102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB2784

 

Introduced 2/19/2021, by Rep. Kelly M. Cassidy

 

SYNOPSIS AS INTRODUCED:
 
New Act
50 ILCS 750/4  from Ch. 134, par. 34

    Creates the Community Emergency Services and Supports Act. Provides that the Act applies to every unit of local government that provides or coordinates ambulance or similar emergency medical response or transportation services for individuals with emergency medical needs. A home rule unit may not respond to or provide services for a mental or behavioral health emergency, or create a transportation plan or other regulation, relating to the provision of mental or behavioral health services in a manner inconsistent with this Act. Provides that one plan shall describe how the EMS Region will provide mobile emergency mental and behavioral health services to individuals who do not present as a threat to the responders, and are not involved in criminal activity at the time of the response. Provides that the plan shall conform to the requirements of the Act and, recognizing the variety of systems, services, and needs across the State, provide the specific requirements and guidance appropriate for that region. Provides that the plan shall be identified as the region's community emergency services and supports plan. Provides that the second plan shall describe the manner and extent to which responders operating under the region's Community Emergency Services and Supports Plan coordinate with law enforcement when responding to individuals who appear to be in a mental or behavioral health emergency while engaged in conduct alleged to constitute a non-violent misdemeanor. Provides that the plan shall be identified as the region's Non-Violent Misdemeanor Coordination Plan. Amends the Emergency Telephone System Act to make conforming changes. Effective immediately.


LRB102 14976 RLC 20331 b

FISCAL NOTE ACT MAY APPLY
HOME RULE NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB2784LRB102 14976 RLC 20331 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Community Emergency Services and Supports Act.
 
6    Section 1.5. This Act may be referred to as the Stephon
7Edward Watts Act.
 
8    Section 5. Findings. The General Assembly recognizes that
9many cities and some states have successfully established
10mobile emergency mental and behavioral health services to
11support people who need that support and do not present a
12threat of physical violence to the responders. In light of
13that experience, the General Assembly finds that in order to
14promote and protect the health, safety, and welfare of the
15public, it is necessary and in the public interest to provide
16emergency response, with or without medical transportation, to
17individuals requiring mental health or behavioral health
18services in a manner that is substantially equivalent to the
19response already provided to individuals who require emergency
20physical health care.
 
21    Section 10. Applicability; home rule. This Act applies to

 

 

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1every unit of local government that provides or coordinates
2ambulance or similar emergency medical response or
3transportation services for individuals with emergency medical
4needs. A home rule unit may not respond to or provide services
5for a mental or behavioral health emergency, or create a
6transportation plan or other regulation, relating to the
7provision of mental or behavioral health services in a manner
8inconsistent with this Act. This Act is a limitation under
9subsection (i) of Section 6 of Article VII of the Illinois
10Constitution on the concurrent exercise by home rule units of
11powers and functions exercised by the State.
 
12    Section 15. Definitions. In this Act:
13    "Emergency" means an emergent circumstance caused by a
14health condition, regardless of whether it is perceived as
15physical, mental, or behavioral in nature, for which an
16individual may require prompt care, support, or assessment at
17the individual's location.
18    "Mental or behavioral health" means any health condition
19involving changes in thinking, emotion, or behavior, and that
20the medical community treats as distinct from physical health
21care.
22    "Physical health" means a health condition that the
23medical community treats as distinct from mental or behavioral
24health care.
25    "Community services" and "community-based mental or

 

 

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1behavioral health services" may include both public and
2private settings.
3    "Treatment relationship" means an active association with
4a mental or behavioral care provider able to respond in an
5appropriate amount of time to requests for care.
6    "Responder" is any person engaging with a member of the
7public to provide the service required by Section 25.
 
8    Section 20. Regional committees. The Department of Human
9Services Division of Mental Health shall establish and oversee
10a community emergency services and support committee in each
11of the Emergency Medical Services (EMS) Regions for the
12purpose of developing and, as appropriate, amending 2 plans to
13set regional guidance and standards for providing mobile
14mental and behavioral health care.
15    (1) One plan shall describe how the EMS Region will
16provide mobile emergency mental and behavioral health services
17to individuals who do not present as a threat to the
18responders, and are not involved in criminal activity at the
19time of the response. This plan shall conform to the
20requirements of this Act and, recognizing the variety of
21systems, services, and needs across the State, provide the
22specific requirements and guidance appropriate for that
23region. This plan shall be identified as the region's
24community emergency services and supports plan.
25    (2) The second plan shall describe the manner and extent

 

 

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1to which responders operating under the region's Community
2Emergency Services and Supports Plan coordinate with law
3enforcement when responding to individuals who appear to be in
4a mental or behavioral health emergency while engaged in
5conduct alleged to constitute a non-violent misdemeanor. This
6plan shall be identified as the region's Non-Violent
7Misdemeanor Coordination Plan.
 
8    Section 25. Community Emergency Services and Supports Plan
9Goals. The Community Emergency Services and Supports Plan
10shall be designed to meet the following service goals,
11specifying specific expectations for these goals as
12appropriate:
13    (1) Provide mobile response service for mental and
14behavioral health emergencies. Every jurisdiction of local
15government that provides mobile emergency medical services for
16individuals with physical health needs must also provide
17appropriate mobile emergency services to individuals
18experiencing a mental or behavioral health emergency.
19Appropriate emergency response services must:
20        (A) Ensure that individuals experiencing mental or
21    behavioral health crises are diverted from hospitalization
22    or incarceration whenever possible, and are instead linked
23    with available appropriate community services.
24        (B) Include the option of on-site care if that type of
25    care is appropriate and does not override the care

 

 

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1    decisions of the individual receiving care. Providing care
2    in the community, through methods like mobile crisis
3    units, is encouraged. If effective care is provided on
4    site, and if it is consistent with the care decisions of
5    the individual receiving the care, further transportation
6    to other medical providers is not required by this Act.
7        (C) Recommend appropriate referrals for available
8    community services if the individual receiving on-site
9    care is not already in a treatment relationship with a
10    service provider or is unsatisfied with their current
11    service providers. The referrals shall take into
12    consideration waiting lists and copayments, which may
13    present barriers to access.
14    (2) Subject to the care decisions of the individual
15receiving care, provide transportation for any individual
16experiencing a mental or behavioral health emergency.
17Transportation shall be to the most integrated and least
18restrictive setting appropriate in the community, such as to
19the individual's home or chosen location, community crisis
20respite centers, clinic settings, behavioral health centers,
21or the offices of particular medical care providers with
22existing treatment relationships to the individual seeking
23care.
24    (3) Prioritize requests for emergency assistance. Provide
25guidance for prioritizing calls for assistance and maximum
26response time in relation to the type of emergency reported.

 

 

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1    (4) Provide appropriate response times. From the time of
2first notification, provide the response within response time
3appropriate to the care requirements of the individual with an
4emergency.
5    (5) Require appropriate responder training. Responders
6must have adequate training to address the needs of
7individuals experiencing a mental or behavioral health
8emergency. Adequate training at least includes:
9        (i) training in de-escalation techniques;
10        (ii) knowledge of local community services and
11    supports; and
12        (iii) training in respectful interaction with people
13    experiencing mental or behavioral health crises, including
14    the concepts of stigma and respectful language.
15    (6) Adopt guidelines directing referral to restrictive
16care settings. Responders must have guidelines to follow when
17considering whether to refer an individual to more restrictive
18forms of care, like emergency room or hospital settings.
19    (7) Specify regional best practices. Responders providing
20these services must do so consistently with best practices,
21which include respecting the care choices of the individuals
22receiving assistance.
23    (8) Adopt system for directing care in advance of an
24emergency. Select and publicly identify a system that allows
25individuals who voluntarily chose to do so to provide
26confidential advanced care directions to individuals providing

 

 

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1services under this Act. No system for providing advanced care
2direction may be implemented unless the Division of Mental
3Health approves it as confidential, available to individuals
4at all economic levels, and non-stigmatizing. The Division of
5Mental Health may defer this requirement for providing a
6system for advanced care direction if it determines that no
7existing systems can currently meet these requirements.
8    (9) Coordinate service providers. The Regional Plan may
9coordinate with or include other similar programs, like those
10operating under the Children's Mental Health Act of 2003, if
11all the requirements of all programs are met.
12    (10) Train dispatching staff. The personnel staffing
139-1-1, 311, or other emergency response intake systems must be
14provided with adequate training to assess whether dispatching
15emergency mental health responders under this Act is
16appropriate.
17    (11) Establish system for emergency responder
18coordination. Establish a protocol for responders, law
19enforcement, and fire and ambulance services to request
20assistance from each other, and train these groups on the
21protocol.
22    (12) Integrate law enforcement. Provide for law
23enforcement to request Responder assistance whenever law
24enforcement engages an individual appropriate for services
25under this Act. If law enforcement would typically request EMS
26assistance when it encounters an individual with a physical

 

 

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1health emergency, law enforcement shall similarly dispatch
2mental or behavioral health personnel or medical
3transportation when it encounters an individual in a mental or
4behavioral health emergency.
 
5    Section 30. Law enforcement responsibility for providing
6mental and behavioral health care.
7    (a) In any area where responders are available for
8dispatch, law enforcement shall not be dispatched to respond
9to an individual requiring mental or behavioral health care
10unless that individual is:
11        (1) involved in a suspected violation of the criminal
12    laws of this State; or
13        (2) presents a threat of physical injury to self or
14    others.
15    (b) Standing on its own or in combination with each other,
16the fact that an individual is experiencing a mental or
17behavioral health emergency, or has a mental health,
18behavioral health, or other diagnosis, is not sufficient to
19Community Emergency Services and Supports Plan Practices to
20avoid. The Community Emergency Services and Supports Plan
21shall be designed to avoid the following practices and
22outcomes:
23        (A) justify an assessment that the individual is a
24    threat of physical injury to self or others; or
25        (B) requires a law enforcement response to a request

 

 

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1    for emergency response or medical transportation.
2    (c) If, based on its assessment of the threat to public
3safety, law enforcement would not accompany medical
4transportation responding to a physical health emergency, law
5enforcement may not accompany emergency response or medical
6transportation personnel responding to a mental or behavioral
7health emergency that presents an equivalent level of threat
8to self or public safety.
9    (d) Without regard to an assessment of threat to self or
10threat to public safety, law enforcement may station personnel
11so that they can rapidly respond to requests for assistance
12from responders if law enforcement does not interfere with the
13provision of emergency response or transportation services. To
14the extent practical, not interfering with services includes
15remaining sufficiently distant from or out of sight of the
16individual receiving care so that law enforcement presence is
17unlikely to escalate the emergency.
18    (e) Responder involvement in involuntary commitment. In
19order to maintain the appropriate care relationship,
20responders shall not in any way assist in the involuntary
21commitment of an individual beyond:
22        (1) reporting to their dispatching entity or to law
23    enforcement that they believe the situation requires
24    assistance the responders are not permitted to provide
25    under this Section;
26        (2) providing witness statements; and

 

 

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1        (3) fulfilling reporting requirements the responders
2    may have under their professional ethical obligations or
3    laws of this state. This prohibition shall not interfere
4    with any responder's ability to provide physical or mental
5    health care.
6    (f) Use of law enforcement for transportation. In any area
7where responders are available for dispatch, law enforcement
8shall not be used to provide transportation to access mental
9or behavioral health care, or travel between mental or
10behavioral health care providers, except where no alternative
11is available.
12    (g) Reduction of educational institution obligations: The
13service provided by the Community Emergency Services and
14Supports Plan may not be used to replace any service an
15educational institution is required to provide to a student.
16It shall not substitute for appropriate special education and
17related services that schools are required to provide by any
18law.
 
19    Section 35. Non-violent Misdemeanor Coordination Plan
20Goal.     The region's Non-violent Misdemeanor Coordination
21Plan shall be designed to meet the following service goals in a
22regionally appropriate manner, specifying specific
23expectations for these goals as appropriate:
24        (1) prioritize health care;
25        (2 to the greatest extent practicable, the Non-Violent

 

 

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1    Misdemeanor Coordination Plan shall first seek to provide
2    community-based mental or behavioral health services
3    before addressing law enforcement objectives; and
4        (3) divert from further criminal justice involvement.
5    The plan shall provide for assessment and referral to
6    health care services with the potential to reduce the
7    likelihood of further law enforcement engagement.
 
8    Section 40. Composition of regional committees. Each
9regional committee shall consist of: (i) representatives of
10the EMS Medical Directors Committee, as constituted under the
11Emergency Medical Services (EMS) Systems Act, or other similar
12committee serving the medical needs of the jurisdiction; (ii)
13representatives of law enforcement officials with jurisdiction
14in the Emergency Medical Services (EMS) Regions;
15representatives of the unions representing EMS or emergency
16mental and behavioral health responders, or both; and iii
17advocates from the mental health, behavioral health,
18intellectual disability, and developmental disability
19communities. The majority of advocates on the Emergency
20Response Equity Committee must either be individuals with a
21lived experience of a condition commonly regarded as a mental
22health or behavioral health disability, developmental
23disability, or intellectual disability, or be from
24organizations primarily composed of those individuals. The
25members of the committee shall also reflect the racial

 

 

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1demographics of the jurisdiction served. Subject to the
2oversight of the Illinois Department of Human Services
3Division of Mental Health, the EMS Medical Directors Committee
4is responsible for convening the meetings of the committee.
5Interested units of local government may also have
6representatives on the committee subject to approval by the
7Division of Mental Health, and if this participation is
8structured in such a way that it does not reduce the influence
9of the advocates on the committee. 100Each Region shall
10begin providing the service required by its plans within 6
11months of the Plan's completion.
 
12    Section 45. Scope. This Act applies to persons of all
13ages, both children and adults. This Act does not limit an
14individual's right to control his or her own medical care. No
15provision of this Act shall be interpreted in such a way as to
16limit an individual's right to choose his or her preferred
17course of care or to reject care. No provision of this Act
18shall be interpreted to promote or provide justification for
19the use of restraints when providing mental or behavioral
20health care.
 
21    Section 50. Plans; completion. Both plans required by this
22Act shall be completed within 6 months after the effective
23date of this Act, and shall thereafter be reviewed by the
24region's community emergency services and support committee

 

 

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1every other year. At the request of any member of the region's
2community emergency services and support committee or by the
3Division of Mental Health, the committee shall reconvene
4outside the 2 year review period.
 
5    Section 105. The Emergency Telephone System Act is amended
6by changing Section 4 as follows:
 
7    (50 ILCS 750/4)  (from Ch. 134, par. 34)
8    (Section scheduled to be repealed on December 31, 2021)
9    Sec. 4.
10    (a) Every system shall include police, firefighting, and
11emergency medical and ambulance services, and may include
12other emergency services. The system may incorporate private
13ambulance service. In those areas in which a public safety
14agency of the State provides such emergency services, the
15system shall include such public safety agencies. Every system
16shall dispatch emergency response services for individuals
17requiring mental or behavioral health care in compliance with
18the requirements of the Community Emergency Services and
19Support Act.
20     (b) Every 9-1-1 Authority shall maintain records of the
21numbers of calls received, the type of service the caller
22requested, and the type of service dispatched in response to
23each call. For emergency medical and ambulance services, the
24records shall indicate whether physical, mental, or behavioral

 

 

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1health response or transportation were requested, and what
2type of response or transportation was dispatched. When a
3mental or behavioral health response is requested at a
4primary, secondary, or post-secondary educational institution,
5the 9-1-1 Authority shall record which type of educational
6institution was involved. Broken down geographically by police
7district, every 9-1-1 Authority shall create aggregated,
8non-individualized monthly reports detailing the system's
9activities, including the frequency of dispatch of each type
10of service and the information required to be collected by
11this subpart. These reports shall be available to both the
12Community Emergency Services and Supports Committees created
13under the Community Emergency Services and Supports Act, and
14to the Administrator of the 9-1-1 Authority, for the purpose
15of conducting an annual analysis of service gaps, and to the
16public upon request.
17(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)
 
18    Section 999. Effective date. This Act takes effect upon
19becoming law.