HB5009 101ST GENERAL ASSEMBLY

LRB101 19272 RLC 68738 b

101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB5009

Introduced 2/18/2020, by Rep. Kelly M. Cassidy

SYNOPSIS AS INTRODUCED:

New Act
50 ILCS 750/4	from Ch. 134, par. 34

Creates the Community Emergency Services and Support Act. Provides that every unit of local government that provides emergency medical services for individuals with physical health needs must also provide appropriate emergency response services to individuals experiencing a mental or behavioral health emergency. Amends the Emergency Telephone System Act to make conforming changes.

FISCAL NOTE ACT MAY APPLY

HOME RULE NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. This Act may be referred to as the Stephon Edward Watts Act.

Section 2. Short title. This Act may be cited as the Community Emergency Services and Support Act.

Section 5. Findings. 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 provided to individuals who require emergency physical health care. An individual who requires an emergency response to address his or her mental or behavioral health care needs should have the choice of accessing providers trained to address mental or behavioral health crises. Whether an individual experiencing a health emergency receives an appropriate emergency response from care providers whose primary occupation is the provision of care and support to individuals experiencing health crises should not depend on the classification of conditions into categories such as physical, mental, or behavioral health. Public welfare is best served when the public has access to substantially equivalent emergency response options for all health crises.

Section 10. Applicability; home rule. This Act applies to every unit of local government that provides emergency medical response or transportation for individuals with physical 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:

"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.

Section 20. Scope. 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 25. Emergency mental or behavioral health care response. Every unit of local government that provides emergency medical services for individuals with physical health needs must also provide appropriate emergency response services to individuals experiencing a mental or behavioral health emergency. This response includes, but is not limited to, the following factors.

(a) Where practicable, the unit of local government must provide an emergency response for mental or behavioral health care with response times appropriate to the care requirements of the individual with an emergency when notified that an individual is experiencing an emergency.

(b) The individuals dispatched to provide emergency response services or transportation for individuals experiencing mental or behavioral health emergency must have adequate training in addressing the needs of individuals experiencing a mental or behavioral health emergency. This includes training in de-escalation techniques, knowledge of local community services and supports, and respect for individuals' dignity and autonomy, including the concepts of stigma and respectful language. Individuals providing these services must do so consistently with best practices, which include respecting the care choices of the individuals receiving assistance. They must ensure that individuals experiencing mental or behavioral health crises are diverted from hospitalization or incarceration whenever possible, and linked with available appropriate community services.

(c) An emergency response may include on-site care where the individual is located if it 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.

(d) When on-site care is provided, care providers must also provide appropriate referrals for available community services if the individual receiving on-site care is not already in a treatment relationship.

(e) When transportation is provided, subject to the care decisions of the individual receiving care, 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.

(f) This service may not replace any service an educational institution is required to provide to a student. It shall not substitute for appropriate special education and related services schools are required to provide by any law.

Section 30. Prohibition of mental and behavioral health response unit involvement in involuntary commitment. In order to maintain the appropriate care relationship, in any jurisdiction that chooses to provide an emergency response under Section 40 that is both separate from law enforcement and from the jurisdiction's physical health emergency response system, the emergency responders for mental and behavioral health emergencies shall not take any role that would assist in the involuntary commitment of an individual beyond whatever reporting requirements they may have under their professional ethical obligations or under other laws of this state. This prohibition shall not interfere with any emergency responder's ability to provide physical health care.

Section 35. Prohibition of use of law enforcement for emergency response or transportation. In any jurisdiction that provides a system for emergency response for individuals with physical health needs that is distinct from the jurisdiction's law enforcement personnel, law enforcement shall not be used to provide emergency response for an individual when an individual only requires on-site emergency mental or behavioral health care, transportation to access health care, or travel between health care providers, except where no alternative is available. The transportation shall instead be provided pursuant to Section 40 of this Act.

Section 40. Equivalent law enforcement response. Unless an individual perceived as requiring mental or behavioral health care or requesting mental or behavioral health care is involved in a suspected violation of the criminal laws of this State, law enforcement shall respond to an individual requiring mental or behavioral health care in a manner that is equivalent to their response to an individual requiring physical health care.

(1) Standing on its own or in combination with each other, neither the fact that an individual is experiencing a mental or behavioral health emergency, nor that an individual has a mental health, behavioral health or other disability diagnosis, is sufficient to justify an assessment of threat to public safety to support a law enforcement response to a request for emergency response or medical transportation.

(2) If, based on their assessment of the threat to public safety, law enforcement would not accompany medical transportation responding to a physical medical emergency, 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 public safety.

(3) If law enforcement would typically dispatch medical response personnel or transportation when they encounter an individual with a physical health emergency, law enforcement shall similarly dispatch mental or behavioral health personnel or medical transportation when they encounter an individual in a mental or behavioral health emergency.

(4) Without regard to an assessment of threat to public safety, law enforcement may station personnel so that they may rapidly respond to requests for assistance from emergency response or medical transportation staff 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.

Section 45. Emergency response equity committees. To address the requirements of this Act, the Illinois Department of Human Services Division of Mental Health shall establish an Emergency Response Equity Committee in each Emergency Medical Services (EMS) Region for the purpose of developing and, as appropriate, amending 2 plans setting regional guidance and standards. The Emergency Response Equity Committee shall create a Regional Response Plan to bring the jurisdiction into compliance with this Act in situations that are not criminal in nature, and shall create a Non-Violent Misdemeanor Plan to coordinate the jurisdiction's response to individuals who appear to be in a mental or behavioral health emergency while engaged in conduct alleged to constitute a non-violent misdemeanor.

(a) Each Regional Response Plan shall also establish for their Region:

(1) The specific training program for individuals providing the response to the mental and behavioral health crises under this Act. Training shall be done by individuals with lived experience to the extent available and shall include guidelines approved by the committee directing when responders may recommend more restrictive forms of care, like emergency room settings.

(2) The protocol for coordinating the existing 9-1-1 services with the response system required by this Act.

(3) Guidance for prioritizing calls for assistance and maximum response time in relation to the type of emergency reported.

(b) The Regional Response Plan may coordinate with or include other similar programs, like those operating under the Children's Mental Health Act of 2003, so long as all the requirements of all programs are met.

(c) The Non-Violent Misdemeanor Plan shall be developed with the goal of providing the most appropriate mental and behavioral health care allowable without significant interference with law enforcement activities and without further criminal justice involvement. To the greatest extent practicable, the plan shall seek to first provide community-based mental or behavioral health services before addressing law enforcement objectives. The plan must align the region's emergency response service with municipal and state efforts to deinstitutionalize people with mental and behavioral disabilities.

(d) Each Emergency Response Equity Committee shall consist of 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; representatives of law enforcement officials with jurisdiction in the Emergency Medical Services (EMS) Regions, and advocates from the mental health, behavioral health, intellectual disability, and developmental disability communities. 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 condition, 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. Subject to the oversight of the Illinois Department of Human Services Division of Mental Health, the EMS Medical Directors Committee is responsible for convening the meetings of the committee. Interested units of local government may also have representatives on the committee subject to approval by the Division of Mental Health and if this participation is structured in such a way that it does not reduce the influence of the advocates on the committee.

(e) Both plans required by this Section shall be completed within 6 months after the effective date of this Act, and shall be reviewed on a bi-annual basis. At the request of any member of the Emergency Response Equity Committee or by the Division of Mental Health, the committee shall reconvene outside the bi-annual review meeting or meetings.

Section 55. The Emergency Telephone System Act is amended by changing Section 4 as follows:

(50 ILCS 750/4) (from Ch. 134, par. 34)

(Section scheduled to be repealed on December 31, 2020)

Sec. 4.

(a) Every system shall include police, firefighting, and emergency medical and ambulance services, and may include other emergency services. The system may incorporate private ambulance service. In those areas in which a public safety agency of the State provides such emergency services, the system shall include such public safety agencies. Every system shall dispatch emergency response services for individuals requiring mental or behavioral health care in compliance with the requirements of the Community Emergency Services and Support Act.

(b) Every 9-1-1 Authority shall maintain records of the numbers of calls received, the type of service the caller requested and the type of service dispatched in response to each call. For emergency medical and ambulance services, the records shall indicate whether physical, mental or behavioral health response or transportation were requested, and what type of response or transportation was dispatched. When a mental or behavioral health response is requested at a primary, secondary or post-secondary educational institution, the 9-1-1 Authority shall record which type of educational institution was involved. Broken down geographically by police district, every 9-1-1 Authority shall create aggregated, non-individualized monthly reports detailing the system's activities, including the frequency of dispatch of each type of service and the information required to be collected by this Section. These reports shall be available to both the Emergency Response Equity Committees and the Administrator of the 9-1-1 Authority for the purpose of conducting an annual analysis of service gaps and to the public upon request.

(Source: P.A. 99-6, eff. 1-1-16; 100-20, eff. 7-1-17.)