Full Text of HB2784 102nd General Assembly
HB2784ham001 102ND GENERAL ASSEMBLY | Rep. Kelly M. Cassidy Filed: 4/20/2021
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| 1 | | AMENDMENT TO HOUSE BILL 2784
| 2 | | AMENDMENT NO. ______. Amend House Bill 2784 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Community Emergency Services and Support Act , and may also be | 6 | | referred to as the Stephon Edward Watts Act. | 7 | | Section 5. Findings. The General Assembly recognizes that | 8 | | the Illinois Department of Human Services Division of Mental | 9 | | Health is preparing to provide mobile mental and behavioral | 10 | | health services to all Illinoisans as part of the federally | 11 | | mandated adoption of the 988 phone number. The General | 12 | | Assembly also recognizes that many municipalities and some | 13 | | states have successfully established mobile emergency mental | 14 | | and behavioral health services as part of their emergency | 15 | | response system to support people who need such support and do | 16 | | not present a threat of physical violence to the responders. |
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| 1 | | In light of that experience, the General Assembly finds that | 2 | | in order to promote and protect the health, safety, and | 3 | | welfare of the public, it is necessary and in the public | 4 | | interest to provide emergency response, with or without | 5 | | medical transportation, to individuals requiring mental health | 6 | | or behavioral health services in a manner that is | 7 | | substantially equivalent to the response already provided to | 8 | | individuals who require emergency physical health care. | 9 | | Section 10. Applicability; home rule. This Act applies to | 10 | | every unit of local government that provides or coordinates | 11 | | ambulance or similar emergency medical response or | 12 | | transportation services for individuals with emergency medical | 13 | | needs. A home rule unit may not respond to or provide services | 14 | | for a mental or behavioral health emergency, or create a | 15 | | transportation plan or other regulation, relating to the | 16 | | provision of mental or behavioral health services in a manner | 17 | | inconsistent with this Act. This Act is a limitation under | 18 | | subsection (i) of Section 6 of Article VII of the Illinois | 19 | | Constitution on the concurrent exercise by home rule units of | 20 | | powers and functions exercised by the State. | 21 | | Section 15. Definitions. As used in this Act: | 22 | | "Emergency" means an emergent circumstance caused by a | 23 | | health condition, regardless of whether it is perceived as | 24 | | physical, mental, or behavioral in nature, for which an |
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| 1 | | individual may require prompt care, support, or assessment at | 2 | | the individual's location. | 3 | | "Mental or behavioral health" means any health condition | 4 | | involving changes in thinking, emotion, or behavior, and that | 5 | | the medical community treats as distinct from physical health | 6 | | care. | 7 | | "Physical health" means a health condition that the | 8 | | medical community treats as distinct from mental or behavioral | 9 | | health care. | 10 | | "Community services" and "community-based mental or | 11 | | behavioral health services" may include both public and | 12 | | private settings. | 13 | | "Treatment relationship" means an active association with | 14 | | a mental or behavioral care provider able to respond in an | 15 | | appropriate amount of time to requests for care. | 16 | | "Responder" means any person engaging with a member of the | 17 | | public to provide the mobile mental and behavioral service | 18 | | established in conjunction with the Division of Mental Health | 19 | | establishing the 988 emergency number. | 20 | | Section 20. Coordination with Division of Mental Health. | 21 | | Each 9-1-1 call center and provider of emergency services | 22 | | dispatched through a 9-1-1 system must coordinate with the | 23 | | mobile mental and behavioral health services established by | 24 | | the Division of Mental Health so that the following State | 25 | | goals and State prohibitions are met whenever a person |
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| 1 | | interacts with one of these entities for the purpose seeking | 2 | | emergency mental and behavioral health care or when one of | 3 | | these entities recognizes the appropriateness of providing | 4 | | mobile mental or behavioral health care to an individual with | 5 | | whom they have engaged. The Division of Mental Health is also | 6 | | directed to provide guidance regarding whether and how these | 7 | | entities should coordinate with mobile mental and behavioral | 8 | | health services when responding to individuals who appear to | 9 | | be in a mental or behavioral health emergency while engaged in | 10 | | conduct alleged to constitute a non-violent misdemeanor. | 11 | | Section 25. State goals. | 12 | | (a) 9-1-1 call centers, emergency services dispatched | 13 | | through 9-1-1 call centers, and the mobile mental and | 14 | | behavioral health service established by the Division of | 15 | | Mental Health must coordinate their services so that the | 16 | | following State goals are achieved. | 17 | | (b) Appropriate mobile response service for mental and | 18 | | behavioral health emergencies will be available regardless of | 19 | | whether the initial contact was with 988, 911 or directly with | 20 | | an emergency service dispatched through 9-1-1. Appropriate | 21 | | mobile response services must: | 22 | | (1) Ensure that individuals experiencing mental or | 23 | | behavioral health crises are diverted from hospitalization | 24 | | or incarceration whenever possible, and are instead linked | 25 | | with available appropriate community services. |
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| 1 | | (2) Include the option of on-site care if that type of | 2 | | care is appropriate and does not override the care | 3 | | decisions of the individual receiving care. Providing care | 4 | | in the community, through methods like mobile crisis | 5 | | units, is encouraged. If effective care is provided on | 6 | | site, and if it is consistent with the care decisions of | 7 | | the individual receiving the care, further transportation | 8 | | to other medical providers is not required by this Act. | 9 | | (3) Recommend appropriate referrals for available | 10 | | community services if the individual receiving on-site | 11 | | care is not already in a treatment relationship with a | 12 | | service provider or is unsatisfied with their current | 13 | | service providers. Such referrals shall take into | 14 | | consideration waiting lists and copayments, which may | 15 | | present barriers to access. | 16 | | (4) be subject to the care decisions of the individual | 17 | | receiving care, provide transportation for any individual | 18 | | experiencing a mental or behavioral health emergency. | 19 | | Transportation shall be to the most integrated and least | 20 | | restrictive setting appropriate in the community, such as | 21 | | to the individual's home or chosen location, community | 22 | | crisis respite centers, clinic settings, behavioral health | 23 | | centers, or the offices of particular medical care | 24 | | providers with existing treatment relationships to the | 25 | | individual seeking care. | 26 | | (5) Prioritize requests for emergency assistance. |
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| 1 | | Provide guidance for prioritizing calls for assistance and | 2 | | maximum response time in relation to the type of emergency | 3 | | reported. | 4 | | (6) Provide appropriate response times. From the time | 5 | | of first notification, provide the response within | 6 | | response time appropriate to the care requirements of the | 7 | | individual with an emergency. | 8 | | (7) Require appropriate responder training. Responders | 9 | | must have adequate training to address the needs of | 10 | | individuals experiencing a mental or behavioral health | 11 | | emergency. Adequate training at least includes: | 12 | | (A) training in de-escalation techniques; | 13 | | (B) knowledge of local community services and | 14 | | supports; and | 15 | | (C) training in respectful interaction with people | 16 | | experiencing mental or behavioral health crises, | 17 | | including the concepts of stigma and respectful | 18 | | language. | 19 | | (8) Require Training from Individuals with Lived | 20 | | Experience. Training shall be provided by individuals with | 21 | | lived experience to the extent available. | 22 | | (9) Adopt guidelines directing referral to restrictive | 23 | | care settings. Responders must have guidelines to follow | 24 | | when considering whether to refer an individual to more | 25 | | restrictive forms of care, like emergency room or hospital | 26 | | settings. |
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| 1 | | (10) Specify regional best practices. Responders | 2 | | providing these services must do so consistently with best | 3 | | practices, which include respecting the care choices of | 4 | | the individuals receiving assistance. | 5 | | (11) Adopt system for directing care in advance of an | 6 | | emergency. Select and publicly identify a system that | 7 | | allows individuals who voluntarily chose to do so to | 8 | | provide confidential advanced care directions to | 9 | | individuals providing services under this Act. No system | 10 | | for providing advanced care direction may be implemented | 11 | | unless the Division of Mental Health approves it as | 12 | | confidential, available to individuals at all economic | 13 | | levels, and non-stigmatizing. The Division of Mental | 14 | | Health may defer this requirement for providing a system | 15 | | for advanced care direction if it determines that no | 16 | | existing systems can currently meet these requirements. | 17 | | (12) Train dispatching staff. The personnel staffing | 18 | | 911, 311, or other emergency response intake systems must | 19 | | be provided with adequate training to assess whether | 20 | | dispatching emergency mental health responders under this | 21 | | Act is appropriate. | 22 | | (13) Establish protocol for emergency responder | 23 | | coordination. Establish a protocol for Responders, law | 24 | | enforcement, and fire and ambulance services to request | 25 | | assistance from each other, and train these groups on the | 26 | | protocol. |
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| 1 | | (14) Integrate law enforcement. Provide for law | 2 | | enforcement to request Responder assistance whenever law | 3 | | enforcement engages an individual appropriate for services | 4 | | under this Act. If law enforcement would typically request | 5 | | EMS assistance when it encounters an individual with a | 6 | | physical health emergency, law enforcement shall similarly | 7 | | dispatch mental or behavioral health personnel or medical | 8 | | transportation when it encounters an individual in a | 9 | | mental or behavioral health emergency. | 10 | | Section 30. State prohibitions. 9-1-1 call centers, | 11 | | emergency services dispatched through 9-1-1 call centers, and | 12 | | the mobile mental and behavioral health service established by | 13 | | the Division of Mental Health must coordinate their services | 14 | | so that the following State prohibitions are avoided: | 15 | | (1) Law enforcement responsibility for providing mental | 16 | | and behavioral health care. In any area where responders are | 17 | | available for dispatch, law enforcement shall not be | 18 | | dispatched to respond to an individual requiring mental or | 19 | | behavioral health care unless that individual is (i) involved | 20 | | in a suspected violation of the criminal laws of this State, or | 21 | | (ii) presents a threat of physical injury to self or others. | 22 | | (A) Standing on its own or in combination with each | 23 | | other, the fact that an individual is experiencing a | 24 | | mental or behavioral health emergency, or has a mental | 25 | | health, behavioral health, or other diagnosis, is not |
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| 1 | | sufficient to justify an assessment that the individual is | 2 | | a threat of physical injury to self or others, or requires | 3 | | a law enforcement response to a request for emergency | 4 | | response or medical transportation. | 5 | | (B) If, based on its assessment of the threat to | 6 | | public safety, law enforcement would not accompany medical | 7 | | transportation responding to a physical health emergency, | 8 | | law enforcement may not accompany emergency response or | 9 | | medical transportation personnel responding to a mental or | 10 | | behavioral health emergency that presents an equivalent | 11 | | level of threat to self or public safety. | 12 | | (C) 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 responders if law enforcement does not | 16 | | interfere with the provision of emergency response or | 17 | | transportation services. To the extent practical, not | 18 | | interfering with services includes remaining sufficiently | 19 | | distant from or out of sight of the individual receiving | 20 | | care so that law enforcement presence is unlikely to | 21 | | escalate the emergency. | 22 | | (2) Responder involvement in involuntary commitment. In | 23 | | order to maintain the appropriate care relationship, | 24 | | responders shall not in any way assist in the involuntary | 25 | | commitment of an individual beyond (i) reporting to their | 26 | | dispatching entity or to law enforcement that they believe the |
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| 1 | | situation requires assistance the responders are not permitted | 2 | | to provide under this section; (ii) providing witness | 3 | | statements; and (iii) fulfilling reporting requirements the | 4 | | responders may have under their professional ethical | 5 | | obligations or laws of this State. This prohibition shall not | 6 | | interfere with any responder's ability to provide physical or | 7 | | mental health care. | 8 | | (3) Use of law enforcement for transportation. In any area | 9 | | where responders are available for dispatch, law enforcement | 10 | | shall not be used to provide transportation to access mental | 11 | | or behavioral health care, or travel between mental or | 12 | | behavioral health care providers, except where no alternative | 13 | | is available. | 14 | | (4) Reduction of educational institution obligations: The | 15 | | services coordinated under this Act may not be used to replace | 16 | | any service an educational institution is required to provide | 17 | | to a student. It shall not substitute for appropriate special | 18 | | education and related services that schools are required to | 19 | | provide by any law. | 20 | | Section 35. Non-violent misdemeanors. The Division of | 21 | | Mental Health's Guidance for 9-1-1 call centers and emergency | 22 | | services dispatched through 9-1-1 call centers for | 23 | | coordinating the response to individuals who appear to be in a | 24 | | mental or behavioral health emergency while engaging in | 25 | | conduct alleged to constitute a non-violent misdemeanor shall |
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| 1 | | promote the following: | 2 | | (1) Prioritization of Health Care. To the greatest extent | 3 | | practicable, community-based mental or behavioral health | 4 | | services should be provided before addressing law enforcement | 5 | | objectives. | 6 | | (2) Diversion from Further Criminal Justice Involvement. | 7 | | To the greatest extent practicable, individuals should be | 8 | | referred to health care services with the potential to reduce | 9 | | the likelihood of further law enforcement engagement. | 10 | | Section 40. Regional Advisory Committees. The Division of | 11 | | Mental Health shall establish regional advisory committees in | 12 | | each EMS Region to advise on emergency response systems for | 13 | | mental and behavioral health. Each Regional Advisory Committee | 14 | | shall consist of representatives of the: EMS Medical Directors | 15 | | Committee, as constituted under the Emergency Medical Services | 16 | | (EMS) Systems Act, or other similar committee serving the | 17 | | medical needs of the jurisdiction; representatives of law | 18 | | enforcement officials with jurisdiction in the Emergency | 19 | | Medical Services (EMS) Regions; representatives of the unions | 20 | | representing EMS or emergency mental and behavioral health | 21 | | responders, or both; and advocates from the mental health, | 22 | | behavioral health, intellectual disability, and developmental | 23 | | disability communities. The majority of advocates on the | 24 | | Emergency Response Equity Committee must either be individuals | 25 | | with a lived experience of a condition commonly regarded as a |
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| 1 | | mental health or behavioral health disability, developmental | 2 | | disability, or intellectual disability, or be from | 3 | | organizations primarily composed of such individuals. The | 4 | | members of the Committee shall also reflect the racial | 5 | | demographics of the jurisdiction served. Subject to the | 6 | | oversight of the Illinois Department of Human Services | 7 | | Division of Mental Health, the EMS Medical Directors Committee | 8 | | is responsible for convening the meetings of the committee. | 9 | | Interested units of local government may also have | 10 | | representatives on the committee subject to approval by the | 11 | | Division of Mental Health, and so long as this participation | 12 | | is structured in such a way that it does not reduce the | 13 | | influence of the advocates on the committee. | 14 | | Section 45. Scope. This Act applies to persons of all | 15 | | ages, both children and adults. This Act does not limit an | 16 | | individual's right to control his or her own medical care. No | 17 | | provision of this Act shall be interpreted in such a way as to | 18 | | limit an individual's right to choose his or her preferred | 19 | | course of care or to reject care. No provision of this Act | 20 | | shall be interpreted to promote or provide justification for | 21 | | the use of restraints when providing mental or behavioral | 22 | | health care. | 23 | | Each 9-1-1 call center and emergency service dispatched | 24 | | through a 9-1-1 call center must begin coordinating their | 25 | | activities with the mobile mental and behavioral health |
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| 1 | | services established by the Division of Mental Health once the | 2 | | mobile mental and behavioral health service is available in | 3 | | their jurisdiction. | 4 | | Section 105. The Emergency Telephone System Act is amended | 5 | | by changing Section 4 as follows:
| 6 | | (50 ILCS 750/4) (from Ch. 134, par. 34)
| 7 | | (Section scheduled to be repealed on December 31, 2021)
| 8 | | Sec. 4. 9-1-1 system; services; maintenance of | 9 | | records. (a) Every system shall include police, | 10 | | firefighting, and emergency medical and
ambulance services, | 11 | | and may include other emergency services. The system may | 12 | | incorporate private
ambulance service. In those areas in which | 13 | | a public safety agency of the State
provides such emergency | 14 | | services, the system shall include such public safety | 15 | | agencies. Every system shall dispatch emergency response | 16 | | services for individuals requiring mental or behavioral health | 17 | | care in compliance with the requirements of the Community | 18 | | Emergency Services and Support Act. | 19 | | (b) Every 9-1-1 Authority shall maintain records of the | 20 | | numbers of calls received, the type of service the caller | 21 | | requested, and the type of service dispatched in response to | 22 | | each call. For emergency medical and ambulance services, the | 23 | | records shall indicate whether physical, mental, or behavioral | 24 | | health response or transportation were requested, and what |
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| 1 | | type of response or transportation was dispatched. When a | 2 | | mental or behavioral health response is requested at a | 3 | | primary, secondary, or post-secondary educational institution, | 4 | | the 9-1-1 Authority shall record which type of educational | 5 | | institution was involved. Broken down geographically by police | 6 | | district, every 9-1-1 Authority shall create aggregated, | 7 | | non-individualized monthly reports detailing the system's | 8 | | activities, including the frequency of dispatch of each type | 9 | | of service and the information required to be collected by | 10 | | this subpart. These reports shall be available to both the | 11 | | Department of Human Service Division of Mental Health and to | 12 | | the Administrator of the 9-1-1 Authority, for the purpose of | 13 | | conducting an annual analysis of service gaps, and to the | 14 | | public upon request.
| 15 | | (Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17 .)".
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