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Public Act 102-0580


 

Public Act 0580 102ND GENERAL ASSEMBLY

  
  
  

 


 
Public Act 102-0580
 
HB2784 EnrolledLRB102 14976 RLC 20331 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title.
    (a) This Act may be cited as the Community Emergency
Services and Support Act.
    (b) This Act may be referred to as the Stephon Edward Watts
Act.
 
    Section 5. Findings. The General Assembly recognizes that
the Illinois Department of Human Services Division of Mental
Health is preparing to provide mobile mental and behavioral
health services to all Illinoisans as part of the federally
mandated adoption of the 9-8-8 phone number. The General
Assembly also recognizes that many cities and some states have
successfully established mobile emergency mental and
behavioral health services as part of their emergency response
system to support people who need such support and do not
present a threat of physical violence to the responders. In
light of that experience, the General Assembly finds that in
order to promote and protect the health, safety, and welfare
of the public, it is necessary and in the public interest to
provide emergency response, with or without medical
transportation, to individuals requiring mental health or
behavioral health services in a manner that is substantially
equivalent to the response already provided to individuals who
require emergency physical health care.
 
    Section 10. Applicability; home rule. This Act applies to
every unit of local government that provides or coordinates
ambulance or similar emergency medical response or
transportation services for individuals with emergency medical
needs. A home rule unit may not respond to or provide services
for a mental or behavioral health emergency, or create a
transportation plan or other regulation, relating to the
provision of mental or behavioral health services in a manner
inconsistent with this Act. This Act is a limitation under
subsection (i) of Section 6 of Article VII of the Illinois
Constitution on the concurrent exercise by home rule units of
powers and functions exercised by the State.
 
    Section 15. Definitions. As used in this Act:
    "Division of Mental Health" means the Division of Mental
Health of the Department of Human Services.
    "Emergency" means an emergent circumstance caused by a
health condition, regardless of whether it is perceived as
physical, mental, or behavioral in nature, for which an
individual may require prompt care, support, or assessment at
the individual's location.
    "Mental or behavioral health" means any health condition
involving changes in thinking, emotion, or behavior, and that
the medical community treats as distinct from physical health
care.
    "Physical health" means a health condition that the
medical community treats as distinct from mental or behavioral
health care.
    "PSAP" means a Public Safety Answering Point
tele-communicator.
    "Community services" and "community-based mental or
behavioral health services" may include both public and
private settings.
    "Treatment relationship" means an active association with
a mental or behavioral care provider able to respond in an
appropriate amount of time to requests for care.
    "Responder" is any person engaging with a member of the
public to provide the mobile mental and behavioral service
established in conjunction with the Division of Mental Health
establishing the 9-8-8 emergency number. A responder is not an
EMS Paramedic or EMT as defined in the Emergency Medical
Services (EMS) Systems Act unless that responding agency has
agreed to provide a specialized response in accordance with
the Division of Mental Health's services offered through its
9-8-8 number and has met all the requirements to offer that
service through that system.
 
    Section 20. Coordination with Division of Mental Health.
Each 9-1-1 PSAP and provider of emergency services dispatched
through a 9-1-1 system must coordinate with the mobile mental
and behavioral health services established by the Division of
Mental Health so that the following State goals and State
prohibitions are met whenever a person interacts with one of
these entities for the purpose seeking emergency mental and
behavioral health care or when one of these entities
recognizes the appropriateness of providing mobile mental or
behavioral health care to an individual with whom they have
engaged. The Division of Mental Health is also directed to
provide guidance regarding whether and how these entities
should coordinate with mobile mental and behavioral health
services when responding to individuals who appear to be in a
mental or behavioral health emergency while engaged in conduct
alleged to constitute a non-violent misdemeanor.
 
    Section 25. State goals.
    (a) 9-1-1 PSAPs, emergency services dispatched through
9-1-1 PSAPs, and the mobile mental and behavioral health
service established by the Division of Mental Health must
coordinate their services so that the State goals listed in
this Section are achieved. Appropriate mobile response service
for mental and behavioral health emergencies shall be
available regardless of whether the initial contact was with
9-8-8, 9-1-1 or directly with an emergency service dispatched
through 9-1-1. Appropriate mobile response services must:
        (1) ensure that individuals experiencing mental or
    behavioral health crises are diverted from hospitalization
    or incarceration whenever possible, and are instead linked
    with available appropriate community services;
        (2) include the option of on-site care if that type of
    care is appropriate and does not override the care
    decisions of the individual receiving care. Providing care
    in the community, through methods like mobile crisis
    units, is encouraged. If effective care is provided on
    site, and if it is consistent with the care decisions of
    the individual receiving the care, further transportation
    to other medical providers is not required by this Act;
        (3) recommend appropriate referrals for available
    community services if the individual receiving on-site
    care is not already in a treatment relationship with a
    service provider or is unsatisfied with their current
    service providers. The referrals shall take into
    consideration waiting lists and copayments, which may
    present barriers to access; and
        (4) subject to the care decisions of the individual
    receiving care, provide transportation for any individual
    experiencing a mental or behavioral health emergency.
    Transportation shall be to the most integrated and least
    restrictive setting appropriate in the community, such as
    to the individual's home or chosen location, community
    crisis respite centers, clinic settings, behavioral health
    centers, or the offices of particular medical care
    providers with existing treatment relationships to the
    individual seeking care.
    (b) Prioritize requests for emergency assistance. 9-1-1
PSAPs, emergency services dispatched through 9-1-1 PSAPs, and
the mobile mental and behavioral health service established by
the Division of Mental Health must provide guidance for
prioritizing calls for assistance and maximum response time in
relation to the type of emergency reported.
    (c) Provide appropriate response times. From the time of
first notification, 9-1-1 PSAPs, emergency services dispatched
through 9-1-1 PSAPs, and the mobile mental and behavioral
health service established by the Division of Mental Health
must provide the response within response time appropriate to
the care requirements of the individual with an emergency.
    (d) Require appropriate responder training. Responders
must have adequate training to address the needs of
individuals experiencing a mental or behavioral health
emergency. Adequate training at least includes:
        (1) training in de-escalation techniques;
        (2) knowledge of local community services and
    supports; and
        (3) training in respectful interaction with people
    experiencing mental or behavioral health crises, including
    the concepts of stigma and respectful language.
    (e) Require minimum team staffing. The Division of Mental
Health, in consultation with the Regional Advisory Committees
created in Section 40, shall determine the appropriate
credentials for the mental health providers responding to
calls, including to what extent the responders must have
certain credentials and licensing, and to what extent the
responders can be peer support professionals.
    (f) Require training from individuals with lived
experience. Training shall be provided by individuals with
lived experience to the extent available.
    (g) Adopt guidelines directing referral to restrictive
care settings. Responders must have guidelines to follow when
considering whether to refer an individual to more restrictive
forms of care, like emergency room or hospital settings.
    (h) Specify regional best practices. Responders providing
these services must do so consistently with best practices,
which include respecting the care choices of the individuals
receiving assistance. Regional best practices may be broken
down into sub-regions, as appropriate to reflect local
resources and conditions. With the agreement of the impacted
EMS Regions, providers of emergency response to physical
emergencies may participate in another EMS Region for mental
and behavioral response, if that participation shall provide a
better service to individuals experiencing a mental or
behavioral health emergency.
    (i) Adopt system for directing care in advance of an
emergency. The Division of Mental Health shall select and
publicly identify a system that allows individuals who
voluntarily chose to do so to provide confidential advanced
care directions to individuals providing services under this
Act. No system for providing advanced care direction may be
implemented unless the Division of Mental Health approves it
as confidential, available to individuals at all economic
levels, and non-stigmatizing. The Division of Mental Health
may defer this requirement for providing a system for advanced
care direction if it determines that no existing systems can
currently meet these requirements.
    (j) Train dispatching staff. The personnel staffing 9-1-1,
3-1-1, or other emergency response intake systems must be
provided with adequate training to assess whether coordinating
with 9-8-8 is appropriate.
    (k) Establish protocol for emergency responder
coordination. The Division of Mental Health shall establish a
protocol for responders, law enforcement, and fire and
ambulance services to request assistance from each other, and
train these groups on the protocol.
    (l) Integrate law enforcement. The Division of Mental
Health shall provide for law enforcement to request responder
assistance whenever law enforcement engages an individual
appropriate for services under this Act. If law enforcement
would typically request EMS assistance when it encounters an
individual with a physical health emergency, law enforcement
shall similarly dispatch mental or behavioral health personnel
or medical transportation when it encounters an individual in
a mental or behavioral health emergency.
 
    Section 30. State prohibitions. 9-1-1 PSAPs, emergency
services dispatched through 9-1-1 PSAPs, and the mobile mental
and behavioral health service established by the Division of
Mental Health must coordinate their services so that, based on
the information provided to them, the following State
prohibitions are avoided:
    (a) Law enforcement responsibility for providing mental
and behavioral health care. In any area where responders are
available for dispatch, law enforcement shall not be
dispatched to respond to an individual requiring mental or
behavioral health care unless that individual is (i) involved
in a suspected violation of the criminal laws of this State, or
(ii) presents a threat of physical injury to self or others.
Responders are not considered available for dispatch under
this Section if 9-8-8 reports that it cannot dispatch
appropriate service within the maximum response times
established by each Regional Advisory Committee under Section
45.
        (1) Standing on its own or in combination with each
    other, the fact that an individual is experiencing a
    mental or behavioral health emergency, or has a mental
    health, behavioral health, or other diagnosis, is not
    sufficient to justify an assessment that the individual is
    a threat of physical injury to self or others, or requires
    a law enforcement response to a request for emergency
    response or medical transportation.
        (2) If, based on its assessment of the threat to
    public safety, law enforcement would not accompany medical
    transportation responding to a physical health emergency,
    unless requested by responders, law enforcement may not
    accompany emergency response or medical transportation
    personnel responding to a mental or behavioral health
    emergency that presents an equivalent level of threat to
    self or public safety.
        (3) Without regard to an assessment of threat to self
    or threat to public safety, law enforcement may station
    personnel so that they can rapidly respond to requests for
    assistance from responders if law enforcement does not
    interfere with the provision of emergency response or
    transportation services. To the extent practical, not
    interfering with services includes remaining sufficiently
    distant from or out of sight of the individual receiving
    care so that law enforcement presence is unlikely to
    escalate the emergency.
    (b) Responder involvement in involuntary commitment. In
order to maintain the appropriate care relationship,
responders shall not in any way assist in the involuntary
commitment of an individual beyond (i) reporting to their
dispatching entity or to law enforcement that they believe the
situation requires assistance the responders are not permitted
to provide under this Section; (ii) providing witness
statements; and (iii) fulfilling reporting requirements the
responders may have under their professional ethical
obligations or laws of this state. This prohibition shall not
interfere with any responder's ability to provide physical or
mental health care.
    (c) Use of law enforcement for transportation. In any area
where responders are available for dispatch, unless requested
by responders, law enforcement shall not be used to provide
transportation to access mental or behavioral health care, or
travel between mental or behavioral health care providers,
except where no alternative is available.
    (d) Reduction of educational institution obligations. The
services coordinated under this Act may not be used to replace
any service an educational institution is required to provide
to a student. It shall not substitute for appropriate special
education and related services that schools are required to
provide by any law.
 
    Section 35. Non-violent misdemeanors. The Division of
Mental Health's Guidance for 9-1-1 PSAPs and emergency
services dispatched through 9-1-1 PSAPs for coordinating the
response to individuals who appear to be in a mental or
behavioral health emergency while engaging in conduct alleged
to constitute a non-violent misdemeanor shall promote the
following:
        (a) Prioritization of Health Care. To the greatest
    extent practicable, community-based mental or behavioral
    health services should be provided before addressing law
    enforcement objectives.
        (b) Diversion from Further Criminal Justice
    Involvement. To the greatest extent practicable,
    individuals should be referred to health care services
    with the potential to reduce the likelihood of further law
    enforcement engagement.
 
    Section 40. Statewide Advisory Committee.
    (a) The Division of Mental Health shall establish a
Statewide Advisory Committee to review and make
recommendations for aspects of coordinating 9-1-1 and the
9-8-8 mobile mental health response system most appropriately
addressed on a State level.
    (b) Issues to be addressed by the Statewide Advisory
Committee include, but are not limited to, addressing changes
necessary in 9-1-1 call taking protocols and scripts used in
9-1-1 PSAPs where those protocols and scripts are based on or
otherwise dependent on national providers for their operation.
    (c) The Statewide Advisory Committee shall recommend a
system for gathering data related to the coordination of the
9-1-1 and 9-8-8 systems for purposes of allowing the parties
to make ongoing improvements in that system. As practical, the
system shall attempt to determine issues including, but not
limited to:
        (1) the volume of calls coordinated between 9-1-1 and
    9-8-8;
        (2) the volume of referrals from other first
    responders to 9-8-8;
        (3) the volume and type of calls deemed appropriate
    for referral to 9-8-8 but could not be served by 9-8-8
    because of capacity restrictions or other reasons;
        (4) the appropriate information to improve
    coordination between 9-1-1 and 9-8-8; and
        (5) the appropriate information to improve the 9-8-8
    system, if the information is most appropriately gathered
    at the 9-1-1 PSAPs.
    (d) The Statewide Advisory Committee shall consist of:
        (1) the Statewide 9-1-1 Administrator, ex officio;
        (2) one representative designated by the Illinois
    Chapter of National Emergency Number Association (NENA);
        (3) one representative designated by the Illinois
    Chapter of Association of Public Safety Communications
    Officials (APCO);
        (4) one representative of the Division of Mental
    Health;
        (5) one representative of the Illinois Department of
    Public Health;
        (6) one representative of a statewide organization of
    EMS responders;
        (7) one representative of a statewide organization of
    fire chiefs;
        (8) two representatives of statewide organizations of
    law enforcement;
        (9) two representatives of mental health, behavioral
    health, or substance abuse providers; and
        (10) four representatives of advocacy organizations
    either led by or consisting primarily of individuals with
    intellectual or developmental disabilities, individuals
    with behavioral disabilities, or individuals with lived
    experience.
    (e) The members of the Statewide Advisory Committee, other
than the Statewide 9-1-1 Administrator, shall be appointed by
the Secretary of Human Services.
 
    Section 45. Regional Advisory Committees.
    (a) The Division of Mental Health shall establish Regional
Advisory Committees in each EMS Region to advise on regional
issues related to emergency response systems for mental and
behavioral health. The Secretary of Human Services shall
appoint the members of the Regional Advisory Committees. Each
Regional Advisory Committee shall consist of:
        (1) representatives of the 9-1-1 PSAPs in the region;
        (2) representatives of the EMS Medical Directors
    Committee, as constituted under the Emergency Medical
    Services (EMS) Systems Act, or other similar committee
    serving the medical needs of the jurisdiction;
        (3) representatives of law enforcement officials with
    jurisdiction in the Emergency Medical Services (EMS)
    Regions;
        (4) representatives of both the EMS providers and the
    unions representing EMS or emergency mental and behavioral
    health responders, or both; and
        (5) advocates from the mental health, behavioral
    health, intellectual disability, and developmental
    disability communities.
    (b) The majority of advocates on the Emergency Response
Equity Committee must either be individuals with a lived
experience of a condition commonly regarded as a mental health
or behavioral health disability, developmental disability, or
intellectual disability, or be from organizations primarily
composed of such individuals. The members of the Committee
shall also reflect the racial demographics of the jurisdiction
served.
    (c) Subject to the oversight of the Department of Human
Services Division of Mental Health, the EMS Medical Directors
Committee is responsible for convening the meetings of the
committee. Impacted units of local government may also have
representatives on the committee subject to approval by the
Division of Mental Health, if this participation is structured
in such a way that it does not give undue weight to any of the
groups represented.
 
    Section 50. Regional Advisory Committee responsibilities.
Each Regional Advisory Committee is responsible for designing
the local protocol to allow its region's 9-1-1 call center and
emergency responders to coordinate their activities with 9-8-8
as required by this Act and monitoring current operation to
advise on ongoing adjustments to the local protocol. Included
in this responsibility, each Regional Advisory Committee must:
        (1) negotiate the appropriate amendment of each 9-1-1
    PSAP emergency dispatch protocols, in consultation with
    each 9-1-1 PSAP in the EMS Region and consistent with
    national certification requirements;
        (2) set maximum response times for 9-8-8 to provide
    service when an in-person response is required, based on
    type of mental or behavioral health emergency, which, if
    exceeded, constitute grounds for sending other emergency
    responders through the 9-1-1 system;
        (3) report, geographically by police district if
    practical, the data collected through the direction
    provided by the Statewide Advisory Committee in
    aggregated, non-individualized monthly reports. These
    reports shall be available to the Regional Advisory
    Committee members, the Department of Human Service
    Division of Mental Health, the Administrator of the 9-1-1
    Authority, and to the public upon request; and
        (4) convene, after the initial regional policies are
    established, at least every 2 years to consider amendment
    of the regional policies, if any, and also convene
    whenever a member of the Committee requests that the
    Committee consider an amendment.
 
    Section 55. Immunity. The exemptions from civil liability
in Section 15.1 of the Emergency Telephone Systems Act apply
to any act or omission in the development, design,
installation, operation, maintenance, performance, or
provision of service directed by this Act.
 
    Section 60. Scope. This Act applies to persons of all
ages, both children and adults. This Act does not limit an
individual's right to control his or her own medical care. No
provision of this Act shall be interpreted in such a way as to
limit an individual's right to choose his or her preferred
course of care or to reject care. No provision of this Act
shall be interpreted to promote or provide justification for
the use of restraints when providing mental or behavioral
health care.
 
    Section 65. PSAP and emergency service dispatched through
a 9-1-1 PSAP; coordination of activities with mobile and
behavioral health services. Each 9-1-1 PSAP and emergency
service dispatched through a 9-1-1 PSAP must begin
coordinating its activities with the mobile mental and
behavioral health services established by the Division of
Mental Health once all 3 of the following conditions are met,
but not later than January 1, 2023:
        (1) the Statewide Committee has negotiated useful
    protocol and 9-1-1 operator script adjustments with the
    contracted services providing these tools to 9-1-1 PSAPs
    operating in Illinois;
        (2) the appropriate Regional Advisory Committee has
    completed design of the specific 9-1-1 PSAP's process for
    coordinating activities with the mobile mental and
    behavioral health service; and
        (3) the mobile mental and behavioral health service is
    available in their jurisdiction.

Effective Date: 1/1/2022