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Illinois General Assembly· SB 2500Governor Approved

MOBILE MENTAL HEALTH PROVIDERS, the official text

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1  AN ACT concerning local government.

2  Be it enacted by the People of the State of Illinois,

3 represented in the General Assembly:

4  Section 5. The Community Emergency Services and Support

5 Act is amended by changing Sections 5, 15, 25, 30, 40, and 65

6 as follows:

7  (50 ILCS 754/5)

8  Sec. 5. Findings. The General Assembly recognizes that the

9 Illinois Department of Human Services Division of Mental

10 Health is preparing to provide mobile mental and behavioral

11 health services to all Illinoisans as part of the federally

12 mandated adoption of the 9-8-8 phone number. The General

13 Assembly also recognizes that many cities and some states have

14 successfully established mobile emergency mental and

15 behavioral health services as part of their emergency response

16 system to support people who need such support and do not

17 present a threat of physical violence to the mobile mental

18 health relief providers. In light of that experience, the

19 General Assembly finds that in order to promote and protect

20 the health, safety, and welfare of the public, it is necessary

21 and in the public interest to provide emergency response, with

22 or without medical transportation, to individuals requiring

23 mental health or behavioral health services in a manner that
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1 is substantially equivalent to the response already provided

2 to individuals who require emergency physical health care.

3   The General Assembly also recognizes the history of

4 vulnerable populations being subject to unwarranted

5 involuntary commitment or other human rights violations

6 instead of receiving necessary care during acute crises which

7 may contribute to an understandable apprehension of behavioral

8 health services among individuals who have historically been

9 subject to these practices. The General Assembly intends for

10 the Mobile Mental Health Relief Providers regulated by this

11 Act to assist with crises that do not rise to the level of

12 involuntary commitment. However, the General Assembly also

13 recognizes that Mobile Mental Health Relief Providers may,

14 during the course of assisting with a crisis, encounter

15 individuals who present an imminent threat of injury to

16 themselves or others unless they receive assistance through

17 the involuntary commitment process. This Act intends to

18 balance concerns about misuse of the involuntary commitment

19 process with the need for emergency care for individuals whose

20 crisis presents an imminent threat of injury.

21 (Source: P.A. 102-580, eff. 1-1-22; 103-105, eff. 6-27-23.)

22  (50 ILCS 754/15)

23  Sec. 15. Definitions. As used in this Act:

24  "Chemical restraint" means any drug used for discipline or

25 convenience and not required to treat medical symptoms.
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1   "Community services" and "community-based mental or

2 behavioral health services" include both public and private

3 settings.

4   "Division of Mental Health" means the Division of Mental

5 Health of the Department of Human Services.

6   "Emergency" means an emergent circumstance caused by a

7 health condition, regardless of whether it is perceived as

8 physical, mental, or behavioral in nature, for which an

9 individual may require prompt care, support, or assessment at

10 the individual's location.

11  "Mental or behavioral health" means any health condition

12 involving changes in thinking, emotion, or behavior, and that

13 the medical community treats as distinct from physical health

14 care.

15  "Mobile mental health relief provider" means a person

16 engaging with a member of the public to provide the mobile

17 mental and behavioral service established in conjunction with

18 the Division of Mental Health establishing the 9-8-8 emergency

19 number. "Mobile mental health relief provider" does not

20 include a Paramedic (EMT-P) or EMT, as those terms are defined

21 in the Emergency Medical Services (EMS) Systems Act, unless

22 that responding agency has agreed to provide a specialized

23 response in accordance with the Division of Mental Health's

24 services offered through its 9-8-8 number and has met all the

25 requirements to offer that service through that system.

26  "Physical health" means a health condition that the
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1 medical community treats as distinct from mental or behavioral

2 health care.

3   "Physical restraint" means any manual method or physical

4 or mechanical device, material, or equipment attached or

5 adjacent to an individual's body that the individual cannot

6 easily remove and restricts freedom of movement or normal

7 access to one's body. "Physical restraint" does not include a

8 seat belt if it is used during transportation of an individual

9 and the individual has access to the mechanism that releases

10 the seat belt.

11  "Public safety answering point" or "PSAP" means the

12 primary answering location of an emergency call that meets the

13 appropriate standards of service and is responsible for

14 receiving and processing those calls and events according to a

15 specified operational policy a Public Safety Answering Point

16 tele-communicator.

17  "Community services" and "community-based mental or

18 behavioral health services" may include both public and

19 private settings.

20  "Treatment relationship" means an active association with

21 a mental or behavioral care provider able to respond in an

22 appropriate amount of time to requests for care.

23 (Source: P.A. 102-580, eff. 1-1-22; 103-105, eff. 6-27-23.)

24  (50 ILCS 754/25)

25  Sec. 25. State goals.
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1   (a) 9-1-1 PSAPs, emergency services dispatched through

2 9-1-1 PSAPs, and the mobile mental and behavioral health

3 service established by the Division of Mental Health must

4 coordinate their services so that the State goals listed in

5 this Section are achieved. Appropriate mobile response service

6 for mental and behavioral health emergencies shall be

7 available regardless of whether the initial contact was with

8 9-8-8, 9-1-1 or directly with an emergency service dispatched

9 through 9-1-1. Appropriate mobile response services must:

10  (1) whenever possible, ensure that individuals

11  experiencing mental or behavioral health crises are

12  diverted from hospitalization or incarceration and are

13  instead linked with available appropriate community

14  services;

15  (2) include the option of on-site care if that type of

16  care is appropriate and does not override the care

17  decisions of the individual receiving care. Providing care

18  in the community, through methods like mobile crisis

19  units, is encouraged. If effective care is provided on

20  site, and if it is consistent with the care decisions of

21  the individual receiving the care, further transportation

22  to other medical providers is not required by this Act;

23  (3) recommend appropriate referrals for available

24  community services if the individual receiving on-site

25  care is not already in a treatment relationship with a

26  service provider or is unsatisfied with their current
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1   service providers. The referrals shall take into

2   consideration waiting lists and copayments, which may

3   present barriers to access; and

4   (4) subject to the care decisions of the individual

5   receiving care, coordinate provide transportation for any

6   individual experiencing a mental or behavioral health

7   emergency to the most integrated and least restrictive

8   setting feasible. A mobile crisis response team may

9   provide transportation if the mobile crisis response team

10  is appropriately equipped and staffed to do so.

11  Transportation shall be to the most integrated and least

12  restrictive setting appropriate in the community, such as

13  to the individual's home or chosen location, community

14  crisis respite centers, clinic settings, behavioral health

15  centers, or the offices of particular medical care

16  providers with existing treatment relationships to the

17  individual seeking care.

18  (b) Prioritize requests for emergency assistance. 9-1-1

19 PSAPs, emergency services dispatched through 9-1-1 PSAPs, and

20 the mobile mental and behavioral health service established by

21 the Division of Mental Health must provide guidance for

22 prioritizing calls for assistance and maximum response time in

23 relation to the type of emergency reported.

24  (c) Provide appropriate response times. From the time of

25 first notification, 9-1-1 PSAPs, emergency services dispatched

26 through 9-1-1 PSAPs, and the mobile mental and behavioral
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1 health service established by the Division of Mental Health

2 must provide the response within response time appropriate to

3 the care requirements of the individual with an emergency.

4   (d) Require appropriate mobile mental health relief

5 provider training. Mobile mental health relief providers must

6 have adequate training to address the needs of individuals

7 experiencing a mental or behavioral health emergency. Adequate

8 training at least includes:

9   (1) training in de-escalation techniques;

10  (2) knowledge of local community services and

11  supports; and

12  (3) training in respectful interaction with people

13  experiencing mental or behavioral health crises, including

14  the concepts of stigma and respectful language; .

15  (4) training in recognizing and working with people

16  with neurodivergent and developmental disability diagnoses

17  and in the techniques available to help stabilize and

18  connect them to further services; and

19  (5) training in the involuntary commitment process, in

20  identification of situations that meet the standards for

21  involuntary commitment, and in cultural competencies and

22  social biases to guard against any group being

23  disproportionately subjected to the involuntary commitment

24  process or the use of the process not warranted under the

25  legal standard for involuntary commitment.

26  (e) Require minimum team staffing. The Division of Mental
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1 Health, in consultation with the Regional Advisory Committees

2 created in Section 40, shall determine the appropriate

3 credentials for the mental health providers responding to

4 calls, including to what extent the mobile mental health

5 relief providers must have certain credentials and licensing,

6 and to what extent the mobile mental health relief providers

7 can be peer support professionals.

8   (f) Require training from individuals with lived

9 experience. Training shall be provided by individuals with

10 lived experience to the extent available.

11  (g) Adopt guidelines directing referral to restrictive

12 care settings. Mobile mental health relief providers must have

13 guidelines to follow when considering whether to refer an

14 individual to more restrictive forms of care, like emergency

15 room or hospital settings.

16  (h) Specify regional best practices. Mobile mental health

17 relief providers providing these services must do so

18 consistently with best practices, which include respecting the

19 care choices of the individuals receiving assistance. Regional

20 best practices may be broken down into sub-regions, as

21 appropriate to reflect local resources and conditions. With

22 the agreement of the impacted EMS Regions, providers of

23 emergency response to physical emergencies may participate in

24 another EMS Region for mental and behavioral response, if that

25 participation shall provide a better service to individuals

26 experiencing a mental or behavioral health emergency.
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1   (i) Adopt system for directing care in advance of an

2 emergency. The Division of Mental Health shall select and

3 publicly identify a system that allows individuals who

4 voluntarily chose to do so to provide confidential advanced

5 care directions to individuals providing services under this

6 Act. No system for providing advanced care direction may be

7 implemented unless the Division of Mental Health approves it

8 as confidential, available to individuals at all economic

9 levels, and non-stigmatizing. The Division of Mental Health

10 may defer this requirement for providing a system for advanced

11 care direction if it determines that no existing systems can

12 currently meet these requirements.

13  (j) Train dispatching staff. The personnel staffing 9-1-1,

14 3-1-1, or other emergency response intake systems must be

15 provided with adequate training to assess whether coordinating

16 with 9-8-8 is appropriate.

17  (k) Establish protocol for emergency responder

18 coordination. The Division of Mental Health shall establish a

19 protocol for mobile mental health relief providers, law

20 enforcement, and fire and ambulance services to request

21 assistance from each other, and train these groups on the

22 protocol.

23  (l) Integrate law enforcement. The Division of Mental

24 Health shall provide for law enforcement to request mobile

25 mental health relief provider assistance whenever law

26 enforcement engages an individual appropriate for services
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1 under this Act. If law enforcement would typically request EMS
2 assistance when it encounters an individual with a physical
3 health emergency, law enforcement shall similarly dispatch
4 mental or behavioral health personnel or medical
5 transportation when it encounters an individual in a mental or
6 behavioral health emergency.
7 (Source: P.A. 102-580, eff. 1-1-22; 103-105, eff. 6-27-23.)

8   (50 ILCS 754/30)

9   Sec. 30. State prohibitions. 9-1-1 PSAPs, emergency

10 services dispatched through 9-1-1 PSAPs, and the mobile mental

11 and behavioral health service established by the Division of

12 Mental Health must coordinate their services so that, based on

13 the information provided to them, the following State

14 prohibitions are avoided:

15  (a) Law enforcement responsibility for providing mental

16 and behavioral health care. In any area where mobile mental

17 health relief providers are available for dispatch, law

18 enforcement shall not be dispatched to respond to an

19 individual requiring mental or behavioral health care unless

20 that individual is (i) involved in a suspected violation of

21 the criminal laws of this State, or (ii) presents a threat of

22 physical injury to self or others. Mobile mental health relief

23 providers are not considered available for dispatch under this

24 Section if 9-8-8 reports that it cannot dispatch appropriate

25 service within the maximum response times established by each
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1 Regional Advisory Committee under Section 45.

2   (1) Standing on its own or in combination with each

3   other, the fact that an individual is experiencing a

4   mental or behavioral health emergency, or has a mental

5   health, behavioral health, or other diagnosis, is not

6   sufficient to justify an assessment that the individual is

7   a threat of physical injury to self or others, or requires

8   a law enforcement response to a request for emergency

9   response or medical transportation.

10  (2) If, based on its assessment of the threat to

11  public safety, law enforcement would not accompany medical

12  transportation responding to a physical health emergency,

13  unless requested by mobile mental health relief providers,

14  law enforcement may not accompany emergency response or

15  medical transportation personnel responding to a mental or

16  behavioral health emergency that presents an equivalent

17  level of threat to self or public safety.

18  (3) Without regard to an assessment of threat to self

19  or threat to public safety, law enforcement may station

20  personnel so that they can rapidly respond to requests for

21  assistance from mobile mental health relief providers if

22  law enforcement does not interfere with the provision of

23  emergency response or transportation services. To the

24  extent practical, not interfering with services includes

25  remaining sufficiently distant from or out of sight of the

26  individual receiving care so that law enforcement presence
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1   is unlikely to escalate the emergency.

2   (b) Mobile mental health relief provider involvement in

3 involuntary commitment. Mobile mental health relief providers

4 may participate in the involuntary commitment process only to

5 the extent permitted under the Mental Health and Developmental

6 Disabilities Code. The Division of Behavioral Health shall, in

7 consultation with each Regional Advisory Committee, as

8 appropriate, monitor the use of involuntary commitment under

9 this Act and provide systemic recommendations to improve

10 outcomes for those subject to commitment. In order to maintain

11 the appropriate care relationship, mobile mental health relief

12 providers shall not in any way assist in the involuntary

13 commitment of an individual beyond (i) reporting to their

14 dispatching entity or to law enforcement that they believe the

15 situation requires assistance the mobile mental health relief

16 providers are not permitted to provide under this Section;

17 (ii) providing witness statements; and (iii) fulfilling

18 reporting requirements the mobile mental health relief

19 providers may have under their professional ethical

20 obligations or laws of this State. This prohibition shall not

21 interfere with any mobile mental health relief provider's

22 ability to provide physical or mental health care.

23  (c) Use of law enforcement for transportation. In any area

24 where mobile mental health relief providers are available for

25 dispatch, unless requested by mobile mental health relief

26 providers, law enforcement shall not be used to provide
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1 transportation to access mental or behavioral health care, or

2 travel between mental or behavioral health care providers,

3 except where (i) no alternative is available; (ii) the

4 individual requests transportation from law enforcement and

5 law enforcement mutually agrees to provide transportation; or

6 (iii) the Mental Health and Developmental Disabilities Code

7 requires or permits law enforcement to provide transportation.

8   (d) Reduction of educational institution obligations. The

9 services coordinated under this Act may not be used to replace

10 any service an educational institution is required to provide

11 to a student. It shall not substitute for appropriate special

12 education and related services that schools are required to

13 provide by any law.

14  (e) This Section is operative beginning on the date the 3

15 conditions in Section 65 are met or July 1, 2025, whichever is

16 earlier.

17 (Source: P.A. 102-580, eff. 1-1-22; 103-105, eff. 6-27-23;

18 103-645, eff. 7-1-24.)

19  (50 ILCS 754/40)

20  Sec. 40. Statewide Advisory Committee.

21  (a) The Division of Mental Health shall establish a

22 Statewide Advisory Committee to review and make

23 recommendations for aspects of coordinating 9-1-1 and the

24 9-8-8 mobile mental health response system most appropriately

25 addressed on a State level.
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1   (b) Issues to be addressed by the Statewide Advisory

2 Committee include, but are not limited to, addressing changes

3 necessary in 9-1-1 call taking protocols and scripts used in

4 9-1-1 PSAPs where those protocols and scripts are based on or

5 otherwise dependent on national providers for their operation.

6   (c) The Statewide Advisory Committee shall recommend a

7 system for gathering data related to the coordination of the

8 9-1-1 and 9-8-8 systems for purposes of allowing the parties

9 to make ongoing improvements in that system. As practical, the

10 system shall attempt to determine issues, which may include,

11 but are not limited to including, but not limited to:

12  (1) the volume of calls coordinated between 9-1-1 and

13  9-8-8;

14  (2) the volume of referrals from other first

15  responders to 9-8-8;

16  (3) the volume and type of calls deemed appropriate

17  for referral to 9-8-8 but could not be served by 9-8-8

18  because of capacity restrictions or other reasons;

19  (4) the appropriate information to improve

20  coordination between 9-1-1 and 9-8-8; and

21  (5) the appropriate information to improve the 9-8-8

22  system, if the information is most appropriately gathered

23  at the 9-1-1 PSAPs; and .

24  (6) the number of instances of mobile mental health

25  relief providers initiating petitions for involuntary

26  commitment, broken down by county and contracting entity
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1   employing the petitioning mobile mental health relief

2   providers and the aggregate demographic data of the

3   individuals subject to those petitions.

4   (d) The Statewide Advisory Committee shall consist of:

5   (1) the Statewide 9-1-1 Administrator, ex officio;

6   (2) one representative designated by the Illinois

7   Chapter of National Emergency Number Association (NENA);

8   (3) one representative designated by the Illinois

9   Chapter of Association of Public Safety Communications

10  Officials (APCO);

11  (4) one representative of the Division of Mental

12  Health;

13  (5) one representative of the Illinois Department of

14  Public Health;

15  (6) one representative of a statewide organization of

16  EMS responders;

17  (7) one representative of a statewide organization of

18  fire chiefs;

19  (8) two representatives of statewide organizations of

20  law enforcement;

21  (9) two representatives of mental health, behavioral

22  health, or substance abuse providers; and

23  (10) four representatives of advocacy organizations

24  either led by or consisting primarily of individuals with

25  intellectual or developmental disabilities, individuals

26  with behavioral disabilities, or individuals with lived
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1   experience.

2   (e) The members of the Statewide Advisory Committee, other

3 than the Statewide 9-1-1 Administrator, shall be appointed by

4 the Secretary of Human Services.

5   (f) The Statewide Advisory Committee shall continue to

6 meet until this Act has been fully implemented, as determined

7 by the Division of Mental Health, and mobile mental health

8 relief providers are available in all parts of Illinois. The

9 Division of Mental Health may reconvene the Statewide Advisory

10 Committee at its discretion after full implementation of this

11 Act.

12 (Source: P.A. 102-580, eff. 1-1-22; 103-105, eff. 6-27-23.)

13  (50 ILCS 754/65)

14  Sec. 65. PSAP and emergency service dispatched through a

15 9-1-1 PSAP; coordination of activities with mobile and

16 behavioral health services.

17  (a) Each 9-1-1 PSAP and emergency service dispatched

18 through a 9-1-1 PSAP must begin coordinating its activities

19 with the mobile mental and behavioral health services

20 established by the Division of Mental Health once all 3 of the

21 following conditions are met, but not later than July 1, 2027

22 2025:

23        (1) the Statewide Committee has negotiated useful

24  protocol and 9-1-1 operator script adjustments with the

25  contracted services providing these tools to 9-1-1 PSAPs
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1   operating in Illinois;

2   (2) the appropriate Regional Advisory Committee has

3   completed design of the specific 9-1-1 PSAP's process for

4   coordinating activities with the mobile mental and

5   behavioral health service; and

6   (3) the mobile mental and behavioral health service is

7   available in their jurisdiction.

8   (b) To achieve the conditions of subsection (a) by July 1,

9 2027, the following activities shall be completed:

10  (1) No later than June 30, 2025, pilot testing of the

11  revised protocols;

12  (2) No later than June 30, 2026:

13  (A) assessment and evaluation of the pilots;

14  (B) revisions, as needed, of protocols and

15  operations based on assessment and evaluation of the

16  pilots;

17  (C) implementation of revised protocols at pilot

18  sites; and

19  (D) implementation of revised protocols by PSAPs

20  who are ready to implement, otherwise known as early

21  adopters; and

22  (3) No later than June 30, 2027, implementation of

23  revised protocols by all remaining PSAPs, including any

24  PSAPs that previously cited financial barriers to updating

25  systems.

26 (Source: P.A. 102-580, eff. 1-1-22; 102-1109, eff. 12-21-22;
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1 103-105, eff. 6-27-23; 103-645, eff. 7-1-24.)

2  Section 99. Effective date. This Act takes effect upon

3 becoming law.
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