CESSA Protocols & Standards Ad Hoc Workgroup Meeting 12/16/2024

CESSA Protocols & Standards Ad Hoc Workgroup Meeting

December 16, 2024, 2:00 - 4:00 pm

Virtual meeting via Zoom

Meeting Minutes - Approved by Members 12/19/2024

Attendees

Workgroup Members present: Jessica Gimeno, Tiffany Burnside-Patton, Candace Coleman, Rachael Ahart, Matthew Fishback, Jim Hennessy, Cindy Barbera-Brelle, Dolores Temes, Nanette Larson, Tanya Cooley
- Workgroup Members who are also Protocols & Standards Subcommittee members: Jim Hennessy, Rachael Arhart, Candace Coleman, Cindy Barbera-Brelle
Workgroup Members present briefly but who did not participate/vote: Jersey Shabazz, Jen McGowan-Tomke
Workgroup Members who were invited but not present: MJ Martin, Shelley Dallas, Alicia Atkinson
The UIC Crisis Hub staff members present (non-voting): Brenda Hampton, Lorrie Jones, Mary Smith, Jessica Atassi

Call to Order: Meeting called to order at 2:03pm by Lorrie Jones.

Introduction and Purpose of Meeting (Lorrie Jones): This workgroup will review the PowerPhone protocols and standards, have discussion, and vote on which ones will be recommended to the Protocols and Standards subcommittee for inclusion in the PowerPhone dispatch decisions so the calls would be eligible for behavioral health dispatch if possible/available.

National Practices (Mary Smith): Review of chart depicting incident types that jurisdictions include in their alternative response dispatch decisions. Noted that this chart does not represent all jurisdictions and incident types, just ones that the Crisis Hub identified based on our research.

Workgroup Protocol Review Process (Mary Smith): Mary Smith reviewed the steps completed by the workgroup so far. The workgroup did not have any questions or comments.

Review of Protocols and Votes (Mary Smith and Lorrie Jones)

The PowerPhone materials are proprietary and cannot be distributed.
The question added is, "Is the person behaving in an unusual manner?" with a bridge to a mental health protocol.
- The questions may differ slightly for each protocol.
- The workgroup previously decided on this phrasing vs. "Is this person having a mental health or behavioral health crisis?" due to the thought that there might be too many subjective interpretations of what a mental health crisis means.

Trespass Protocol Discussion and Vote

Dolores Temes: Many PSAPs don't use law enforcement protocols. My agency doesn't use these, we only use EMS, so these are irrelevant. After listening to Denver STAR, it confirmed what I thought we would do: create a policy around how to respond to any call where there might be an MH concern and there are no safety concerns, and then we can utilize 988 and MCRTs.
- Cindy, do we know the percentage of PSAPs using PowerPhone Total Response for law enforcement?
- Cindy Barbera-Brelle: I don't have the exact number, but it's small. I can get that.
Dolores Temes: Right, so the majority of the PSAPs are never going to use the protocols because they don't use them for police calls. I do think writing a policy is the way that I see us moving forward on this because we want to achieve what you guys want.
Mary Smith: While Denver wrote policies, they also identified at least 5 of the protocol areas that we have identified here. It's not just a matter of having a policy. They identify suspicious person or welfare check, then consider that for a dispatch to the Denver STAR Crisis team. You have to go further than just writing a policy; it's having people consider that if these kinds of incidents occur, you consider a different kind of response.
Mary Smith: I think this is a pretty good opportunity for Illinois with PowerPhone. They provide all the protocols, so you don't have to buy the law enforcement protocol.
Dolores Temes: We won't use the law enforcement protocols because they don't enhance call-taking. We have a policy for every single kind of call. These can guide and we could add those questions to those internal call guides.
Lorrie Jones: It sounds like we could do both. The call guides are another opportunity. Of course, the statute requires us to change the protocols, probably not understanding the full breadth of how PSAPs operate. So, we should probably also go to the guides.
Jim Hennessy: When I read the statute, it says that any time they are involved or in suspect of a violation of the state, then Law Enforcement responds. These incident types are crimes; I'm hearing this feedback from other 911 directors. Why are we using incident types that indicate a crime was committed? Like trespassing, criminal damage to property.
Lorrie Jones: Yes, but some discretion comes into play. We know that trespassing is often the behavior of someone who is homeless or in the middle of a behavioral health crisis. It's an opportunity to manage that person without escalating with the presence of law enforcement. We are pointing at discretion when dealing with low-risk opportunities. I agree with criminal property damage; no other jurisdiction is doing this.
Note: At this point, the discussion on Trespass paused, and was resumed at the 1 hour and 23-minute mark of the meeting.
Lorrie Jones: Tiffany, does Chicago include trespass?
Tiffany Patton-Burnside: Yes. It is included in our call types. But it's typically someone who is a person with a mental illness. That has happened like at the store where somebody, the owner of wants the person out the store. They are, quote unquote, trespassing, but they're also mentally ill. So we'll spend a lot of time at the Walgreens on the corner with certain homeless people who are also mentally ill.
Dolores Temes: If the caller is the property owner and it's a residential property, or even a commercial property, then a co-response would be okay. But I wouldn't be able not to send the police because they are the victim of a crime.
Jim Hennessy: I was going to say that. It has to be a co-response.
Lorrie Jones: I think that caveat, just like for public indecency, makes sense.
Matt Fishback: What stood out from the Denver STAR presentation is that they realized they spent too much eliminating calls that they could go to and not enough time on calls they could get them to go to. And that's how they have progressed to so many calls over the past few years. In all these cases, there could be a crime being committed, and there could be a crime not being committed. There could be a mental health crisis or developmental disability where a police response is inappropriate.
Lorrie Jones: That might be possible, Matt. And I think it was Dolores and Jim who said that a co-response would be appropriate, but not necessarily for this particular incident, which is a crime, for mobile crisis to go to alone. Now, they could stand down once they get there, and hopefully, this would be the case if someone is in a behavioral health emergency, and they can get serviced by a mobile crisis response team.
Jim Hennessy: I agree with that as well. Our stakeholders are the callers and they are going to want police officers. They're calling about someone trespassing on their land. They want the crime addressed. We want to get everybody the best help, that's what 911 is all about.
Matt Fishback: Co-response means a designated co-response program, like the one that we have. Not as in, a Sheriff's office is dispatched, and then a mobile crisis response is also dispatched.
Lorrie Jones: We haven't defined co-response, lots of different versions of it. But as long as it meets the definition of behavioral health and law enforcement, or EMS in some cases.
Mary Smith: I will note that when we heard that Denver STAR speak, this is one that they send their mobile crisis response team to and they find it is enough in many instances.
Lorrie Jones: During the pilot we'll be collecting data to see what it looks like in the field with these.
Rachael Arhart: My concern on this is that there might be a positive outcome, you might not need police, but the way that the legislation is written, if there's a suspected violation of the law, you're sending the police. Granted, if you have a co-response you could include that and get the mobile crisis response on the scene immediately. But if this is a criminal violation, sending to 988 and not law enforcement, I'm struggling to see where in the CESSA legislation it allows for that.
Lorrie Jones: You raise a good point, Rachel, and I don't know that we're prepared to respond to that. That is the way the statute is written (which could be changed). People around this call are part of discussions that are involving in changing the statute. It's not forever but this is how we're starting.
Jim Hennessy: To confirm, is this with co-response?
Lorrie Jones: That wasn't the motion she did. If Candace wants to amend the motion then she can.
Candace Coleman: Yes, co-response.
Rachael Ahart: I guess I'm a little confused by what just was added in there. I thought we were looking at using the mental health protocol like, you're going through this and you're utilizing the mental health protocol. The co-response, to my understanding, is going to be allowed in any type of police call for service if there are suspected mental health components or behavioral health components. And of course, that's going to be ideal on most calls. But I didn't realize that that would be part of this vote.
Lorrie Jones: I think Jim just wanted to make sure that there is recognition trespassing is formally a crime and that it would not fall at risk level 1 where there is not a law enforcement response.
Rachael Ahart: So if the mental health protocol is utilized on this one, that it would go to the interim level risk matrix, it would still go to law enforcement dispatch due to the crime. But then co-response would be allowed.
Lorrie Jones: That's correct. So it would be coded as risk level 2, 3, or 4, and not a 1 with mobile crisis response or 988 call response only.
Vote: Candace Coleman made the motion to include Trespass protocol with co-response, Dolores Temes seconded it (amended from originally being a motion to include Trespass only)
- Yes votes: Candace Coleman, Jim Hennessy, Cindy Barbera-Brelle, Dolores Temes, Jessica Gimeno, Matt Fishback, Nanette Larson, Rachael Arhart, Tanya Cooley, Tiffany Patton-Burnside
- Motion carries with 10 voting yes

Public Disturbance Protocol Discussion and Vote

Mary Smith reviewed protocol modifications on slide for Public Disturbance.
Mary Smith: 9 out of 12 jurisdictions we studied included this one.
Jim Hennessy: The bridge question, is the person behaving in an usual manner? For EMD protocols, they want you to follow exactly to be covered by liability/under EMD guidelines. I don't know anyone who would not say yes, to the question, "Is this person behaving in an unusual manner?" The way I've been using script cards for 15 years for EMD, PowerPhone covers you in court if you are using their scripts as written. So, if you're using this script card as written, the caller will always answer yes to the bridge question, never no. Can it be more descriptive, so it implies a mental health problem?
Lorrie Jones: That's a good point that you described. We could describe the types of unusual behaviors that constitute a behavioral health emergency. It's a training issue. There may be a lot of bridging to the mental health protocols. Let's try the training and if it's insufficient we'll have another approach.
Cindy Barbera-Brelle: The bridge to mental health is a protocol, so it takes you to the mental health protocol and you have additional questions you can ask to narrow down the situation. It doesn't mean to transfer to 988 or mobile crisis response to mental health response.
Jim Hennessy: Aren't there the questions in mental health, just going over the interim risk level matrix and making sure that it doesn't meet any of those criteria before transfer?
Cindy Barbera-Brelle: I don't have the card in front of me, so I can't speak that specifically. I think we can look. I think we can certainly take a look at that and see what that card looks like and then have further conversation.
Matt Fishback: There is always talk about liability. If my memory serves, CESSA provides liability protection for any situation that could arise from following the law and the protocols as they're set. Whenever there's discussion of any of these protocols or deflecting calls, people's concern is liability. I think if everyone had the comfort of knowing that they would be protected on liability, we can look at using the 988 and mobile crisis response more frequently on these kinds of questions.
Cindy Barbera-Brelle: CESSA legislation points to the Emergency Telephone System Act and the liability section within.
Matt Fishback: With all these calls, is there a way that we can put into these protocols some bridge to mental health or mobile crisis response to situations with EMS or police? I don't think there's anything that prohibits that.
Lorrie Jones: Yes, that's in the interim risk level matrix- different kinds of responses are possible given the resources available.
Matt Fishback: Right, but the entire State is supposed to have resources available for mobile crisis response. They don't have co-responder programs. From what I gather from the pretest is, there were not many calls that would have been bridged to mental health or use crisis response.
Lorrie Jones: One of the reasons why is because a lot of incidents were not included in that. Welfare check was tone that was frequently used in the pre-check, which is why it's on the list of consideration today.
Jim Hennesy: If I vote yes to including public disturbance, is that voting yes to this exact protocol card? Or is it just saying the nature will be evaluated?
Lorrie Jones: The protocol card is final for the pilot. It's not that it can't change, but it's too late to make changes to the pilot. After the pilot and before full implementation, we can make some changes. Our thinking is that we will handle this by training, but if in the pilot we find that's insufficient, then we would try again.
Vote: Cindy Barbera-Brelle made the motion to include the Public Disturbance protocol, Tanya Cooley seconded.
- Yes votes: Candace Coleman, Dolores Temes, Tiffany Patton-Burnside, Jessica Gimeno, Matt Fishback, Rachael Arhart, Nanette Larson, Tanya Cooley, Cindy Barbera-Brelle
- No vote: Jim Hennessy
- Not available to vote: Jersey Shabazz
- Motion carries with 9 voting yes, 1 voting no, and 1 unavailable to vote.

Welfare Check Discussion and Vote

8 out of 12 jurisdictions that we researched are using welfare check.
When our work group started to talk about welfare check, we were unsure if we wanted to include it, we did say, consider, including it. And each of the pretest sites checked their welfare check calls or well-being calls. And actually, this is where they found a number of individuals who may have had a behavioral health or a mental health crisis. And so we're recommending that we include this. We did not add any additional questions to this protocol.
Nanette Larson in chat: I absolutely think this one should be in the pilot
Vote: Matt Fishback made the motion to include the Welfare Check protocol, Jim Hennessy seconded it.
- Yes votes: Candace Coleman, Jim Hennessy, Cindy Barbera-Brelle, Dolores Temes, Jessica Gimeno, Matt Fishback, Nanette Larson, Rachael Arhart, Tanya Cooley
- Not available to vote: Jersey Shabazz, Tiffany Patton-Burnside
- Motion carries with 9 voting yes and 2 unavailable to vote.

Public Indecency Discussion and Vote

4 of the 12 jurisdictions use some form of this
Dolores Temes: I have a problem with this one. If the victim is calling I don't think they will be happy if the police aren't sent. It's a crime. They're the victim. They have a right to a police response.
Jim Hennessy: If a caller is calling in because this is happening, they want an officer. They definitely want to speak to an officer, and if they wanted to sign complaints for the criminal activity, I mean law enforcement has to respond to crimes, or at least that's the way the statute reads to me.
Mary Smith: So this is a third-party call right?
Dolores Temes: Not necessarily. A witness?
Tiffany Patton-Burnside: I've seen it either way. I've seen it be the person who is being exposed to, I've seen it where it's a third party and the person is driving by and reports it. Typically, it may be better suited as a co-response in case there is a need for a police report.
Lorrie Jones: Is this one that the CARE team includes?
Tiffany: It's not one of our call types specifically in Chicago. What we get is bizarre behavior, and they don't have on pants. I think the call type that this will fall under for us would be suspicious person.
Dolores Temes: So that's not how we'd process this call, its indecent exposure, that's a separate crime, and the third-party caller is also the victim.
Jim Hennessy: I agree completely with that.
Matt Fishback in chat: Need step out for couple minutes. I approve of including this. There are several different ways that public indecency could transpire that isn't criminal.
Candace Coleman: I understand that it could be a crime, but most often it's definitely a mental health crisis. I would actually push for a mobile crisis team
Jim Hennessy: There are provisions in the law that if law enforcement is responding to a crime, and they say that it is mental health related, then there are provisions in there for what they need to do in those situations. The way it reads to me is that law enforcement is supposed to respond when a crime is committed.
Lorrie Jones: But that doesn't preclude whether or not a co-response is actually necessary or appropriate.
Matt Fishback: A lot of this assumes a person has intended to be indecent. A lot of people in the field have seen someone who is indecent and was unaware of it and did not intend for other people to be victims of it. Those people can use a different response besides police or something else.
Lorrie Jones: The question is whether or not the telecommunicator should actually bridge. It's not saying that it can't be a co-response or a law enforcement response. But if it bridges to mental health, at least they're finding out if it should be a co-response.
Dolores Temes: As long as it's a co-response I'm okay with that. To not send the police would be an issue.
Lorrie Jones: I think that's fair.
Jim Hennessey: I'm curious how that mental health protocol actually bridges it to a co-response.
Lorrie Jones: If a co-response is available in that jurisdiction, then that can be the response. You have to look at the risk level matrix to see that, Jim. If co-response is not available in that system, but they rely on mobile crisis response to be there and mobile crisis response can't be there for an hour and a half or more, then law enforcement has to address this. The interim risk level matrix is where the dispatch opportunities and descriptions are.
Jim Hennessy: I thought the mental health card had more of that stuff on there, too, that goes over the questions that are the risk level matrix. Like, is anyone hurt? Are there any weapons?
Lorrie Jones: For those kinds of questions, then we bridge it to the risk level matrix.
Lorrie Jones: Can we take a vote on this one?
Jessica Gimeno: Would a yes vote preclude sending both police and EMS?
Lorrie Jones: No, it would not at all. A yes vote means they will ask questions about mental health. It'll bridge to the mental health protocol, so that if a co-response is available, it would be possible.
Rachael Ahart: In the protocol, the third question asking what they're doing. If they're doing something that falls under the statute under public indecency. I'm looking at the CESSA Law the same way that someone commented earlier that if there is a suspected violation of criminal laws, that law enforcement should be dispatched. So if that 3rd question goes in that direction, then this would default to law enforcement dispatch. Is that correct?
Lorrie Jones: Yes, it would be law enforcement. The question is whether it will be a co-response.
Candace Coleman: If we vote no, or vote in co-response, and if we vote yes, we vote police?
Lorrie Jones: If you're voting yes, you're voting that there will be a bridge to mental health questions in this protocol, so the telecommunicator will know if the person is likely to be a person experiencing a behavioral health crisis which could lead to a co-response in that jurisdiction if the resource is allowed. That's what a yes vote is.
Nanette Larson in the chat: In any area where mobile mental health relief providers are available for dispatch, law enforcement shall not be dispatched to respond to an individual requiring mental or behavioral health care unless that individual is (i) involved in a suspected violation of the criminal laws of this State.
Rachael Ahart: How would you get a no response to those first few questions?
Mary Smith: There is no "no response" to those. These are questions that the telecommunicator has to ask to even figure out what's going on. There are a number of questions they ask to even find out what the person's doing so. They're text responses that the telecommunicator would type into a text box as more information as they're collecting information.
Tiffany Patton-Burnside: I noticed in question 9. Does it appear? Does the person appear to be intoxicated or under the influence of drugs? This is usually one of the things that will disqualify the CARE team and make this a medical response. If this answer is yes, it will not bridge to mental health. It bridges to medical because of whatever the drug may be, may require a medical intervention.
Tanya Cooley: The matrix talks about that, though correct? If this is a medical emergency, then this should be EMS and it bridges back if necessary. As we go down these questions, from 1 to the bottom, if any of the answers are yes - if there's an injury, if it's immediate, if the person is in danger, etc., then it would automatically go to EMS or police. It only bridges to the mental health protocol if we get through all of those and its low risk.
Tiffany Patton-Burnside: So we're saying that this call will bridge over from the PSAP to the 988, and then a mobile crisis response team will respond. Do those teams have supplies to deal with indecent exposure? Do they have clothes?
Lorrie Jones: That's a good question; we would have to work with the mobile crisis response teams to make sure that they have those resources. I don't know if they do or not right now but thank you for raising it as an issue.
Vote: Lorrie Jones called for a vote to include the Public Indecency protocol with a co-response.
- Yes votes: Candace Coleman, Cindy Barbera-Brelle, Jessica Gimeno, Dolores Temes, Matt Fishback, Nanette Larson, Tanya Cooley, Tiffany Patton-Burnside
- No votes: Jim Hennessy, Rachael Arhart
- Motion carries with 8 voting yes and 2 voting no.

Suspicious Person or Vehicle Discussion and Vote

4 out of the 12 jurisdictions we looked at included suspicious person.
Mary Smith reviewed changes to protocol.
Lorrie Jones: Tiffany, does the CARE team does include this? Can you share your experience?
Tiffany Patton-Burnside: We go to suspicious person and it's one of our call types; suspicious vehicles not as much. Typically, they are homeless individuals, and the caller thinks they shouldn't be in that neighborhood, or they may be in a vacant lot.
Candace Coleman: Why is it together with the vehicle?
Mary Smith: That's how they wrote it, but we focused on suspicious person.
Dolore Temes: I'm okay with the suspicious person not the suspicious vehicle. I think it needs to be separated.
Lorrie Jones: Yes, that's fair.
Jim Hennessy: The same thing I had to say about the other card. I don't like that the question is "Is this person behaving in an unusual manner?" as a bridge, because a suspicious person or vehicle will always be behaving in an unusual manner. Even if we're trained, I don't think we should ask a question where we'll always get the same answer.
Lorrie Jones: If we put in parentheses what this looks like, would that help?
Cindy Barbera-Brelle: I think we can make that request.
Lorrie Jones: We'll make that request and see if we can do that before the pilot.
Jim Hennessy: I have one more question. If it's the lowest level on the risk level matrix, that's when it says, transfer to 988. What determines the co response? For public indecency, there typically wouldn't be a threat to anyone so it's always going to be the lowest level on the risk level matrix. So how would it ever qualify for a co-response if you bridge to mental health?
Lorrie Jones: All calls are transferred to 988. It's not always going to be risk level 1. It's always going to be a 2, 3, 4, in which law enforcement can respond either with or without mental health. Law enforcement will respond to public indecency. The question is whether or not it bridges to mental health, and they need a co-response because the person appears to be having a behavioral health emergency.
Jessica Gimeno: To respond to what Jim was saying, I think the alternative to "behaving in an unusual manner" is, "Is this person having a mental health crisis?" I think Mary said that they had considered a question about is the person having a mental health crisis, and that was even that more difficult.
Lorrie Jones: Yes, we can describe unusual behavior that a person may be demonstrating. The behavioral manifestations of auditory visual hallucinations, i.e. talking to themselves when no one appears to be around, waving at things that aren't there, inappropriately dressed for the weather, etc. We can put some brief descriptors that might make it easier for people to understand.
Candace Coleman: I feel like people don't realize that a lot of people with developmental disabilities could qualify under what a suspicious person may look like, and if you don't have the parameters of that, then they'll end up getting police when they need mental health support.
Vote: Candace Coleman made the motion to include the Suspicious Person protocol, and Dolores Temes seconded it.
- Yes votes: Cindy Barbera-Brelle, Candace Coleman, Jim Hennessy, Jessica Gimeno, Dolores Temes, Matt Fishback, Nanette Larson, Tanya Cooley, Tiffany Patton-Burnside, Rachael Ahart
  - Rachael Ahart and Tiffany Patton-Burnside indicated their yes vote was specifically for suspicious persons without the inclusion of suspicious vehicles.
- No one objected to removing suspicious vehicle from the motion.
- Motion carries with 10 voting yes.

Domestic Disturbance Discussion and Vote

2 out of 12 jurisdictions we looked at include Domestic Disturbance.
For this protocol we did not add a question here relating to unusual behavior. We thought there should just be an alert that would pop up to say that there could possibly be a mental health issue to consider.
Lorrie Jones: Tiffany, do you have any experience with this?
Tiffany Patton Burnside: It's not one of our formal protocols but we self-dispatch when there is a mention of a mental illness. Or law enforcement might dispatch the CARE Team once they are on the scene and they realize it's behavioral health in nature.
Dolores Temes: Domestics are really tricky. If a first-person caller indicates that they have a mental illness, I'd ask the person if they felt comfortable with the police or mobile crisis response team. For a third-party caller, is trickier because we don't know what's happening and it has to be the police.
Lorrie Jones: How about if this were law enforcement, but they can call mobile crisis response to the scene? I'm not sure if we can write all those caveats into the protocol, but if information is discerned, then they can be called to the scene even if they aren't dispatched together.
Mary Smith: That's pretty much what this says; ask all questions and note to be added to alert function. Police may request mental health response.
Tanya Cooley: What Lorrie said is perfect. I would be hesitant to just send mobile crisis response to these because domestic disturbances can go south quickly.
Jim Hennesy: I see in the process, ask all questions and note to be added to alert function. What are the triggers? What is the process for the note being added to the alert? Is it police who would be putting in the note on this address, like it's a premise hazard? What are the guidelines for the alert, or is that something that will be decided locally?
Mary Smith: An alert would pop up on the telecommunicators screen, just asking them to consider whether this may have a mental health component as they collect all of this other information.
Jim Hennessy: It's not based on any address, previous history, or anything like that? It would just be on every domestic?
Mary Smith: That would be good, but no, we didn't write that in. What we're trying to do is provide some guidelines and guidance. It's my understanding that with these protocols, PSAPS can add some additional questions to customize them, or there may even be some secondary questions that could be posed, and perhaps that's where I'm thinking that additional questions could be added. So we didn't try to cover every potential question. We're trying to point people in the direction to have them consider incidents or complaints that might have a mental health or a behavioral health component.
Rachel Ahart: How did you decide that this would be a good one for the alert versus having an alert across the board? If the intent is identifying mental health components, why would this be something domestic issues are singled out for but not other call types? Did you look at any dispatch types and data and see which ones ended up being coded as CIT or mental health?
Mary Smith: We did the alert because we were on the fence about this one. We didn't have access to the CIT or mental health data, but during pre-test we tried to collect information from the sites about which kinds of incidents they were reviewing.
Rachael Ahart: We do have co-response that has been operating for a number of years. Our calls have a very low percentage of mental health/behavioral health dispositions, around 3%. So typically ours is co-response, or if it's law enforcement only, we'll engaged crisis response on-scene if appropriate
Rachael Ahart: A catch-all alert or over-arching question may be helpful if the goal is to get mental health providers on the scene as frequently as possible. Otherwise, you'll be missing more opportunities for calls where having someone with mental health experience would be very beneficial.
Lorrie Jones: Good caveat and thanks for raising that. I don't know if we will be able to make a change before the pilot, but we can make a change before full implementation. We can check on that.
Candace Coleman in the chat: I agree with Rachael on that point.
Matt Fishback: Something else from STAR was the question - do you want STAR only as a responder? Is there a possibility of adding something like a universal question to some of these questionable calls like, Do you want a civilian mobile crisis, response, responder, something like that.
Rachael Ahart: How would this be different than any other call for service that police are going on, though? Shouldn't they be able to request that on any call if we get to the scene and determine there are mental health components?
Mary Smith: We are trying to guide people in the direction if they haven't considered a behavioral health component. For co-response, it just depends on the resources that you have available and the information that's being collected.
Jim Hennessy: I think Rachael's point is that, if it can be done every call, then why is domestic disturbance flagged as "may request mental health response." Does the alert have a purpose?
Mary Smith: Remember there were 80 possible protocols, and we picked the small number of protocols that might have a behavioral health or mental health component.
Candace Coleman: What happens if they're on the scene and they need the team?
Mary Smith: They can request mobile crisis response if the police are on the scene
Rachael Ahart: How would we see this working in the field, if mobile crisis is dispatched through 988 and not 911, and police have communication via radio back to their PSAP. So, if we're going to have this alert and notify that they can request mobile crisis response, but here's not mechanism in place to actually do that, how we do that?
Mary: In some jurisdictions like Chicago, folks have police radios and they're able to communicate with the police. I think that's something we would have to look at.
Lorrie: They always have the option to call 988 to request a mobile crisis response team. That's the fallback if they're not communicating directly.
Cindy Barbera-Brelle: the 911 center can call 988.
Tanya Cooley in the chat: Most local MCRTs also can be contacted directly
Jessica Gimeno in the chat: I have to go now to another meeting but it was nice seeing everybody and how other jurisdictions do this
Vote: Dolores Temes made the motion to include a mental health alert and the possibility for police to request a mobile response for the Domestic Disturbance protocol, and Cindy Barbera-Brelle seconded it.
- Yes votes: Cindy Barbera-Brelle, Candace Coleman, Jim Hennessy, Jessica Gimeno, Dolores Temes, Matt Fishback, Nanette Larson, Tanya Cooley, Tiffany Patton-Burnside, Rachael Ahart
- Motion carries with 10 voting yes.

Abandoned/Found Person Discussion and Vote

This, along with criminal damage and elevator rescue, is not being used by other jurisdictions.
Jim Hennessy: If no other jurisdiction uses these why are we?
Mary Smith: No other jurisdictions have that we have seen, it doesn't mean that there aren't any other people using them.
Lorrie Jones: Are abandoned persons mainly a person with dementia who is lost or a child?
Jim Hennessy: We don't use that call type.
Dolores: We don't use abandoned person, but we use found person. I think law enforcement is going, and they can request mobile response.
Matt Fishback: I would agree with that.
Candace Coleman: What if they are non-verbal?
Jim Hennessy: I understand that. This is the first one where it makes sense to me that we'd be asking if the person is behaving in a usual manner. I don't know if it should be a co-response or not, but this actually makes sense to me.
Candace Coleman: This rings disability - deaf or hard of hearing, developmental disability, visually impaired. There are a lot of scenarios with this that relate to disability.
Dolores Temes: We have a lot of Alzheimer or dementia folks who walk away, and we keep them in a database, so I'd want the police there to try to ascertain who the person is.
Lorrie Jones: Are we okay with this bridging to mental health?
Jim Hennessy: I'm okay with this as long as co-response.
Tiffany Patton-Burnside: I agree, we have a suspicious person that fills this gap of lost person, and it should be a co-response.
Nanette Larson in chat: I have another meeting that started at 4pm. My vote is YES on all of these.
Tiffany Patton-Burnside: If it's a child, under 12 or under 18, does it make it a SAAS call if they're they may be presenting with behavioral symptoms?
Mary Smith: I would guess if it's a minor it's going to be law enforcement. I think Tiffany you're talking about 911 folks transferring a call to the CARE team, and I don't think we have that set up.
Jim Hennessy: To me if we're coding it as a found person as opposed to like a welfare check or something, it almost indicates you need the police to go, or else we'd code it differently. We have a lot of walkaways, and then police could help identify the person and get them back to where they want. It just seems like it would be beneficial in my area for law enforcement to go, but I'm willing to hear your thoughts.
Matt Fishback: It just seems like an EMS or mobile crisis response would be good for this situation. An adult that disorganized like this might have a disability, or you something else that's not law enforcement related.
Dolores Temes: The weather is very dependent, if it is very hot or very cold, the police are going.
Tanya Cooley: So that this all speaks of disability. You know somebody who's nonverbal, possibly on the autism spectrum. In my mind, those were the kinds of calls that we wanted mobile crisis response to go to as opposed to the police because those are the ones that, unfortunately, are part of why we have this whole process. I'm with the co-response and EMS because especially with older adults, mental health and health concerns actually mimic each other.
Lorrie Jones: What do folks think about mobile crisis response and EMS?
Candace Coleman: I agree with that 100%.
Vote: Matt Fishback made the motion to include the Abandoned Person protocol, and Candace Coleman seconded it.
- Yes votes: Cindy Barbera-Brelle, Candace Coleman, Jessica Gimeno, Matt Fishback, Nanette Larson (expressed yes vote in chat prior to departing meeting), Tanya Cooley, Tiffany Patton-Burnside, Rachael Ahart
- No votes: Dolores Temes, Jim Hennessy
- Motion carries with 8 voting yes and 2 voting no.

Criminal Damage Discussion and Vote

Jim Hennessy: I don't think this question should be on there, especially not with the person behaving in an unusual manner, and it's a crime, and it'd need a co-response at least for sure.
Candace Coleman: Can someone give a scenario for this situation?
Dolores Temes: Yes, someone is outside with a baseball bat or a rock, damaging the car. It's a crime, police need to go. It can be a co-response.
Rachael Ahart: I agree that this should be law enforcement response, but I think it would be fine to have an alert pop out. I don't understand why we're singling out calls for that versus having a general policy.
Tanya Cooley: What defines it to criminal damage and not just property damage?
Dolores Temes: Property is there is no intent, and criminal damage is someone is damaging someone else's property.
Mary Smith: The thought here is that there would be secondary questions that would be used to gather additional information to sort this out.
Matt Fishback: I agree with Rachael, criminal damage is a crime and needs police response. Having a note/alert to indicate that it might have a behavioral health component would be good, but it should be on all calls. You're still going to need some law enforcement. But you know you could have other useful responders to the situation.
Tanya Cooley in the chat: Ya, I think this one would need additional information
Candace Coleman: Does Chicago CARE have a response to criminal damage?
Tiffany Patton-Burnside: No, we don't. We don't have a response to criminal damage, we don't go. We went to what was the domestic disturbance that moved to criminal damage, but the police were there, so it was a call response. It was not a primary dispatch for CARE.
Matt Fishback: There's a lot of criminal damage cases that are involved with domestic cases, too, and same could escalate.
Candace Coleman: I want to clarify the vote is for co-response
Mary Smith: I heard that the motion involves sending law enforcement but having an alert for telecommunicators to consider behavioral health or mental health issues.
Vote: Matt Fishback made the motion made the motion to include a mental health alert and a possibility to request co-response for the Criminal Damage protocol, Candace Coleman seconded it.
- Yes votes: Cindy Barbera-Brelle, Dolores Temes, Jim Hennessy, Candace Coleman, Matt Fishback, Tanya Cooley, Tiffany Patton-Burnside, Rachael Ahart
- Motion carries with 8 voting yes.

Elevator Rescue Discussion and Vote

Mary Smith: Elevator rescue is a co-response at the request of EMS or police.
Lorrie Jones: For this, would expect only to be called to this mobile crisis to be called to the team, to the scene. If you've got an issue with someone, who is experiencing a behavioral health crisis because they're in elevator rescue mode.
Lorrie Jones: Are we in agreement that elevator rescue is that EMS or police can call MCRT?
Jim Hennessy: I can agree with that, but I don't see the purpose of the alert.
Mary Smith: Because we're just trying to get people to go into that mode of thinking. It's not impossible to have some kind of a panic attack or go into a panic mode, and that there's a reminder that mobile crisis response is available to assist.
Vote: Dolores Temes made the motion to include a mental health alert with the option to request mental health response for the Elevator Rescue protocol, and Jim Hennessy seconded it.
- Yes votes: Cindy Barbera-Brelle, Dolores Temes, Jim Hennessy, Candace Coleman, Matt Fishback, Tanya Cooley, Tiffany Patton-Burnside, Rachael Ahart, Nanette Larson (expressed yes vote in chat prior to departing meeting)
- Motion carries with 9 voting yes.

Public Comment

Jim Moldenhauer, Director of Lyons Township, PowerPhone customer and slated to be part of the pilot, had three comments:
1. One thing I took from the Denver STAR presentation is that they are in communication with the PSAP rather than warm transfer. Reviewing some of these protocols, we will be getting multiple calls back from the public if the response is not as quick.
Response from Lorrie Jones: We will have to manage expectations to the public going forward, and the state is moving pretty rapidly toward centralized dispatch.
1. Abandoned person: We call this Person/Body found. For this type we've pulled 6 tickets, 3 were errors, 3 were dead on arrival. We would definitely be sending police to those calls.
2. Domestic disturbance: I still have a hard time understanding what a non-lethal weapon is.

Adjournment

Lorrie Jones adjourned meeting at 4:28pm.