Illinois General Assembly - Full Text of HB2784
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Full Text of HB2784  102nd General Assembly

HB2784sam001 102ND GENERAL ASSEMBLY

Sen. Robert Peters

Filed: 5/14/2021

 

 


 

 


 
10200HB2784sam001LRB102 14976 RLC 26498 a

1
AMENDMENT TO HOUSE BILL 2784

2    AMENDMENT NO. ______. Amend House Bill 2784 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title.
5    (a) This Act may be cited as the Community Emergency
6Services and Support Act.
7    (b) This Act may be referred to as the Stephon Edward Watts
8Act.
 
9    Section 5. Findings. The General Assembly recognizes that
10the Illinois Department of Human Services Division of Mental
11Health is preparing to provide mobile mental and behavioral
12health services to all Illinoisans as part of the federally
13mandated adoption of the 9-8-8 phone number. The General
14Assembly also recognizes that many cities and some states have
15successfully established mobile emergency mental and
16behavioral health services as part of their emergency response

 

 

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1system to support people who need such support and do not
2present a threat of physical violence to the responders. In
3light of that experience, the General Assembly finds that in
4order to promote and protect the health, safety, and welfare
5of the public, it is necessary and in the public interest to
6provide emergency response, with or without medical
7transportation, to individuals requiring mental health or
8behavioral health services in a manner that is substantially
9equivalent to the response already provided to individuals who
10require emergency physical health care.
11    This Act applies to every unit of local government that
12provides or coordinates ambulance or similar emergency medical
13response or transportation services for individuals with
14emergency medical needs. A home rule unit may not respond to or
15provide services for a mental or behavioral health emergency,
16or create a transportation plan or other regulation, relating
17to the provision of mental or behavioral health services in a
18manner inconsistent with this Act. This Act is a limitation
19under subsection (i) of Section 6 of Article VII of the
20Illinois Constitution on the concurrent exercise by home rule
21units of powers and functions exercised by the State.
 
22    Section 10. Definitions. As used in this Act:
23    "Division of Mental Health" means the Division of Mental
24Health of the Department of Human Services.
25    "Emergency" means an emergent circumstance caused by a

 

 

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1health condition, regardless of whether it is perceived as
2physical, mental, or behavioral in nature, for which an
3individual may require prompt care, support, or assessment at
4the individual's location.
5    "Mental or behavioral health" means any health condition
6involving changes in thinking, emotion, or behavior, and that
7the medical community treats as distinct from physical health
8care.
9    "Physical health" means a health condition that the
10medical community treats as distinct from mental or behavioral
11health care.
12    "PSAP" means a Public Safety Answering Point
13tele-communicator.
14    "Community services" and "community-based mental or
15behavioral health services" may include both public and
16private settings.
17    "Treatment relationship" means an active association with
18a mental or behavioral care provider able to respond in an
19appropriate amount of time to requests for care.
20    "Responder" is any person engaging with a member of the
21public to provide the mobile mental and behavioral service
22established in conjunction with the Division of Mental Health
23establishing the 9-8-8 emergency number. A responder is not an
24EMS Paramedic or EMT as defined in the Emergency Medical
25Services (EMS) Systems Act unless that responding agency has
26agreed to provide a specialized response in accordance with

 

 

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1the Division of Mental Health's services offered through its
29-8-8 number and has met all the requirements to offer that
3service through that system.
 
4    Section 15. Coordination with Division of Mental Health.
5Each 9-1-1 call center and provider of emergency services
6dispatched through a 9-1-1 system must coordinate with the
7mobile mental and behavioral health services established by
8the Division of Mental Health so that the following State
9goals and State prohibitions are met whenever a person
10interacts with one of these entities for the purpose seeking
11emergency mental and behavioral health care or when one of
12these entities recognizes the appropriateness of providing
13mobile mental or behavioral health care to an individual with
14whom they have engaged. The Division of Mental Health is also
15directed to provide guidance regarding whether and how these
16entities should coordinate with mobile mental and behavioral
17health services when responding to individuals who appear to
18be in a mental or behavioral health emergency while engaged in
19conduct alleged to constitute a non-violent misdemeanor.
 
20    Section 20. State goals.
21    (a) 9-1-1 PSAPs, emergency services dispatched through
229-1-1 PSAPs, and the mobile mental and behavioral health
23service established by the Division of Mental Health must
24coordinate their services so that the State goals listed in

 

 

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1this Section are achieved. Appropriate mobile response service
2for mental and behavioral health emergencies shall be
3available regardless of whether the initial contact was with
49-8-8, 9-1-1 or directly with an emergency service dispatched
5through 9-1-1. Appropriate mobile response services must:
6        (1) ensure that individuals experiencing mental or
7    behavioral health crises are diverted from hospitalization
8    or incarceration whenever possible, and are instead linked
9    with available appropriate community services;
10        (2) include the option of on-site care if that type of
11    care is appropriate and does not override the care
12    decisions of the individual receiving care. Providing care
13    in the community, through methods like mobile crisis
14    units, is encouraged. If effective care is provided on
15    site, and if it is consistent with the care decisions of
16    the individual receiving the care, further transportation
17    to other medical providers is not required by this Act;
18        (3) recommend appropriate referrals for available
19    community services if the individual receiving on-site
20    care is not already in a treatment relationship with a
21    service provider or is unsatisfied with their current
22    service providers. The referrals shall take into
23    consideration waiting lists and copayments, which may
24    present barriers to access;
25        (4) subject to the care decisions of the individual
26    receiving care, provide transportation for any individual

 

 

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1    experiencing a mental or behavioral health emergency.
2    Transportation shall be to the most integrated and least
3    restrictive setting appropriate in the community, such as
4    to the individual's home or chosen location, community
5    crisis respite centers, clinic settings, behavioral health
6    centers, or the offices of particular medical care
7    providers with existing treatment relationships to the
8    individual seeking care;
9        (5) provide guidance for prioritizing calls for
10    assistance and maximum response time in relation to the
11    type of emergency reported;
12        (6) from the time of first notification, provide the
13    response within response time appropriate to the care
14    requirements of the individual with an emergency.
15    (b) Responders must have adequate training to address the
16needs of individuals experiencing a mental or behavioral
17health emergency. Adequate training at least includes:
18        (1) training in de-escalation techniques;
19        (2) knowledge of local community services and
20    supports; and
21        (3) training in respectful interaction with people
22    experiencing mental or behavioral health crises, including
23    the concepts of stigma and respectful language.
24    (c) The Division of Mental Health, in consultation with
25the Regional Advisory Committees created in Section 40, shall
26determine the appropriate credentials for the mental health

 

 

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1providers responding to calls, including to what extent the
2responders must have certain credentials and licensing, and to
3what extent the responders can be peer support professionals.
4    (d) Training shall be provided by individuals with lived
5experience to the extent available.
6    (e) Responders must have guidelines to follow when
7considering whether to refer an individual to more restrictive
8forms of care, like emergency room or hospital settings.
9    (f) Responders providing these services must do so
10consistently with best practices, which include respecting the
11care choices of the individuals receiving assistance. Regional
12best practices may be broken down into sub-regions, as
13appropriate to reflect local resources and conditions. With
14the agreement of the impacted EMS Regions, providers of
15emergency response to physical emergencies may participate in
16another EMS Region for mental and behavioral response, if that
17participation shall provide a better service to individuals
18experiencing a mental or behavioral health emergency.
19    (g) The Division of Mental Health shall select and
20publicly identify a system that allows individuals who
21voluntarily chose to do so to provide confidential advanced
22care directions to individuals providing services under this
23Act. No system for providing advanced care direction may be
24implemented unless the Division of Mental Health approves it
25as confidential, available to individuals at all economic
26levels, and non-stigmatizing. The Division of Mental Health

 

 

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1may defer this requirement for providing a system for advanced
2care direction if it determines that no existing systems can
3currently meet these requirements.
4    (h) The personnel staffing 9-1-1, 3-1-1, or other
5emergency response intake systems must be provided with
6adequate training to assess whether dispatching emergency
7mental health responders under this Act is appropriate.
8    (i) The Division of Mental Health shall establish a
9protocol for responders, law enforcement, and fire and
10ambulance services to request assistance from each other, and
11train these groups on the protocol.
12    (j) The Division of Mental Health shall provide for law
13enforcement to request responder assistance whenever law
14enforcement engages an individual appropriate for services
15under this Act. If law enforcement would typically request EMS
16assistance when it encounters an individual with a physical
17health emergency, law enforcement shall similarly dispatch
18mental or behavioral health personnel or medical
19transportation when it encounters an individual in a mental or
20behavioral health emergency.
 
21    Section 25. State prohibitions.
22    (a) 9-1-1 PSAPs, emergency services dispatched through
239-1-1 PSAPs, and the mobile mental and behavioral health
24service established by the Division of Mental Health must
25coordinate their services so that, based on the information

 

 

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1provided to them, the following State prohibitions are
2avoided:
3        (1) In any area where responders are available for
4    dispatch, law enforcement shall not be dispatched to
5    respond to an individual requiring mental or behavioral
6    health care unless that individual is (i) involved in a
7    suspected violation of the criminal laws of this State, or
8    (ii) presents a threat of physical injury to self or
9    others. Responders are not considered available for
10    dispatch under this Section if 9-8-8 reports that it
11    cannot dispatch appropriate service within the maximum
12    response times established by each Regional Advisory
13    Committee under Section 45.
14        (2) Standing on its own or in combination with each
15    other, the fact that an individual is experiencing a
16    mental or behavioral health emergency, or has a mental
17    health, behavioral health, or other diagnosis, is not
18    sufficient to justify an assessment that the individual is
19    a threat of physical injury to self or others, or requires
20    a law enforcement response to a request for emergency
21    response or medical transportation.
22        (3) If, based on its assessment of the threat to
23    public safety, law enforcement would not accompany medical
24    transportation responding to a physical health emergency,
25    unless requested by responders, law enforcement may not
26    accompany emergency response or medical transportation

 

 

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1    personnel responding to a mental or behavioral health
2    emergency that presents an equivalent level of threat to
3    self or public safety.
4        (4) Without regard to an assessment of threat to self
5    or threat to public safety, law enforcement may station
6    personnel so that they can rapidly respond to requests for
7    assistance from responders if law enforcement does not
8    interfere with the provision of emergency response or
9    transportation services. To the extent practical, not
10    interfering with services includes remaining sufficiently
11    distant from or out of sight of the individual receiving
12    care so that law enforcement presence is unlikely to
13    escalate the emergency.
14    (b) In order to maintain the appropriate care
15relationship, responders shall not in any way assist in the
16involuntary commitment of an individual beyond (i) reporting
17to their dispatching entity or to law enforcement that they
18believe the situation requires assistance the responders are
19not permitted to provide under this Section; (ii) providing
20witness statements; and (iii) fulfilling reporting
21requirements the responders may have under their professional
22ethical obligations or laws of this state. This prohibition
23shall not interfere with any responder's ability to provide
24physical or mental health care.
25    (c) Use of law enforcement for transportation. In any area
26where responders are available for dispatch, unless requested

 

 

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1by responders, law enforcement shall not be used to provide
2transportation to access mental or behavioral health care, or
3travel between mental or behavioral health care providers,
4except where no alternative is available.
5    (d) Reduction of educational institution obligations: The
6services coordinated under this Act may not be used to replace
7any service an educational institution is required to provide
8to a student. It shall not substitute for appropriate special
9education and related services that schools are required to
10provide by any law.
 
11    Section 30. Non-violent misdemeanors. The Division of
12Mental Health's Guidance for 9-1-1 PSAPs and emergency
13services dispatched through 9-1-1 PSAPs for coordinating the
14response to individuals who appear to be in a mental or
15behavioral health emergency while engaging in conduct alleged
16to constitute a non-violent misdemeanor shall promote the
17following:
18        (a) Prioritization of Health Care. To the greatest
19    extent practicable, community-based mental or behavioral
20    health services should be provided before addressing law
21    enforcement objectives.
22        (b) Diversion from Further Criminal Justice
23    Involvement. To the greatest extent practicable,
24    individuals should be referred to health care services
25    with the potential to reduce the likelihood of further law

 

 

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1    enforcement engagement.
 
2    Section 35. Statewide Advisory Committee.
3    (a) The Division of Mental Health shall establish a
4Statewide Advisory Committee to review and make
5recommendations for aspects of coordinating 9-1-1 and the
69-8-8 mobile mental health response system most appropriately
7addressed on a State level.
8    (b) Issues to be addressed by the Statewide Advisory
9Committee include, but are not limited to, addressing changes
10necessary in 9-1-1 call taking protocols and scripts used in
119-1-1 PSAPs where those protocols and scripts are based on or
12otherwise dependent on national providers for their operation.
13    (c) The Statewide Advisory Committee shall recommend a
14system for gathering data related to the coordination of the
159-1-1 and 9-8-8 systems for purposes of allowing the parties
16to make ongoing improvements in that system. As practical, the
17system shall attempt to determine issues including, but not
18limited to:
19        (1) the volume of calls coordinated between 9-1-1 and
20    9-8-8;
21        (2) the volume of referrals from other first
22    responders to 9-8-8;
23        (3) the volume and type of calls deemed appropriate
24    for referral to 9-8-8 but could not be served by 9-8-8
25    because of capacity restrictions or other reasons;

 

 

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1        (4) the appropriate information to improve
2    coordination between 9-1-1 and 9-8-8; and
3        (5) the appropriate information to improve the 9-8-8
4    system, if the information is most appropriately gathered
5    at the 9-1-1 PSAPs.
6    (d) The Statewide Advisory Committee shall consist of:
7        (1) the Statewide 9-1-1 Administrator, ex officio;
8        (2) one representative designated by the Illinois
9    Chapter of National Emergency Number Association (NENA);
10        (3) one representative designated by the Illinois
11    Chapter of Association of Public Safety Communications
12    Officials (APCO);
13        (4) one representative of the Division of Mental
14    Health;
15        (5) one representative of the Illinois Department of
16    Public Health;
17        (6) one representative of a statewide organization of
18    EMS responders;
19        (7) one representative of a statewide organization of
20    fire chiefs;
21        (8) two representatives of statewide organizations of
22    law enforcement;
23        (9) two representatives of mental health, behavioral
24    health, or substance abuse providers; and
25        (10) four representatives of advocacy organizations
26    either led by or consisting primarily of individuals with

 

 

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1    intellectual or developmental disabilities, individuals
2    with behavioral disabilities, or individuals with lived
3    experience.
4    The members of the Statewide Advisory Committee, other
5than the Statewide 9-1-1 Administrator, shall be appointed by
6the Secretary of Human Services.
 
7    Section 40. Regional Advisory Committees.
8    (a) The Division of Mental Health shall establish Regional
9Advisory Committees in each EMS Region to advise on regional
10issues related to emergency response systems for mental and
11behavioral health. The Secretary of Human Services shall
12appoint the members of the Regional Advisory Committees. Each
13Regional Advisory Committee shall consist of:
14        (1) representatives of the 9-1-1 PSAPs in the region;
15        (2) representatives of the EMS Medical Directors
16    Committee, as constituted under the Emergency Medical
17    Services (EMS) Systems Act, or other similar committee
18    serving the medical needs of the jurisdiction;
19        (3) representatives of law enforcement officials with
20    jurisdiction in the Emergency Medical Services (EMS)
21    Regions;
22        (4) representatives of both the EMS providers and the
23    unions representing EMS or emergency mental and behavioral
24    health responders, or both; and
25        (5) advocates from the mental health, behavioral

 

 

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1    health, intellectual disability, and developmental
2    disability communities.
3    (b) The majority of advocates on the Emergency Response
4Equity Committee must either be individuals with a lived
5experience of a condition commonly regarded as a mental health
6or behavioral health disability, developmental disability, or
7intellectual disability, or be from organizations primarily
8composed of such individuals. The members of the Committee
9shall also reflect the racial demographics of the jurisdiction
10served. Subject to the oversight of the Department of Human
11Services Division of Mental Health, the EMS Medical Directors
12Committee is responsible for convening the meetings of the
13committee. Impacted units of local government may also have
14representatives on the committee subject to approval by the
15Division of Mental Health, if this participation is structured
16in such a way that it does not give undue weight to any of the
17groups represented.
 
18    Section 45. Regional Advisory Committee responsibilities.
19Each Regional Advisory Committee is responsible for designing
20the local protocol to allow its region's 9-1-1 call center and
21emergency responders to coordinate their activities with 9-8-8
22as required by this Act and monitoring current operation to
23advise on ongoing adjustments to the local protocol. Included
24in this responsibility, each Regional Advisory Committee must:
25        (1) negotiate the appropriate amendment of each 9-1-1

 

 

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1    PSAP emergency dispatch protocols, in consultation with
2    each 9-1-1 PSAP in the EMS Region and consistent with
3    national certification requirements;
4        (2) set maximum response times for 9-8-8 to provide
5    service when an in-person response is required, based on
6    type of mental or behavioral health emergency, which, if
7    exceeded, constitute grounds for sending other emergency
8    responders through the 9-1-1 system;
9        (3) report, geographically by police district if
10    practical, the data collected through the direction
11    provided by the Statewide Advisory Committee in
12    aggregated, non-individualized monthly reports. These
13    reports shall be available to the Regional Advisory
14    Committee members, the Department of Human Service
15    Division of Mental Health, the Administrator of the 9-1-1
16    Authority, and to the public upon request; and
17        (4) convene, after the initial regional policies are
18    established, at least every 2 years to consider amendment
19    of the regional policies, if any, and also convene
20    whenever a member of the Committee requests that the
21    Committee consider an amendment.
 
22    Section 50. Immunity. The exemptions from civil liability
23in Section 15.1 of the Emergency Telephone Systems Act apply
24to any act or omission in the development, design,
25installation, operation, maintenance, performance, or

 

 

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1provision of service directed by this Act.
 
2    Section 55. Scope. This Act applies to persons of all
3ages, both children and adults. This Act does not limit an
4individual's right to control his or her own medical care. No
5provision of this Act shall be interpreted in such a way as to
6limit an individual's right to choose his or her preferred
7course of care or to reject care. No provision of this Act
8shall be interpreted to promote or provide justification for
9the use of restraints when providing mental or behavioral
10health care.
 
11    Section 60. PSAP and emergency service dispatched through
12a 9-1-1 PSAP; coordination of activities with mobile and
13behavioral health services. Each 9-1-1 PSAP and emergency
14service dispatched through a 9-1-1 PSAP must begin
15coordinating its activities with the mobile mental and
16behavioral health services established by the Division of
17Mental Health once all 3 of the following conditions are met,
18but not later than January 1, 2023:
19        (1) the Statewide Committee has negotiated useful
20    protocol and 9-1-1 operator script adjustments with the
21    contracted services providing these tools to 9-1-1 PSAPs
22    operating in Illinois;
23        (2) the appropriate Regional Advisory Committee has
24    completed design of the specific 9-1-1 PSAP's process for

 

 

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1    coordinating activities with the mobile mental and
2    behavioral health service; and
3        (3) the mobile mental and behavioral health service is
4    available in their jurisdiction.".