SB0459sam001 100TH GENERAL ASSEMBLY

Sen. Kwame Raoul

Filed: 5/3/2018

10000SB0459sam001 LRB100 05003 AWJ 39547 a

AMENDMENT TO SENATE BILL 459

AMENDMENT NO. ______. Amend Senate Bill 459 by replacing everything after the enacting clause with the following:

"Section 1. Short title; references to Act.

(a) Short title. This Act may be cited as the Mental Health Emergency Services Response Equity Act.

(b) References to Act. This Act may be referred to as the Stephon Edward Watts Act.

Section 5. Findings. The General Assembly finds that in order to promote and protect the health, safety, and welfare of the public, it is necessary and in the public interest to provide emergency response, with or without medical transportation, to individuals requiring mental health or behavioral health services in a manner that is substantially equivalent to the response provided to individuals who require emergency physical health care. An individual who requires an emergency response to address his or her mental or behavioral health care needs should have the choice of accessing providers trained to address mental or behavioral health crises. Whether an individual experiencing a health crisis receives an appropriate emergency response should not depend on the type of crises the individual experiences. Further, an individual requesting an emergency medical response because of a mental or behavioral health issue is not best served when care or transportation is provided by law enforcement officers. Emergency response and transportation by law enforcement officers contributes to the stigma associated with mental and behavioral health crises, and frequently results in individuals being physically harmed, needlessly incarcerated, or needlessly hospitalized. Moreover, law enforcement officers should not be routinely removed from their duties to provide medical care and transportation.

Section 10. Applicability; home rule. This Act applies to every unit of local government that provides emergency medical response or transportation for individuals with physical medical needs. A home rule unit may not respond to or provide services for a mental or behavioral health crisis or create a transportation plan or other regulation relating to the provision of mental health services in a manner inconsistent with this Act. This Act is a limitation under subsection (i) of Section 6 of Article VII of the Illinois Constitution on the concurrent exercise by home rule units of powers and functions exercised by the State.

Section 15. Definitions. As used in this Act:

"Crisis" means an emergent circumstance caused by a health condition, regardless of whether it is perceived as physical, mental, or behavioral in nature, for which an individual may require prompt care, support, or assessment at the individual's location.

"Mental or behavioral health" means a health condition involving changes in thinking, emotion, or behavior and that the medical community treats as distinct from physical health care.

"Physical health" means a health condition that the medical community treats as distinct from mental or behavioral health care.

Section 17. Scope. This Act does not limit an individual's right to control his or her own medical care. No provision of this Act shall be interpreted in such a way as to limit an individual's right to choose his or her preferred course of care or to reject care. No provision of this Act shall be interpreted to promote the use of restraints when providing mental or behavioral health care.

Section 20. Emergency mental or behavioral health crisis response. Every unit of local government that provides emergency medical services for individuals with physical health needs must also provide appropriate emergency response services to individuals experiencing a mental or behavioral health crisis. This response includes, but is not limited to, the following:

(1) Where practicable, the unit of local government must provide an emergency response for mental or behavioral health care when notified that an individual is experiencing a crisis.

(2) The individuals dispatched to provide emergency response services or transportation for an individual experiencing a mental or behavioral health crisis must have adequate training in addressing the needs of individuals experiencing mental or behavioral health crises, including training in de-escalation techniques, knowledge of community services and supports, and respect for individuals' dignity and autonomy. Individuals providing these services must do so consistently with best practices, including the use of de-escalation techniques where appropriate. They must ensure that an individual experiencing a mental or behavioral health crisis is diverted from hospitalization or incarceration whenever possible and linked with available appropriate community services.

(3) An emergency response may include on-site care where the individual is located if it does not override the care decisions of the individual receiving care. Providing care in the community, through methods like mobile crisis units, is encouraged. If effective care is provided on site and if it is consistent with the care decisions of the individual receiving the care, further transportation to other medical providers is not required.

(4) When transportation is provided, subject to the care decisions of the individual receiving care, transportation shall, where practicable, be to the most integrated and least restrictive setting appropriate in the community, such as to the individual's home or chosen location, community crisis respite centers, clinic settings, or the offices of particular medical care providers with existing treatment relationships to the individual seeking care.

Section 25. Prohibition of use of law enforcement for emergency response or transportation. In a unit of local government that provides a system for emergency response for individuals with physical health needs that are distinct from the unit's law enforcement personnel, law enforcement shall not be used to provide emergency response for an individual when the individual only requires on-site emergency mental or behavioral health care, transportation to access health care, or travel between health care providers, except where no alternative is available. Transportation shall instead be provided pursuant to Section 20 of this Act.

Section 30. Equivalent law enforcement response.

(a) Unless an individual perceived as requiring mental or behavioral health care or requesting mental or behavioral health care is involved in a suspected violation of criminal laws of this State, law enforcement shall respond to an individual requiring mental or behavioral health care in a manner that is equivalent to their response to an individual requiring physical health care.

(b) Standing on its own or in combination with each other, neither the fact that an individual is experiencing a mental or behavioral health crisis nor that an individual has a mental health or other disability diagnosis is sufficient to justify an assessment of threat to public safety to support a law enforcement response to a request for emergency response or medical transportation.

(c) If, based on their assessment of the threat to public safety, law enforcement would not accompany medical transportation responding to a physical medical emergency, law enforcement may not accompany emergency response or medical transportation personnel responding to a mental or behavioral health medical emergency that presents an equivalent level of threat to public safety.

(d) If law enforcement would typically dispatch medical response personnel or transportation when they encounter an individual with a physical health crisis, law enforcement shall similarly dispatch mental or behavioral health personnel or medical transportation when they encounter an individual in a mental or behavioral health crisis.

(e) Without regard to an assessment of threat to public safety, law enforcement may station personnel so that they may rapidly respond to requests for assistance from emergency response or medical transportation staff if law enforcement does not interfere with the provision of emergency response or transportation services.

Section 35. Transportation plan.

(a) To address the care of individuals who appear to be in mental or behavioral health crisis who are involved in nonviolent misdemeanors, a committee shall be established in each Emergency Medical Services (EMS) Region to develop a plan to coordinate the provision of mental health services where appropriate and to divert the individuals from the criminal justice system wherever possible. The plan shall be developed with the goal of providing the most appropriate mental health care allowable without significant interference with law enforcement activities and to avoid further criminal justice involvement. To the greatest extent practicable, the plan shall seek to first provide community-based mental or behavioral health services before addressing law enforcement objectives.

(b) The plan required by this Section shall be created by a committee consisting of representatives of the Region's EMS Medical Directors Committee, formed under the Emergency Medical Services (EMS) Systems Act, or other similar committee serving the medical needs of the region; representatives of law enforcement officials with jurisdiction in the Emergency Medical Services (EMS) Region, and advocates from the mental health, intellectual disability, and developmental disability communities. The majority of advocates on this committee must either be individuals with a lived experience of a condition commonly regarded as a mental health or behavioral health condition, developmental disability, or intellectual disability or be from organizations primarily composed of such individuals. Subject to the oversight of the Illinois Department of Public Health, a Region's EMS Medical Directors Committee is responsible for selecting the transportation plan committee members and convening meetings of the transportation plan committee.

(c) The plan shall be completed within 6 months after the effective date of this Act and the plan shall be reviewed on a biannual basis. At the request of any member of the committee or the Illinois Department of Public Health, the committee shall reconvene outside the biannual review meeting or meetings.

Section 900. The Emergency Telephone System Act is amended by changing Section 4 as follows:

(50 ILCS 750/4) (from Ch. 134, par. 34)

(Section scheduled to be repealed on December 31, 2020)

Sec. 4. (a) Every system shall include police, firefighting, and emergency medical and ambulance services, and may include other emergency services. The system may incorporate private ambulance service. In those areas in which a public safety agency of the State provides such emergency services, the system shall include such public safety agencies. Every system shall dispatch emergency response services for individuals requiring mental or behavioral health care in compliance with the requirements of the Mental Health Emergency Services Response Equity Act.

(b) Every 9-1-1 Authority shall maintain records of the numbers of calls received, the type of service the caller requested, and the type of service dispatched in response to each call. For emergency medical and ambulance services, the records shall indicate whether physical, mental, or behavioral health response or transportation was requested and what type of response or transportation was dispatched. Broken down geographically by police district, every 9-1-1 Authority shall create aggregated, non-individualized monthly reports detailing the 9-1-1 Authority's activities as provided in this subsection, including the frequency of dispatch of each type of service. These reports shall be available both to the Administrator and 9-1-1 Authority for the purpose of conducting an annual analysis of service gaps and to the public upon request.

(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)".