CESSA Statewide Advisory Committee Meeting 09/08/2025 Approved Minutes

Community Emergency Services and Support Act (CESSA)

Statewide Advisory Committee

September 8, 2025

10:00 am - 1:00 pm

Virtual (via Zoom)

Call to Order (David Albert)

  • David Albert called the meeting to order at 10:04 am and reviewed OMA procedures
  • This is a joint meeting between SAC members and RAC chairs/co-chairs

Roll Call (Sarah Ferguson)

  • SAC Members present: David Albert, Rachael Ahart, Alicia Atkinson, Blanca Campos, Rick Manthy (designee for Pete Dyer), Jessica Gimeno (designee for Candace Coleman), Drew Hansen, Jim Hennessy, Justin Houcek, Jim Kaitschuk, Brent Reynolds, Bobby Van Bebber, Curtis Harris (arrived late)
  • SAC Members absent: Emily Miller
  • Quorum is present

Approval of Minutes from SAC Meetings on June 9, 2025 and August 11, 2025

  • Brent Reynolds motioned to approve the minutes; Jim Hennessy second the motion
  • Members who voted to approve: David Albert, Rachael Ahart, Alicia Atkinson, Blanca Campos, Rick Manthy (designee for Pete Dyer), Jessica Gimeno (designee for Candace Coleman), Drew Hansen, Jim Hennessy, Curtis Harris, Justin Houcek, Jim Kaitschuk, Brent Reynolds, Bobby Van Bebber
  • Minutes are approved

State Updates (Allie Lichterman)

  • Responses to public comment from August 11, 2025 SAC meeting
    • Thank you for comments on communications messages; currently integrating feedback.
    • Thank you to Jen McGowan-Tomke and Jessica Gimeno who raised the importance of knowing more about total calls in the pilot. We will address today.
    • LEAP/living rooms came up in the context of talking about places to go last meeting. LEAP is a policy trade organization; it makes sense to talk to them about CESSA implementation, alternate destinations as opposed to ERs, and how living rooms are set up for their use. We appreciate comments about the importance of talking to policy and trade orgs and people who are doing the work.
  • Operational planning update
    • DBHR is working with UIC Crisis Hub to review programs related to CESSA to identify opportunities to align their work in the same direction as the Unified Crisis Continuum
    • Crisis residential programs are not among the programs being reviewed at this time
  • Collaborative in-person meetings with HFS focused on Unified Crisis Continuum
    • Two meetings have been held; four initial meetings scheduled; more are expected
    • Blanca Campos: Important to talk about billing and administrative burden, and how we can streamline everything on the commercial side is critical.
    • Allie Lichterman: Private side is a long-term goal to be sustainable and scalable but we're starting with the unified Medicaid billing that we have more control over.
  • 988 in-state call answer rate is consistently at or above 90%. Our next goal is setting up chat and text. Chat and text are currently being handled at the national center, but Illinois is setting up three centers to serve chat and text in-state
  • Reminder: Annual training for SAC and RAC to be completed by Dec. 31, 2026
  • CESSA flyers (ready for distribution) and new FAQs to be posted on DBHR website this week

BHCH Updates (Dr. Lorrie Jones)

  • UIC Crisis Hub selected as a recipient of pro bono services from Compass. Compass will work with us for 4 months, starting in October, to develop a strategic communications approach

Technical Subcommittees

Training and Education Subcommittee (Terry Solomon)

  • 1,842 people have completed the Core Pilot Trainings as of August 22, 2025.
    • PSAP Telecommunicators: 653; 988 Crisis Counselors: 272; Mobile Crisis Response Team Members: 815; Other: 78
  • New trainings in Public Act 104-0155, Sec. 25
    • Neurodivergent and developmental disability diagnoses
    • Involuntary commitment process
    • Subcommittee members were invited to recommend trainers and content

Technology, Systems Integration & Data Management Subcommittee (Jodie Bargeron)

  • Baseline assessment anticipated to occur for calendar year 2024 to get an impression of what volume was like before pilot testing occurs
    • Data collected from 988; next is PSAPs and MCRTs
  • Pilot/implementation data collection is ongoing
  • Crisis Data Reporting System (CDRS) updates based on pre-alpha testing results in progress
  • Police social worker survey
    • Goal: Gain knowledge of existing alternative response options that may impact CESSA roll-out. How many LEAs use social workers to respond to mental health crisis calls
    • Sent to Law Enforcement Agencies (LEAs) with social workers on staff through members of Association of Police Social Services
    • Survey closed 8/27/2025
  • 51 LEAs received it and 35 agencies included in analysis
  • 18 (51%) reported that social workers respond to mental health crisis
  • 16 reported social workers available 24/7
    • Survey results: Types of Mental Health Crisis Calls Police Social Workers Respond To
  • Mental health symptoms; Suicidal ideation; Well-being check; Suicide attempt; Homelessness; Domestic violence; Abandoned person; Public disturbance; Public indecency; Trespass
    • Survey results: Types of Services Social Workers Provid
      • Create crisis plan; Crisis Intervention; Linkage and referral; De-escalation; Community outreach; Assess for risk to self/others; Coordinate EMS transportation to hospital; Dispense Narcan; Coordinate with psychiatrist to obtain emergency medication; Provide transportation
    • Survey results: Most agencies in survey reported beginning pre-2023 (15) and 3 in 2023.

Discussion

  • Rachael Ahart: I recommend in the future sending it out to IL Sheriffs' Association and IL Association of Chiefs of Police and distributing the survey widely.
  • Heather Butler: I will second that. Our social workers are embedded in our PSAPs but employed through the 590 and we had to request it.
  • Lori Carnahan: Do you know where across the state they are located?
    • Jodie Bargeron: Of the 35 different agencies, respondents were from all areas of IL.

Illinois Risk Level Matrix (IRLM) (Dr. Lorrie Jones and Dr. Mary Smith)

IRLM Timeline for Discussion, Feedback and Action

  • We spent the early summer reviewing the IRLM and then we took it to a wide range of people for feedback
    • Overview of IRLM Update Process - August 7, 2025
    • Distribution of Updated IRLM to PSTSC - August 13, 2025
    • Review of Updated IRLM - August 14, 2025
  • IRLM and CESSA Implementation Timeline
  • Discussion and Initial Feedback
    • IRLM Continued Discussion/Feedback - August 21, 2025
    • Discussion and Possible Vote on Updated Risk Level Matrix - August 28, 2025
    • Vote and Unanimous Approval - September 4, 2025
  • After a lot of hard work and feedback, the Protocols and Standards Subcommittee approved the new IRLM by unanimous vote. This will be open for further discussion in the future, such as if the legislation changes

Approach to Amending the IRLM

  1.  Reviewed other risk level matrices nationally
  2. Reviewed previous commentary on the IRLM 
  3.  Reviewed information garnered from the pilot
    1. We thought the pilot would tell us more about the IRLM than it did, but it did give us anecdotal evidenc
  4. Created an 'internally consistent' document (all factors addressed across all levels) 
  5.  Asked for and feedback from PSTSC members, public and wide array of others 
  6.  Addressed feedback, updated and reviewed with PSTSC

Summary of Improvement: Updated Factors

  • Current factors: Threats to life and property; Weapons; History; Intoxication; Aggression; Unknown Status; Psychosis
  • Proposed new factors: Threats to life and property; Weapons; Violence (formerly aggression); Criminal Activity (new category); Mental State and History (merged psychosis and history); Intoxication; Unknown current status/well-being check
  • Overall, changes are designed to create more opportunities for deflection into the mental health system

Additional Significant changes

  • Defined co-responder models (non-law enforcement and law-enforcement or LE)
  • Introduced diversion into language on Criminal activity
  • Changed response times to expand use of 'up to 60 minutes response times,' which is more realistic for areas that can't be reached in 30 minutes
  • Defined when MCRT should respond to Unknown status/well-being check
  • Removed use of 'psychosis' term and replaced it with symptom description to remove terms that may be stigmatizing
  • Removed verbal aggression in Level 4 and moved to Level 3
  • Offered examples of non-lethal weapons
  • Classified domestic violence calls as requiring LE response

Discussion

  • Sharronne Ward: How does the first responder community respond to 60-minute response?
  • Lorrie Jones:
    • Must be situation that can maintain stability for 60 minutes; 30 minutes or other level for greater acuity. Following statute to involve MCRT with or without LE based on acuity.
    • MCRT not designed as emergency response but play significant role. Other jurisdictions and 100+ alternative response models across the country were configured so that response could be more emergent (e.g. circumscribed to small areas within cities or embedded in fire departments)
    • Need to focus on CESSA implementation first; then later support communities to design their own systems/funding streams

Feedback Themes Received from PSTSC, Public Comment, Others

  • Response Type Clarification
    • LE response to criminal activity
      • Lorrie Jones: Current statute says LE must respond to criminal activity but there are some very low-level crimes, like trespassing, for which LE may not be necessary.
      • Jim Kaitschuk asked to review list of non-lethal weapon
    • Medical Clearance and response type - Intoxication
    • Use of protocols to address intoxication risk factor
  • Language/Subjective terms to describe risk acuity
    • Replacement of terms including implied aggression, physical and verbal aggression, belligerence, hysterical and "evidence of mental illness"
  • Mobile Crisis Response Teams
    • Dispatch of MCRT - Who can dispatch and risks types to which MCRT and 988 can respond
    • Integration of MCRT in the emergency response system
    • Clarification that MCRT could be a o-responder at any level of the IRLM
    • Dispatch of MCRT as a co-responder with LE
    • Expansion of opportunities for MCRT response/Changes to level 1 IRLM
    • Homelessness and MCRT response
  • Lethal and non-lethal weapon clarification
    • Non-lethal weapons can be lethal in certain circumstances, based on access and intent
    • Allie Lichterman: If someone has a bat, what other questions do they ask to determine lethality? Reminder that the IRLM is a policy document to guide and create questions; it's not what they are actually looking at.
    • Rachael Ahart: Neither response type is different if you're looking at the matrix; those are both co-response with LE for level 3 and level 4. We don't specify what type of co-response.
  • Lorrie Jones: It's designed that way, to give specific PSAP flexibility given what they understand about the resource. If they have co-response, they can send co-response. If they have MCRT, they can mobilize that. But for the IRLM, we're speaking of co-response that includes LE.
    • Jim Hennessy: Still struggling to understand lethal and non-lethal. Level 4 could be weapons implied or actively wielded; Level 3 could be threatened to use. When we're taking calls, we understand anything can be lethal. Simply asking about presence of weapons and circumstances might be better.
    • Lorrie Jones: Thank you; we deliberated and thought it was useful for telecommunicators to know whether it was an official lethal weapon under statute, or if it's something that someone is weaponizing, without including an exhaustive list because an exhaustive list doesn't exist. You make a good point, and when we review it we can look at rephrasing.
    • Dr. David Mikolajczak: The term "less lethal" has been used (rather than non-lethal) within LE because anything can become lethal.
  • IRLM and protocol use
    • Mental health symptoms/Intoxication as indicators of risk
    • Use of protocols by 911 telecommunicators
    • IRLM Structure
  • DBHR substance use experts' language related to intoxication risk and acuity
  • Missing data for Pilot call type
  • Preamble to the IRLM: In development to explain the work, ground in our vision, and clarify that IRLM will be used as a policy document to inform work, not to explicitly instruct actual telecommunicators.

Pilot Data Follow-up (Dr. Mary Smith)

  • Pilot Updates
    • Total Response and Priority Dispatch: Evaluation in process, weekly and biweekly meetings continue
    • APCO: Continued planning for pilot; Protocols submitted to Vendor to update
  • Total Response Update
    • Dataset includes data received by 9/4/2025
    • 289 completed transfers to Centerstone (including 222 resolved by Centerstone, 5 transferred to MCRT, 3 transferred back to 911)
    • 33 incomplete transfers to Centerstone
  • Priority Dispatch Pilot Update
    • Dataset includes data received by 9/4/2025
    • 31 completed transfers to Centerstone (18 resolved by Centerstone, 4 transferred to MCRT, 2 transferred back to 911)
    • 5 incomplete transfers to Centerstone
  • Discussion
    • Mary Smith: Incomplete transfers could be a call that's dropped between 911 and 988, that the individual doesn't want to talk to 988, or a cold transfer.
    • David Mikolajczak: Do you get data on what type of calls are transferred back to 911?
      • Mary Smith: Yes, for calls with safety issue that need to go back to 911.
    • David Albert: Why do the numbers look so different for Total Response and Priority Dispatch?
      • Lorrie Jones: The vendors are very different in structure, complexity and willingness to change protocols. This is an unfunded mandate, so they don't have to use certain protocols from the vendor if they don't want to pay for it. It's harder with Priority Dispatch and will look different because we don't have access to their LE protocols.

Pilot Evaluation Report (Dr. Mary Smith)

Cautions and limitations when interpreting the data include the following themes:

  • Operational issues
  • Call transfer issues
  • Data collection and reporting

Total Response Pilot

  • Dr. Smith reviewed data regarding:
    • Dispatch/Referral Status of Behavioral Health Crisis Calls
    • Call types
    • Completed Calls to Centerstone 988
    • Outcome of Call Transfers to Centerstone 988
    • Call Volume by Site for January - June 2025
    • Number of Behavioral Health Calls Reported in the Dataset
  • Why can't this data be used to estimate the percentage of behavioral health calls received by 911 PSAPs that could be considered for a behavioral health response?
    • All behavioral health related calls received by sites during the pilot period are not reflected in these figures.
    • Protocols were not used by some participating sites.
    • The sites are not statistically representative of all the calls in the state.

Priority Dispatch Pilot

  • Dr. Smith reviewed data regarding:
    • Total Number of Behavioral Health Related Calls Reported between April 1 and June 30, 2025
    • Outcome of Calls Transferred to Centerstone
    • Call Suffix for Determinant Code
    • Call Volume by Site (April - June 2025)
    • Number of Behavioral Health Calls Reported in the Dataset
  • Why can't this data be used to estimate the percentage of behavioral health calls received by 911 PSAPs that could be considered for a behavioral health response?
    • All behavioral health related calls received by sites during the pilot period are not reflected in these figures. These numbers represent only a portion of behavioral health-related calls received by the plot sites
    • The sites participating in the pilot are not a statistically representative sample of all sites in the state.
    • Some call types that could be considered for a behavioral health response are not included

Pilot Observations Pertaining to the IRLM

  • Provide more guidance for identifying behavioral health calls that are eligible for transfer to 988
  • More specificity regarding defining/determining unusual behavior
  • Guidance for determining the difference between highly intoxicated and moderate intoxication
  • Guidance for transfer of third-party calls; reluctance to transfer calls when not all information is available
  • Distinguishing between lethal and non-lethal weapons; Difference between intent to secure non-lethal weapons for use vs non-lethal weapons that are available, but with no plan to secure or use them
  • Guidance for responding to well-being checks
  • Some calls answered using LE protocols could be transferred to 988 and/or MCRT, but software programming prevents this from occurring due to the programmed response type

General Perspective on the Pilots: It's a Win!

  • The Pilots are doing what we want them to do. We are seeing transfers from 911 to 988
  • The structural changes in the Pilots have become a template for replicable changes that we can build on and improve in other PSAP implementations
  • The training that has been developed provides the necessary support for continuing CESSA implementation
  • Low risk calls can be addressed by 988 crisis counselors; higher risk calls can be addressed by MCRT
  • There are 174 PSAPs and 3500 telecommunicators who need to be trained

Discussion

  • Now that we're beyond this pilot, is there discussion about other 988 call centers accepting transfers from 911?
    • Lorrie Jones: When we made this decision, there was a lot of pressure on the 988 centers to get to their call answer rate. Also, it aligns with Centerstone as the statewide backup.
    • Allie Lichterman: Some centers are still working on call answer rates. We don't want our dispatch system to get too far ahead of HFS and the unified crisis system, aligning with the CARES procurement, and the NOFOs for providers. So that is frustrating when there are centers that could do it all and you have to wait for the system to catch up with you but no solution yet.
  • Heather Butler: I suggest getting some of the pilots to talk about calls that were successfully transferred. So, having telecommunicators in a training sharing examples of successful calls.
    • Alicia Atkinson: I agree, and we are having conversations about how to build trust. We had Centerstone join the pilot meetings which helped build the relationships. 911 wants to know where the call is going.
  • Jim Hennessy: I know we can't track data as well as we could. How many calls are being initiated to 988? How many calls are being transferred to 911 that did not initiate from 911?
    • Lorrie Jones: We have all the 988 data so we can get that information for you and share it with the group.
  • Jessica Gimeno: Hearing a behavioral health call all the way through would help people to picture CESSA being implemented. Also, in Tuscon, they embedded 911 and 988 together to build trust. So that's something to consider.

Regional and Subregional Committees (Brenda Hampton)

  • Reminder for annual mandatory trainings due by the end of December 2025
  • Information about RAC meetings can be found on DBHR website
  • Subregional committees
    • The total is 18 subregional committees. These committees can talk more about collaboration and strategize how to increase services at the local level.

Presentations from the Regions

Sharronne Ward

  • RAC 7 Members were asked to nominate or refer potential Subregional Committee candidates within their geographical area:
    • Targeted candidates across disciplines; each was personally contacted by RAC Co-Chair
    • Subregional Committee candidates submit resume and cover letter explaining interest
    • The candidate's correspondence and any other relevant information are shared with the RAC 7 membership and partners, i.e., UIC Crisis Hub.
    • The candidate's information is reviewed by the RAC 7 membership for clarity and continuity, and an acceptance vote is cast at the CESSA RAC 7 monthly meeting.
  • Diverse voices and people from different disciplines; helpful for gathering multiple perspectives
  • There are 32 municipalities in the Southland community; the majority of them don't know what CESSA is yet, but they want a better way to address crisis in the community.
    • Example: A police Chief recently called and asked for someone to respond to a 7-year-old experiencing a crisis who got in trouble at school; shows LE willingness to engage
  • The biggest need LE said they have is housing in the community, so they asked for MCRT to come and talk to LE about housing options and also interacting with people with disabilities. So, we shared training tips and also resources for police, fire, and first responders.
  • Another example is co-location with the police department in South Holland which has led to invitations to provide crisis care in the community of Flossmoor. This work builds general enthusiasm and respect for each person's role, especially first responders, for what they do.
  • Dave Mikolajczak: I have found meeting in-person invaluable. It is hard with people's schedules but it makes a big difference

Lori Carnahan

  • Process for opening DuPage Crisis Recovery Center
    • We did community mapping; it takes a lot of time and growth to do it all at once
    • Many, varied partnerships with county & government leadership; health systems & hospitals; first responders & LE; community partners; local, statewide & national associations and expert consultations
    • We had a decentralized pilot
    • We expanded it to provide support for overdoses in the community. Crisis care was following up after an overdose call
    • Opened in 2025
  • We have almost a million people in the county
    • 36 municipalities; 4 hospital systems with 6 hospitals
    • Bringing as many people to the table as possible through professional associations
    • Crisis supervisors are getting the word out, attending roll calls, explaining 988 function
    • Bumper stickers for the first responders about calling 988 for a mental health crisis
  • Our North Star: optional care for DuPage County residents experiencing a behavioral health crisis at a single point of access, destigmatized, safe, efficient, effective
  • We also are working with hospital systems to get data. We are developing policies and protocols so someone can get into the hospital if they came to us and we determine they need hospital, they aren't just being sent to the ER
  • Crisis recovery entry points: Schools; 988; LE; EMS; Hospitals; Community agencies
  • Secure drop off that is quick. Its voluntary so LE and EMS just drop off and tell us what's going on, it's easy for them. We made sure ambulances can bill for those services. We partners with hospitals so EMS can get clearance from their medical directors to bring someone to us.
  • We have a warm handoff. We have a follow up team to see if you went to the appointment.
  • Services
    • Youth 5-18; For under 5, we will assess and provide linkage to specialized community provider for early intervention support.
    • Adults
    • Sobering and withdrawal management
  • If they are willingly present and medically stable, can be served (no other exclusionary criteria)
  • A lot of this was developed based on what the community was seeing
  • We feel like this is a model that is scalable
  • You don't have to necessarily have the building, but you have to work with partners and have community partnerships
  • Sustainability
    • The building was paid for with a combo of state and federal grants, and DuPage County and County Health department so its paid for our right
    • There is still a lot of advocacy needed for the state of Illinois to have a different system
    • Medicaid fee for service is difficult to get providers paid
    • For today, we rely on Medicaid
    • For commercial insurance, you can't bill much
    • We got start up funds from BCBS to pilot this
    • Talking to hospitals about partnership funding
    • We have 9 different 708 boards with townships and 3 have funding upcoming soon
    • State and federal grants
    • DuPage Health Matters is a fundraising arm that is a 501c3
  • CESSA is one piece of the puzzle
    • We designed this with the full system in mind
    • In our RAC meetings and subregional work, we try to make it work altogether
    • If 911 to 988 is taking time because its a culture change, then how we can get the word out now so people know what 988 is
  • It's amazing to see what can happen when a community comes together to build something
  • Lorrie Jones: What if someone comes to you through the emergency room or post-hospitalization? You mentioned medical clearance?
    • Lori Carnahan: If they come to us and during the 24 hours of observation, we determine a higher level of care is needed, we can admit them to a unit so they don't have to go back to the ER. We are also contracting with ambulances to take pressure off the ER. We also made the decision to do point-of-care testing with the hospitals' help. We have nurses and psychiatric nurse practices that do a medical screening. Medical clearance is actually for EMS in the field when they screen and call their EMD to request they approve bring patient to us.
  • Blanca Campos: Can you do a toolkit or a best practice guide? We know this works so how can we share it with others for the RAC to disseminate so it's less intimidating?
    • Brenda Hampton: We did put together a toolkit for the RACs recently to help them understand what they could be doing to build an SRC. It directs them back to the landscape survey they did about two years about and questions to guide local level planning.
    • Lorrie Jones: Great idea. It's really important but that's something we would have to work with the state on because it goes beyond CESSA. It shows the importance of bringing communities together to respond to what they need...Lori/Sharronne could take their models on the road to showcase possibilities.
  • Heather Butler: I think it shows the opportunity for town halls again. It was useful to show resources in the region. The RACs that need help could reach out to the RACs that are flourishing, and we can come to you and talk about our model.

Next Meeting Dates (Allie Lichterman)

  • Next Meeting: October 20, 2025 from 1:00-3:00 pm

Public Comment (David Albert)

  • No hands raised.

Adjournment (David Albert)

  • Jim H. motioned to adjourn, and Blanca Campos seconded the motion
    • Voted to adjourn: David Albert, Rachael Ahart, Alicia Atkinson, Blanca Campos, Jessica Gimeno, Drew Hansen, Curtis Harris, Jim Hennessy, Justin Houcek, Brent Reynolds
    • Absent at vote: Rick Manthy (designee for Pete Dyer), Jim Kaitschuk, Bobby Van Bebber
    • Motion passed; David Albert adjourned the meeting at 12:50 pm.