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


Rep. Kelly M. Cassidy

Filed: 4/20/2021





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2    AMENDMENT NO. ______. Amend House Bill 2784 by replacing
3everything after the enacting clause with the following:
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.



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1In light of that experience, the General Assembly finds that
2in order to promote and protect the health, safety, and
3welfare of the public, it is necessary and in the public
4interest to provide emergency response, with or without
5medical transportation, to individuals requiring mental health
6or behavioral health services in a manner that is
7substantially equivalent to the response already provided to
8individuals who require emergency physical health care.
9    Section 10. Applicability; home rule. This Act applies to
10every unit of local government that provides or coordinates
11ambulance or similar emergency medical response or
12transportation services for individuals with emergency medical
13needs. A home rule unit may not respond to or provide services
14for a mental or behavioral health emergency, or create a
15transportation plan or other regulation, relating to the
16provision of mental or behavioral health services in a manner
17inconsistent with this Act. This Act is a limitation under
18subsection (i) of Section 6 of Article VII of the Illinois
19Constitution on the concurrent exercise by home rule units of
20powers and functions exercised by the State.
21    Section 15. Definitions. As used in this Act:
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



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1individual may require prompt care, support, or assessment at
2the individual's location.
3    "Mental or behavioral health" means any health condition
4involving changes in thinking, emotion, or behavior, and that
5the medical community treats as distinct from physical health
7    "Physical health" means a health condition that the
8medical community treats as distinct from mental or behavioral
9health care.
10    "Community services" and "community-based mental or
11behavioral health services" may include both public and
12private settings.
13    "Treatment relationship" means an active association with
14a mental or behavioral care provider able to respond in an
15appropriate amount of time to requests for care.
16    "Responder" means any person engaging with a member of the
17public to provide the mobile mental and behavioral service
18established in conjunction with the Division of Mental Health
19establishing the 988 emergency number.
20    Section 20. Coordination with Division of Mental Health.
21Each 9-1-1 call center and provider of emergency services
22dispatched through a 9-1-1 system must coordinate with the
23mobile mental and behavioral health services established by
24the Division of Mental Health so that the following State
25goals and State prohibitions are met whenever a person



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1interacts with one of these entities for the purpose seeking
2emergency mental and behavioral health care or when one of
3these entities recognizes the appropriateness of providing
4mobile mental or behavioral health care to an individual with
5whom they have engaged. The Division of Mental Health is also
6directed to provide guidance regarding whether and how these
7entities should coordinate with mobile mental and behavioral
8health services when responding to individuals who appear to
9be in a mental or behavioral health emergency while engaged in
10conduct alleged to constitute a non-violent misdemeanor.
11    Section 25. State goals.
12    (a) 9-1-1 call centers, emergency services dispatched
13through 9-1-1 call centers, and the mobile mental and
14behavioral health service established by the Division of
15Mental Health must coordinate their services so that the
16following State goals are achieved.
17    (b) Appropriate mobile response service for mental and
18behavioral health emergencies will be available regardless of
19whether the initial contact was with 988, 911 or directly with
20an emergency service dispatched through 9-1-1. Appropriate
21mobile 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,
11emergency services dispatched through 9-1-1 call centers, and
12the mobile mental and behavioral health service established by
13the Division of Mental Health must coordinate their services
14so that the following State prohibitions are avoided:
15    (1) Law enforcement responsibility for providing mental
16and behavioral health care. In any area where responders are
17available for dispatch, law enforcement shall not be
18dispatched to respond to an individual requiring mental or
19behavioral health care unless that individual is (i) involved
20in 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
23order to maintain the appropriate care relationship,
24responders shall not in any way assist in the involuntary
25commitment of an individual beyond (i) reporting to their
26dispatching entity or to law enforcement that they believe the



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1situation requires assistance the responders are not permitted
2to provide under this section; (ii) providing witness
3statements; and (iii) fulfilling reporting requirements the
4responders may have under their professional ethical
5obligations or laws of this State. This prohibition shall not
6interfere with any responder's ability to provide physical or
7mental health care.
8    (3) Use of law enforcement for transportation. In any area
9where responders are available for dispatch, law enforcement
10shall not be used to provide transportation to access mental
11or behavioral health care, or travel between mental or
12behavioral health care providers, except where no alternative
13is available.
14    (4) Reduction of educational institution obligations: The
15services coordinated under this Act may not be used to replace
16any service an educational institution is required to provide
17to a student. It shall not substitute for appropriate special
18education and related services that schools are required to
19provide by any law.
20    Section 35. Non-violent misdemeanors. The Division of
21Mental Health's Guidance for 9-1-1 call centers and emergency
22services dispatched through 9-1-1 call centers for
23coordinating the response to individuals who appear to be in a
24mental or behavioral health emergency while engaging in
25conduct alleged to constitute a non-violent misdemeanor shall



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1promote the following:
2    (1) Prioritization of Health Care. To the greatest extent
3practicable, community-based mental or behavioral health
4services should be provided before addressing law enforcement
6    (2) Diversion from Further Criminal Justice Involvement.
7To the greatest extent practicable, individuals should be
8referred to health care services with the potential to reduce
9the likelihood of further law enforcement engagement.
10    Section 40. Regional Advisory Committees. The Division of
11Mental Health shall establish regional advisory committees in
12each EMS Region to advise on emergency response systems for
13mental and behavioral health. Each Regional Advisory Committee
14shall consist of representatives of the: EMS Medical Directors
15Committee, as constituted under the Emergency Medical Services
16(EMS) Systems Act, or other similar committee serving the
17medical needs of the jurisdiction; representatives of law
18enforcement officials with jurisdiction in the Emergency
19Medical Services (EMS) Regions; representatives of the unions
20representing EMS or emergency mental and behavioral health
21responders, or both; and advocates from the mental health,
22behavioral health, intellectual disability, and developmental
23disability communities. The majority of advocates on the
24Emergency Response Equity Committee must either be individuals
25with a lived experience of a condition commonly regarded as a



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1mental health or behavioral health disability, 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
7Division of Mental Health, the EMS Medical Directors Committee
8is responsible 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 so long as this participation
12is structured in such a way that it does not reduce the
13influence of the advocates on the committee.
14    Section 45. Scope. This Act applies to persons of all
15ages, both children and adults. This Act does not limit an
16individual's right to control his or her own medical care. No
17provision of this Act shall be interpreted in such a way as to
18limit an individual's right to choose his or her preferred
19course of care or to reject care. No provision of this Act
20shall be interpreted to promote or provide justification for
21the use of restraints when providing mental or behavioral
22health care.
23    Each 9-1-1 call center and emergency service dispatched
24through a 9-1-1 call center must begin coordinating their
25activities with the mobile mental and behavioral health



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1services established by the Division of Mental Health once the
2mobile mental and behavioral health service is available in
3their jurisdiction.
4    Section 105. The Emergency Telephone System Act is amended
5by 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
9records.     (a) Every system shall include police,
10firefighting, and emergency medical and ambulance services,
11and may include other emergency services. The system may
12incorporate private ambulance service. In those areas in which
13a public safety agency of the State provides such emergency
14services, the system shall include such public safety
15agencies. Every system shall dispatch emergency response
16services for individuals requiring mental or behavioral health
17care in compliance with the requirements of the Community
18Emergency Services and Support Act.
19    (b) Every 9-1-1 Authority shall maintain records of the
20numbers of calls received, the type of service the caller
21requested, and the type of service dispatched in response to
22each call. For emergency medical and ambulance services, the
23records shall indicate whether physical, mental, or behavioral
24health response or transportation were requested, and what



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1type of response or transportation was dispatched. When a
2mental or behavioral health response is requested at a
3primary, secondary, or post-secondary educational institution,
4the 9-1-1 Authority shall record which type of educational
5institution was involved. Broken down geographically by police
6district, every 9-1-1 Authority shall create aggregated,
7non-individualized monthly reports detailing the system's
8activities, including the frequency of dispatch of each type
9of service and the information required to be collected by
10this subpart. These reports shall be available to both the
11Department of Human Service Division of Mental Health and to
12the Administrator of the 9-1-1 Authority, for the purpose of
13conducting an annual analysis of service gaps, and to the
14public upon request.
15(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)".