to what the deflection work is, so something we can build off of. Our similar goal is how do we connect people with substance use disorders to services because not everyone with substance use issues needs to go to the hospital.
  • Lorrie Jones: For those of you who know about the Sequential Intercept Model, this is work that would be Intercept 0 which is Community-based Deflection. I know Scott Block's office, the Administrative Office of the Illinois Supreme Court, has a lot of projects with the intercept models, so we can ask him what's going on in Illinois. We could come back and look at the models that are available. It's an interesting and important opportunity to pay attention to other parts of the law besides the protocols.

Next Meeting Date: May 16, 2024

Public Comment: There were no public comments made.

Adjournment: Rick Manthy motioned to adjourn the meeting. Shelley Dallas seconded. No opposition. Lorrie Jones adjourned the meeting at 3:23 pm.