CESSA Protocols & Standards Subcommittee Meeting 10/03/2024

CESSA Protocols & Standards Subcommittee Meeting October 03, 2024, 2:30 - 4:00 pm

  • Virtual meeting via Zoom

Meeting Minutes - Approved by Members 11/07/2024

Call to Order/Roll Call:

  • Meeting called to order by Cindy Barbera-Brelle at 2:33 pm (via Zoom)
  • Shelley Dallas motioned for approval of September 19, 2024, meeting minutes, seconded by Jessica Gimeno.
  • Members present and voted to approve: Cindy Barbera-Brelle, Rachael Ahart, Blanca Campos, Jessica Gimeno (Designee Candace Coleman), Shelley Dallas, Lee Ann Reinert (Designee for David Albert)
  • Members not present: Bobby Van Bebber (joined at 2:44 pm), Drew Hansen, Rick Manthy, Brent Reynolds
  • Motion carried.

State Updates (Lee Ann Reinert):

  • Geo-routing started at the end of last month. Verizon and T-Mobile calls are now based on closest cell phone tower rather than area code. The remainer of calls are being routed through area-code based routing systems.
  • Geo-routing had to consider Cook County as one county, so three centers share responsibility based on an algorithm that takes into consideration staffing and hours of operation. So far, the centers seem to be more efficient so far for Cook County. It's resulted in higher answer rates for the centers. We may be able to allocate resources based on the October report we will receive in November.
  • ATT geo-routing is supposed to go into effect later this fall

Update on Work with Protocol Vendors (Cindy Barbera-Brelle):

  • PowerPhone
    • We continued to meet with pre-testers
    • PowerPhone is finalizing the reference sheet they will use to work with the reports. Hopefully the reports be sent to the pre-testers within the next week.
    • Right now, pre-test is being calculated by administrators reviewing CAD notes which is not sustainable.
    • We will be meeting with pilot participants and discussing training that will be required for the pilots. Because calls will actually be transferred during the pilot phase, additional training is needed.
    • If there are existing relationships, those remain in place during the pilots.
  • Priority Dispatch
    • We are continuing to work with Priority Dispatch.
    • Priority Dispatch introduced a new mental health card, and some of the PSAP sites that will ultimately be pilots have already deployed that so the telecommunicators are using that particular protocol that did not exist previously.
  • APCO
    • APCO protocols are pretty similar to PowerPhone in some respects. We are reviewing their protocols and then will have further conversations with APCO.
  • Independents
    • We still need to meet with them. They need to look at the scripts they are using and making sure they are in lock step with the other vendors.
  • Other Protocol Issues
    • The other thing we determined is there are about 120 PSAPs using EMS protocols. There is a legislative requirement that telecommunicators to be licensed. While the majority have to do EMD, they are not legislatively required to do fire or police protocols. The vendors may make them available, but there is training and licensing involved. Something we are going to need to address is that often times, a behavioral health situation isn't necessarily called in as an EMD event so the telecommunicator isn't using EMD protocols. So, we need protocols that can be used in a non-EMD situation.
    • Dr. Mary Smith comments:
      • We have also met with the MCRT project directors and agency executive directors to appraise them of what the pilot is and what their role will be. We also met with Centerstone, which is the 988 call center that will receive the calls from the PSAPs in the pilot.
      • There's also training that has been developed for 988 crisis call counselors and MCRT staff. That training will be on-demand.
      • The report from PowerPhone will include the indicators recommended by the Data Subcommittee.

Discussion:

  • Shelley Dallas: Last week it was mentioned that Centerstone will not conduct an assessment during the pilot, they will just accept the information from 911 and then immediately contact the MCRT. Have the concerns about that been discussed?
  • Lorrie Jones: We discussed it and decided that we are going to keep the decision in place for the pilot to have all the calls transferred to 988 for immediate dispatch. We want to make sure that the calls get routed and that MCRT gets used to responding to calls. We also want to make sure that we aren't delaying access to a response by having multiple entities repeat an assessment. As we go through the pilot and see the types of calls being dispatched, we can determine in the future if there are calls that would be more appropriate to be resolved at the crisis call center.
  • Shelley Dallas: Its not a true pilot and I think its setting us up for failure, because 988 is able to mitigate within 80-90% of the time.
  • Lorrie Jones: I think you have a point, but we know this is the way we want to start out and then we can make adjustments later. We want the volume of calls to be pushed from 911 to the field. If 80% of calls stay at the 988 center, there would be very little opportunity for mobile crisis response to be a part of the process. We need MCRT to start responding more and building relationships with law enforcement.
  • Stacie Kemp: We might be delaying response by requiring on-site response when it isn't necessary. This also came up in our RAC meeting that we don't want people to repeat their stories but also the majority of calls are resolved through the 988 call so we aren't really setting up for the real system because its different than what the ultimate goal is.
  • Heather Butler: While I understand experience is needed, these are real people who are calling for help, and not test dummies. I think there are other ways to get experience or encourage engagement. While they are waiting for the MCRT to arrive, is 988 going to speak with them? If not, why are we preventing 988 from helping them?
  • Dr. Mary Smith: There is, in some jurisdictions, the ability for 911 to dispatch directly without going through 988. So, we hope that the protocols will identify those folks. Additionally, I don't think the 988 call centers are going to be missing out on responding to calls, as they get quite a few calls.
  • Shelley Dallas: In our area, RAC 1, we have four counties covered by 1 MCRT. So, in the event we have multiple calls at the same time, we would be delaying that response.
  • Brenda Hampton: In that situation, 911 would divert back to their existing protocol. Centerstone would call back the PSAP and let them know MCRT is unable to respond.
  • Lorrie Jones: We will go back and review this again and see if there is some way to take this input into consideration and see if there is a way to come up with a different approach.
  • Lee Ann Reinert: A lot of valid concerns have been raised. Becky Stoll from Centerstone had similar concerns. We know that centralized dispatch would go a long way. Over time, we want to see 988 utilized in its fullest potential but in its pilot phase, I'm not sure its possible and the people closest to it, designing it, are saying its not. We want to create something that makes sense and meets the needs of people and isn't unnecessarily sending out MCRT that aren't needed.

Subregional Committees (Dr. Lorrie Jones)

  • We used to call this a hyper-local approach.
  • The PSAPs are central to having the relationship with law enforcement, EMS, and medical directors in their locales. The CESSA amendment allows for subregional committees at this local level, more local than regional, for smaller areas to come up with dispatch decisions based on the resources in their area. With 179 different PSAPs, there was the possibility that we would have 179 different subregions. So, we decided that was untenable and hard to manage, and proposed the approach to organize around the vendors. We'd have three or four subregional groups.
  • Upon rereading the legislation, we had to revise our approach to meet the letter of the law, we need to have the subregional committees under the RACs even though we know its an administrative burden.
  • The PSAPs will be the center of the Subregional committees (SRCs) and can pull together the necessary representatives in their area to decide the changes necessary for their community.
  • The RACs would ensure SRCs have training and representatives while the SRCs are responsible for following all the OMA requirements.
  • We will also have learning collaboratives, by vendor, to pull together PSAPs from all regions with the same vendor type to discuss and difficulties with implementing revised protocols.
  • We have discussed this with the RACs, and next Cindy is going to talk to the PSAPs to make sure they can be involved. We will have documentation about this new process including responsibilities of each group.
  • No questions or comments.

Next Meeting Date:

Meetings are held virtually 2:30-4:00 PM on the first and third Thursdays of each month, unless otherwise noted.

  • October 17, 2024
  • November 07, 2024
  • November 21, 2024

Public Comment: There were no public comments made.

Adjournment: Cindy Barbera-Brelle adjourned the meeting at 3:20 pm.