IORAB Medical & Research Workgroup Minutes 3.21.23

Illinois Opioid Remediation Advisory Board Medical & Research Working Group Meeting

March 21, 2023

Virtual Meeting Held Via Zoom

MEETING MINUTES

Medical and Research Working Group Members

Welcome and Roll Call

• Sue Pickett, PhD of Advocates for Human Potential, Inc., facilitator, welcomed the group and roll call was taken. All members were present except for Dr. Austman, Mr. Isaacson, Dr. Jasmin, Ms. King-Johnson, Dr. Lustig, Ms. Mehl, Dr. Rose, Dr. Smith, Ms. Thome, Dr. Olt, and Dr. Wahl. Quorum was established. Dr. Adams, Medical & Research Working Group Chair, welcomed the group.

Review and Approval of February 21, 2023 Meeting Minutes

• Dr. Gastala made a motion to approve the minutes. Dr. Ray seconded the motion. All members present voted in favor of approving the minutes. The motion passed.

Collaboration and Coordination with Illinois Opioid Crisis Response Advisory Council Committees

• Dr. Pickett gave an update on the work of the each of the Council Committee. We may wish to explore the potential synergy between the State Overdose Action Plan (SOAP) initiatives that the Committees are working on and the Medical & Research Working Group's recommendations.
• The Children and Families Committee focuses on issues related to children, youth, and families and the overdose crisis and is address SOAP Priorities 4, 12 and 20 (improving infrastructure to better serve the needs of families, access to MAR for pregnant and postpartum women, maternal morbidity and mortality) related to the opioid crisis.
• The MAR Prescribing Practices Committee focuses on SOAP Priorities 5, 6, and 10 (Prescription Monitoring Program peer educators, naloxone dispensing and buprenorphine initiation in emergency departments).
• The Criminal Justice Populations Committee focuses on justice-involved populations and is working on SOAP Priorities 22-25 (naloxone distribution, access to MAR in correctional facilities, naloxone distribution in correctional facilities and at community re-entry).
• The Public Awareness and Education Committee focuses on stigma reduction and youth prevention and is working on Priority 8 (stigma reduction campaigns for people of color, rural communities and justice-involved individuals).
• The Opioid Social Equity Committee focuses on strategies to address racial and ethnic disparities and is working Priorities 1-4.
• The Cross-Sector Data Committee examines and reviews data on the overdose crisis across state and local agencies and data repositories.
• Dr. Pickett shared that the Council Committees are not subject to the Open Meetings Act (OMA). Anyone may attend Committee meetings at any time. If you would like to attend a meeting, please email Dr. Pickett at spickett@ahpnet.com  Ms. Peyton stated that Council Committees may also propose recommendations, and these may be reviewed or refined by Working Groups. The Committees have a lot of information that may inform the recommendations proposed by Medical & Research

Priority Recommendations for the IORAB

• Dr. Adams led a discussion about proposed recommendations related to SOAP Priority #23, Ensure access to all forms of medications/MAR in correctional facilities and Priority #10, Increase initiation to buprenorphine in emergency departments. A draft recommendations document detailing information on barriers, barrier reductions, and solutions related to Priorities 23 and 10 was discussed.
• Ms. Peyton reminded the group that initiatives to increase access to MAR within county jails are ongoing and that the recommendations put forth by the Medical & Research Working Group should not duplicate those efforts.
  • A working group member reported that a learning collaborative funded IDHS/SUPR via federal State Opioid Response (SOR) monies is working to provide access to MAR in county jails. There has been some progress, but the program is voluntary, so not all jails are involved. While IDOC is interested in changing its practices regarding MAR in Illinois prisons, it is a challenging process. The Medical & Research Working Group's drafted recommendations propose to expand access to all three FDA-approved medications, and to harm reduction efforts, within Illinois jails and prisons.
• Working group members developed a summary statement recommending equal access to MAR and harm reduction for everyone in Illinois.
  • Group members discussed the following the importance of ensuring that medication induction is included in the statement, and that the statement and recommendations clarify that the intended audience includes people in county jails and IDOC facilities (i.e., prisons).
  • Working Group members will vote to approve the summary statement as well as the already drafted recommendations related to Priority 23. The document will be provided to Ms. Peyton for her review, and then forwarded to the IORAB.Ms. Peyton stated that if the IORAB approves the recommendations, it is possible that the Medical & Research Working Group might be asked for additional information to help inform a Notice of Funding Opportunity (NOFO). Additionally, the IORAB may provide the draft document to the Access & Equity Working Group to ensure that the proposed recommendations address access and equity.
• Dr. Adams made a motion to approve the summary statement and proposed recommendations related to Priority 23. Dr. Dennis seconded the motion. All working group members who were present voted in favor of approving the summary statement and proposed recommendations to move forward to Ms. Peyton for review and then the Advisory Committee. The motion passed.
• Summary Statement and Proposed Recommendations:
  • Equitable access to all forms of MAR, overdose treatment and prevention, harm reduction, and recovery support services - for any individual within the justice system.
  • Solutions to allow implementation of better access to medications for opioid use disorder (MOUD) within IDOC:
    1. Mandate/incentivize all counties to join the learning collaborative project funded by IDHS/SUPR and become active members
    2. Standardize the services for MOUD to include: common formularies among all facilities and appropriate staff to inmate ratio to maintain competent standard of care which should include: screening for all, referral of positive screens to providers for OUD treatment, case management for connection to outpatient resources upon discharge (MAR), and funding for transportation for IDOC warm handoffs
    3. Develop local community partnerships to allow for MOUD including suboxone treatment.
    4. Support/fund/expand peer support/peer re-entry support training and services
• The group discussed voting on Priority 10 proposed recommendations. Dr. Pickett shared that the MAR Prescribing Practices Committee is also working on Priority 10, and we may wish to invite the Committee chairs to attend the next meeting and describe these efforts. The group agreed to discussed Priority 10 recommendations at the April meeting.

Public Participation

• A member of the public asked about access to MAR in Illinois correctional facilities. A Working Group member explained that within IDOC facilities, only pregnant women who enter IDOC on MAR are allowed to receive MAR while incarcerated. Access to MAR in county jails is dependent on each individual jail's polices.