Committee on Health and Human Relations

Chicago City Council
Health
Politics

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Reporting

Edited and summarized by the Chicago - IL Documenters Team

Note-taking by Karen Viado

Crisis Assistance Response and Engagement (CARE) pilot, alternative co-responder, Mental health emergency

Live reporting by Kurt Santana

Crisis Assistance Response and Engagement (CARE) pilot, alternative co-responder, Mental health emergency

Kurtney Luv @KurtneyLuvTTV
Good Morning, #Chicago Today I will be live-tweeting the Committee on Health and Human Relations on behalf of #ChicDocumenters @CHIdocumenters

10:57 AM Mar 4, 2022 CST

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@CHIdocumenters The time is 11:05am and Roderick Sawyer calls the meeting to order.
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This is time for public speaking, first to speak is Latisha Newsom a licensed clinical social worker, advocating for the rights of those with mental illness.
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"Under the previous administration, nine mental health clinics were closed... We have an ethical obligation to offer resources and police are not the right resource"
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She mentions Quintonio Legrier, who called for police support but was actually shot by a Chicago cop.
chicagotribune.com/news/breaking/…
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Kenita Taylor, advocates for the Treatment Not Trauma campaign, a new crisis response tactic.
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Emma Tai, Executive Director of United Working Families introduces Frank Roach who offers his testimonial of his experience with mental health institutions.
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Frank was 33 years old in 2019 and homeless, he would be arrested 9 times that year and attests that social workers helped his situation.
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Jack Lewis a member of the Democratic Socialists of America calls the indifference of the city's leaders and how the priority is to harass members of the community. He criticizes Mayor Lightfoot's proposals for mental health advocacy.
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Kathleen Powers, whose audio was cut out speaks out on the lack of public health institutions in the 49th ward. The police presence in emergency rooms.
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Elliot Weiss, One North Chicago member, and social worker, says that Chicagoans are sidelined by committees and substantive engagement. While Chicago creates programs to help vocalize marginalized voices, it ends up silencing them.
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Joy Bunton is speaking in support of the Treatment Not Trauma and echoes the words by Elliot Weiss who advocates for more community engagement in order to produce transformative effects.
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Quality of life is what she asks leaders to consider, the new variants are right around the corner.
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William Lame, a retired CPS teacher, worked in a psychiatric ward in a general hospital and has experience of deescalating situations in public schools. The skills of the professionals he worked along with are not police officers.
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"The very presence of police can exacerbate the situation and result in violence. Certainly, police can be given training, but however many hours doesn't produce a police officer ready to deescalate a situation."
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Eileen Nikolai, of Thresholds programs, offers examples of individuals who received help on behalf of intervention teams. Most people need shelter and not hospitalization.
thresholds.org
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Last speaker, Elena Gormely, member of the Collaborative for Community Wellness and social worker, speaks up on the reputation for labor practices of Thresholds. Gormely is concerned about the open contempt of community input on the open meetings.
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Social Workers are required to advocate for a dignified living. Collaborating with police would be antithetical to that.
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Dr. Allison Arwady, Director of Public Health, introduces the Chicago Crisis Response and Care System pilot. She calls its a learning opportunity for these departments to collaborate.
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BJ Wagner, Senior Vice President of Health and Public Safety at Meadows Mental Health Policy Institute, speaks on the root causes of the crisis.
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Wagner was originally working in law enforcement and left because of her experience and witnessing the treatment of those that have mental illnesses. She acknowledges the need for a civilian-only response team.
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To provide mental health equitably to all, we have to be willing to say that there are instances that there are real risks of violence in some situations. This is where a public safety initiative fits in.
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Categorizing responses and choosing what type of care is needed https://t.co/v37b2G3Q9Y
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Advocation for a hybrid civilian/police response team https://t.co/PaXtZcsRMT
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Obstacles and concerns about this type of response https://t.co/6l7MTj1VDI
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What the team looks like https://t.co/I845cKP3AO
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Mission of the Multidisciplinary Response Teams, “where we remove police, we remove the ability for the enforcement to protect victims.” https://t.co/2oO6flBqf4
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What the city needs for this program to work https://t.co/kHHqREFurc
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Traditional response from law enforcement as opposed to the hybrid team https://t.co/5SPscD61Pj
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Recognizing the problem with today’s system https://t.co/ZmZsu3nzP3
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Other models for crisis reponse in other cities https://t.co/Ukq3PrwxDo
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How call identification works and is effective in reducing use of force https://t.co/u4zpLmXxDf
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Wagner discusses the quality of life impacts in Texas with multidisciplinary response teams, specifically how arrests and citations have decreased or increased.
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Ald. Michele Smith speaks on the effects of those that are mentally ill or affected by drugs in business settings. She asks what the response looks like.
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Wagner says most calls in public settings, especially retail, result in a call to the police. She says that this type of occurrence is the reason a multidisciplinary team needs to exist because they need to be able to recognize the type of treatment needed.
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Ald. Smith says that the intervention, making the person accept treatment has really only worked with the threat of arrest. She asks how many teams are needed.
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Wagner says that this is a case by case basis.
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Dr. Arwady speaks on the pilot program at a glance and its goals. https://t.co/ZYOMWeRGjz
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Looking at the process of the response team, with the hope to expand in each area. https://t.co/pdoBCzRuyA
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Areas where the program is focused https://t.co/LDrQsvyF6p
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How the dispatching of the CARE Team works https://t.co/zzhMlPIbDC
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Timeline of of the CARE pilot program https://t.co/ypYONUiYrH
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- the alternate response team was halted due to the Omicron wave of Covid.
-988 is the newest hotline for suicide prevention
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Initial data on CARE response. CARE intervention without transport is on scene response without using emergency departments. Other is when the team offer services when they werent called. https://t.co/Cn5QbWac5S
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Other initial data https://t.co/MtrsUNwgTi
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Director Rich Guidance, of the Office of Emergency Management and Communications, speaks on the developments on the OEMC due to this CARE pilot program including e-learning training and a weekly review on practice.
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First Deputy Eric Carter speaks on behalf of the Chicago Police Department. The officers rotate into the care team from our district operations and offer investigation for safety needs.
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Comissioner Annete Nance-Holt speaks on behalf of the Chicago Fire Department. The fire department members of the CARE are paramedics that operate in preventative care. Offers medical screenings and connects individuals to a broad spectrum of community-based care.
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Ald. Rodriguez Sanchez offers a Happy Social Work Week asks for a round two for additional questions. She is confused about why the hybrid model is prioritized and how many resources are used toward this effect. She also wonders how many of these incidents result in violence.
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Dr. Arwady says that getting clinicians embedded within the existing infrastructure from other models is the best way to start and to improve from them. Adding mental health professionals adds value, but they need to be safe.
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Ald. Rodriguez Sanchez asks if a new hotline was made perhaps a different model can be used? Dr. Arwady says that there are extra requirements when things go through the OEMC.
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Ald. Rodriguez Sanchez says that they have to be committed to creating a response that doesn't involve the police. The alternate response required a separate protocol that needed to be approved by the Department of Health.
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Since this is a new model in Illinois, the approval of this model by EMS is complicated. Ald. Rodriguez Sanchez asks about the role of mental health clinics. It is used for same-day evaluation and determining post-response.
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The setting of CPDH is in an out-patient model, and to advocate for an alternative way to offer more resources would require seeing how it would affect the current model.
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Ald. Rodriguez Sanchez says that there is a large disparity in the quality of care from workers that are undervalued. She says this is an opportunity to change our public health system.
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Ald. Scott Waguespack asks Director Guidice about additional training with dispatchers. There is roll call training every day according to Guidice and a weekly meeting with other departments.
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Do we have the depth of time in roll calls to have training on how to take a call, asks Ald. Waguespack. Antoinette Ursitti says that roll call meetings are continual engagement, but is a focused presentation.
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Ald. Waguespack wants to hear about the impact; he is concerned that people will see it as just another manual to memorize. Ursitti says that officers themselves know that jail is not the right response and therefore are grateful for a new response.
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Ald. Waguespack asks if the officers themselves are evaluated by the CARE team on their response. Ursitti says there is a dedicated time for leadership to meet with officers to speak with officers on their interactions with the new mechanisms.
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Ald. Matt Martin observes that the first presentation was very long and should have been presented before the plan implemented. Ald. Martin asks, how much was budgeted for each team?
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Arwady's team says that $3 million was granted to the model, including personnel, supplies and vehicles, not including CIT or CPD officers that are already paid that are just reassigned.
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Ald. Martin asks for the range of funds for the year to be displayed for the committee. With regard to the CARE team, Ald. Martin asks about hours active. 10:30am - 4:30pm are normal working hours, and the amount of calls taken in a day depends on the situation.
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This time window is to respond to the most amount of calls. Each agency schedules slightly differently, but the agency works Monday to Friday. Ald. Martin asks about the future of the program where two teams exist but work in the same district.
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If a caller is reporting public safety risks, officer response teams will be called, that's the main criterion for CIT/CPD response
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Ald. Daniel La Spata is concerned about the number of calls made that relate to mental health and the small response from the program. Is it a matter of scheduling?
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Dr. Arwady says that only a subset of those calls would be referred to the CARE team, but expanding the program would increase that subset.
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Ald. La Spata says that 134 responses totals to less than one a day and wants to know why those instances aren't picked up by the CARE team. Dr. Arwady says that state approval is the key to increasing that response.
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IDPH approval is submitting protocols and getting responses back, for example, changing procedures for call response for each team. Annette Nance Holt says that the back and forth is the only thing halting the process of rollout and there isn't a way to predict that response.
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In regard to the Chicago Recovery Plan, what can we expect the funds to be allocated toward this program, asks Ald. La Spata. Funding the crisis stabilization settings and funding the call center RFP is the next stage of funding according to Arwady's office.
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Dr. Arwady says that evaluation will pay a large part of where the next thing to allocate funding to is determined.
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Ald. James Cappleman asks about the community's response to these initiatives. Arwady's team says what is exciting is that callers are requesting the CARE team. Dr. Arwady says that business owners empathize with those individuals that need assistance and are grateful for CARE.
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Are we assessing whether it's good or not good to wear a uniform, asks Ald. Cappleman. Ursitti says that there is a "soft" that still identifies the officer that includes a polo tee.
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Ald. Cappleman asks about the system in place that identifies different types of callers and situations. Data work is being used to create higher utilization lists that use data from committees and sister organizations, according to Arwady's team.
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Does the CARE team model promote service approval for drug treatment asks Ald. Cappleman. Arwady's team says there is not enough longitudinal data to determine whether the denial of these services has decreased.
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Ald. Cappleman cites Malcolm Gladwell on the need to address the outlying problem when it comes to addressing homelessness. He asks about whether there is feedback from the team about outlier cases.
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Arwady's team says that because of outlier cases, diversionary housing is what is being advocated for in the expansion of this program. In the outlier cases, there were no settings that could treat the patient.
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Ald. Byron Sigcho Lopez asks about evaluating this pilot and the method. Dr. Arwady says that speaking to the learnings means adjusting the pilot and for the health department to become more intensive in their role.
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According to Dr. Arwady, the pilot has helped with identifying who falls through the cracks and creating systems to care for them. The Road Map Initiaive is cited. smartpolicyworks.com/wp-content/upl…
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Ald. Sigcho Lopez asks about the deployment in terms of de-escalation and the involvement of armed officers. Ursitti says they are into 40 hours of police training that involve consideration of an individual's response.
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This is in addition to the officers who receive CIT training as part of the CARE team.
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Ald. Sigcho Lopez says that the 40 hour training isn't enough if his ward is still struggling to receive those mental health resources. He is concerned with the next phase of budgeting and whether more mental health professionals will be added to the field.
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Dr. Arwady says that in the evaluation process, decisions can be made as to where those resources are allocated. Matt Richards, Deputy Commissioner of CPDH, says that there isn't an MDR team in Ald. Sigcho Lopez ward and that's because there is more to learn.
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Ald. Rodriguez Sanchez asks if the goal of the model is to not include police. Dr. Arwady says that the question they face is whether it should be an "and" or an "or" model and since there aren't indications from other models that an "or" model work, it isn't the goal.
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Matt Richards says that the data and goal is defining what type of response is given to each call. He predicts that there will be a space and a need for both.
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Ald. Rodriguez Sanchez asks about the instance of a MDR member being injured. Matt Richards says that the situation involved an EMS getting hurt during the transport of an individual. Additional info from the fire department says that there was no weapon involved.
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Dr. Arwady clarifies that the role of the CIT officer is to protect the CARE team member. Ald. Rodriguez Sanchez is confused about the role of CIT in the engagement.
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Antoinette Ursitti, deputy chief of training, says that this is after the fact information, whether there is an instance of weapon and that officer involvement wasn't needed. She speaks to the need for the officer to be on the scene to control any factors that might escalate.
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Ald. Rodguez Sanchez says that she is hopeful for the data leading toward responses that don't involve police involvement.
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Chairman Roderick Sawyer asks for a motion to adjourn. The meeting is adjourned at 2:31 PM

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Documents

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