Illinois General Assembly - Full Text of SB3449
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Full Text of SB3449  101st General Assembly




State of Illinois
2019 and 2020


Introduced 2/14/2020, by Sen. Robert Peters


New Act
50 ILCS 750/4  from Ch. 134, par. 34

    Creates the Community Emergency Services and Support Act. Provides that 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 emergency. Amends the Emergency Telephone System Act to make conforming changes.

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SB3449LRB101 19277 RLC 68743 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. This Act may be referred to as the Stephon
5Edward Watts Act.
6    Section 2. Short title. This Act may be cited as the
7Community Emergency Services and Support Act.
8    Section 5. Findings. The General Assembly finds that in
9order to promote and protect the health, safety, and welfare of
10the public, it is necessary and in the public interest to
11provide emergency response, with or without medical
12transportation, to individuals requiring mental health or
13behavioral health services in a manner that is substantially
14equivalent to the response provided to individuals who require
15emergency physical health care. An individual who requires an
16emergency response to address his or her mental or behavioral
17health care needs should have the choice of accessing providers
18trained to address mental or behavioral health crises. Whether
19an individual experiencing a health emergency receives an
20appropriate emergency response from care providers whose
21primary occupation is the provision of care and support to
22individuals experiencing health crises should not depend on the



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



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1    "Physical health" means a health condition that the medical
2community treats as distinct from mental or behavioral health
4    Section 20. Scope. This Act does not limit an individual's
5right to control his or her own medical care. No provision of
6this Act shall be interpreted in such a way as to limit an
7individual's right to choose his or her preferred course of
8care or to reject care. No provision of this Act shall be
9interpreted to promote or provide justification for the use of
10restraints when providing mental or behavioral health care.
11    Section 25. Emergency mental or behavioral health care
12response. Every unit of local government that provides
13emergency medical services for individuals with physical
14health needs must also provide appropriate emergency response
15services to individuals experiencing a mental or behavioral
16health emergency. This response includes, but is not limited
17to, the following factors.
18    (a) Where practicable, the unit of local government must
19provide an emergency response for mental or behavioral health
20care with response times appropriate to the care requirements
21of the individual with an emergency when notified that an
22individual is experiencing an emergency.
23    (b) The individuals dispatched to provide emergency
24response services or transportation for individuals



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1experiencing mental or behavioral health emergency must have
2adequate training in addressing the needs of individuals
3experiencing a mental or behavioral health emergency. This
4includes training in de-escalation techniques, knowledge of
5local community services and supports, and respect for
6individuals' dignity and autonomy, including the concepts of
7stigma and respectful language. Individuals providing these
8services must do so consistently with best practices, which
9include respecting the care choices of the individuals
10receiving assistance. They must ensure that individuals
11experiencing mental or behavioral health crises are diverted
12from hospitalization or incarceration whenever possible, and
13linked with available appropriate community services.
14    (c) An emergency response may include on-site care where
15the individual is located if it does not override the care
16decisions of the individual receiving care. Providing care in
17the community, through methods like mobile crisis units, is
18encouraged. If effective care is provided on site, and if it is
19consistent with the care decisions of the individual receiving
20the care, further transportation to other medical providers is
21not required by this Act.
22    (d) When on-site care is provided, care providers must also
23provide appropriate referrals for available community services
24if the individual receiving on-site care is not already in a
25treatment relationship.
26    (e) When transportation is provided, subject to the care



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1decisions of the individual receiving care, transportation
2shall be to the most integrated and least restrictive setting
3appropriate in the community, such as to the individual's home
4or chosen location, community crisis respite centers, clinic
5settings, behavioral health centers, or the offices of
6particular medical care providers with existing treatment
7relationships to the individual seeking care.
8    (f) This service may not replace any service an educational
9institution is required to provide to a student. It shall not
10substitute for appropriate special education and related
11services schools are required to provide by any law.
12    Section 30. Prohibition of mental and behavioral health
13response unit involvement in involuntary commitment. In order
14to maintain the appropriate care relationship, in any
15jurisdiction that chooses to provide an emergency response
16under Section 40 that is both separate from law enforcement and
17from the jurisdiction's physical health emergency response
18system, the emergency responders for mental and behavioral
19health emergencies shall not take any role that would assist in
20the involuntary commitment of an individual beyond whatever
21reporting requirements they may have under their professional
22ethical obligations or under other laws of this state. This
23prohibition shall not interfere with any emergency responder's
24ability to provide physical health care.



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1    Section 35. Prohibition of use of law enforcement for
2emergency response or transportation. In any jurisdiction that
3provides a system for emergency response for individuals with
4physical health needs that is distinct from the jurisdiction's
5law enforcement personnel, law enforcement shall not be used to
6provide emergency response for an individual when an individual
7only requires on-site emergency mental or behavioral health
8care, transportation to access health care, or travel between
9health care providers, except where no alternative is
10available. The transportation shall instead be provided
11pursuant to Section 40 of this Act.
12    Section 40. Equivalent law enforcement response. Unless an
13individual perceived as requiring mental or behavioral health
14care or requesting mental or behavioral health care is involved
15in a suspected violation of the criminal laws of this State,
16law enforcement shall respond to an individual requiring mental
17or behavioral health care in a manner that is equivalent to
18their response to an individual requiring physical health care.
19    (1) Standing on its own or in combination with each other,
20neither the fact that an individual is experiencing a mental or
21behavioral health emergency, nor that an individual has a
22mental health, behavioral health or other disability
23diagnosis, is sufficient to justify an assessment of threat to
24public safety to support a law enforcement response to a
25request for emergency response or medical transportation.



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1    (2) If, based on their assessment of the threat to public
2safety, law enforcement would not accompany medical
3transportation responding to a physical medical emergency, law
4enforcement may not accompany emergency response or medical
5transportation personnel responding to a mental or behavioral
6health emergency that presents an equivalent level of threat to
7public safety.
8    (3) If law enforcement would typically dispatch medical
9response personnel or transportation when they encounter an
10individual with a physical health emergency, law enforcement
11shall similarly dispatch mental or behavioral health personnel
12or medical transportation when they encounter an individual in
13a mental or behavioral health emergency.
14    (4) Without regard to an assessment of threat to public
15safety, law enforcement may station personnel so that they may
16rapidly respond to requests for assistance from emergency
17response or medical transportation staff if law enforcement
18does not interfere with the provision of emergency response or
19transportation services. To the extent practical, not
20interfering with services includes remaining sufficiently
21distant from or out of sight of the individual receiving care
22so that law enforcement presence is unlikely to escalate the
24    Section 45. Emergency response equity committees. To
25address the requirements of this Act, the Illinois Department



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1of Human Services Division of Mental Health shall establish an
2Emergency Response Equity Committee in each Emergency Medical
3Services (EMS) Region for the purpose of developing and, as
4appropriate, amending 2 plans setting regional guidance and
5standards. The Emergency Response Equity Committee shall
6create a Regional Response Plan to bring the jurisdiction into
7compliance with this Act in situations that are not criminal in
8nature, and shall create a Non-Violent Misdemeanor Plan to
9coordinate the jurisdiction's response to individuals who
10appear to be in a mental or behavioral health emergency while
11engaged in conduct alleged to constitute a non-violent
13    (a) Each Regional Response Plan shall also establish for
14their Region:
15        (1) The specific training program for individuals
16    providing the response to the mental and behavioral health
17    crises under this Act. Training shall be done by
18    individuals with lived experience to the extent available
19    and shall include guidelines approved by the committee
20    directing when responders may recommend more restrictive
21    forms of care, like emergency room settings.
22        (2) The protocol for coordinating the existing 9-1-1
23    services with the response system required by this Act.
24        (3) Guidance for prioritizing calls for assistance and
25    maximum response time in relation to the type of emergency
26    reported.



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1    (b) The Regional Response Plan may coordinate with or
2include other similar programs, like those operating under the
3Children's Mental Health Act of 2003, so long as all the
4requirements of all programs are met.
5    (c) The Non-Violent Misdemeanor Plan shall be developed
6with the goal of providing the most appropriate mental and
7behavioral health care allowable without significant
8interference with law enforcement activities and without
9further criminal justice involvement. To the greatest extent
10practicable, the plan shall seek to first provide
11community-based mental or behavioral health services before
12addressing law enforcement objectives. The plan must align the
13region's emergency response service with municipal and state
14efforts to deinstitutionalize people with mental and
15behavioral disabilities.
16    (d) Each Emergency Response Equity Committee shall consist
17of representatives of the EMS Medical Directors Committee, as
18constituted under the Emergency Medical Services (EMS) Systems
19Act, or other similar committee serving the medical needs of
20the jurisdiction; representatives of law enforcement officials
21with jurisdiction in the Emergency Medical Services (EMS)
22Regions, and advocates from the mental health, behavioral
23health, intellectual disability, and developmental disability
24communities. The majority of advocates on the Emergency
25Response Equity Committee must either be individuals with a
26lived experience of a condition commonly regarded as a mental



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1health or behavioral health condition, developmental
2disability, or intellectual disability, or be from
3organizations primarily composed of such individuals. The
4members of the Committee shall also reflect the racial
5demographics of the jurisdiction served. Subject to the
6oversight of the Illinois Department of Human Services Division
7of Mental Health, the EMS Medical Directors Committee is
8responsible for convening the meetings of the committee.
9Interested units of local government may also have
10representatives on the committee subject to approval by the
11Division of Mental Health and if this participation is
12structured in such a way that it does not reduce the influence
13of the advocates on the committee.
14    (e) Both plans required by this Section shall be completed
15within 6 months after the effective date of this Act, and shall
16be reviewed on a bi-annual basis. At the request of any member
17of the Emergency Response Equity Committee or by the Division
18of Mental Health, the committee shall reconvene outside the
19bi-annual review meeting or meetings.
20    Section 55. The Emergency Telephone System Act is amended
21by changing Section 4 as follows:
22    (50 ILCS 750/4)  (from Ch. 134, par. 34)
23    (Section scheduled to be repealed on December 31, 2020)
24    Sec. 4.



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1    (a) Every system shall include police, firefighting, and
2emergency medical and ambulance services, and may include other
3emergency services. The system may incorporate private
4ambulance service. In those areas in which a public safety
5agency of the State provides such emergency services, the
6system shall include such public safety agencies. Every system
7shall dispatch emergency response services for individuals
8requiring mental or behavioral health care in compliance with
9the requirements of the Community Emergency Services and
10Support Act.
11    (b) Every 9-1-1 Authority shall maintain records of the
12numbers of calls received, the type of service the caller
13requested and the type of service dispatched in response to
14each call. For emergency medical and ambulance services, the
15records shall indicate whether physical, mental or behavioral
16health response or transportation were requested, and what type
17of response or transportation was dispatched. When a mental or
18behavioral health response is requested at a primary, secondary
19or post-secondary educational institution, the 9-1-1 Authority
20shall record which type of educational institution was
21involved. Broken down geographically by police district, every
229-1-1 Authority shall create aggregated, non-individualized
23monthly reports detailing the system's activities, including
24the frequency of dispatch of each type of service and the
25information required to be collected by this Section. These
26reports shall be available to both the Emergency Response



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1Equity Committees and the Administrator of the 9-1-1 Authority
2for the purpose of conducting an annual analysis of service
3gaps and to the public upon request.
4(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)