CESSA - Region 4 Committee Meeting Approved Minutes 11/19/2024

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

Meeting Minutes- November 19, 2024 - 10:00-11:30 via Zoom

Meeting Minutes - Approved by Members 01/21/2025

• Call to Order
  • Meeting called to order at 10:01 by Co-Chair, Julie Brugger

• State Updates Brenda Hampton
  • Vibrant, the national overseer for 988 and the FCC has approved Geo location by county. The agreement was that the two 988 Lifeline centers in Cook County, C4 Community Counseling Centers of Chicago and NAMI which only dealt with certain ZIP codes in Chicago, will pick up the entirety of Cook County and Centerstone will back them up. The 988 routing by county is working well. The only other updates were just to remind about the mandatory trainings.

• Technical Subcommittee Updates: Protocols and Standards
  • The PowerPhone pre-test was completed, and the Subcommittee Members will be meeting to review what was learned from the information gathered. They will be discussing recommendations to address any issues that were discovered.
  • From the pre-test, the results have been summarized within five categories.
  • Protocol Use. For Protocol Use, it was recognized that PowerPhone protocols are not uniformly accessed, and the Emergency Telephone Safety Boards may opt to not participate in CESSA even though required by the statute.
  • PSAP Operations. Some of the unions may impact PSAP operations including the use of modified protocols. PSAP Administrators noted that the number and types of calls received varies based on factors such as the time of year, PSAP locations, population served and to the extent to which the protocol vendor software is activated at the start of the call can vary.
  • Training. In this area, it was learned that the PSAP Administrators have periodic meetings with telecommunicators to update them on operational changes. PSAP Administrators prefer brief to the point training and reported that augmenting PowerPoint training with scenarios highlighting the types of callers appropriate for transfer to 988 for Mobile Crisis Response Team response. It is unclear at this point how effective the training provided by PSAP Administrators was in conveying the intent of CESSA as well as the need to utilize the protocols updated by the Protocols and Standards Work Group. Although in the pre-test, PSAP Administrators were part of the work group making modifications to the protocols, it was not realized until the pre-tests were initiated, that most of the modified protocols would not be used by telecommunicators.
  • Data Collections and Referrals. During the pre-test, there were fewer calls related to mental health issues than we anticipated based on the national benchmarks and the national data. Most of the calls were ruled out as appropriate transfer to 988 for Mobile Crisis Response. Law enforcement was subsequently dispatched because those calls were ruled out. It is very labor intensive for the PSAP Administrators to review all the behavioral health related calls to determine if the calls could have been referred to 988 for Mobile Crisis Response. The PowerPhone vendor has developed a report that has been deployed to the pre-test PSAP Administrators, which should help address that issue.
  • Organizational Change-Cultural Change Issues. In this area, telecommunicators have decades of experience in dispatching law enforcement, EMS, and fire, so adding a fourth dispatch option is a technical and cultural change that will take a little time to implement. 911 telecommunicators, 988 Crisis Counselors and Mobile Crisis Response Team staff may not be aware of each entity's strengths and experiences in working with individuals experiencing behavioral health crises. CESSA requires major system and organization changes as well as a change in the mindset of line staff active in the field. This level of change does not occur in a brief period of time such as the 45-day pre-test. Also, there is a widespread lack of information regarding 988. It is difficult to change response to crisis callers when there is not much information regarding the other components of the crisis system.

• Priority Dispatch met to clarify the use of protocols. There will be a follow up meeting with Priority Dispatch SME Workgroup and Priority Dispatch to discuss further how protocols comport with the IRLM to meet CESSA goals.

• APCO continued review and finalization for recommendations for modifying protocols.

• In December, the Statewide Advisory Committee meeting discussed some changes to the pilots during the October meeting with identified pilot sites; this included the 911 PSAP Administrators, Centerstone from 988 and the Mobile Crisis Response Project Directors. It was found that several stakeholders expressed concerns about that approach and wondered why 988 was not first being allowed to conduct crisis counseling and de-escalation for those mental health behavioral health emergency calls that were transferred from 911. After some review and some further discussion and identifying pros and cons, a decision was made to present a question for the vote in the Statewide Advisory Committee meeting on November 12th. The question was, "Should the 988 call centers be instructed to attempt to resolve a crisis situation referred by 911 in lieu of transferring all calls automatically to a mobile crisis response team"? A vote was taken and passed that will allow the transfer of those emergency calls made to 911 that meet the level one of the risk level matrix for mental health and behavioral health crisis situations. For those specific calls, when transferred to 988, they are going to be addressed by the 988 Crisis Counselors for resolution prior to a decision to transfer those calls to the MCRT. The change will more closely align with the format and actual implementation of CESSA when that does happen in July 2025.

• Technical Subcommittee Updates: Training and Education
  • All agencies participating in the pilots are expected to complete training in topics required by CESSA; these trainings are on demand and self-paced. CEU's will be offered for certain courses. PowerPoint-only courses are not eligible for CEU's. Exemptions will be considered, upon request, for certain courses if a comparable course has been taken in the last 12 months. Thirty-seven training courses have been completed for the pilots.

• Goals-SAC Membership:
• Regional/Subregional Strategies
  • Phased implementation of the revised, approved PowerPhone protocols by the end of the FY25 including the ability to transfer from 911 to 988 to mobile crisis response.
  • Complete the pilots for APCO, Priority Dispatch and the Independents by the end of the FY25.
  • Stakeholder groups to understand the purpose of CESSA and what crisis response services are going to be available and how to access them.
• Statewide Strategies
  • Reducing the reliance of people and behavioral health crisis on 911.
  • Developing and implementing a Quality Assurance plan for CESSA implementation.
  • Increase the collaboration between the various parts of the crisis response system.
  • Having an actionable and sustainable plan for FY26 and beyond.

• Finalizing plan for the Pilot
  • We will be looking at a pre-test phase and trying out the protocols in different areas. This pre-test sets the stage for all of the pilots to begin. Priority Dispatch is used in our region.

• Next Steps
  • To contact Madison County's ETSB to inquire to see if there is another PSAP that can be identified in that would be willing to assist in the pretest phase.

• Next Meeting Date: December 17, 2024
• Public Comment- none
• Adjournment- John Nowak motioned and Deborah Humprey seconded.

• Zoom link: https://zoom.us/j/97228537775?pwd=YmNSTGYzbjFDN3ZvUlZHVUJwUVBIUT09
• Meeting ID: 972 2853 7775
• Passcode: 443050
• Join by phone: 1-309-205-3325 (US)