Sen. Laura Fine

Filed: 5/11/2023

 

 


 

 


 
10300HB1364sam002LRB103 24835 AWJ 61655 a

1
AMENDMENT TO HOUSE BILL 1364

2    AMENDMENT NO. ______. Amend House Bill 1364 on page 3,
3line 17, by replacing "working group" with "workgroup"; and
 
4on page 4, line 24, by replacing "Workforce" with "Workgroup";
5and
 
6on page 7, by replacing line 5 with the following:
7"2025.
 
8    Section 85. The Community Emergency Services and Support
9Act is amended by changing Sections 5, 15, 20, 25, 30, 35, 40,
1045, 50, and 65 and by adding Section 70 as follows:
 
11    (50 ILCS 754/5)
12    Sec. 5. Findings. The General Assembly recognizes that the
13Illinois Department of Human Services Division of Mental
14Health is preparing to provide mobile mental and behavioral

 

 

10300HB1364sam002- 2 -LRB103 24835 AWJ 61655 a

1health services to all Illinoisans as part of the federally
2mandated adoption of the 9-8-8 phone number. The General
3Assembly also recognizes that many cities and some states have
4successfully established mobile emergency mental and
5behavioral health services as part of their emergency response
6system to support people who need such support and do not
7present a threat of physical violence to the mobile mental
8health relief providers responders. In light of that
9experience, the General Assembly finds that in order to
10promote and protect the health, safety, and welfare of the
11public, it is necessary and in the public interest to provide
12emergency response, with or without medical transportation, to
13individuals requiring mental health or behavioral health
14services in a manner that is substantially equivalent to the
15response already provided to individuals who require emergency
16physical health care.
17(Source: P.A. 102-580, eff. 1-1-22.)
 
18    (50 ILCS 754/15)
19    Sec. 15. Definitions. As used in this Act:
20    "Division of Mental Health" means the Division of Mental
21Health of the Department of Human Services.
22    "Emergency" means an emergent circumstance caused by a
23health condition, regardless of whether it is perceived as
24physical, mental, or behavioral in nature, for which an
25individual may require prompt care, support, or assessment at

 

 

10300HB1364sam002- 3 -LRB103 24835 AWJ 61655 a

1the individual's location.
2    "Mental or behavioral health" means any health condition
3involving changes in thinking, emotion, or behavior, and that
4the medical community treats as distinct from physical health
5care.
6    "Mobile mental health relief provider" means a person
7engaging with a member of the public to provide the mobile
8mental and behavioral service established in conjunction with
9the Division of Mental Health establishing the 9-8-8 emergency
10number. "Mobile mental health relief provider" does not
11include a Paramedic (EMT-P) or EMT, as those terms are defined
12in the Emergency Medical Services (EMS) Systems Act, unless
13that responding agency has agreed to provide a specialized
14response in accordance with the Division of Mental Health's
15services offered through its 9-8-8 number and has met all the
16requirements to offer that service through that system.
17    "Physical health" means a health condition that the
18medical community treats as distinct from mental or behavioral
19health care.
20    "PSAP" means a Public Safety Answering Point
21tele-communicator.
22    "Community services" and "community-based mental or
23behavioral health services" may include both public and
24private settings.
25    "Treatment relationship" means an active association with
26a mental or behavioral care provider able to respond in an

 

 

10300HB1364sam002- 4 -LRB103 24835 AWJ 61655 a

1appropriate amount of time to requests for care.
2    "Responder" is any person engaging with a member of the
3public to provide the mobile mental and behavioral service
4established in conjunction with the Division of Mental Health
5establishing the 9-8-8 emergency number. A responder is not an
6EMS Paramedic or EMT as defined in the Emergency Medical
7Services (EMS) Systems Act unless that responding agency has
8agreed to provide a specialized response in accordance with
9the Division of Mental Health's services offered through its
109-8-8 number and has met all the requirements to offer that
11service through that system.
12(Source: P.A. 102-580, eff. 1-1-22.)
 
13    (50 ILCS 754/20)
14    Sec. 20. Coordination with Division of Mental Health.
15Each 9-1-1 PSAP and provider of emergency services dispatched
16through a 9-1-1 system must coordinate with the mobile mental
17and behavioral health services established by the Division of
18Mental Health so that the following State goals and State
19prohibitions are met whenever a person interacts with one of
20these entities for the purpose of seeking emergency mental and
21behavioral health care or when one of these entities
22recognizes the appropriateness of providing mobile mental or
23behavioral health care to an individual with whom they have
24engaged. The Division of Mental Health is also directed to
25provide guidance regarding whether and how these entities

 

 

10300HB1364sam002- 5 -LRB103 24835 AWJ 61655 a

1should coordinate with mobile mental and behavioral health
2services when responding to individuals who appear to be in a
3mental or behavioral health emergency while engaged in conduct
4alleged to constitute a non-violent misdemeanor.
5(Source: P.A. 102-580, eff. 1-1-22.)
 
6    (50 ILCS 754/25)
7    Sec. 25. State goals.
8    (a) 9-1-1 PSAPs, emergency services dispatched through
99-1-1 PSAPs, and the mobile mental and behavioral health
10service established by the Division of Mental Health must
11coordinate their services so that the State goals listed in
12this Section are achieved. Appropriate mobile response service
13for mental and behavioral health emergencies shall be
14available regardless of whether the initial contact was with
159-8-8, 9-1-1 or directly with an emergency service dispatched
16through 9-1-1. Appropriate mobile response services must:
17        (1) whenever possible, ensure that individuals
18    experiencing mental or behavioral health crises are
19    diverted from hospitalization or incarceration whenever
20    possible, and are instead linked with available
21    appropriate community services;
22        (2) include the option of on-site care if that type of
23    care is appropriate and does not override the care
24    decisions of the individual receiving care. Providing care
25    in the community, through methods like mobile crisis

 

 

10300HB1364sam002- 6 -LRB103 24835 AWJ 61655 a

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

 

 

10300HB1364sam002- 7 -LRB103 24835 AWJ 61655 a

1relation to the type of emergency reported.
2    (c) Provide appropriate response times. From the time of
3first notification, 9-1-1 PSAPs, emergency services dispatched
4through 9-1-1 PSAPs, and the mobile mental and behavioral
5health service established by the Division of Mental Health
6must provide the response within response time appropriate to
7the care requirements of the individual with an emergency.
8    (d) Require appropriate mobile mental health relief
9provider responder training. Mobile mental health relief
10providers Responders must have adequate training to address
11the needs of individuals experiencing a mental or behavioral
12health emergency. Adequate training at least includes:
13        (1) training in de-escalation techniques;
14        (2) knowledge of local community services and
15    supports; and
16        (3) training in respectful interaction with people
17    experiencing mental or behavioral health crises, including
18    the concepts of stigma and respectful language.
19    (e) Require minimum team staffing. The Division of Mental
20Health, in consultation with the Regional Advisory Committees
21created in Section 40, shall determine the appropriate
22credentials for the mental health providers responding to
23calls, including to what extent the mobile mental health
24relief providers responders must have certain credentials and
25licensing, and to what extent the mobile mental health relief
26providers responders can be peer support professionals.

 

 

10300HB1364sam002- 8 -LRB103 24835 AWJ 61655 a

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

 

 

10300HB1364sam002- 9 -LRB103 24835 AWJ 61655 a

1as confidential, available to individuals at all economic
2levels, and non-stigmatizing. The Division of Mental Health
3may defer this requirement for providing a system for advanced
4care direction if it determines that no existing systems can
5currently meet these requirements.
6    (j) Train dispatching staff. The personnel staffing 9-1-1,
73-1-1, or other emergency response intake systems must be
8provided with adequate training to assess whether coordinating
9with 9-8-8 is appropriate.
10    (k) Establish protocol for emergency responder
11coordination. The Division of Mental Health shall establish a
12protocol for mobile mental health relief providers responders,
13law enforcement, and fire and ambulance services to request
14assistance from each other, and train these groups on the
15protocol.
16    (l) Integrate law enforcement. The Division of Mental
17Health shall provide for law enforcement to request mobile
18mental health relief provider responder assistance whenever
19law enforcement engages an individual appropriate for services
20under this Act. If law enforcement would typically request EMS
21assistance when it encounters an individual with a physical
22health emergency, law enforcement shall similarly dispatch
23mental or behavioral health personnel or medical
24transportation when it encounters an individual in a mental or
25behavioral health emergency.
26(Source: P.A. 102-580, eff. 1-1-22.)
 

 

 

10300HB1364sam002- 10 -LRB103 24835 AWJ 61655 a

1    (50 ILCS 754/30)
2    Sec. 30. State prohibitions. 9-1-1 PSAPs, emergency
3services dispatched through 9-1-1 PSAPs, and the mobile mental
4and behavioral health service established by the Division of
5Mental Health must coordinate their services so that, based on
6the information provided to them, the following State
7prohibitions are avoided:
8    (a) Law enforcement responsibility for providing mental
9and behavioral health care. In any area where mobile mental
10health relief providers responders are available for dispatch,
11law enforcement shall not be dispatched to respond to an
12individual requiring mental or behavioral health care unless
13that individual is (i) involved in a suspected violation of
14the criminal laws of this State, or (ii) presents a threat of
15physical injury to self or others. Mobile mental health relief
16providers Responders are not considered available for dispatch
17under this Section if 9-8-8 reports that it cannot dispatch
18appropriate service within the maximum response times
19established by each Regional Advisory Committee under Section
2045.
21        (1) Standing on its own or in combination with each
22    other, the fact that an individual is experiencing a
23    mental or behavioral health emergency, or has a mental
24    health, behavioral health, or other diagnosis, is not
25    sufficient to justify an assessment that the individual is

 

 

10300HB1364sam002- 11 -LRB103 24835 AWJ 61655 a

1    a threat of physical injury to self or others, or requires
2    a law enforcement response to a request for emergency
3    response or medical transportation.
4        (2) If, based on its assessment of the threat to
5    public safety, law enforcement would not accompany medical
6    transportation responding to a physical health emergency,
7    unless requested by mobile mental health relief providers
8    responders, law enforcement may not accompany emergency
9    response or medical transportation personnel responding to
10    a mental or behavioral health emergency that presents an
11    equivalent level of threat to self or public safety.
12        (3) Without regard to an assessment of threat to self
13    or threat to public safety, law enforcement may station
14    personnel so that they can rapidly respond to requests for
15    assistance from mobile mental health relief providers
16    responders if law enforcement does not interfere with the
17    provision of emergency response or transportation
18    services. To the extent practical, not interfering with
19    services includes remaining sufficiently distant from or
20    out of sight of the individual receiving care so that law
21    enforcement presence is unlikely to escalate the
22    emergency.
23    (b) Mobile mental health relief provider Responder
24involvement in involuntary commitment. In order to maintain
25the appropriate care relationship, mobile mental health relief
26providers responders shall not in any way assist in the

 

 

10300HB1364sam002- 12 -LRB103 24835 AWJ 61655 a

1involuntary commitment of an individual beyond (i) reporting
2to their dispatching entity or to law enforcement that they
3believe the situation requires assistance the mobile mental
4health relief providers responders are not permitted to
5provide under this Section; (ii) providing witness statements;
6and (iii) fulfilling reporting requirements the mobile mental
7health relief providers responders may have under their
8professional ethical obligations or laws of this state. This
9prohibition shall not interfere with any mobile mental health
10relief provider's responder's ability to provide physical or
11mental health care.
12    (c) Use of law enforcement for transportation. In any area
13where mobile mental health relief providers responders are
14available for dispatch, unless requested by mobile mental
15health relief providers responders, law enforcement shall not
16be used to provide transportation to access mental or
17behavioral health care, or travel between mental or behavioral
18health care providers, except where no alternative is
19available.
20    (d) Reduction of educational institution obligations. The
21services coordinated under this Act may not be used to replace
22any service an educational institution is required to provide
23to a student. It shall not substitute for appropriate special
24education and related services that schools are required to
25provide by any law.
26    (e) Subsections (a), (c), and (d) are operative beginning

 

 

10300HB1364sam002- 13 -LRB103 24835 AWJ 61655 a

1on the date the 3 conditions in Section 65 are met or July 1,
22024, whichever is earlier. Subsection (b) is operative
3beginning on July 1, 2024.
4(Source: P.A. 102-580, eff. 1-1-22.)
 
5    (50 ILCS 754/35)
6    Sec. 35. Non-violent misdemeanors. The Division of Mental
7Health's Guidance for 9-1-1 PSAPs and emergency services
8dispatched through 9-1-1 PSAPs for coordinating the response
9to individuals who appear to be in a mental or behavioral
10health emergency while engaging in conduct alleged to
11constitute a non-violent misdemeanor shall promote the
12following:
13        (a) Prioritization of Health Care. To the greatest
14    extent practicable, community-based mental or behavioral
15    health services should be provided before addressing law
16    enforcement objectives.
17        (b) Diversion from Further Criminal Justice
18    Involvement. To the greatest extent practicable,
19    individuals should be referred to health care services
20    with the potential to reduce the likelihood of further law
21    enforcement engagement and referral to a pre-arrest or
22    pre-booking case management unit should be prioritized in
23    any areas served by pre-arrest or pre-booking case
24    management.
25(Source: P.A. 102-580, eff. 1-1-22.)
 

 

 

10300HB1364sam002- 14 -LRB103 24835 AWJ 61655 a

1    (50 ILCS 754/40)
2    Sec. 40. 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;

 

 

10300HB1364sam002- 15 -LRB103 24835 AWJ 61655 a

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

 

 

10300HB1364sam002- 16 -LRB103 24835 AWJ 61655 a

1    intellectual or developmental disabilities, individuals
2    with behavioral disabilities, or individuals with lived
3    experience.
4    (e) 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    (f) The Statewide Advisory Committee shall continue to
8meet until this Act has been fully implemented, as determined
9by the Division of Mental Health, and mobile mental health
10relief providers are available in all parts of Illinois. The
11Division of Mental Health may reconvene the Statewide Advisory
12Committee at its discretion after full implementation of this
13Act.
14(Source: P.A. 102-580, eff. 1-1-22.)
 
15    (50 ILCS 754/45)
16    Sec. 45. Regional Advisory Committees.
17    (a) The Division of Mental Health shall establish Regional
18Advisory Committees in each EMS Region to advise on regional
19issues related to emergency response systems for mental and
20behavioral health. The Secretary of Human Services shall
21appoint the members of the Regional Advisory Committees. Each
22Regional Advisory Committee shall consist of:
23        (1) representatives of the 9-1-1 PSAPs in the region;
24        (2) representatives of the EMS Medical Directors
25    Committee, as constituted under the Emergency Medical

 

 

10300HB1364sam002- 17 -LRB103 24835 AWJ 61655 a

1    Services (EMS) Systems Act, or other similar committee
2    serving the medical needs of the jurisdiction;
3        (3) representatives of law enforcement officials with
4    jurisdiction in the Emergency Medical Services (EMS)
5    Regions;
6        (4) representatives of both the EMS providers and the
7    unions representing EMS or emergency mental and behavioral
8    health responders, or both; and
9        (5) advocates from the mental health, behavioral
10    health, intellectual disability, and developmental
11    disability communities.
12    If no person is willing or available to fill a member's
13seat for one of the required areas of representation on a
14Regional Advisory Committee under paragraphs (1) through (5),
15the Secretary of Human Services shall adopt procedures to
16ensure that a missing area of representation is filled once a
17person becomes willing and available to fill that seat.
18    (b) The majority of advocates on the Regional Advisory
19Emergency Response Equity Committee must either be individuals
20with a lived experience of a condition commonly regarded as a
21mental health or behavioral health disability, developmental
22disability, or intellectual disability, or be from
23organizations primarily composed of such individuals. The
24members of the Committee shall also reflect the racial
25demographics of the jurisdiction served. To achieve the
26requirements of this subsection, the Division of Mental Health

 

 

10300HB1364sam002- 18 -LRB103 24835 AWJ 61655 a

1must establish a clear plan and regular course of action to
2engage, recruit, and sustain areas of established
3participation. The plan and actions taken must be shared with
4the general public.
5    (c) Subject to the oversight of the Department of Human
6Services Division of Mental Health, the EMS Medical Directors
7Committee is responsible for convening the meetings of the
8committee. Impacted units of local government may also have
9representatives on the committee subject to approval by the
10Division of Mental Health, if this participation is structured
11in such a way that it does not give undue weight to any of the
12groups represented.
13(Source: P.A. 102-580, eff. 1-1-22.)
 
14    (50 ILCS 754/50)
15    Sec. 50. Regional Advisory Committee responsibilities.
16Each Regional Advisory Committee is responsible for designing
17the local protocol to allow its region's 9-1-1 call center and
18emergency responders to coordinate their activities with 9-8-8
19as required by this Act and monitoring current operation to
20advise on ongoing adjustments to the local protocol. Included
21in this responsibility, each Regional Advisory Committee must:
22        (1) negotiate the appropriate amendment of each 9-1-1
23    PSAP emergency dispatch protocols, in consultation with
24    each 9-1-1 PSAP in the EMS Region and consistent with
25    national certification requirements;

 

 

10300HB1364sam002- 19 -LRB103 24835 AWJ 61655 a

1        (2) set maximum response times for 9-8-8 to provide
2    service when an in-person response is required, based on
3    type of mental or behavioral health emergency, which, if
4    exceeded, constitute grounds for sending other emergency
5    responders through the 9-1-1 system;
6        (3) report, geographically by police district if
7    practical, the data collected through the direction
8    provided by the Statewide Advisory Committee in
9    aggregated, non-individualized monthly reports. These
10    reports shall be available to the Regional Advisory
11    Committee members, the Department of Human Service
12    Division of Mental Health, the Administrator of the 9-1-1
13    Authority, and to the public upon request; and
14        (4) convene, after the initial regional policies are
15    established, at least every 2 years to consider amendment
16    of the regional policies, if any, and also convene
17    whenever a member of the Committee requests that the
18    Committee consider an amendment; and .
19        (5) identify regional resources and supports for use
20    by the mobile mental health relief providers as they
21    respond to the requests for services.
22(Source: P.A. 102-580, eff. 1-1-22.)
 
23    (50 ILCS 754/65)
24    Sec. 65. PSAP and emergency service dispatched through a
259-1-1 PSAP; coordination of activities with mobile and

 

 

10300HB1364sam002- 20 -LRB103 24835 AWJ 61655 a

1behavioral health services. Each 9-1-1 PSAP and emergency
2service dispatched through a 9-1-1 PSAP must begin
3coordinating its activities with the mobile mental and
4behavioral health services established by the Division of
5Mental Health once all 3 of the following conditions are met,
6but not later than July 1, 2024 2023:
7        (1) the Statewide Committee has negotiated useful
8    protocol and 9-1-1 operator script adjustments with the
9    contracted services providing these tools to 9-1-1 PSAPs
10    operating in Illinois;
11        (2) the appropriate Regional Advisory Committee has
12    completed design of the specific 9-1-1 PSAP's process for
13    coordinating activities with the mobile mental and
14    behavioral health service; and
15        (3) the mobile mental and behavioral health service is
16    available in their jurisdiction.
17(Source: P.A. 102-580, eff. 1-1-22; 102-1109, eff. 12-21-22.)
 
18    (50 ILCS 754/70 new)
19    Sec. 70. Report. On or before July 1, 2023 and on a
20quarterly basis thereafter, the Division of Mental Health
21shall submit a report to the General Assembly on its progress
22in implementing this Act, which shall include, but not be
23limited to, a strategic assessment that evaluates the success
24toward current strategy, identification of future targets for
25implementation that help estimate the potential for success

 

 

10300HB1364sam002- 21 -LRB103 24835 AWJ 61655 a

1and provides a basis for assessing future performance, and key
2benchmarks to provide a comparison to set in context and help
3stakeholders understand their positions.".