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




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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. Short title. This Act may be cited as the
5Community Emergency Services and Support Act, and may also be
6referred to as the Stephon Edward Watts Act.
7    Section 5. Findings. The General Assembly recognizes that
8the Illinois Department of Human Services Division of Mental
9Health is preparing to provide mobile mental and behavioral
10health services to all Illinoisans as part of the federally
11mandated adoption of the 988 phone number. The General
12Assembly also recognizes that many municipalities and some
13states have successfully established mobile emergency mental
14and behavioral health services as part of their emergency
15response system to support people who need such support and do
16not present a threat of physical violence to the responders.
17In light of that experience, the General Assembly finds that
18in order to promote and protect the health, safety, and
19welfare of the public, it is necessary and in the public
20interest to provide emergency response, with or without
21medical transportation, to individuals requiring mental health
22or behavioral health services in a manner that is
23substantially equivalent to the response already provided to



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



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1medical community treats as distinct from mental or behavioral
2health care.
3    "Community services" and "community-based mental or
4behavioral health services" may include both public and
5private settings.
6    "Treatment relationship" means an active association with
7a mental or behavioral care provider able to respond in an
8appropriate amount of time to requests for care.
9    "Responder" means any person engaging with a member of the
10public to provide the mobile mental and behavioral service
11established in conjunction with the Division of Mental Health
12establishing the 988 emergency number.
13    Section 20. Coordination with Division of Mental Health.
14Each 9-1-1 call center and provider of emergency services
15dispatched through a 9-1-1 system must coordinate with the
16mobile mental and behavioral health services established by
17the Division of Mental Health so that the following State
18goals and State prohibitions are met whenever a person
19interacts with one of these entities for the purpose of
20seeking emergency mental and behavioral health care or when
21one of these entities recognizes the appropriateness of
22providing mobile mental or behavioral health care to an
23individual with whom they have engaged. The Division of Mental
24Health is also directed to provide guidance regarding whether
25and how these entities should coordinate with mobile mental



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1and behavioral health services when responding to individuals
2who appear to be in a mental or behavioral health emergency
3while engaged in conduct alleged to constitute a non-violent
5    Section 25. State goals.
6    (a) 9-1-1 call centers, emergency services dispatched
7through 9-1-1 call centers, and the mobile mental and
8behavioral health service established by the Division of
9Mental Health must coordinate their services so that the
10following State goals are achieved.
11    (b) Appropriate mobile response service for mental and
12behavioral health emergencies will be available regardless of
13whether the initial contact was with 988, 911 or directly with
14an emergency service dispatched through 9-1-1. Appropriate
15mobile response services must:
16        (1) Ensure that individuals experiencing mental or
17    behavioral health crises are diverted from hospitalization
18    or incarceration whenever possible, and are instead linked
19    with available appropriate community services.
20        (2) Include the option of on-site care if that type of
21    care is appropriate and does not override the care
22    decisions of the individual receiving care. Providing care
23    in the community, through methods like mobile crisis
24    units, is encouraged. If effective care is provided on
25    site, and if it is consistent with the care decisions of



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1    the individual receiving the care, further transportation
2    to other medical providers is not required by this Act.
3        (3) Recommend appropriate referrals for available
4    community services if the individual receiving on-site
5    care is not already in a treatment relationship with a
6    service provider or is unsatisfied with their current
7    service providers. Such referrals shall take into
8    consideration waiting lists and copayments, which may
9    present barriers to access.
10        (4) Be subject to the care decisions of the individual
11    receiving care, provide transportation for any individual
12    experiencing a mental or behavioral health emergency.
13    Transportation shall be to the most integrated and least
14    restrictive setting appropriate in the community, such as
15    to the individual's home or chosen location, community
16    crisis respite centers, clinic settings, behavioral health
17    centers, or the offices of particular medical care
18    providers with existing treatment relationships to the
19    individual seeking care.
20        (5) Prioritize requests for emergency assistance.
21    Provide guidance for prioritizing calls for assistance and
22    maximum response time in relation to the type of emergency
23    reported.
24        (6) Provide appropriate response times. From the time
25    of first notification, provide the response within
26    response time appropriate to the care requirements of the



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1    individual with an emergency.
2        (7) Require appropriate responder training. Responders
3    must have adequate training to address the needs of
4    individuals experiencing a mental or behavioral health
5    emergency. Adequate training at least includes:
6            (A) training in de-escalation techniques;
7            (B) knowledge of local community services and
8        supports; and
9            (C) training in respectful interaction with people
10        experiencing mental or behavioral health crises,
11        including the concepts of stigma and respectful
12        language.
13        (8) Require Training from Individuals with Lived
14    Experience. Training shall be provided by individuals with
15    lived experience to the extent available.
16        (9) Adopt guidelines directing referral to restrictive
17    care settings. Responders must have guidelines to follow
18    when considering whether to refer an individual to more
19    restrictive forms of care, like emergency room or hospital
20    settings.
21        (10) Specify regional best practices. Responders
22    providing these services must do so consistently with best
23    practices, which include respecting the care choices of
24    the individuals receiving assistance.
25        (11) Adopt system for directing care in advance of an
26    emergency. Select and publicly identify a system that



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1    allows individuals who voluntarily chose to do so to
2    provide confidential advanced care directions to
3    individuals providing services under this Act. No system
4    for providing advanced care direction may be implemented
5    unless the Division of Mental Health approves it as
6    confidential, available to individuals at all economic
7    levels, and non-stigmatizing. The Division of Mental
8    Health may defer this requirement for providing a system
9    for advanced care direction if it determines that no
10    existing systems can currently meet these requirements.
11        (12) Train dispatching staff. The personnel staffing
12    911, 311, or other emergency response intake systems must
13    be provided with adequate training to assess whether
14    dispatching emergency mental health responders under this
15    Act is appropriate.
16        (13) Establish protocol for emergency responder
17    coordination. Establish a protocol for Responders, law
18    enforcement, and fire and ambulance services to request
19    assistance from each other, and train these groups on the
20    protocol.
21        (14) Integrate law enforcement. Provide for law
22    enforcement to request Responder assistance whenever law
23    enforcement engages an individual appropriate for services
24    under this Act. If law enforcement would typically request
25    EMS assistance when it encounters an individual with a
26    physical health emergency, law enforcement shall similarly



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1    dispatch mental or behavioral health personnel or medical
2    transportation when it encounters an individual in a
3    mental or behavioral health emergency.
4    Section 30. State prohibitions. 9-1-1 call centers,
5emergency services dispatched through 9-1-1 call centers, and
6the mobile mental and behavioral health service established by
7the Division of Mental Health must coordinate their services
8so that the following State prohibitions are avoided:
9    (1) Law enforcement responsibility for providing mental
10and behavioral health care. In any area where responders are
11available for dispatch, law enforcement shall not be
12dispatched to respond to an individual requiring mental or
13behavioral health care unless that individual is (i) involved
14in a suspected violation of the criminal laws of this State, or
15(ii) presents a threat of physical injury to self or others.
16        (A) Standing on its own or in combination with each
17    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 is
21    a threat of physical injury to self or others, or requires
22    a law enforcement response to a request for emergency
23    response or medical transportation.
24        (B) If, based on its assessment of the threat to
25    public safety, law enforcement would not accompany medical



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



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1mental health care.
2    (3) Use of law enforcement for transportation. In any area
3where responders are available for dispatch, law enforcement
4shall not be used to provide transportation to access mental
5or behavioral health care, or travel between mental or
6behavioral health care providers, except where no alternative
7is available.
8    (4) Reduction of educational institution obligations: The
9services coordinated under this Act may not be used to replace
10any service an educational institution is required to provide
11to a student. It shall not substitute for appropriate special
12education and related services that schools are required to
13provide by any law.
14    Section 35. Non-violent misdemeanors. The Division of
15Mental Health's Guidance for 9-1-1 call centers and emergency
16services dispatched through 9-1-1 call centers for
17coordinating the response to individuals who appear to be in a
18mental or behavioral health emergency while engaging in
19conduct alleged to constitute a non-violent misdemeanor shall
20promote the following:
21    (1) Prioritization of Health Care. To the greatest extent
22practicable, community-based mental or behavioral health
23services should be provided before addressing law enforcement
25    (2) Diversion from Further Criminal Justice Involvement.



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1To the greatest extent practicable, individuals should be
2referred to health care services with the potential to reduce
3the likelihood of further law enforcement engagement.
4    Section 40. Regional Advisory Committees. The Division of
5Mental Health shall establish regional advisory committees in
6each EMS Region to advise on emergency response systems for
7mental and behavioral health. Each Regional Advisory Committee
8shall consist of representatives of the: EMS Medical Directors
9Committee, as constituted under the Emergency Medical Services
10(EMS) Systems Act, or other similar committee serving the
11medical needs of the jurisdiction; representatives of law
12enforcement officials with jurisdiction in the Emergency
13Medical Services (EMS) Regions; representatives of the unions
14representing EMS or emergency mental and behavioral health
15responders, or both; and advocates from the mental health,
16behavioral health, intellectual disability, and developmental
17disability communities. The majority of advocates on the
18Emergency Response Equity Committee must either be individuals
19with a lived experience of a condition commonly regarded as a
20mental health or behavioral health disability, developmental
21disability, or intellectual disability, or be from
22organizations primarily composed of such individuals. The
23members of the Committee shall also reflect the racial
24demographics of the jurisdiction served. Subject to the
25oversight of the Illinois Department of Human Services



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1Division of Mental Health, the EMS Medical Directors Committee
2is responsible for convening the meetings of the committee.
3Interested units of local government may also have
4representatives on the committee subject to approval by the
5Division of Mental Health, and so long as this participation
6is structured in such a way that it does not reduce the
7influence of the advocates on the committee.
8    Section 45. Scope. This Act applies to persons of all
9ages, both children and adults. This Act does not limit an
10individual's right to control his or her own medical care. No
11provision of this Act shall be interpreted in such a way as to
12limit an individual's right to choose his or her preferred
13course of care or to reject care. No provision of this Act
14shall be interpreted to promote or provide justification for
15the use of restraints when providing mental or behavioral
16health care.
17    Each 9-1-1 call center and emergency service dispatched
18through a 9-1-1 call center must begin coordinating their
19activities with the mobile mental and behavioral health
20services established by the Division of Mental Health once the
21mobile mental and behavioral health service is available in
22their jurisdiction.
23    Section 105. The Emergency Telephone System Act is amended
24by changing Section 4 as follows:



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1    (50 ILCS 750/4)  (from Ch. 134, par. 34)
2    (Section scheduled to be repealed on December 31, 2021)
3    Sec. 4. 9-1-1 system; services; maintenance of
4records.     (a) Every system shall include police,
5firefighting, and emergency medical and ambulance services,
6and may include other emergency services. The system may
7incorporate private ambulance service. In those areas in which
8a public safety agency of the State provides such emergency
9services, the system shall include such public safety
10agencies. Every system shall dispatch emergency response
11services for individuals requiring mental or behavioral health
12care in compliance with the requirements of the Community
13Emergency Services and Support Act.
14    (b) Every 9-1-1 Authority shall maintain records of the
15numbers of calls received, the type of service the caller
16requested, and the type of service dispatched in response to
17each call. For emergency medical and ambulance services, the
18records shall indicate whether physical, mental, or behavioral
19health response or transportation were requested, and what
20type of response or transportation was dispatched. When a
21mental or behavioral health response is requested at a
22primary, secondary, or post-secondary educational institution,
23the 9-1-1 Authority shall record which type of educational
24institution was involved. Broken down geographically by police
25district, every 9-1-1 Authority shall create aggregated,



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1non-individualized monthly reports detailing the system's
2activities, including the frequency of dispatch of each type
3of service and the information required to be collected by
4this subpart. These reports shall be available to both the
5Department of Human Service Division of Mental Health and to
6the Administrator of the 9-1-1 Authority, for the purpose of
7conducting an annual analysis of service gaps, and to the
8public upon request.
9(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)