IORAB Minutes 1.12.2023

Illinois Opioid Remediation Advisory Board Meeting Minutes

January 12, 2023

2:00 - 3:30 PM

Virtual Meeting Held Via WebEx

MEETING MINUTES

Illinois Opioid Remediation Advisory Board Members

Welcome and Roll Call

• Roll call of the Illinois Opioid Remediation Advisory Board (IORAB) was taken. Each member was present except for Mr. Borrayo, Ms. Rosenweig, and Dr. Yoder. Quorum was established. The ex-officio roll call was taken. All members except Chief Vaught, Representative Windhorst and Representative Ford were present. Adam Braun and Susan Ellis attended on behalf of Attorney General Raoul. Renee Martin attended on behalf of Senator Turner.

Approve Agenda and September Meeting Minutes

• Mr. Brauns made a motion to approve the January 12, 2023 agenda and the September 30, 2022 meeting minutes. Director Kelly seconded the motion. All IORAB members who were present voted to approve the agenda and the minutes. The motion passed.

Discussion of IORAB Structure and Process

Chief Jones reviewed the IORAB structure and process. Executive Order 2022-19 states that all funding from the Opioid Settlement Agreement shall be in alignment with the State Overdose Action Plan (SOAP) and the Illinois Opioid Allocation Agreement. There are several avenues for stakeholders to make recommendations for funding.

• As the Single State Authority for Substance Use Disorders in Illinois and the facilitator of the SOAP and associated bodies, and the home of the State Opioid Settlement Administrator (SOSA), IDHS/SUPR may make recommendations for funding to the IORAB.
• As appointed individuals to represent the state's interest and to bring subject-matter expertise, IORAB members may present recommendations during its regularly scheduled meetings or may send them to the SOSA.
• The IORAB Working Group chair(s) may present recommendations at regularly scheduled meetings or may send them to the SOSA.
• Recommendations may be submitted to the IORAB via public comment at regularly scheduled meetings or public comments may be sent to the SOSA.
• Recommendations should be submitted to the SOSA. Recommendations submitted at least two weeks before the next scheduled IORAB or Working Group meetings will be presented to the Members.
• The SOSA and IDHS/SUPR will review the recommendations to ensure alignment with the SOAP and the Illinois Opioid Allocation Agreement.
• The SOSA will develop an opinion to support, amend, or decline the recommendations for review with the Advisory Board.
• The IORAB will deliberate and vote to support recommendations.
• Any approved IORAB recommendations will be presented to the Governor's Opioid Overdose Prevention and Recovery Steering Committee for consideration. Per Executive Order 2022-19, the Steering Committee shall consider the Board's advisory recommendations and make the final determination as to the uses of Fund monies.
• The SOSA will ensure that the Attorney General or their designee certify compliance with the terms of the Illinois Opioid Allocation Agreement, the Settlements, and any court order prior to expenditure.
• Recommendations approved by the Steering Committee and certified by the Attorney General will be processed following all State procurement regulations.

It was noted that the SOAP and Illinois Opioid Allocation Agreement should be used to evaluate proposed recommendations. The IORAB may also want to consider whether proposed recommendations are being implemented and/or funded by other resources.

Working Group Updates

• Adrienne Adams, MD, Rosecrance, Chair, Medical & Research Working Group
• Dr. Adams provided an update on the Medical & Research Working Group. The Medical & Research Working Group met in December. The group developed and approved their mission statement. After discussing the SOAP, working group members agreed to initially focus on SOAP Priorities 10 and 23 (increasing buprenorphine initiation in emergency departments and ensuring access to all forms of medication/MAR in correctional facilities).
• Joel K. Johnson, President & CEO, Treatment Alternatives for Safe Communities (TASC), Chair, Access & Equity Working Group Mr. Johnson provided an update on the Access & Equity Working Group. The working group developed the following recommendations:

1. Create IORAB working group on workforce development
2. Provide funding for services for pregnant and postpartum women with opioid use disorder
3. Fund infrastructure support for small and emerging organizations
4. Provide sustainable funding for services that increase access to opioid use disorder treatment and recovery, including assertive outreach, peer-led team services, harm reduction, and practical assistance related to social determinants of health
   • A question was asked about how working group members were selected and if IORAB members can participate in the working groups. Director Garcia stated that the working group members were selected based on interest, background and experience. IORAB members may participate in working groups and should contact the SOSA (Sherrine.Peyton@illinois.gov ) if they would like to join a working group. Working group meeting dates and other information are posted on the website (IDHS: Illinois Opioid Remediation Advisory Board (state.il.us)).

Key Opioid Abatement Strategies

Access Narcan

• Ms. Peyton shared information on the request for additional funding for IDHS/SUPR's Access Narcan program. Access Narcan provides nasal naloxone to community organizations, hospitals and clinics at no cost. Monies are requested to address a funding gap for the program and ensure statewide naloxone saturation: $2 million is requested for FY2023 and $2.5 million is requested for FY2024. Increasing public access to naloxone is a SOAP strategy as well as an approved abatement strategy in the Opioid Allocation Agreement.

Expanding the Illinois Prescription Monitoring Program (ILPMP)

• Dr. Sarah Pointer, Clinical Director of the ILPMP presented the recommendation to expand the ILPMP. The ILPMP is an electronic database that collects, tracks, and stores reported dispensing data on controlled substances in schedules II-V and selected drugs of interest. The ILPMP supports clinical decisions and improves patient outcomes while preventing prescription opioid misuse, abuse, and diversion. Funds are requested to improve the ILPMP's software technology and increase the number of providers utilizing the IPMP: $750,000 for FY 2023 and $3 million for FY 2024.

Board Member Discussion of Proposed Recommendations and Votes

Board members discussed the recommendations under consideration.

• IORAB members asked if geography would be considered when distributing the funding to ensure equity in funding allocations. Chief Jones stated that the SOAP was created with consideration to geography and said he would include this information in processes going forward.
• It was noted that people with lived experience of opioid use often prefer intramuscular (IM) naloxone to Narcan, and increased access to and distribution of IM naloxone should be considered.
• IORAB members requested information on the total amount of settlement funds available and the percentage of funds being requested. Director Garcia stated that this information would be presented at a future meeting.
• IORAB members requested clarification as to why these existing programs require additional funding. Director Garcia stated that increased demand for Narcan to address overdoses statewide necessitates additional funding for Access Narcan. Additional funding for the ILPMP is needed to increase provider registration and use. It was noted that ILPMP costs are minimal and would not require additional, annual funding.
• IORAB members discussed concerns related to the ILPMP, including prescribers' fears of punitive action and patients' fears of losing access to needed opioid prescriptions. It was noted that the ILPMP is mandated by law.
• IORAB members requested that future meetings provide appropriate vetting of recommendations and allow more time for recommendation review and discussion.
• Chief Jones called for a motion to support additional funding for Access Narcan. Dr. Adams made a motion to approve the additional funding for Access Narcan. Mr. DeLoss seconded the motion. A roll call vote was conducted. All IORAB members present voted in favor of the motion. The motion passed.
  • The following IORAB members asked that caveats be added to their vote. Dr. Arwady requested information on Access Narcan's geographical distribution of Narcan; Dr. Gordon-Young and Ms. Laliberte Barnes requested additional information on the program; and Ms. Laliberte Barnes requested that the SOSA explore access to IM naloxone.
• Chief Jones called for a motion to support expansion of the ILPMP. Dr. Goyal made a motion to support ILMP expansion. Mr. Brauns seconded the motion. A roll call vote was conducted. Dr. Arwady, Ms. Ayala, Mr. Brauns, Ms. Campos, Dr. Gordon-Young, Mr. Johnson, Ms. Lechowicz, Mr. Ziegler, and Ms. Hampton voted in favor of the motion. Dr. Adams and Mr. Ewing abstained. Mr. DeLoss and Ms. Laliberte Barnes voted against the motion. The motion passed.
  • The following IORAB members asked that caveats be added to their vote. Dr. Arwady requested that geographic information on the ILPMP be provided. Ms. Ayala requested additional information on ILPMP expansion. Ms. Campos asked for a commitment to improve the ILPMP and utilize funding for infrastructure improvements so that other systems can integrate with the ILPMP. Dr. Gordon-Young requested the opportunity for more discussion on the ILPMP.

Public Comments

Ms. Peyton read comments submitted by the public:

• Sue Tinsdale, Duney's Defense, requested that funding to be concentrated in rural areas in central Illinois that have limited substance use resources, treatment options, transportation, and housing barriers.
• John Werning, Executive Director of Chicago Recovery Alliance, stated that Illinois needs money for syringe service programs, drug checking services, comprehensive overdose prevention materials, wound care, and housing.

Jamie Mosser, Kane County State's Attorney, spoke on behalf of Fight Crime: Invest in Kids Illinois. She discussed the need to fund voluntary home visiting programs and therapies for very young children.

Adjournment

Chief Jones called for a motion to adjourn the meeting. Ms. Laliberte Barnes made a motion to adjourn the meeting. Ms. Ayala seconded the motion. All members voted in favor of the motion; the motion passed, and the meeting was adjourned.  m