CESSA Protocols and Standards Subcommittee Meeting - Approved Minutes 08/21/2025

Date: August 21, 2025

Time: 2:30-4:00 pm

via Zoom

Call to Order/Review of Official Notices (Cindy Barbera-Brelle)

• Meeting called to order by Cindy Barbera-Brelle at 2:34 pm (via Zoom)
• Cindy Barbera-Brelle reviewed OMA Official Notices
• Cindy Barbera-Brelle reviewed the agenda

Roll Call (Cindy Barbera-Brelle)

• Members present: Bobby Van Bebber, Jessica Gimeno (designee for Candace Coleman), Cindy Barbera-Brelle (designee for Alicia Atkinson), Allie Lichterman (designee for David Albert), Pete Dyer, Rachael Ahart (had to leave at 3:00 pm), Blanca Campos, Justin Houcek
• Members absent: James Hennessy, Brent Reynolds, Drew Hansen
• Quorum is present

Approval of Previous Meeting Minutes (Cindy Barbera-Brelle)

• Approval of minutes from August 14, 2025
  • Jessica Gimeno made a motion to approve the minutes; Bobby Van Bebber seconded the motio
  • Members who voted to approve: Bobby Van Bebber, Jessica Gimeno (designee for Candace Coleman), Cindy Barbera-Brelle (designee for Alicia Atkinson), Allie Lichterman (designee for David Albert), Rachael Ahart, Blanca Campos, Justin Houcek
  • No response: Pete Dyer
  • Quroum voted (7 total) to approve August 14, 2025, minutes

State Updates (Allie Lichterman)

• No major updates since last week

Pilot Updates (Cindy Barbera-Brelle)

• Total Response
  • Evaluation phase for Total Response pilot; individually meeting with pilot PSAPs about training experience, transfer experience, etc. Three meetings completed and more scheduled for next week
• Priority Dispatch
  • Pilot in progress
• APCO
  • Final touches on APCO 988 reference card and law enforcement protocols; hope to have changes to APCO by next week

IRLM Feedback and Response

• Comments from recent Protocols & Standards Subcommittee; includes members' comments and public comment
• Comment from Jim Hennessey: The CESSA statute says that law enforcement was not supposed to respond unless there was violation of criminal law, So why in the IRLM are putting a MCRT response for crimes? The statute determine when law enforcement can't go. They can't go when there is a mental health crisis with no threat of injury or no violation of criminal laws of the state. So, for trespassing, law enforcement has the ability to go.
  • Response: CESSA Statute: (50 ILCS 754/30, Section 30) states "(a) Law enforcement responsibility for providing mental and behavioral health care. 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, or (ii) presents a threat of physical injury to self or others
    • In accordance with the CESSA Statute, LE with possible co-response by MCRT or other co-response types will be added as the response for calls related to Trespassing, Public Disturbance and Public Indecency (e.g. Criminal Activity)
  • Mary Smith checked if Jim Hennessy was on the call to respond; he was not present and there were no other comments
• Comment from Justyna Cerny about Medical Clearance in Relation to moderate Intoxication: When we say medically cleared, does this mean they are in an emergency room?
  • Response: As a point of reference, relates to Intoxication Risk Factor, Level 3 of the IRLM (E.G. a response type of EMS with possible LE backup and a co-response with MCRT, once an individual is medically cleared
    • If EMS is dispatched with MCRT as a co-responder for an individual identified as having a behavioral health problem who has used drugs or alcohol, but not at the level that requires a medical intervention, would/could EMS medically clear the individual on-site so that a MCRT could then provide services?
    • EMS and MCRT would not have a definite pathway to identifying what was ingested, how long ago, or the individual impact this would have on this person.. EMS cannot medically clear an individual on their own.
  • Bobby Van Bebber: Whenever we talk about intoxication, through alcohol or other substances, we have to consider some key pieces; part of that is, what and how much and when did they become intoxicated? It becomes tricky when we talk about just sending MCR. They shouldn't be doing medical assessments and pulling that information. We have to focus on the physiological harm of a large amount of substance, and what the timeline will be. For example, if I am experiencing a crisis and ingested a large amount of alcohol, I may not be able to keep my airway clear. A lot of times, you will see people experiencing crisis transferred to emergency departments for evaluation and medical clearance to ensure they are safe to receive a safety plan or go to another location or receive services. We need to make sure they are physiologically safe.
  • Mary: So if EMS responds, they're not able to medically clear an individual on site?
  • Bobby Van Bebber: Yes, that's correct. When someone is under the influence, it's not within the scope of EMS practice to medically clear someone. They would likely have to see a physician for medical clearance.
• Comment from Alyssa Marrero about MCRT as an option for co-response: I'm looking for some clarification on the sections that identify MCRT as an option for co-response. Would 911 be dispatching MCRT with police in those situations? Or only if they already have an existing relationship?
  • Response: There could be different ways in which MCRTs could be dispatched depending upon what resources exist within a jurisdiction
    • LE with a formal MOU or agreement with an MCRT agenc
    • LE could contact 911 for MCRT response and 988 could then refer to MCRT for an immediate respons
    • Guidance needed in instances in which no formal relationship exist
  • Alyssa Marrero: I have more questions, should I wait until public comment?
  • Mary Smith: Yes, thank you.
• Comment from Jim Poole of NAMI Chicago: We also think it's important to recognize that people without a mental illness can experience a mental health crisis, and those risk factors must be included in these matrices. As currently written, the matrix seems to use mental illness as an indicator of risk
  • Response: Reviewing this comment and the matrix
• Further comment from Jim Poole of NAMI Chicago: The matrix still falls short of evidence-based practice and risk assessment. It does not consider the context of a situation or speak to other factors that may impact the risk of any given situation, like whether or not a person is alone
  • Response: It's important to remember that the IRLM is not used as an assessment. by Telecommunicators. It is a guidance document to inform the scripts that Telecommunicators used to make dispatch decisions. Telecommunicators collect a range of information related to the context of the call including whether or not the caller is alone. Telecommunicators may adjust their decisions based on contextual information from the caller
• Further comment from Jim Poole of NAMI Chicago: In some cases, the matrix seems to use symptoms of a mental health condition or intoxication as the sole reason for indicating higher levels of risk. While that can be true in certain cases, it is generally not true that people with mental illness are riskier or more prone to violence. Basing a risk determination solely on the fact that someone is living with a mental health condition or using substances is stigmatizing and risks leading to more unnecessary, overly restrictive, and harmful interventions.
  • Response: Agreed. Very often individuals with BH/MH issues are more likely to be at risk of violence being perpetrated against them, however research has found that the risk of violence has potential to escalate when there is concurrent use of substances.
• Further comment from Jim Poole of NAMI Chicago: The content of the detail matrix includes pejorative or subjective terms like belligerence, hysterical, and implied aggression. These terms should be replaced with neutral and descriptive language to reduce bias and improve consistency.
  • Response: The terms described above will be replaced as suggested.
    • Threatening or confrontational behavior instead of belligerenc
    • Agitated instead of hysterica
    • Anger towards others instead of implied aggression
• Further comment from Jim Poole of NAMI Chicago: We're generally concerned that we are putting the 988 continuum itself over to the side, and making it sort of a secondary responder. We think that it must be possible for 911 to dispatch mobile crisis itself
  • Response: Dispatch/referral of calls from 911 to 988 for de-escalation before referring to MCRT was the result of vote by Protocols and Standards and the CESSA State Advisory Committee
• Further comment from Jim Poole of NAMI Chicago: We would just ask that there is a greater role for transfers or conferences from 911 to 988 in levels 2 and 3 that would do more direct dispatch, and really building this integration in, even as we're still building the behavioral health side of the system.
  • Response: More opportunities for a 988 and/or MCRT response are included in Level 2 of the updated IRLM. Level 3 includes opportunities for MCRT as a co-response.
• Comment from Matt Fishback: Going through the data, it looked like most of the calls that were transferred to 988 were in the missing data/undefined category, and I'm wondering if it just didn't have any call code associated with it. And how those calls were transferred to begin with.
  • Response: The call type codes were not reported; We are checking to see what happened. Calls were transferred to 988 by 911 Telecommunicators
• Discussion
  • Jessica Gimeno: We breezed through the pilot updates. My question for the pilot updates was - can members have the data slides from Total Response emailed to them from the August 14 meeting? We did not receive the data slides.
  • Mary Smith: That's really preliminary data. Jessica, you asked about the total number of calls received by the PSAP in the pilot. We have been working to collect that data, and we don't want to send out data that might be incomplete or changing. Goal is to complete the analysis and get to you as part of report. We don't want data floating around without the proper context.
  • Jessica Gimeno: We addressed Jim's comment, and the other commenters got a chance to respond.
  • Cindy Barbera-Brelle: Jim, did you want to add to the comment provided?
  • Jim Poole: I appreciate the additional clarification you have made and we should have some more comment.
  • Cindy Barbera Brelle read Jessica Gimeno's comment in the chat: "For the previous question - fyi - 50 ILCS 754/35 has the details on misdemeanors: healthcare prioritized; police after" and asked for clarification
    • Refers to comment from Matt Fishbac
    • Jessica Gimeno: A member had a question about law enforcement response to criminal activity. The statute addresses those concerns.
  • Alyssa Marrero [in the chat]: If the the co-response decision will be up to discretion of the 911 operators/Law enforcement, how will we ensure that the calls that fall in these categories are getting that type of response. Might be something that still needs to be worked out down the road but I do think we should consider how that will be evaluated
    • Mary smith: I agree. As I went through Alyssa's question, I mentioned that some guidance needs to be developed that doesn't exist right now.
    • Lorrie Jones: We are in the process of developing quality monitoring plan. Help us get into the weeds, see how many were actually transferred and how many need to be transferred. That's going to be complex, but it's ahead of us in terms of quality, monitoring, and compliance.
  • Allie Lichterman expressed appreciation for dialogue
• Mary Smith: There was a question about Level 1 offering less of an opportunity for MCR. We have a comparison showing March 2024 IRLM and August 2025 IRLM.
  • Weapons risk area: increased MCR response time from 30 minutes to 60 minutes
  • Intoxication risk area: more examples and intoxication indicators offered
  • The previous matrix had 7 risk areas, but not all 7 risk areas were reflected in each level of the matrix. For the current matrix, we had every risk area represented at every level and combined a few of the risk areas.
    • "History" risk area combined with "Psychosis" risk rea is now "Mental state/history" risk are
    • "Aggression" risk area was folded into "Violence" risk area with the same response options and tim
    • New "Criminal activity" risk area applies to Level 1; and points people back to Levels 2-4
  • Hopefully, this visualization dispels notions about Level 1 offering fewer opportunities for MCR
  • Jessica Gimeno: The two versions side by side are helpful. It seems like the changes with the August 2025 version states "Criminal Activity" as a risk area and "All potential criminal activity requires some level of law enforcement response." Can you explain why that was added?
  • Mary Smith: I think it goes back to Jim Hennessy's question, with law enforcement needing to respond if there is criminal activity.
  • Jessica Gimeno: There is a wide range of criminal activity. For example, trespassing at Walmart. There are situations when someone is loitering not doing anything, and that's different from committing vandalism and acting aggressively. At the RAC 7 meeting, the police chief of Hazelcrest and fire chief of Homewood Flossmoor were saying that there are more calls they wish to send a mental health/social work response to. I would just be mindful of the catch-all classification. From that perspective, there is a dramatic change from March 2024.
  • Lorrie Jones: We didn't have that category before, and I do agree with you that this is complicated. We went back and forth on this. If you look at the criminal code, trespassing and public disturbance are crimes. Based on how the statute is written, we felt we had to go this way. But then there's the criminal code and also related city ordinances. To honor the statue how it's currently written, we had to put it this way. I agree with you Jessica, that there should be a different consideration for different situations.
  • Allie Lichterman: My follow up question is, how often are telecommunicators' script guided by behavior, or criminal activity, or behavior that might be connected to criminal activity? The telecommunicators aren't explicitly asking on the phone "Is there criminal activity happening?" What about behavior that is safe for MCRT and considered criminal activity?
  • Lorrie Jones: If the caller says - "somebody is in my yard - it's trespassing. Law enforcement might get out there and decide to call MCR. There is always the opportunity to deflect to mental health.
  • Alicia Atkinson: It's tricky. Often driven by why caller is calling. Are you calling because someone's in your backyard and you don't want them there? Or because you're worried the person is having a crisis?
  • Lorrie Jones: This is where telecommunicators use their discretion and we can start addressing that in our training. Alicia, maybe you can help us with language for those concerns, about meeting the letter of the law and limiting unnecessary law enforcement.
  • Allie Lichterman: I appreciate the training piece; that's a good reminder. The IRLM is guiding the scripts and protocols; it's not what shows up on their screen. This is the difficulty of third part calls-someone can describe what they're seeing, but not exacty what's happening.
  • Lorrie Jones: Great discussion, and Alicia we will look to you for more language on Level 1 criminal activity.
  • Alicia Atkinson: Yes, and highlighting the gray area. All that the caller provides, is all they have to go off of in the moment.
  • Jessica Gimeno: I like that idea, along with the 911 perspective, it's important to have someone from the suicide lifeline. I also wanted to draw attention to a comment in the chat.
  • Alyssa Marrero [in the chat]: If a community has an ordinance that criminalizes homeless how would MCRT's be involved? This is a real life example happening in our community and I think its relevant to this discussion.
  • Lorrie Jones: That's a tough one. MCRs are behavioral health centered; they're not homeless outreach teams. But there are instances when a person experiencing homelessness might also experience a crisis. We have to look at handling those situations at a local level. There are city ordinances and criminal statutes; I don't know if CESSA includes city ordinances as well. We may have to do a little research for a reasonable answer.
  • Justin Houcek: I have a question that goes to criminal activity. What are you going to do with a 15 year old lighting off fireworks? Fireworks are criminal activity, but how would you respond to that? It's an example of who are they going to call?
  • Alicia Atkinson: It's going to depend on the area; different communities have different expectations. People call 911 for fireworks, and centers dispatch officers out to fireworks all the time. Anytime someone calls in, they're gonna send someone out there.
  • Lorrie Jones: We are talking about deflecting people with behavioral or mental health disorders. So, unless the person doing fireworks has a disorder, this wouldn't pertain to our work.

Questions from the Committee

• Jessica Gimeno: I think we could share the data with dates and the word "draft," to help boost transparency. When voting in December 2023, we said we wanted to revise the IRLM when we had draft data. We could mark the data as "non-final" so at least the Subcommittee members have them.
  • Lorrie Jones: I need to go back to talk to state partners, because we are very worried about this going out in the public domain. We need a firm commitment from Committee members not to share this. We also want to expedite the final report and have it available in a few weeks.
  • Jessica Gimeno: Yes, I understand.
  • Allie Lichterman: I know we talked as we were going during the pilots, so a lot of the qualitative stuff is guiding the changes, and it's been discussed over the past months in terms of procedure and relationship building.

Next Meeting Dates

• Meetings are held virtually 2:30-4:00 PM on the first and third Thursdays of each month starting in August, unless otherwise noted.
  • Thursday, August 28
  • Thursday, September 4
  • Thursday, September 19
• Note: There may be requests to schedule additional meetings over the summer as discussed at the last State Advisory Council Meeting

Public Comment

• Alyssa Marrero: I want to circle back on the homelessness conversation. We have struggled with the line between behavioral health crisis and general crisis. But what happens is that they can go into crisis. And the local police department has asked us about how to support and engage these individuals. We're trying to figure out the appropriate role for that. I think it's something to think about because it's going to continue happening. The ordinance says that people living on public property can be ticketed and jailed if they do not respond.
  • Will respond to public comment next week

Adjournment

• Bobby Van Bebber made a motion to adjourn the meeting; Allie Lichterman seconded the motion.
• Voted to adjourn: Bobby Van Bebber, Jessica Gimeno, Cindy Barbera-Brelle, Allie Lichterman, Justin Houcek, Pete Dyer
• Motion passed. Cindy Barbera-Brelle adjourned the meeting at 3:34 pm.