103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1672

 

Introduced 2/8/2023, by Sen. Laura Fine

 

SYNOPSIS AS INTRODUCED:
 
50 ILCS 754/5
50 ILCS 754/15
50 ILCS 754/25
50 ILCS 754/30
50 ILCS 754/35
50 ILCS 754/40

    Amends the Community Emergency Services and Support Act. Replaces the term "responder" with "mobile crisis response team member" in the Act. Removes provisions concerning responder involvement in involuntary commitment, and makes other changes in provisions concerning State prohibitions relating to emergency response. Provides that the Division of Mental Health's guidance for 9-1-1 PSAPs and emergency services dispatched through 9-1-1 PSAPs shall promote, to the greatest extent practicable, referrals to a prearrest or prebooking case management unit in any area served by a prearrest or prebooking case management unit. Makes other changes.


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A BILL FOR

 

SB1672LRB103 05032 AWJ 50045 b

1    AN ACT concerning local government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Community Emergency Services and Support
5Act is amended by changing Sections 5, 15, 25, 30, 35, and 40
6as follows:
 
7    (50 ILCS 754/5)
8    Sec. 5. Findings. The General Assembly recognizes that the
9Illinois Department of Human Services Division of Mental
10Health is preparing to provide mobile mental and behavioral
11health services to all Illinoisans as part of the federally
12mandated adoption of the 9-8-8 phone number. The General
13Assembly also recognizes that many cities and some states have
14successfully established mobile emergency mental and
15behavioral health services as part of their emergency response
16system to support people who need such support and do not
17present a threat of physical violence to the mobile crisis
18response team members responders. In light of that experience,
19the General Assembly finds that in order to promote and
20protect the health, safety, and welfare of the public, it is
21necessary and in the public interest to provide emergency
22response, with or without medical transportation, to
23individuals requiring mental health or behavioral health

 

 

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1services in a manner that is substantially equivalent to the
2response already provided to individuals who require emergency
3physical health care.
4(Source: P.A. 102-580, eff. 1-1-22.)
 
5    (50 ILCS 754/15)
6    Sec. 15. Definitions. As used in this Act:
7    "Division of Mental Health" means the Division of Mental
8Health of the Department of Human Services.
9    "Emergency" means an emergent circumstance caused by a
10health condition, regardless of whether it is perceived as
11physical, mental, or behavioral in nature, for which an
12individual may require prompt care, support, or assessment at
13the individual's location.
14    "Mental or behavioral health" means any health condition
15involving changes in thinking, emotion, or behavior, and that
16the medical community treats as distinct from physical health
17care.
18    "Mobile crisis response team member" means any person who
19engages with a member of the public to provide the mobile
20mental and behavioral service established in conjunction with
21the Division of Mental Health's implementation of the 9-8-8
22emergency number. "Mobile crisis response team member" does
23not mean an EMS Paramedic or EMT, as defined in the Emergency
24Medical Services (EMS) Systems Act, unless that responding
25agency has agreed to provide a specialized response in

 

 

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1accordance with the Division of Mental Health's services
2offered through its 9-8-8 number and has met all the
3requirements to offer that service through that system.
4    "Physical health" means a health condition that the
5medical community treats as distinct from mental or behavioral
6health care.
7    "PSAP" means a Public Safety Answering Point
8tele-communicator.
9    "Community services" and "community-based mental or
10behavioral health services" may include both public and
11private settings.
12    "Treatment relationship" means an active association with
13a mental or behavioral care provider able to respond in an
14appropriate amount of time to requests for care.
15    "Responder" is any person engaging with a member of the
16public to provide the mobile mental and behavioral service
17established in conjunction with the Division of Mental Health
18establishing the 9-8-8 emergency number. A responder is not an
19EMS Paramedic or EMT as defined in the Emergency Medical
20Services (EMS) Systems Act unless that responding agency has
21agreed to provide a specialized response in accordance with
22the Division of Mental Health's services offered through its
239-8-8 number and has met all the requirements to offer that
24service through that system.
25(Source: P.A. 102-580, eff. 1-1-22.)
 

 

 

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1    (50 ILCS 754/25)
2    Sec. 25. State goals.
3    (a) 9-1-1 PSAPs, emergency services dispatched through
49-1-1 PSAPs, and the mobile mental and behavioral health
5service established by the Division of Mental Health must
6coordinate their services so that the State goals listed in
7this Section are achieved. Appropriate mobile response service
8for mental and behavioral health emergencies shall be
9available regardless of whether the initial contact was with
109-8-8, 9-1-1 or directly with an emergency service dispatched
11through 9-1-1. Appropriate mobile response services must:
12        (1) ensure that individuals experiencing mental or
13    behavioral health crises are diverted from hospitalization
14    or incarceration whenever possible, and are instead linked
15    with available appropriate community services;
16        (2) include the option of on-site care if that type of
17    care is appropriate and does not override the care
18    decisions of the individual receiving care. Providing care
19    in the community, through methods like mobile crisis
20    units, is encouraged. If effective care is provided on
21    site, and if it is consistent with the care decisions of
22    the individual receiving the care, further transportation
23    to other medical providers is not required by this Act;
24        (3) recommend appropriate referrals for available
25    community services if the individual receiving on-site
26    care is not already in a treatment relationship with a

 

 

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1    service provider or is unsatisfied with their current
2    service providers. The referrals shall take into
3    consideration waiting lists and copayments, which may
4    present barriers to access; and
5        (4) subject to the care decisions of the individual
6    receiving care, provide transportation for any individual
7    experiencing a mental or behavioral health emergency.
8    Transportation shall be to the most integrated and least
9    restrictive setting appropriate in the community, such as
10    to the individual's home or chosen location, community
11    crisis respite centers, clinic settings, behavioral health
12    centers, or the offices of particular medical care
13    providers with existing treatment relationships to the
14    individual seeking care.
15    (b) Prioritize requests for emergency assistance. 9-1-1
16PSAPs, emergency services dispatched through 9-1-1 PSAPs, and
17the mobile mental and behavioral health service established by
18the Division of Mental Health must provide guidance for
19prioritizing calls for assistance and maximum response time in
20relation to the type of emergency reported.
21    (c) Provide appropriate response times. From the time of
22first notification, 9-1-1 PSAPs, emergency services dispatched
23through 9-1-1 PSAPs, and the mobile mental and behavioral
24health service established by the Division of Mental Health
25must provide the response within response time appropriate to
26the care requirements of the individual with an emergency.

 

 

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1    (d) Require appropriate responder training of mobile
2crisis response team members. Mobile crisis response team
3members Responders must have adequate training to address the
4needs of individuals experiencing a mental or behavioral
5health emergency. Adequate training at least includes:
6        (1) training in de-escalation techniques;
7        (2) knowledge of local community services and
8    supports; and
9        (3) training in respectful interaction with people
10    experiencing mental or behavioral health crises, including
11    the concepts of stigma and respectful language.
12    (e) Require minimum team staffing. The Division of Mental
13Health, in consultation with the Regional Advisory Committees
14created in Section 40, shall determine the appropriate
15credentials for the mental health providers responding to
16calls, including to what extent the mobile crisis response
17team members responders must have certain credentials and
18licensing, and to what extent the mobile crisis response team
19members responders can be peer support professionals.
20    (f) Require training from individuals with lived
21experience. Training shall be provided by individuals with
22lived experience to the extent available.
23    (g) Adopt guidelines directing referral to restrictive
24care settings. Mobile crisis response team members Responders
25must have guidelines to follow when considering whether to
26refer an individual to more restrictive forms of care, like

 

 

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1emergency room or hospital settings.
2    (h) Specify regional best practices. Mobile crisis
3response team members Responders providing these services must
4do so consistently with best practices, which include
5respecting the care choices of the individuals receiving
6assistance. Regional best practices may be broken down into
7sub-regions, as appropriate to reflect local resources and
8conditions. With the agreement of the impacted EMS Regions,
9providers of emergency response to physical emergencies may
10participate in another EMS Region for mental and behavioral
11response, if that participation shall provide a better service
12to individuals experiencing a mental or behavioral health
13emergency.
14    (i) Adopt a system for directing care in advance of an
15emergency. The Division of Mental Health shall select and
16publicly identify a system that allows individuals who
17voluntarily choose chose to do so to provide confidential
18advanced care directions to individuals providing services
19under this Act. No system for providing advanced care
20direction may be implemented unless the Division of Mental
21Health approves it as confidential, available to individuals
22at all economic levels, and non-stigmatizing. The Division of
23Mental Health may defer this requirement for providing a
24system for advanced care direction if it determines that no
25existing systems can currently meet these requirements.
26    (j) Train dispatching staff. The personnel staffing 9-1-1,

 

 

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13-1-1, or other emergency response intake systems must be
2provided with adequate training to assess whether coordinating
3with 9-8-8 is appropriate.
4    (k) Establish protocol for emergency mobile crisis
5response team member responder coordination. The Division of
6Mental Health shall establish a protocol for mobile crisis
7response team members responders, law enforcement, and fire
8and ambulance services to request assistance from each other,
9and train these groups on the protocol.
10    (l) Integrate law enforcement. The Division of Mental
11Health shall provide for law enforcement to request mobile
12crisis response team member responder assistance whenever law
13enforcement engages an individual appropriate for services
14under this Act. If law enforcement would typically request EMS
15assistance when it encounters an individual with a physical
16health emergency, law enforcement shall similarly dispatch
17mental or behavioral health personnel or medical
18transportation when it encounters an individual in a mental or
19behavioral health emergency.
20(Source: P.A. 102-580, eff. 1-1-22.)
 
21    (50 ILCS 754/30)
22    Sec. 30. State prohibitions. 9-1-1 PSAPs, emergency
23services dispatched through 9-1-1 PSAPs, and the mobile mental
24and behavioral health service established by the Division of
25Mental Health must coordinate their services so that, based on

 

 

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1the information provided to them, the following State
2prohibitions are avoided:
3    (a) Law enforcement responsibility for providing mental
4and behavioral health care. In any area where mobile crisis
5response team members responders are available for dispatch,
6law enforcement shall not be dispatched to respond to an
7individual requiring mental or behavioral health care unless
8that individual is (i) involved in a suspected violation of
9the criminal laws of this State, or (ii) presents a threat of
10physical injury to self or others. Mobile crisis response team
11members Responders are not considered available for dispatch
12under this Section if 9-8-8 reports that it cannot dispatch
13appropriate service within the maximum response times
14established by each Regional Advisory Committee under Section
1545.
16        (1) The Standing on its own or in combination with
17    each other, the fact that an individual is experiencing a
18    mental or behavioral health emergency, or has a mental
19    health, behavioral health, or other diagnosis, is not
20    sufficient to justify an assessment that the individual
21    presents is a threat of physical injury to self or others,
22    or that the situation requires a law enforcement response
23    to a request for emergency response or medical
24    transportation.
25        (2) If, based on its assessment of the threat to
26    public safety, law enforcement would not accompany the

 

 

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1    emergency response or medical transportation personnel
2    responding to a physical health emergency, unless
3    requested by those responders, then law enforcement may
4    not accompany the emergency response or medical
5    transportation personnel responding to a mental or
6    behavioral health emergency that presents an equivalent
7    level of threat to self or public safety unless requested
8    by those responders. Law enforcement may respond to a
9    mental or behavioral health emergency in accordance with
10    subparagraph (3).
11        (3) Without regard to an assessment of threat to self
12    or threat to public safety, law enforcement may station
13    personnel so that they can rapidly respond to requests for
14    assistance from mobile crisis response team members,
15    emergency response, or medical transportation personnel
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) (Blank). Responder involvement in involuntary
24commitment. In order to maintain the appropriate care
25relationship, responders shall not in any way assist in the
26involuntary commitment of an individual beyond (i) reporting

 

 

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1to their dispatching entity or to law enforcement that they
2believe the situation requires assistance the responders are
3not permitted to provide under this Section; (ii) providing
4witness statements; and (iii) fulfilling reporting
5requirements the responders may have under their professional
6ethical obligations or laws of this state. This prohibition
7shall not interfere with any responder's ability to provide
8physical or mental health care.
9    (c) Use of law enforcement for transportation. In any area
10where mobile crisis response team members responders are
11available for dispatch, unless requested by mobile crisis
12response team members responders, law enforcement shall not be
13used to provide transportation to access mental or behavioral
14health care, or travel between mental or behavioral health
15care providers, except where no alternative is available.
16    (d) Reduction of educational institution obligations. The
17services coordinated under this Act may not be used to replace
18any service an educational institution is required to provide
19to a student. It shall not substitute for appropriate special
20education and related services that schools are required to
21provide by any law.
22(Source: P.A. 102-580, eff. 1-1-22.)
 
23    (50 ILCS 754/35)
24    Sec. 35. Non-violent misdemeanors. The Division of Mental
25Health's guidance Guidance for 9-1-1 PSAPs and emergency

 

 

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1services dispatched through 9-1-1 PSAPs for coordinating the
2response to individuals who appear to be in a mental or
3behavioral health emergency while engaging in conduct alleged
4to constitute a non-violent misdemeanor shall promote the
5following:
6        (a) Prioritization of Health Care. To the greatest
7    extent practicable, community-based mental or behavioral
8    health services should be provided before addressing law
9    enforcement objectives.
10        (b) Diversion from Further Criminal Justice
11    Involvement. To the greatest extent practicable,
12    individuals should be referred to health care services
13    with the potential to reduce the likelihood of further law
14    enforcement engagement.
15        (c) Prearrest or prebooking case management
16    initiatives. To the greatest extent practicable, a
17    referral to a prearrest or prebooking case management unit
18    should be prioritized in any area served by a prearrest or
19    prebooking case management unit.
20(Source: P.A. 102-580, eff. 1-1-22.)
 
21    (50 ILCS 754/40)
22    Sec. 40. Statewide Advisory Committee.
23    (a) The Division of Mental Health shall establish a
24Statewide Advisory Committee to review and make
25recommendations for aspects of coordinating 9-1-1 and the

 

 

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19-8-8 mobile mental health response system most appropriately
2addressed on a State level.
3    (b) Issues to be addressed by the Statewide Advisory
4Committee include, but are not limited to, addressing changes
5necessary in 9-1-1 call taking protocols and scripts used in
69-1-1 PSAPs where those protocols and scripts are based on or
7otherwise dependent on national providers for their operation.
8    (c) The Statewide Advisory Committee shall recommend a
9system for gathering data related to the coordination of the
109-1-1 and 9-8-8 systems for purposes of allowing the parties
11to make ongoing improvements in that system. As practical, the
12system shall attempt to determine issues including, but not
13limited to:
14        (1) the volume of calls coordinated between 9-1-1 and
15    9-8-8;
16        (2) the volume of referrals from other first
17    responders to 9-8-8;
18        (3) the volume and type of calls deemed appropriate
19    for referral to 9-8-8 but could not be served by 9-8-8
20    because of capacity restrictions or other reasons;
21        (4) the appropriate information to improve
22    coordination between 9-1-1 and 9-8-8; and
23        (5) the appropriate information to improve the 9-8-8
24    system, if the information is most appropriately gathered
25    at the 9-1-1 PSAPs.
26    (d) The Statewide Advisory Committee shall consist of:

 

 

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1        (1) the Statewide 9-1-1 Administrator, ex officio;
2        (2) one representative designated by the Illinois
3    Chapter of National Emergency Number Association (NENA);
4        (3) one representative designated by the Illinois
5    Chapter of Association of Public Safety Communications
6    Officials (APCO);
7        (4) one representative of the Division of Mental
8    Health;
9        (5) one representative of the Illinois Department of
10    Public Health;
11        (6) one representative of a statewide organization of
12    EMS responders;
13        (7) one representative of a statewide organization of
14    fire chiefs;
15        (8) two representatives of statewide organizations of
16    law enforcement;
17        (9) two representatives of mental health, behavioral
18    health, or substance abuse providers or a statewide
19    organization representing one or more of these types of
20    providers; and
21        (10) four representatives of advocacy organizations
22    either led by or consisting primarily of individuals with
23    intellectual or developmental disabilities, individuals
24    with behavioral disabilities, or individuals with lived
25    experience.
26    (e) The members of the Statewide Advisory Committee, other

 

 

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1than the Statewide 9-1-1 Administrator, shall be appointed by
2the Secretary of Human Services.
3(Source: P.A. 102-580, eff. 1-1-22.)