CESSA Technology, Systems Integration & Data Management Subcommittee Meeting - Approved Minutes 09/03/2024

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

September 03, 2024, 2:00 - 3:30 pm via Zoom

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

  • Welcome and Call to Order (Roll Call)
  • Open Meetings Act
  • Approval of the Minutes from previous meeting
  • State updates
  • Hub updates
  • Discussion on Subcommittee activities for FY 25
  • CESSA Pre-tests and Pilot
  • Public comment
  • Adjournment

The meeting was called to order by Brent Reynolds at 9:03 am.

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

Roll call and previous meeting minutes:

  • Motion to approve meeting minutes from June 17, 2024, from Robert Van Bebber, seconded by Lee Ann Reinert. Motion carried.
  • Present: Brent Reynolds (approve), Jim Kaitschuk (approve), Robert Van Bebber (approve), Lee Ann Reinert (approve), Jessica Gimeno (approve)
  • Absent: Cindy Barbera-Brelle (joined at 9:27 am), Richard Manthy

State updates (Lee Ann Reinert):

  • We continued to work over the summer and sent out an email update to keep you informed while we didn't meet.
  • The Governor signed the legislation, so we officially have an extension until July 1, 2025. This will be a very active year for CESSA.
  • Centerstone has taken on the large 988 call center contract for DMH. They entered routing on July 1, 2024. They are in the process of hiring and training to be fully staffed. We are meeting regularly with them for internal program management.
  • It will take a bit of time to build institutional knowledge with Centerstone. Each member of the committee should be mindful that Centerstone is eager to learn and think about what needs to be brought to their attention so they can be successful.

Hub updates (Pete Eckart):

  • The Hub has a new team member, Jessica Atassi, that will take over for Sarah Ferguson doing the email updates, minutes, etc. Sarah Ferguson is still part of the Hub team and will be available for questions.
  • The Hub will present the Deliverables Report to the SAC on September 9, 2024, so they can see the work we've been doing. While we don't need their approval, we want to present it to them so they are aware and then we can present it to the regions and subregions.
  • Data system development updates:
    • We have been meeting with the UIC Center for Clinical and Translational Science, the group that will be building the provider data collection system.
    • We're moving forward with the contract-we have a scope of work and have begun, but we do not have a finish date yet.
    • We will provide updates, and there will be places for this committee and the expert consulting group to offer content and see what we're doing for transparency and to make suggestions.

CESSA Pre-test and Pilots (Dr. Mary Smith):

  • Dr. Smith provided an overview of the work and recap of the vendor work from the Protocols and Standards Subcommittee, including a review of the design and focus of the PowerPhone pre-tests.
    • PowerPhone has created an IL database, and we're working with them to create 1-2 reports for sites to evaluate the data.
    • Pre-test sites are Lee County, Cumberland County, and Cicero.
    • Pre-test gives us the chance to test the changes to the protocols to determine if they are successful in identifying individuals experiencing BH crises based on the questions we've added. And evaluate if based on the responses to the questions, that the dispatch referrals comport with interim risk level matrix recommended response types that are available in the PSAPs' coverage areas.
    • Each PSAP will have different responses based on the resources that are available. We did work with the regions last year to identify available resources that exist to respond to mental health crises (as part of the Landscape Survey).
    • The pre-test and pilot only include PowerPhone. Two regions don't have representation, #4 and #11, which means there are no PSAPs with that vendor in those regions.
    • With the pre-test, we are really just looking at how protocols work. During pretest we are not actually making dispatch referrals to 988 agency (Centerstone).
    • We will be able to capture information with regards to what the 911 decision would be as if they were able to transfer to 988.
    • We will be collecting data throughout the pretest. If changes need to be made, we would need to do that before the pilot.
    • Once the pre-test is complete, the EMD docs and IDPH have to approve the protocols - this is the behind the scenes work that will be done during the pre-test period.
  • Dr. Smith also recapped the focus of the upcoming PowerPhone pilots. The pilot actually tests the referral process from 911 to 988 to MCRT, which is the difference between the pre-test and pilot.
  • Data Elements:
    • Same data elements for pre-test and pilots
  • Next Steps:
    • One of the things we can do in the next meeting will be to go into much more detail about the pilot data that we will be collecting.
    • We hope that the pre-test will start this week and last for 45 days.
    • PowerPhone has already uploaded the database changes for two out of the three pre-test PSAPs, and the third will occur this week.
    • We encountered some issues because we discovered that each PSAP handles calls pretty differently when they come in, in terms of if they open PowerPhone Total Response right away or not.

Discussion:

  • Pete Eckart: The pre-tests and pilots are a crucial way for us to understand where the barriers are going to show up when we design the changes needed for the system. This will be a big topic for this subcommittee going forward.
  • Mary Smith: Wanted to point out that Cindy has a major role in this.
  • Charlie Petrof: Understanding that changing to Centerstone has caused some wrinkles with dispatching an entity in the pre-test, has there been a discussion of what happens with the 911 data when the 911 center takes a call and transfers to 988? Unlike CARES in Chicago when the 911 center does the dispatch so they keep the data. It sounds like 911 had a substantial amount of data around calls that involved Sonya Massey and that data would be important to keep in connection with a call about that address, to inform whoever the responders are and the 911 operators.
  • Cindy Barbera-Brelle: That is functionality that is still being worked out, depending on the relationship that the PSAP has with the 590 MCRT program and any other co-responder model they are using. The data that is being collected and reported on will come from multiple sources.
  • Mary Smith: I'm wondering if you're talking about the information that went to 911 from the family member who called, or if you're talking about what we're doing during the pre-test? The 988 centers collect a lot of data and record their calls. We're not going to have all that data, but we will have data that will permit us to determine if the dispatch referrals comport with the interim risk level matrix.
  • Jim Kaitschuk: That call came in as a prowler report so dispatchers won't know the mental health or suicidal history if they are responding to a prowler. You're trying to get someone out there for quick action too if there is a prowler. If I go to the same address on a frequent basis due to mental health issues, that's probably more known by the responding officer than the dispatcher. The challenge is it's uncommon for it to be clear-cut because the call may be associated with something criminal as well as a mental health issue. Speed and accuracy for the responder are also critical.
  • Brent Reynolds: Depending on the 911 center and the agencies involved, there is Premise Alert Information that should be shared. How do we, from those frequent visits the Jim described, share that across different organizations? If we don't have something shared across all these entities, things will slip through the cracks. Privacy concerns may cause some issues. A central clearinghouse would be good but also people are transient so there's no guarantee that information will follow the caller.
  • Pete Eckart: We are recognizing that our current system doesn't allow us to have information about callers or addresses. I'd like to translate this into what we should do for FY 25:
    • To continue to lift up places that have cracks in the system that have dire consequences. What are interim ways we can address those system failures?
    • To continue to be a place within CESSA especially that will be informing the additional development of systems:
  • The smaller one we are developing with UIC
  • The bigger system that we have talked about here and is in the Deliverables Report, about the eventual design of an integrated dispatch system.
    • This body could collect and send back to DMH ideas/opportunities to consider as they design that larger system.
  • Lee Ann Reinert:
    • Don't have an update on plans for centralized dispatch because it's complicated and related to procurement.
    • In addition to the CESSA work for 911 to MCRT transfer, there is also continuing challenges around when a call comes into 988 and needs an emergency response from 911 due to a suicide in progress. That's not new, that's been a need for the lifeline all the way back to 2005. The challenges is that 988 doesn't always know where the person is. This will get better with geo-routing in the fall but it won't be perfect.
    • When 988 contacts 911 and they don't have all the information that 911 needs because they can't track calls the same way, it damages the trust that 911 has in the mental health crisis response system. At every juncture, we need to remind them that the mental health crisis system doesn't have the same capacity to gather all the information upfront that 911 does. Needs to be fixed separately over time, but it's important that 911 centers don't interpret this lack of information as lack of expertise/responsiveness. Everyone is trying their best to save a life but we don't have a system that fits together yet.
  • Brett Reynolds: There was a concern from August, at the same time there were two different patients that needed assistance, and they were confused by the call center. Specifics aren't necessary on this call but there needs to be some way to get the 911 and 988 professionals into a meeting so they can understand the capabilities they have and what challenges they face. Important to focus on solving issues rather than pointing fingers.
  • Lee Ann Reinert: Agree that a 911 to 988 discussion between the people actually doing the work is needed, and maybe we can facilitate that.
  • Jessica Gimeno: In Will County, Dr. Troiani calls that mixed training. They use CIT training as a vehicle, and invite the MCRT, 988, and 911 people to build that trust as soon as possible.
  • Pete Eckart: One of the things I heard in this conversation was the opportunity to do some joint convening.

Discussion on Subcommittee activities for FY25:

  • Pete Eckart: Who needs to be a part of this body for FY25? Two ways that people can join:
    • Existing or new SAC members - "official" members of subcommittee
    • Members of the public that could be invited as expert consultants, such as IDPH data staff or staff from 988 call centers that could appropriately participate
  • Charlie Petrof: Some of my concerns rotate around the dispatch process, so we need to get the 988 call centers back in, and then have a representative of people on the ground like 911 operators so we are building bridges. I also think it would be interesting to have someone from Chicago with their experience with the CARES line, or Will County who has also started on implementation process. I've also heard of Arukah program. I'm not suggesting them all as members but suggesting them as people to discuss with.
  • Pete Eckart: Some of those avenues are participation are happening in a very direct, intentional way, as a part of the pilots and pre-tests and within the system. In this question about dispatch, we will be supporting that work but the lead for that needs to come through Protocols and Standards.
  • Brent Reynolds: The general invites have been shared with the 911 centers meetings but next I will be starting personal invitations, which may be more effective. I think it would be good to have someone from Will County and maybe the pre-tests. I know that Shelley from Lee County has her own committee but maybe we could get Cicero or Cumberland County to start attending these subcommittee meetings.
  • Lee Ann Reinert: Should we be more intentional as we move forward with this subcommittee with the content that will be discussed during the meeting? A personal invitation with "this is what we are going to discuss, and we want your input" may get more participation. I also think that we need to be really intentional as a subcommittee in committing to having a dialogue and not just presentations so people don't think they can just watch the recording later.
  • Brent Reynolds: We could get communications out through associations that include the meeting topics; could potentially increase participation.
  • Brent Reynolds: The co-chair, Rick Manthy, will be resigning from SAC. Need to identify a new co-chair (ideally representing Fire).
  • Pete Eckart: He is intending to pass the responsibility on to his successor in his organization, but we need to confirm with him.
  • Lee Ann Reinert: I hadn't heard about Rick Manthy resigning. We want to make sure we're following the official process.
  • Pete Reinert: I will follow up with him and include Lee Ann and the DMH CESSA mailbox.

Next Meeting Dates

  • Monthly on the first Monday from 2-3:30 pm unless there is a holiday.
  • Monday, October 7, 2024, from 2-3:30 pm
  • Monday, November 4, 2024, from 2-3:30 pm

Public Comment:

* Charlie Petrof: I just wanted to share that what these groups are doing putting people together from different work culture environments. And I want to respect that I hear a real drive for perfection but I also hear that a perspective that is to take another step forward instead of perfection just to move forward. I respect that the committee is holding those two different views.

Adjournment: Motion to adjourn by Lee Ann Reinert, seconded by Bobby Van Bebber. No opposition. Meeting adjourned by Brent Reynolds at 10:18 am.