CESSA - Region 11 Committee Meeting Approved Minutes 10/20/2025

Time: 11:00 AM - 1:00 PM

Via Webex and In-person (Access Living)

September Meeting Minutes Approved by: Eddie Markul, Jennifer McGowan-Tomke, Tiffany Patton-Burnside, Jessica Gimeno, Matthew Fishback, Jenique Dean, Jim Poole, Dr. Chenetra Washington, Johnathan Zaentz, Cosette Ayele, Greg Lee, Rhonda Anderson (Sgt. Jose Estrada proxy) Sandra Heidt (Kimberly Johnson proxy), Kenji Grandberry

Call to Order/Introductions:

Meeting called to order at 11:05a by Dr. Eddie Markul
Members Present: Eddie Markul, M.D.,(in person), Jennifer Tomke-McGowan(in person), Tiffany Patton-Burnside(in person), Jessica Gimeno(in person), Matthew Fishback(in person), Jenique Dean(in person), Jim Poole(in person), Dr. Chenetra Washington(in person), Johnathan Zaentz(in person), Cosette Ayele(in person), Greg Lee(in person), Rhonda Anderson (Sgt. Jose Estrada proxy) (in person), Sandra Heidt (Kimberly Johnson proxy) (in person), Kenji Grandberry (virtual)

Meeting Logistics/Open Meetings Act:

Meeting recorded in accordance with the Open Meetings Act site at the Office of the Illinois Attorney General
Minutes to be provided to the Illinois Department of Human Services Division of Mental Health
Meetings are recorded. You may choose to turn off your camera.
Minutes will be posted at the Illinois Department of Human Services Division of Mental Health on the Open Meetings page.
Minutes will be posted after they have been approved at the following RAC meeting.
Please remain mute during the meeting unless you want to have some discussion. If you would like to speak, please raise your hand to get the presenters' attention.
Only appointed members may contribute to the discussion at any point during the meeting. Members of the public will be able to speak during the "Public Comment" session of the meeting.

Mayor's Office:

The city of Chicago has been focused on how we build out our mental health responses for some time.
We're seeing many calls into 911, 311, and 988 for mental health and there are a lot of avenues available for support.
It's important that the city continues to build out these services over the next few years, how we will continue to show up for people who are in need, and make sure that our responses are tailored for those who are in need.

State Updates:

988 and "SENTRI" Implementation Rollout in Illinois

SENTRI Overview: SENTRI (System for Emergency Triage to Response Integration) is a new system changing how mental and behavioral health crisis calls are handled. A pilot phase ran from January to June 2025, involving 19 PSAPs (Public Safety Answering Points) and corresponding mobile crisis response teams.
Next Phase of Implementation:
- A new cohort of 23 PSAPs across Illinois (excluding Region 11) has been identified for training.
- These PSAPs will undergo weekly or biweekly meetings and training before being officially brought into SENTRI operations.
- Full statewide implementation is targeted by June 30, 2027, with 21-24 PSAPs added each quarter.
Region 11 (Chicago): Chicago is excluded from the current phase due to its complexity and independent protocols.
- Chicago uses its own dispatch systems, unlike other regions that rely on vendors like Priority Dispatch or Total Response.
- Special meetings are planned with Chicago leadership to ensure thoughtful integration into SENTRI.
Key Point: A PSAP is not considered part of SENTRI until it has completed all required training and onboarding steps.

Chicago CPD/CFD/OMEC:

Mental Health-Related Call Volume and Response (Jan-June 2025)

911 Call Center Operations:
- All calls, regardless of type, are routed through the 911 center.
- 25,000 calls were flagged for mental health triage using a "CX" button.
- If a CFD (Fire Department) response is needed, dispatchers can quickly route the call to them.
- CARE and CPD are also engaged based on the nature of the call, using system attributes to determine appropriate response.

CIT Officer Dispatching:

Calls involving mental health or Crisis Intervention Team (CIT) components are flagged using a "Z" attribute. These certified officers are prioritized for response, but if unavailable, a sergeant and another officer are dispatched initially until a CIT officer can join.

Mental Health Transports:

The goal is to avoid unnecessary hospitalizations. CFD is only allowed to transport to emergency departments. CPD can only transported to approved facilities. There are no living room programs included in the approved facilities list at this time.

Non-Emergent Calls & 988 Transfers:

Non-urgent calls may be routed to 988 reps for phone-based support. If the situation escalates, 988 can transfer the call back to dispatch for CPD, CDPH, or CFD response.

Call Discrepancies:

Differences may arise between OEMC and CPD data due to how calls are triaged and flagged. A call may not initially be marked as CIT but could be reclassified based on field assessment.

Common CIT Call Types:

Five main event types often indicate mental health components:

Mental health disturbances
Suspicious person
Well-being checks
Threats of suicide
Criminal trespass

Statistics:

In the first half of the year, there were 13,829 mental health-related calls, resulting in 10,744 transport. Some were referred to 988 for further support.

Collaboration & Resources: CPD works closely with OEMC, CDPH, and CFD to ensure appropriate response and transport. Ambulance transport remains a key method for individuals in crisis, supported by CPD manpower when needed.

Training & Support:

Firefighters and paramedics operate 24/7 and are well-positioned to provide care

CFD Behavioral Crisis Calls and EMS Response Insights

Behavioral/Crisis Calls : In the previous year, 17% of calls returned to the Chicago Fire Department (CFD) were tagged as behavioral or crisis related. These tags are based on a basic classification system that OEMC is working to improve.
Top Dispatch Complaint: The most common reason for dispatch was difficulty breathing, while only 7% of dispatches were for behavioral crises.
Mental Health in Medical Emergencies: Many medical emergencies have overlapping mental health components. Crises-whether physical or psychological, often require integrated responses.
Field Realities: EMS teams respond to a wide range of situations, from severe emergencies to uncertain wellness checks. Every call, regardless of its nature, may involve a mental health aspect.

988/NAMI:

988 vs. 911: Unlike 911, which evolved locally over decades, 988 was launched nationally as a centralized mental health and suicide prevention line. It's still in early stages of implementation and will continue to evolve.
Chicago's 988 Network:
- NAMI Chicago, C4, and Centerstone serve as call centers for the city and surrounding counties.
- In the recent reporting period, 83,000 calls were received from Cook County, with 75,000 answering a major improvement from the pre-988 era when Illinois had only a 19% answer rate.
Call Handling & Impact:
- Average call time is 13 minutes, allowing for thoughtful, least-restrictive interventions.
- Only 1.3% of calls required in-person response, mostly handled by mobile crisis teams.
- Many in-person needs still default to 911, due to public habit and limited awareness of 988's capabilities.
Cultural Shift Needed: The public still instinctively calls 911 for urgent help. Over time, education and system integration are needed to shift appropriate crisis responses to 988 and mobile teams.

590 Crisis CARE System /Mobile Crisis Response Teams:

Chicago CARE Pilot:

There is not a crisis line for the CARE team, but it is accessible through 911 and will soon be available through 311
5,750 incoming calls to 911, and 586 were responded to by CARE
These calls were CARE appropriate, meaning there were no weapons, medical needs, intoxicated and in the age range
Average time to scene is 9 minutes
Of the 586 engagements, CPD was requested 38 teams for a more acute situation or involuntary transport

HRDI Crisis Response Summary

Call Volume:
- 161 calls from 988 and 911
- 62 in-person calls
- Total: 223 calls
Response:
- 100% of calls receive an in-person response
- Average response time: 15-20 minutes
Escalations:
- 1 case referred for additional care
- 23 individuals hospitalized
Nature of Calls:
- Most callers just need someone to talk to
- Intake provides info on additional services
- Follow-up offered even if initially declined
Hospital Referrals:
- Primarily Jackson Park and St. Bernard (others not excluded)
Operational Approach:
- HRDI sends staff in person for every call, regardless of severity
- Goal: "Eyes on" for safety and proper assessment
CPD Involvement:
- 1 call required CPD on scene
- City staff used for overnight safety checks
Challenges:
- Recent decrease in in-person responses due to community fear and safety concerns
- Variation in mobile crisis response practices across organization

Pilsen Wellness Center Crisis Response Summary

Call Volume:
- 233 calls
- 35 from 988 and 911
- 104 in-person calls
Response:
- Average response time: 15
Escalations:
- 7 individuals referred to higher level of care, to UIC Emergency Care and Sinai
CPD involvement
- None during this time
Challenges:
- In person responses due to community fear
- Not impacting call volume at this time

Trilogy Crisis Response Summary

Call Volume:
- Over 2,100 calls to crisis line
- Referrals from 988 and 911 included
- In-Person Responses: 283
Approach:
- Initial phone assessment and de-escalation before deciding on in-person response
- Average response time: ~33 minutes
Hospitalizations & Referrals:
- Hospitals: St. Francis (Evanston), Swedish, plus Thresholds Living Room and Turning Point
Coverage Area:
- Includes parts of Evanston and Skokie
CPD Involvement:
- Occurred twice, for safety support during in-person assessments
- Strong emphasis on relationship building with CPD and Evanston PD for coordinated response
Transportation:
- Uses a van for field visits and hospital transport
Operational Notes:
- Agencies allowed to apply for their own geographic coverage under 590 funding

Discussion around differences in approach for in-person response, and differences in volume of response across providers.

Crisis Support Utilization Overview

Living Room & CSU Usage:
- Over 2,300 individuals accessed Living Room programs.
- 65 individuals were referred to the Crisis Stabilization Unit (CSU).

These numbers reflect real people seeking emergency behavioral health support

Breakout Discussion on Operationalizing Behavioral Health Crisis Response:

Purpose of the Breakout: The goal was to discuss practical and operational changes needed to better route 911 calls to the appropriate behavioral health services.
Local Variation Matters: Mobile Crisis Response (MCR) teams operate differently across neighborhoods, highlighting the need for hyper-local data to guide policy and service improvements.
Hospital Transport & Flexibility:
- MCR teams do not have formal contracts with hospitals.
- CPD and CFD typically transport individuals to the closest appropriate hospital.
- CARE teams have more flexibility and can transport citywide based on patient needs.
Call Routing & Geographic Boundaries:
- MCR teams generally serve specific geographic areas.
- Calls may come from 988, crisis lines, or community referrals-not usually from 911, which reveals a gap in strategic coordination with OEMC.
- The state provides a keystone directory to help 988 operators route calls to the correct MCR team based on zip code and location.
Community Awareness & Outreach: Many crisis line calls come from word-of-mouth referrals or individuals already familiar with the services, emphasizing the importance of community engagement and education.
Data Needs & Next Steps: There's a strong need to collect and share geographic service data, team staffing levels, and transport destinations to inform future planning and ensure equitable access across neighborhoods.

Questions from the Committee:

None

Public Comment:

Reflection on Access and Response in Mental Health Crises

Access Challenges: A key concern raised is that citizens often don't know where to turn for help, and may not meet specific criteria for certain services, leading to misdirected or inadequate responses.
Police Involvement in Region 11 (Chicago): While some advocate for non-police responses, others note that CIT-trained officers in Chicago have shown compassion and effectiveness in handling mental health crises.
- Some officers actively request clinician support when appropriate.
- The perception of police response is evolving, with certain officers embracing behavioral health collaboration.
Systemic Frustration: Despite the presence of many dedicated professionals and organizations, there's a disconnect between available services and actual help delivered.
- The speaker expresses frustration over bureaucratic barriers and lack of unified action, especially when so many resources and people are already engaged.
Call for Action: The conversation emphasizes the need to move beyond statistics and planning to real, coordinated efforts that ensure people in crisis get the help they need-regardless of where they are or who they call.

Next Steps:

Next meeting on November 17, 2025, virtually

Meeting adjourned at 12:58p

Adjournment approved by: Eddie Markul, Jennifer McGowan-Tomke, Tiffany Patton-Burnside, Jessica Gimeno, Matthew Fishback, Jenique Dean, Jim Poole, Dr. Chenetra Washington, Johnathan Zaentz, Cosette Ayele, Greg Lee