Alternative Health Intervention and Response Task Force

Cook County Board of Commissioners

Health

Politics

Wednesday, July 6, 2022
10:00 a.m. CDT

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Reporting

Edited and summarized by the Chicago - IL Documenters Team

Note-taking by Roveena Jassal

State RFP for hospital based crisis stabilization units and Crisis Response System direct action

View notes

Live reporting by Ayesha Riaz

State RFP for hospital based crisis stabilization units and Crisis Response System direct action

ayesha_offline @ayesha_offline

Morning, covering Cook County's Alternative Health Intervention and Response Task Force for @CHIdocumenters.

10:57 AM Jul 6, 2022 CDT

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Meeting 6 was called to order at 10:06 AM by task force co-chair Avik Das of Cook County Justice Advisory Council. Today’s agenda consists of discussion regarding: structure, review process, material for recommendation and public commentary.

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Meeting minutes were approved from the previous June 22 2022 meeting, covered by @Danijaime22 here: twitter.com/Danijaime22/st…

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There are 3 more task force meetings. The internal team will draft a full report with a discussion on July 20, review on July 26, final report on August 1 and finalized vote on August 3.

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Report outline includes 4 sections: 1) ALT-HIR (alternative health intervention & response) intro , 2) behavioral health & crisis intervention matrix, 3) cook county crisis intervention landscape, and 4) recommendations & next steps.

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Bridget Degnen, 12th District Cook County Commissioner asks who is the intended audience? Avik Das responds that it will be the County Board. Degnen mentions that intention was to create a framework and to discuss if a mental health mobile crisis unit should even be invested in?

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Additionally, Degnen continues that part 4 of the plan should include subsections to identify more direct action items and overlaps based on the national landscape and to include the continuum of care.

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Kiran Joshi, task force co-chair,Cook County Dept of Public Health includes that they had to look at the spectrum of crisis response systems, including the question of if mobile response teams are expanded, then ppl will be taken to either the emergency room or jail…[both bad]

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Otis Story, Cook County Health Dept, states that maybe it would traumatize some citizens and Story is concerned what will happen to citizens if we continue this patchwork around behavioral health. “It is troublesome to me personally as well as professionally.”

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Story is able to appreciate the continuity of care, because some institutions could not support it, which led to patients being bounced around. It would be in the best interest to find an appropriate and proper response.

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Illiana Mora of Cook County Ambulatory Services, asks where to include future assessments and findings for the draft, and clarification around what ‘areas to investigate’ means.

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Kiran Joshi explains that during the board’s recent visit to San Diego studying crisis stabilization units, the recommendations have been not to plop, but to investigate where there are existing resources and agencies & where the highest burden of behavioral health issues exist.

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Based on the previous SWOT (strengths, weaknesses, opportunity, threat) analysis with focus on opportunity and threat quadrants. They move from the matrix framework into 3 focuses: 1) areas to investigate, 2) areas to contribute/collaborate and 3)areas for direct action.

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Iliana Mora expects to move items from investigation to direct action eventually.

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Areas to investigate includes public education, frontline education, rollout of IL’s 590 program (crisis response teams) in Cook County, workforce in hospitals and landscapes, and crisis response coordination.

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Otis Story, Cook County Health and Hospital Board of Directors, shares their concern of being ‘overly cautious as to what's being presented in the first round’

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Iliana Mora questions about public education, isn’t sure if the definition, accuracy and depth of the problem is apparent. She states that it is unclear for a public citizen to figure out where to go for these emergency services.

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Jason Hernandez of Intergovernmental Affairs wonders which section would be to demonstrate commitment to ongoing evaluation for the program efficacy.

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“In this space, I do not believe there’s consensus or agreement around whether the mobile response infrastructure is really going to pan out once these systems are at play.”

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“wondering if we have a responsibility to very very closely monitor and report back to the County Board about whether or not [programs] are really serving their purpose and whether or not it would really require the task force to reconvene and assess.”

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Avik Das agrees, they are trying to present a glass half full type of situation so they have room for improvements.

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Degnen (12th District Cook County Commissioner) would like to clarify if we need a mobile crisis intervention team or something else like program development.

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In terms of program development, the county level is not as robust as the state level. She would like to see a clear recommendation for monetary resources for mobile response teams.

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Martin Bennet of Cook County Emergency Telephone System Board asks how they measure how many calls come in? / Data is collected through 590 from 17 behavioral service providers, the county decides they should probably have conversations with the state about those gaps in data.

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At this point, audio and video dropped off for several members as they experienced technical difficulties.

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Continuing the focus points, the areas to contribute/collaborate included: state-level (state and regional planning councils for CESSA and 988), provider relationship building, and coordination between crisis stabilization units.

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Co-Chair Joshi asks again about gaps in the mobile response teams as it was one of the initial reasons that the task force was formed.

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There is an RFP from the state that will fund hospital-based crisis stabilization units. However, not all crisis stabilization units need to be hospital-based.

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Iliana Mora thinks maybe there could be a better network/best practices because it seems like the Living Rooms know of each other but are not well connected.

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Living Room model = community crisis center that offers folks experiencing mental health crisis an alternative to hospitalization.

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Final focus is areas for Direct Action. This includes a crisis response system strength and needs assessment (988 and 590 programs), the workforce, state incentive structures, crisis stabilization centers and extending suburban Cook County living room services to 24/7.

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Iliana Mora mentions the importance of bridging a coordinated effort between all 3 parts of the crisis response. Since the state is already funding things within communities, ‘how can we also better partner with them instead of adding resources to a disjointed system?’

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Bridget Degnen, reiterates that she would like to see more direct action items. Jerry Davis of GRO mentions that they should be mindful of the workforce shortage. Jason Hernandez of Cook County Sheriff’s Office asks about follow-up plan and how to follow data in a fidelity model.

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Martin Bennett of Cook County Emergency Telephone System Board brings up other concerns: 911/988 CESSA (Community Emergency Services and Supports Act) changes will not take effect until January 2023, which is outside of the task force meeting times.

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Co-Chair Avik Das confirms the importance of continued oversight, that the task force should follow up, that they might need to come back and reconvene to see if new data is working.

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Draft will be up for review at the next meeting on July 20. Degnen requests for the document to be made available for members 24 hours prior to meeting, which Das agrees to. Avik Das clarifies that ‘it's not so wordsmithing the pros, but building into the draft’.

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Alternative Health Intervention and Response Task Force did not receive public comment or written testimony for this meeting. Meeting is adjourned at 11:23 AM.

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County Commissioners are elected officials who oversee county activities and work to ensure that citizen concerns are met, federal and state requirements are fulfilled, and county operations run smoothly. The Cook County Board of Commissioners is the governing board and legislative body of the county. It is comprised of 17 Commissioners, each serving a four-year term and is elected from single member districts. Each district represents approximately 300,000 residents. The Board also operates approximately 40 committees and subcommittees chaired by members of Board of Commissioners.

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