CESSA Protocols and Standards Subcommittee Meeting - Approved Minutes 08/28/2025

CESSA Protocols and Standards Subcommittee Meeting - Approved Minutes 08/28/2025

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 2:30 pm (via Zoom)
• Cindy Barbera-Brelle reviewed OMA Official Notices
• Cindy Barbera-Brelle reviewed the agenda

Roll Call (Cindy Barbera-Brelle)

• Members present: Blanca Campos, Jim Poole (as designee for Candace Coleman/Jessica Gimeno), Cindy Barbera-Brelle, Allie Lichterman (as designee for David Albert), Drew Hansen, Jim Hennessy, Justin Houcek, Pete Dyer, Rachel Ahart
• Members absent: Bobby Van Bebber, Brent Reynolds
• Quorum is present

Approval of Previous Meeting Minutes (Cindy Barbera-Brelle)

• Approval of minutes from August 21, 2025
  • Rachael Ahart made a motion to approve the minutes; Pete Dyer seconded the motion
  • Members who voted to approve: Blanca Campos, Jim Poole, Cindy Barbera-Brelle, Allie Lichterman, Drew Hansen, Jim Hennessy, Justin Houcek, Pete Dyer, Rachel Ahart
  • Quroum voted to approve August 21, 2025, minutes

State Updates (Allie Lichterman)

• No major updates since last week; continuing work and gathering feedback for the updated IRLM

Pilot Updates (Cindy Barbera-Brelle)

• Total Response
  • Currently conducting follow-up interviews with pilot participants; interviews to be completed next week
  • Gathering feedback about training and guidance and providing an opportunity to ask questions
  • Information to be presented to Subcommittee in the near future
• Priority Dispatch
  • Rolling start; no end date currently set
• APCO
  • 2 pilot PSAPs
  • Still addressing protocols and clarifying questions about mental health-psychological protocol law enforcement protocols, and expect to finish this week
• Law-enforcement only pilot
  • Considering a pilot for PSAPs that are just law enforcement, they don't dispatch fire or EMS
  • We are working on getting guidance together for those PSAPs
  • We have one pilot PSAP identified for this and are looking for a couple others

Interim Risk Level Matrix (IRLM)

IRLM Comments from 8/21/2025 and Response

• Comment from Jessica Gimeno, Access Living: The Risk Matrix has changed significantly; this is most obvious in level 1. Changes to the ILRM now make it harder for MCRTs to be dispatched. What is the rationale for reducing level 1?
  • Response: The updated matrix does not reduce the ability of MCRT to respond to crises. A side-by-side comparison was presented and discussed in the 8/21 meeting to address this comment.
• Comment from Jessica Gimeno, Access Living: The 08-13-25 ILRM does not set up the 988 continuum and our MCRTs to deliver an equivalent response. Level 4 asks for immediate response but does not allow for 911 to initiate dispatch of MCRT; it appears as if 988 must be activated. This is an inefficient arrangement. Both 911 and 988 should be able to dispatch MCRT.
  • Response: A policy decision was made by the PSTSC for 911 telecommunicators to transfer calls meeting the pilot criteria to 988 where crisis counselors would work with callers to de-escalate their crisis and provide a means of referral of callers to MCRT when appropriate. This avoids asking telecommunicators to make additional complex triage decisions related to behavioral health issues.
  • Jim Poole: Is there any thought that down the line this may be adjusted as we get more capacity? Can MCRT be allowed as an accessory to come and help and be another resource on the ground? I wonder if they could also benefit from behavioral health as well as officers in some cases.
  • Mary Smith: Level 4 does allow for a co-response. Before we got into this process, there had been a change made last March that calls for a co-response at level 4. As far as mobile crisis response, because of the level of acuity associated with the risk factor, I'm not sure that we would see a mobile crisis response there. So, it's not necessarily a mobile crisis team response, but a co-response is possible there.
  • Allie Lichterman: We know that there is a lot of room on the acuity spectrum that we don't have an appropriate non-police response for right now. There are localities building out teams that fill in some of those gaps, like CARE in Chicago and in Evanston, where there's an EMT on the vehicles, they can go to higher acuity calls. The state is very supportive of entities building out those different types of teams. We're just trying to be careful about what MCRT can go to on its own.
• Comment from Jessica Gimeno, Access Living: The current matrix uses mental illness as an indicator of risk. The matrix falls short of evidence-based practices in risk assessment because it does not consider the context of a situation or speak to other factors that may impact risk- such as if a person is alone
  • Response: The IRLM is not a document used by PSAP telecommunicators. When PSAPs answer calls, they take into account the callers situation including whether or not the caller is alone. The range of risk factors and acuity is considered when TCs answer a call
• Comment from Jessica Gimeno, Access Living: The matrix also uses intoxication as a sole reason for indicating higher levels of risk. Basing a risk determination solely on the basis of using a substance is dangerous
  • Response: Risk factors/acuity are considered in conjunction with the other risk factors. Decisions are not made based on one standalone factor
• Comment from Jessica Gimeno, Access Living: Language in the matrix promotes stigma against people with mental health conditions through subjective terms like "belligerence" and "hysterical." We recommend using more neutral and descriptive language to reduce bias. Similar to NAMI comment addressed during 8/21 meeting. Reviewed with ACCESS Living who agreed with suggested terms
  • Response: The terms described above have been replaced as suggested.
    • Threatening or confrontational behavior instead of belligerence
    • Agitated instead of hysterical
    • Anger towards others instead of implied aggression
  • Rachael Ahart: "Anger towards other" isn't always associated with aggression. Aggression implies threat of physical battery. How did it land there?
    • Mary Smith: We took into account the comments we received and tried to use an agreed upon term. Let's make a note of that.
  • Jim Hennessy: Regions and Subregions can make there own decisions on MCRT notification as well through their co response model as well?
    • Mary Smith: There are a number of different models around the state. We want mobile crisis response teams to respond when they're available in the appropriate amount of time. If there are other co-response models out there, such as law enforcement agencies that have memorandums of understanding with mobile crisis response teams or teams with licensed clinicians, those things can be taken into account, as we move forward and consider what the response would be. We know also that mobile crisis response teams can't respond rapidly enough in some situations, depending on where they're located and where the individual with the crisis is. So, I think there's some flexibility in terms of who can respond.
• Comment from Jessica Gimeno, Access Living: The matrix does not specifically mention least restrictive interventions-a value that is central to best practices in crisis response.
  • Response: 9-1-1 telecommunicators do not use the IRLM. Least restrictive interventions are the goal.
• Comment from Jessica Gimeno, Access Living: does not support the full integration of MCR in emergency response systems. As presented, the risk matrix does not integrate the 988 Continuum into 911. In fact, the new matrix puts mobile crisis response in the corner. Over the last few years, stakeholders strongly supported the principle that some 911 and police calls should be 988 and MCR calls, and that integrating 988 and MCRs into the system would make all stakeholders better off and able to focus their time/work on their designated purpose. (Addressed in 8/21 Meeting)
  • 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; As discussed during 8/21 meeting, the CESSA Statute does require LE response for criminal activity; The Intoxication risk factor/acuity at Levels 3 and 4 require an EMS response.
• Comment from Justin Houcek, ASDWithMe: The request for feedback and the voting seems rushed. I believe more time should have been provided to review material that was distributed to the subcommittee.
  • Response: The time period for feedback was extended based on feedback from committee members during the August 7th meeting
• Comment from Justin Houcek, ASDWithMe: The IRLM has some "structure", and I think the language still needs adjusting. More explicit, less opportunity for subjectiveness. Examples: Minimal, moderate, high, "Serious mental illness and "Implied"
  • Response: A method was needed to describe type of risk and to provide descriptions of the risk factors for the different types of risks; The PSTSC's decision was to use this structure to accomplish these goals
• Comment from Justin Houcek, ASDWithMe: Also, it seems the "conditions" of the risk matrix can be determined in some instances by the call taker or call handler. The other instances can be determined by the caller and/or responder or all three.? Should this wording be stated somewhere in the IRLM document.
  • Response: The matrix describes risk type and acuity. The information provided by the caller is used by telecommunicators to determine the response type and immediacy of response.
• Comment from Justin Houcek, ASDWithMe: Someone to call, someone to respond and somewhere to go. Somewhere to go (to be taken) seems to be an area we haven't spoken much of. Though at a meeting Dr. Jones did mention "living rooms" and I did make a comment about the need for more or more time at. Does it/should it be mentioned/described in the IRLM? Or is this separate from the IRLM?
  • Response: The discussion of "where to go" is beyond the purview of the IRLM.
• Comment from Alyssa Marrero, RAC 7: 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. 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.
  • Response: Criminal Activity in the CESSA statute does not reference city ordinances or the criminal code. It refers to the criminal laws of the state (50 ILCS 754/30, Section 30). Homelessness is an important issue that needs to be addressed, but is beyond the purview of the IRLM

A draft of the IRLM was screenshared.

• The detailed section is where we made changes. The summary section was updated to match the detailed section. All four levels now have the same seven risk areas

Questions from the Committee

• Jim Hennessy [in chat]: I had a question about the non-lethal weapons that were changed. When I last saw it, I saw "bat" listed as a non-lethal weapon. What did we use to make the distinction between lethal and non-lethal? Sorry if this has been answered before.
  • Mary Smith: This isn't really a change, but we wanted to make sure it was possible to distinguish between lethal and non-lethal so we gave these examples of non-lethal weapons. So, they're bats, umbrellas, and other objects that can be weaponized, but aren't usually lethal weapons.
• Rachael Ahart: Did you send out a copy of this to the Subcommittee?
  • Mary Smith: No, we made changes based on the comments received last week.
  • Rachael Ahart: Can you send a copy of that out? I think it would be helpful to look through.
  • Mary Smith: Yes.
• Jim Poole: Is there a table currently where the continuum-building and systems conversations are happening? What is the process around those kind of continuum-building concerns? I would like to see some guidance to localities and the regions on what they might consider, what some of the interoperability challenges might be, and kind of help frame their conversations locally, so they can get at some of these things that can't be addressed in the matrix. We're saying co-response in levels 3 and 4. But there is not a standard co-response model or an integrated response. It's important that the continuum we're building is interoperable and integrated to the greatest extent possible. 911 will usually overrespond and behavioral health will respond with least intensive so there's lot of questions that will pop up and need further guidance and local decisions made.
  • Mary Smith: Great comment, and this is what we want the regions and the subregional committees to work on. They can talk now about the current responses and are being asked to think about what other possible responses could be provided. If the resources aren't available, how would you work to put something different into place.
• Cindy Barbera-Brelle: Is there a motion for a vote?
  • Rachael Ahart: Would we be able to review these after receiving it and vote at our next meeting?
  • Cindy Barbera-Brelle: Sure.

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, September 4
• Thursday, September 18

Public Comment

• Alyssa Marrero [in chat]: So, does this meant that when a co-response needs to occur that only 988 will be able to contact MCRT and request that?
• Jen McGowan-Tomke:
  • [in chat]: Can it be clarified how broad of a term "co-response" is within the matrix?
  • There's been a lot of discussion today about the options for co-response, and in looking at the document as it was scrolling through the screen, I saw that the definition was specific to co-response, between law enforcement, indicated EMS option, or behavioral health option. It seems like one of the definitions of co-response is a law enforcement response with a follow-up mobile crisis team response, and I didn't see that in the definition in the matrix, so if that's intended, I would just, suggest that a broader definition is included in the actual matrix.
  • Also, in the response type columns, there's still maybe terms that are used inconsistently between risk areas, and just for clarity, I think it would make sense to use the same terms in each of those boxes.
  • I also noticed that there are some response types that are not defined, like mental health crisis counselor. So, just a suggestion to go through and make sure that there are definitions within the matrix.

Adjournment

• Jim Poole motioned to adjourn the meeting; Drew Hansen seconded the motion.
• Voted to adjourn: Blanca Campos, Jim Poole, Cindy Barbera-Brelle, Drew Hansen, Jim Hennessy, Justin Houcek, Pete Dyer, Rachael Ahart
• Motion passed. Cindy Barbera-Brelle adjourned the meeting at 3:28 pm.