CESSA Technology, Systems Integration & Data Management Subcommittee Meeting - Approved Minutes 09/22/2025

CESSA Technology, Systems Integration & Data Management Subcommittee Meeting - Approved Minutes 09/22/2025

Time: 2:00 - 3:30 pm

Via Zoom

Subcommittee members: Brent Reynolds, Alicia Atkinson, David Albert (Designee-Allie Lichterman), Jim Kaitschuk, Robert Van Bebber (Designee-Irene Wadhams), Candace Coleman (Designee-Jessica Gimeno), Pete Dyer

The meeting was called to order by Brent Reynolds at 2:03 p.m.

Roll Call (Sarah Ferguson)

  • Present: Brent Reynolds, Alicia Atkinson, Allie Lichterman, Irene Wadhams, Jessica Gimeno, Pete Dyer
  • Absent: Jim Kaitschuk
  • Quorum is present

Approval of Minutes from the Previous Meeting

  • Pete Dyer motioned to approve June 2, 2025, meeting minutes; Brent Reynolds seconded the motion
    • No discussion/changes
    • Voted to approve: Brent Reynolds, Alicia Atkinson, Allie Lichterman, Irene Wadhams, Jessica Gimeno, Pete Dyer
    • Minutes approved.

State Updates (Allie Lichterman)

  • PSTSC approved the IRLM
  • Looking forward to hearing updates about CDRS and streamlining data collection

Hub Updates (Dr. Lorrie Jones)

  • Working on a preamble; getting input from PSTSC before that's finalized
  • We are in the process of identifying the next 22 sites for implementation by Oct. 1 so they can start training to implement in the next quarter
  • We are also working with the vendors to see the work on the IRLM to make updates if necessary
  • We are also working to get EMD approvals on those changes from the vendors

Information System Updates: CDRS (Erin Condon)

  • Completed: Preliminary Pre-Alpha testing with select group of key DBHR staff
  • In progress: Working with the Center for Clinical and Translational Science to finalize content and add updates and features requested in Pre-Alpha
  • Up next: Alpha testing of the updated system with larger group of DBHR staff; to be followed by Beta testing with providers

Police Social Worker Survey (Erin Condon)

  • Goal: gain knowledge of existing alternative response options that may influence CESSA roll-out
  • We wanted to understand how Law Enforcement Agencies (LEAs) with social workers on staff use their social workers to respond to mental health crisis calls
  • We emailed members of police social worker professional association
  • Intended to obtain one response from each LEA with social workers on staff
  • Survey closed 8/27/2025
  • 35 LEAs included in analysis
  • 18 (51%) reported that social workers respond to mental health crisis
  • 16 reported social workers available 24/7

Information System Updates: Baseline Assessment (Erin Condon)

  • Goal: to understand how the crisis response system is evolving, we need to have a baseline knowledge about our performance before CESSA implementation began (calendar year 2024).
  • 988 Data Collection: Received data from Centerstone and PATH
  • PSAP Data Collection: Preparing to pilot test data collection tool with four PSAPs
  • MCRT Data Collection: Later this year

Information System Updates: Landscape Survey (Erin Condon)

  • Goal: Identify and catalogue the local behavioral health crises resources that are available in PSAP's jurisdictional coverage areas to whom referrals can be made
  • Includes non-law enforcement and law enforcement co-response models
  • Most PSAPs completed the initial surveys conducted in 2023. PSAPs will update the surveys as part of CESSA implementation

Dashboard Preview (Pete Eckart)

Intro

  • Data continues to be an important part of CESSA work
  • Ongoing conversations about data dashboards and data visualization; all SAC members were invited to participate in this TSIDM meeting
  • Will provide brief overview of data visualization mechanism; will also explain why dashboards are not being rolled out immediately
  • Concurrently working on 1) data presentation infrastructure and 2) actual systems change that will generate data to be shared
  • We previewed this to the SAC but have made changes since then
  • A graph is a static picture of data while a dashboard gives users ability to change parameters of what is shown on the screen. It is interactive and customizable.
  • The state is also working on a different set of dashboards for a different part of the work.

Sample dashboard

  • The dashboards we are looking at today are using sample data. It is not data from the pilots or any other aspect of implementation.
  • Reported mental health calls
    • Ability to filter by geographic type of PSAP (rural, suburban, urban)
  • Percentage of calls transferred to 988 in time period
    • Ability to select individual PSAP to see levels over time and see the differences in PSAP to PSAP
  • Reported mental health calls by call reason
    • By percentage
    • By call number
  • Outcomes of the calls transferred to 988
    • Outcomes options
      • Crisis counselor resolved the call
      • Transferred for MCRT
      • Incomplete transfer from 911
      • Transferred back to 911
    • Ability to sort by priority level
      • ILRM has four levels with descriptions of what counts for levels 1-4 but that has to be programed into vendor systems for us to be able to report so it's not an IRLM but rather what level the protocols show
    • Dr. Lorrie Jones: For calls transferred to 988, you wouldn't have priority level. We have to adjust that and show all the calls or take that out.
    • Dr. Mary Smith: Priority level is specific to the Total Response vendor and is low, medium, or high. It's not a number. Other vendors prioritize differently.
  • Discussion
    • Jessica Gimeno: What is an incomplete transfer?
  • Dr. Mary Smith: That would be where the call drops, for example.
    • Jim Hennessy: Where would this data from the PSAP be coming from? Is it protocol system, CAD, or both?
      • Dr. Mary Smith: We are collecting data from every entity we are working with to implement CESSA, so PSAPs, 988, and MCRTs. We have a minimum data set from the pilots to show you the metrics. Right now, it's coming from the EMD protocol system. Moving forward, it could come from the CAD system. One of the reasons to do the pilots was to see how we could collect and what else we will need for implementation.
    • Brent Reynolds: How will the 911 data be provided? I think it's great to see this but the concern from the 911 side is the amount of reporting. A challenge we've had with PSAPs across the state is the variety of resources and methods to collect data. It has to be easy to gather.
      • Pete Eckart: We know how important it is that data is accurate, meaningful, and fair. We are absolutely committed to that. There has been a lot of requests for information and because of the reasons you just expressed we have to be careful about sharing data.

Data Readiness for Dashboard Usage (Pete Eckart)

  • Quantity
    • Number of participating PSAPs
    • Number of cases with complete data
      • The source of the data may change over time
  • Quality
    • Protocol usage
    • Consistency of data
      • With PSAPs using different vendors and different CADs, we need to confidently talk about numbers/metrics across the system that mean the same thing
  • Implementation phase
    • Low value of earliest data from any new behavior change program
      • Relationship building and qualitative data has been more impactful at this stage of data collection, when there is limited numeric data
    • Ability to show real trends vs. "wobbles"
      • With limited numeric data, difficult to tell which spikes, drops, and other data trends are meaningful (vs. Naturally occurring variation)

MCRT Data for Dashboards in the Future (Pete Eckart)

  • This is a sample of what we will collect quarterly for MCRTs
    • Number of calls
    • Service data
    • Staffing data
  • Currently MCRTs provide this data through Excel sheets but eventually it will be through the Crisis Data Reporting System database. This will be easier for providers than Excel sheets.
  • Allie Lichterman: This is really going to be helpful for the state because right now it is someone's job copy and paste from every provider's individual spreadsheet which leaves room for error and is very time consuming. CDRS will allow for great flexibility accuracy and efficiency in running reports.

Data Support for Full CESSA Implementation (Pete Eckart)

  • What data will be collected?
  • How will data be collected and stored?
  • How will data be used and reported?
  • TSIDM Subcommittee will continuously monitor and review these questions

Reminder: What drives our data collection? (Pete Eckart)

  • This subcommittee started with data elements required by the original CESSA legislation.
    • In the latest revision of CESSA, there is another data element requirement about hospitalization and if involuntary
  • CESSA itself requires reporting, but it did not give us guidance on what metrics we need to collect in order to get those reports.
  • The work you did on this subcommittee for two years is now reflected in the data the Crisis Hub is collecting in the implementation process

Data Collection Elements (Dr. Mary Smith)

  • Minimum data set: We came up with variables that are needed for moving CESSA implementation forward and to evaluate the pre-tests and pilots.
  • Those who don't use protocols will have to open another system. So, ease of collection was something we considered and it's easier if you open the protocols.
  • The only way we can tell if we meet the goals of CESSA legislation is to collect data and continue to evaluate the process.
  • As Pete said, we don't have enough data for a dashboard but we are able to share the data in other ways.
    • We have provided and will continue to provide updates to you at the SAC meetings and Protocols and Standards meetings.
  • We have more data from 988 because we were able to work with them to create a report for this purpose.
  • Elements for 911:
    • Total # of BH Calls Reported - note this is different than total # of behavioral health calls. We can only report on bh calls reported.
    • Call Date
    • PSAP Name
    • TC Identifier
    • Call Start (Time)
    • Call End (Time)
    • Caller Incident ID: This is a unique number that comes from 911 to be provided to 988 and MCRT if and when necessary to track what happens to the call throughout the referral process
    • Chief Complaint (Call Type)
    • Response Priority
    • Responder Type
    • Call Priority
    • RAC Region
    • Geographic Area
    • Percentage of calls referred for a BH response (based on # of calls reported)
    • Percentage of callers refusing referral to 988
    • Percentage of BH calls as a portion of total calls
  • Elements for 988:
    • Total # of Calls Received From 911
    • PSAP Name
    • PSAP Telecommunicator (TC) Name
    • Caller Incident ID Unique Number for Call
    • Time Call Received from 911
    • Call Completion (911)
    • Call Type (1st Party, 3rd Party)
    • 1st 2nd 3rd 4th Party Call Outcome
    • Incomplete Call Outcomes (Reason)
    • Name of MCRT contacted for Transfer
    • Call Time From 988 to MCRT (when applicable)
    • Call Answered MCRT (Time)
    • Call Contact Outcome (e.g., answered, not answered)
    • Call Accepted for Transfer
    • Warm Handoff completed
    • Call Completion (Time 988 Disconnected)
    • Secondary MCRT Contact Name if Necessary
    • Time 988 Call to Secondary MCRT Name
    • Secondary Outcome if complete (Accepted/Not Accepted)
    • Warm Transfer Complete?
    • Call Completion Time
    • Time Call Transferred Back to 911 if Warm Transfer Not Complete
    • Notes (Additional Explanation)
    • Percentage of Calls Resolved by 988
    • Percentage of calls transferred for MCRT Response
    • Percentage of Calls Dropped
    • Percentage of Calls Transferred Back to 911
  • Elements for MCRT:
    • Total # of calls received from 988
    • Date Call Received from 988
    • Time Call Received
    • Caller Incident Number
    • Call Transfer Outcome (Accepted/Rejected)
    • If Rejected, Reason
    • If Rejected, Time Call Completed
    • If accepted Time Call Warm Transferred from 988
    • Time MCRT Departed for On-Site Response
    • MCRT Arrival Crisis Site (Time)
    • MCRT Intervention Outcome (Includes involuntary/voluntary hospitalization)
    • MCRT Departure from Site (Time)
    • Appropriateness of Call for MCRT Response
    • MCRT Transfer Issues Form Completed if Applicable
    • MCRT Response Rate
    • MCRT Referral Rate
    • Time Between Departure and Arrival for On-Site Response
    • Percentage of Warm Transfers From 988
    • Percentage of Responses Leading to Voluntary Hospitalizations? Non-Voluntary
  • Jim Hennessy: What are the data elements that flag a call as "behavioral health"? Is it based on protocols? Are they excluded if there is a weapon or some similar threat? Are we separating out the data for calls that really shouldn't be transferred? Or is it just the number of calls-excluding all factors-that are behavioral health and then the number of calls that were transferred?
    • Dr. Mary Smith: When PSAPs telecommunicators use the protocols, the idea is to identify calls that relate to those protocols that we identified as types of calls that might have a mental health component. So, there's the mental health protocols, trespassing protocols, wellbeing protocols, suspicious person protocols, and a few questions about exhibiting unusual behavior and being depressed/anxious. So, as they work through the protocols, they ask the usual questions and if a mental health issue is identified using one of the protocols we talked about, and that field is filled out, then it's classified as a behavioral health call. For Total Response, there were over 1,000 calls but only 132 calls were referred to 988. As a caveat: We are still not capturing every behavioral health call that comes into the PSAP, but we are collecting a lot.
    • Jim Hennessy: Let's say a police response is selected, but they also indicated a behavioral health component. But because they have a weapon or threat of harm or some other exclusionary criteria, are we still counting that in the total number of behavioral health calls, even if it wouldn't qualify to go to 988?
    • Dr. Mary Smith: Yes, it's included in the total number of behavioral health calls that are reported on. There is a difference between total number of behavioral health calls and number of behavioral health calls transferred to 988, usually because of a safety issue or telecommunicator decision to forgo 988.

CESSA Implementation Quality Improvement (Brittan Harris)

  • Quality improvement is a significant effort that we are still developing, and this a broad, high-level overview that hasn't been vetted or approved by anyone.
  • Quality improvement is both a producer and consumer of data
  • Process mapping showing Qualitative Data Input Mechanisms
    • PSAPs
      • Weekly and bi-weekly check-in calls
      • Pilot evaluation feedback
      • SAC and SAC subcommittees, RACs
    • 988
      • Bi-weekly check-in calls
      • Pilot evaluation feedback
      • Transfer Issue Forms
    • MCRTs
      • Bi-weekly check-in calls
      • Pilot evaluation feedback
      • Transfer Issue Forms
      • SAC and SAC subcommittees, RACs
    • Public and other stakeholders
      • SAC and SAC subcommittees, RACs (public comment sections)
      • CESSA public comment email and website form
  • Output: Improved BHCH CESSA implementation process and products, recommendations for improved training and communication

Vote on Meeting Cadence for FY 26 (Brent Reynolds)

  • Proposed cadence:
    • Beginning in September 2025, meetings will be held on the first Monday of every other month from 2:00 pm to 3:30 pm
    • Note: Today's meeting was rescheduled from Monday, September 1 to account for the Labor Day holiday
  • Proposed next meeting date:
    • Monday, November 3, 2025
    • Monday, January 5, 2026
  • Jessica Gimeno motioned to adopt proposed meeting cadence. Allie Lichterman seconded the motion.
    • Vote to approve: Brent Reynolds, Alicia Atkinson, Allie Lichterman, Irene Wadhams, Jessica Gimeno, Pete Dyer
    • Quorum approved the motion/new meeting cadence

Public Comment

  • Public comments will be replied to at the next subcommittee meeting.
  • Anthony Stua: I have talked to PSAPs about 988 and they have some concerns. Will 988 have the same infrastructure/data that 911 has, so that location data is not lost upon transfer?

Adjournment:

  • Alicia Atkinson made a motion to adjourn; Brent Reynolds seconded the motion.
    • Voted to adjourn: Brent Reynolds, Alicia Atkinson, Allie Lichterman, Irene Wadhams, Jessica Gimeno, Pete Dyer
    • Meeting adjourned at 3:24 PM.