Full Text of HB2784 102nd General Assembly
HB2784sam001 102ND GENERAL ASSEMBLY | Sen. Robert Peters Filed: 5/14/2021
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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. | 5 | | (a) This Act may be cited as the Community Emergency | 6 | | Services and Support Act. | 7 | | (b) This Act may be referred to as the Stephon Edward Watts | 8 | | Act. | 9 | | Section 5. Findings. The General Assembly recognizes that | 10 | | the Illinois Department of Human Services Division of Mental | 11 | | Health is preparing to provide mobile mental and behavioral | 12 | | health services to all Illinoisans as part of the federally | 13 | | mandated adoption of the 9-8-8 phone number. The General | 14 | | Assembly also recognizes that many cities and some states have | 15 | | successfully established mobile emergency mental and | 16 | | behavioral health services as part of their emergency response |
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| 1 | | system to support people who need such support and do not | 2 | | present a threat of physical violence to the responders. In | 3 | | light of that experience, the General Assembly finds that in | 4 | | order to promote and protect the health, safety, and welfare | 5 | | of the public, it is necessary and in the public interest to | 6 | | provide emergency response, with or without medical | 7 | | transportation, to individuals requiring mental health or | 8 | | behavioral health services in a manner that is substantially | 9 | | equivalent to the response already provided to individuals who | 10 | | require emergency physical health care. | 11 | | This Act applies to every unit of local government that | 12 | | provides or coordinates ambulance or similar emergency medical | 13 | | response or transportation services for individuals with | 14 | | emergency medical needs. A home rule unit may not respond to or | 15 | | provide services for a mental or behavioral health emergency, | 16 | | or create a transportation plan or other regulation, relating | 17 | | to the provision of mental or behavioral health services in a | 18 | | manner inconsistent with this Act. This Act is a limitation | 19 | | under subsection (i) of Section 6 of Article VII of the | 20 | | Illinois Constitution on the concurrent exercise by home rule | 21 | | units of powers and functions exercised by the State. | 22 | | Section 10. Definitions. As used in this Act: | 23 | | "Division of Mental Health" means the Division of Mental | 24 | | Health of the Department of Human Services. | 25 | | "Emergency" means an emergent circumstance caused by a |
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| 1 | | health condition, regardless of whether it is perceived as | 2 | | physical, mental, or behavioral in nature, for which an | 3 | | individual may require prompt care, support, or assessment at | 4 | | the individual's location. | 5 | | "Mental or behavioral health" means any health condition | 6 | | involving changes in thinking, emotion, or behavior, and that | 7 | | the medical community treats as distinct from physical health | 8 | | care. | 9 | | "Physical health" means a health condition that the | 10 | | medical community treats as distinct from mental or behavioral | 11 | | health care. | 12 | | "PSAP" means a Public Safety Answering Point | 13 | | tele-communicator. | 14 | | "Community services" and "community-based mental or | 15 | | behavioral health services" may include both public and | 16 | | private settings. | 17 | | "Treatment relationship" means an active association with | 18 | | a mental or behavioral care provider able to respond in an | 19 | | appropriate amount of time to requests for care. | 20 | | "Responder" is any person engaging with a member of the | 21 | | public to provide the mobile mental and behavioral service | 22 | | established in conjunction with the Division of Mental Health | 23 | | establishing the 9-8-8 emergency number. A responder is not an | 24 | | EMS Paramedic or EMT as defined in the Emergency Medical | 25 | | Services (EMS) Systems Act unless that responding agency has | 26 | | agreed to provide a specialized response in accordance with |
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| 1 | | the Division of Mental Health's services offered through its | 2 | | 9-8-8 number and has met all the requirements to offer that | 3 | | service through that system.
| 4 | | Section 15. Coordination with Division of Mental Health. | 5 | | Each 9-1-1 call center and provider of emergency services | 6 | | dispatched through a 9-1-1 system must coordinate with the | 7 | | mobile mental and behavioral health services established by | 8 | | the Division of Mental Health so that the following State | 9 | | goals and State prohibitions are met whenever a person | 10 | | interacts with one of these entities for the purpose seeking | 11 | | emergency mental and behavioral health care or when one of | 12 | | these entities recognizes the appropriateness of providing | 13 | | mobile mental or behavioral health care to an individual with | 14 | | whom they have engaged. The Division of Mental Health is also | 15 | | directed to provide guidance regarding whether and how these | 16 | | entities should coordinate with mobile mental and behavioral | 17 | | health services when responding to individuals who appear to | 18 | | be in a mental or behavioral health emergency while engaged in | 19 | | conduct alleged to constitute a non-violent misdemeanor. | 20 | | Section 20. State goals. | 21 | | (a) 9-1-1 PSAPs, emergency services dispatched through | 22 | | 9-1-1 PSAPs, and the mobile mental and behavioral health | 23 | | service established by the Division of Mental Health must | 24 | | coordinate their services so that the State goals listed in |
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| 1 | | this Section are achieved. Appropriate mobile response service | 2 | | for mental and behavioral health emergencies shall be | 3 | | available regardless of whether the initial contact was with | 4 | | 9-8-8, 9-1-1 or directly with an emergency service dispatched | 5 | | through 9-1-1. Appropriate mobile response services must: | 6 | | (1) ensure that individuals experiencing mental or | 7 | | behavioral health crises are diverted from hospitalization | 8 | | or incarceration whenever possible, and are instead linked | 9 | | with available appropriate community services;
| 10 | | (2) include the option of on-site care if that type of | 11 | | care is appropriate and does not override the care | 12 | | decisions of the individual receiving care. Providing care | 13 | | in the community, through methods like mobile crisis | 14 | | units, is encouraged. If effective care is provided on | 15 | | site, and if it is consistent with the care decisions of | 16 | | the individual receiving the care, further transportation | 17 | | to other medical providers is not required by this Act; | 18 | | (3) recommend appropriate referrals for available | 19 | | community services if the individual receiving on-site | 20 | | care is not already in a treatment relationship with a | 21 | | service provider or is unsatisfied with their current | 22 | | service providers. The referrals shall take into | 23 | | consideration waiting lists and copayments, which may | 24 | | present barriers to access;
| 25 | | (4) subject to the care decisions of the individual | 26 | | receiving care, provide transportation for any individual |
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| 1 | | experiencing a mental or behavioral health emergency. | 2 | | Transportation shall be to the most integrated and least | 3 | | restrictive setting appropriate in the community, such as | 4 | | to the individual's home or chosen location, community | 5 | | crisis respite centers, clinic settings, behavioral health | 6 | | centers, or the offices of particular medical care | 7 | | providers with existing treatment relationships to the | 8 | | individual seeking care; | 9 | | (5) provide guidance for prioritizing calls for | 10 | | assistance and maximum response time in relation to the | 11 | | type of emergency reported; | 12 | | (6) from the time of first notification, provide the | 13 | | response within response time appropriate to the care | 14 | | requirements of the individual with an emergency. | 15 | | (b) Responders must have adequate training to address the | 16 | | needs of individuals experiencing a mental or behavioral | 17 | | health emergency. Adequate training at least includes: | 18 | | (1) training in de-escalation techniques; | 19 | | (2) knowledge of local community services and | 20 | | supports; and
| 21 | | (3) training in respectful interaction with people | 22 | | experiencing mental or behavioral health crises, including | 23 | | the concepts of stigma and respectful language. | 24 | | (c) The Division of Mental Health, in consultation with | 25 | | the Regional Advisory Committees created in Section 40, shall | 26 | | determine the appropriate credentials for the mental health |
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| 1 | | providers responding to calls, including to what extent the | 2 | | responders must have certain credentials and licensing, and to | 3 | | what extent the responders can be peer support professionals. | 4 | | (d) Training shall be provided by individuals with lived | 5 | | experience to the extent available. | 6 | | (e) Responders must have guidelines to follow when | 7 | | considering whether to refer an individual to more restrictive | 8 | | forms of care, like emergency room or hospital settings. | 9 | | (f) Responders providing these services must do so | 10 | | consistently with best practices, which include respecting the | 11 | | care choices of the individuals receiving assistance. Regional | 12 | | best practices may be broken down into sub-regions, as | 13 | | appropriate to reflect local resources and conditions. With | 14 | | the agreement of the impacted EMS Regions, providers of | 15 | | emergency response to physical emergencies may participate in | 16 | | another EMS Region for mental and behavioral response, if that | 17 | | participation shall provide a better service to individuals | 18 | | experiencing a mental or behavioral health emergency. | 19 | | (g) The Division of Mental Health shall select and | 20 | | publicly identify a system that allows individuals who | 21 | | voluntarily chose to do so to provide confidential advanced | 22 | | care directions to individuals providing services under this | 23 | | Act. No system for providing advanced care direction may be | 24 | | implemented unless the Division of Mental Health approves it | 25 | | as confidential, available to individuals at all economic | 26 | | levels, and non-stigmatizing. The Division of Mental Health |
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| 1 | | may defer this requirement for providing a system for advanced | 2 | | care direction if it determines that no existing systems can | 3 | | currently meet these requirements. | 4 | | (h) The personnel staffing 9-1-1, 3-1-1, or other | 5 | | emergency response intake systems must be provided with | 6 | | adequate training to assess whether dispatching emergency | 7 | | mental health responders under this Act is appropriate. | 8 | | (i) The Division of Mental Health shall establish a | 9 | | protocol for responders, law enforcement, and fire and | 10 | | ambulance services to request assistance from each other, and | 11 | | train these groups on the protocol. | 12 | | (j) The Division of Mental Health shall provide for law | 13 | | enforcement to request responder assistance whenever law | 14 | | enforcement engages an individual appropriate for services | 15 | | under this Act. If law enforcement would typically request EMS | 16 | | assistance when it encounters an individual with a physical | 17 | | health emergency, law enforcement shall similarly dispatch | 18 | | mental or behavioral health personnel or medical | 19 | | transportation when it encounters an individual in a mental or | 20 | | behavioral health emergency. | 21 | | Section 25. State prohibitions. | 22 | | (a) 9-1-1 PSAPs, emergency services dispatched through | 23 | | 9-1-1 PSAPs, and the mobile mental and behavioral health | 24 | | service established by the Division of Mental Health must | 25 | | coordinate their services so that, based on the information |
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| 1 | | provided to them, the following State prohibitions are | 2 | | avoided: | 3 | | (1) In any area where responders are available for | 4 | | dispatch, law enforcement shall not be dispatched to | 5 | | respond to an individual requiring mental or behavioral | 6 | | health care unless that individual is (i) involved in a | 7 | | suspected violation of the criminal laws of this State, or | 8 | | (ii) presents a threat of physical injury to self or | 9 | | others. Responders are not considered available for | 10 | | dispatch under this Section if 9-8-8 reports that it | 11 | | cannot dispatch appropriate service within the maximum | 12 | | response times established by each Regional Advisory | 13 | | Committee under Section 45. | 14 | | (2) Standing on its own or in combination with each | 15 | | other, the fact that an individual is experiencing a | 16 | | mental or behavioral health emergency, or has a mental | 17 | | health, behavioral health, or other diagnosis, is not | 18 | | sufficient to justify an assessment that the individual is | 19 | | a threat of physical injury to self or others, or requires | 20 | | a law enforcement response to a request for emergency | 21 | | response or medical transportation. | 22 | | (3) If, based on its assessment of the threat to | 23 | | public safety, law enforcement would not accompany medical | 24 | | transportation responding to a physical health emergency, | 25 | | unless requested by responders, law enforcement may not | 26 | | accompany emergency response or medical transportation |
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| 1 | | personnel responding to a mental or behavioral health | 2 | | emergency that presents an equivalent level of threat to | 3 | | self or public safety. | 4 | | (4) Without regard to an assessment of threat to self | 5 | | or threat to public safety, law enforcement may station | 6 | | personnel so that they can rapidly respond to requests for | 7 | | assistance from responders if law enforcement does not | 8 | | interfere with the provision of emergency response or | 9 | | transportation services. To the extent practical, not | 10 | | interfering with services includes remaining sufficiently | 11 | | distant from or out of sight of the individual receiving | 12 | | care so that law enforcement presence is unlikely to | 13 | | escalate the emergency. | 14 | | (b) In order to maintain the appropriate care | 15 | | relationship, responders shall not in any way assist in the | 16 | | involuntary commitment of an individual beyond (i) reporting | 17 | | to their dispatching entity or to law enforcement that they | 18 | | believe the situation requires assistance the responders are | 19 | | not permitted to provide under this Section; (ii) providing | 20 | | witness statements; and (iii) fulfilling reporting | 21 | | requirements the responders may have under their professional | 22 | | ethical obligations or laws of this state. This prohibition | 23 | | shall not interfere with any responder's ability to provide | 24 | | physical or mental health care. | 25 | | (c) Use of law enforcement for transportation. In any area | 26 | | where responders are available for dispatch, unless requested |
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| 1 | | by responders, law enforcement shall not be used to provide | 2 | | transportation to access mental or behavioral health care, or | 3 | | travel between mental or behavioral health care providers, | 4 | | except where no alternative is available. | 5 | | (d) Reduction of educational institution obligations: The | 6 | | services coordinated under this Act may not be used to replace | 7 | | any service an educational institution is required to provide | 8 | | to a student. It shall not substitute for appropriate special | 9 | | education and related services that schools are required to | 10 | | provide by any law. | 11 | | Section 30. Non-violent misdemeanors. The Division of | 12 | | Mental Health's Guidance for 9-1-1 PSAPs and emergency | 13 | | services dispatched through 9-1-1 PSAPs for coordinating the | 14 | | response to individuals who appear to be in a mental or | 15 | | behavioral health emergency while engaging in conduct alleged | 16 | | to constitute a non-violent misdemeanor shall promote the | 17 | | following: | 18 | | (a) Prioritization of Health Care. To the greatest | 19 | | extent practicable, community-based mental or behavioral | 20 | | health services should be provided before addressing law | 21 | | enforcement objectives. | 22 | | (b) Diversion from Further Criminal Justice | 23 | | Involvement. To the greatest extent practicable, | 24 | | individuals should be referred to health care services | 25 | | with the potential to reduce the likelihood of further law |
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| 1 | | enforcement engagement. | 2 | | Section 35. Statewide Advisory Committee. | 3 | | (a) The Division of Mental Health shall establish a | 4 | | Statewide Advisory Committee to review and make | 5 | | recommendations for aspects of coordinating 9-1-1 and the | 6 | | 9-8-8 mobile mental health response system most appropriately | 7 | | addressed on a State level. | 8 | | (b) Issues to be addressed by the Statewide Advisory | 9 | | Committee include, but are not limited to, addressing changes | 10 | | necessary in 9-1-1 call taking protocols and scripts used in | 11 | | 9-1-1 PSAPs where those protocols and scripts are based on or | 12 | | otherwise dependent on national providers for their operation.
| 13 | | (c) The Statewide Advisory Committee shall recommend a | 14 | | system for gathering data related to the coordination of the | 15 | | 9-1-1 and 9-8-8 systems for purposes of allowing the parties | 16 | | to make ongoing improvements in that system. As practical, the | 17 | | system shall attempt to determine issues including, but not | 18 | | limited to: | 19 | | (1) the volume of calls coordinated between 9-1-1 and | 20 | | 9-8-8; | 21 | | (2) the volume of referrals from other first | 22 | | responders to 9-8-8; | 23 | | (3) the volume and type of calls deemed appropriate | 24 | | for referral to 9-8-8 but could not be served by 9-8-8 | 25 | | because of capacity restrictions or other reasons; |
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| 1 | | (4) the appropriate information to improve | 2 | | coordination between 9-1-1 and 9-8-8; and | 3 | | (5) the appropriate information to improve the 9-8-8 | 4 | | system, if the information is most appropriately gathered | 5 | | at the 9-1-1 PSAPs. | 6 | | (d) The Statewide Advisory Committee shall consist of: | 7 | | (1) the Statewide 9-1-1 Administrator, ex officio; | 8 | | (2) one representative designated by the Illinois | 9 | | Chapter of National Emergency Number Association (NENA); | 10 | | (3) one representative designated by the Illinois | 11 | | Chapter of Association of Public Safety Communications | 12 | | Officials (APCO); | 13 | | (4) one representative of the Division of Mental | 14 | | Health; | 15 | | (5) one representative of the Illinois Department of | 16 | | Public Health; | 17 | | (6) one representative of a statewide organization of | 18 | | EMS responders; | 19 | | (7) one representative of a statewide organization of | 20 | | fire chiefs; | 21 | | (8) two representatives of statewide organizations of | 22 | | law enforcement; | 23 | | (9) two representatives of mental health, behavioral | 24 | | health, or substance abuse providers; and | 25 | | (10) four representatives of advocacy organizations | 26 | | either led by or consisting primarily of individuals with |
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| 1 | | intellectual or developmental disabilities, individuals | 2 | | with behavioral disabilities, or individuals with lived | 3 | | experience. | 4 | | The members of the Statewide Advisory Committee, other | 5 | | than the Statewide 9-1-1 Administrator, shall be appointed by | 6 | | the Secretary of Human Services. | 7 | | Section 40. Regional Advisory Committees. | 8 | | (a) The Division of Mental Health shall establish Regional | 9 | | Advisory Committees in each EMS Region to advise on regional | 10 | | issues related to emergency response systems for mental and | 11 | | behavioral health. The Secretary of Human Services shall | 12 | | appoint the members of the Regional Advisory Committees. Each | 13 | | Regional Advisory Committee shall consist of: | 14 | | (1) representatives of the 9-1-1 PSAPs in the region; | 15 | | (2) representatives of the EMS Medical Directors | 16 | | Committee, as constituted under the Emergency Medical | 17 | | Services (EMS) Systems Act, or other similar committee | 18 | | serving the medical needs of the jurisdiction; | 19 | | (3) representatives of law enforcement officials with | 20 | | jurisdiction in the Emergency Medical Services (EMS) | 21 | | Regions; | 22 | | (4) representatives of both the EMS providers and the | 23 | | unions representing EMS or emergency mental and behavioral | 24 | | health responders, or both; and | 25 | | (5) advocates from the mental health, behavioral |
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| 1 | | health, intellectual disability, and developmental | 2 | | disability communities. | 3 | | (b) The majority of advocates on the Emergency Response | 4 | | Equity Committee must either be individuals with a lived | 5 | | experience of a condition commonly regarded as a mental health | 6 | | or behavioral health disability, developmental disability, or | 7 | | intellectual disability, or be from organizations primarily | 8 | | composed of such individuals. The members of the Committee | 9 | | shall also reflect the racial demographics of the jurisdiction | 10 | | served. Subject to the oversight of the Department of Human | 11 | | Services Division of Mental Health, the EMS Medical Directors | 12 | | Committee is responsible for convening the meetings of the | 13 | | committee. Impacted units of local government may also have | 14 | | representatives on the committee subject to approval by the | 15 | | Division of Mental Health, if this participation is structured | 16 | | in such a way that it does not give undue weight to any of the | 17 | | groups represented. | 18 | | Section 45. Regional Advisory Committee responsibilities. | 19 | | Each Regional Advisory Committee is responsible for designing | 20 | | the local protocol to allow its region's 9-1-1 call center and | 21 | | emergency responders to coordinate their activities with 9-8-8 | 22 | | as required by this Act and monitoring current operation to | 23 | | advise on ongoing adjustments to the local protocol. Included | 24 | | in this responsibility, each Regional Advisory Committee must: | 25 | | (1) negotiate the appropriate amendment of each 9-1-1 |
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| 1 | | PSAP emergency dispatch protocols, in consultation with | 2 | | each 9-1-1 PSAP in the EMS Region and consistent with | 3 | | national certification requirements; | 4 | | (2) set maximum response times for 9-8-8 to provide | 5 | | service when an in-person response is required, based on | 6 | | type of mental or behavioral health emergency, which, if | 7 | | exceeded, constitute grounds for sending other emergency | 8 | | responders through the 9-1-1 system; | 9 | | (3) report, geographically by police district if | 10 | | practical, the data collected through the direction | 11 | | provided by the Statewide Advisory Committee in | 12 | | aggregated, non-individualized monthly reports. These | 13 | | reports shall be available to the Regional Advisory | 14 | | Committee members, the Department of Human Service | 15 | | Division of Mental Health, the Administrator of the 9-1-1 | 16 | | Authority, and to the public upon request; and | 17 | | (4) convene, after the initial regional policies are | 18 | | established, at least every 2 years to consider amendment | 19 | | of the regional policies, if any, and also convene | 20 | | whenever a member of the Committee requests that the | 21 | | Committee consider an amendment. | 22 | | Section 50. Immunity. The exemptions from civil liability | 23 | | in Section 15.1 of the Emergency Telephone Systems Act apply | 24 | | to any act or omission in the development, design, | 25 | | installation, operation, maintenance, performance, or |
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| 1 | | provision of service directed by this Act. | 2 | | Section 55. Scope. This Act applies to persons of all | 3 | | ages, both children and adults. This Act does not limit an | 4 | | individual's right to control his or her own medical care. No | 5 | | provision of this Act shall be interpreted in such a way as to | 6 | | limit an individual's right to choose his or her preferred | 7 | | course of care or to reject care. No provision of this Act | 8 | | shall be interpreted to promote or provide justification for | 9 | | the use of restraints when providing mental or behavioral | 10 | | health care. | 11 | | Section 60. PSAP and emergency service dispatched through | 12 | | a 9-1-1 PSAP; coordination of activities with mobile and | 13 | | behavioral health services. Each 9-1-1 PSAP and emergency | 14 | | service dispatched through a 9-1-1 PSAP must begin | 15 | | coordinating its activities with the mobile mental and | 16 | | behavioral health services established by the Division of | 17 | | Mental Health once all 3 of the following conditions are met, | 18 | | but not later than January 1, 2023: | 19 | | (1) the Statewide Committee has negotiated useful | 20 | | protocol and 9-1-1 operator script adjustments with the | 21 | | contracted services providing these tools to 9-1-1 PSAPs | 22 | | operating in Illinois; | 23 | | (2) the appropriate Regional Advisory Committee has | 24 | | completed design of the specific 9-1-1 PSAP's process for |
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| 1 | | coordinating activities with the mobile mental and | 2 | | behavioral health service; and | 3 | | (3) the mobile mental and behavioral health service is | 4 | | available in their jurisdiction.".
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