Opioid Crisis Response Advisory Council Meeting Minutes - June 17, 2019

IDHS/SUPR Director Danielle Kirby welcomed the group and introduced Lizzy Whitehorn, First Assistant Deputy Governor. Ms. Whitehorn spoke on behalf of Deputy Governor Sol Flores. She noted that Deputy Governor Flores oversees HFS, IDHS, DCFS and the Department of Human Rights and has been charged by Governor Pritzker to help these agencies work better together. Ms. Whitehorn remarked that the Council is a good example of how agencies and organizations can join together to address a specific problem, i.e., the opioid crisis. The Deputy Governor will work with state agencies over the summer to identify what is working-and not working-in regard to efforts to address the opioid crisis. New efforts will build on the work of the Council and results of the membership survey.

Illinois Department of Human Services (IDHS) Remarks and Updates

  • Secretary Hou noted that the SFY2020 budget includes increases that are a welcome change from prior years' budgets. Director Kirby is working with HFS on rate increases. Secretary Hou echoed Ms. Whitehorn's remarks that to address the opioid crisis, we need to strengthen our broader system and take time to examine existing efforts and build on that work.
  • Director Kirby announced that SUPR will release a Notice of Funding Opportunity (NOFO) for Oxford Houses by the end of June. Oxford Houses are independent, democratically-run, self-supporting sober living homes. SUPR will provide funding to community-based organizations as two-year start-up loan to set up Oxford Houses for people on MAT. The organizations will provide housing and recovery support services. Residents are required to pay rent.
  • Director Kirby was a member of delegation from Illinois that visited an opioid prevention site in Canada in early June. Director Kirby described the visit as an eye-opening experience that has potential implications for our own harm reduction efforts. We will discuss this topic at a future Council meeting.

Illinois Department of Public Health (IDPH) Updates

Assistant Director Evonda Thomas-Smith gave the following updates:

  • Two grants funded through the CDC Opioid CoAg closed in early May. Awardees will be announced soon.
    • IDPH will fund 10 local health departments to strengthen opioid overdose and associated infections surveillance and response activities through internal capacity or coordination with partnered organizations via the Local Health Department Overdoses Surveillance and Response 2019 project. 
    • Six agencies will receive funding for the Harm Reduction Community Linkages Project to support capacity building at harm reduction organizations across the state to serve for individuals with opioid use disorder (OUD). IDPH did not receive any applications for the region that covers suburban Cook County, so this NOFO will be re-released in the near future.
  • The SAMHSA-funded Rural Illinois Opioid Overdose Prevention Initiative - Naloxone Distribution project will equip municipal police and sheriff departments in Illinois with naloxone and providing training on naloxone administration, overdose prevention, and treatment referral. Assistant Director Thomas-Smith will be conducting a statewide needs assessment of law enforcement agencies throughout the state as part of this project. The grantee will be announced in the coming weeks.
  • IDPH is supporting the Naloxone Education and Dispensing Program at Cook County Jail with the goal of increasing the number of individuals leaving corrections with access to naloxone. Information on this program will be shared at a future Council meeting.

Department of Healthcare and Family Services (HFS) Updates

Dr. Maria Bruni, Senior Policy Advisory, gave the following updates on behalf of Director Theresa Eagleson:

  • The Medicaid Advisory Committee is creating the Detox Subcommittee to examine the quality of care delivered in inpatient withdrawal management and how to better connect patients in those settings to MAT upon discharge. The next Detox Subcommittee meeting is Friday, June 21st from 10 AM - 12 PM, 401 S. Clinton (Chicago) HFS 7th floor conference room. (Note: Information about this meeting was emailed to the Council on June 17th).
  • HFS received feedback from the Centers for Medicare and Medicaid (CMS) on integrated health homes and has decided to have two models: a children's integrated health home model and an adult integrated health home model. The MedWac Advisory Council meeting to discuss these models and the state plan amendments that will be submitted to CMS is Friday, June 28th. The meeting to discuss the children's integrated health home model is from 10 AM to 12 PM. The meeting to discuss the adult model is from 1:30-3:30 PM. Both meetings will be held at 401 S. Clinton (Chicago) HFS 7th floor conference room.
  • There are three new proposed Healthcare Effectiveness Data and Information (HEDIS) measures related to substance use disorder for Medicaid patients. These include MAT use, continuity of care after withdrawal and continuity of care after residential treatment. The New Quality Measure Related to Substance Use Disorders in Medicaid (the CMS webinar to discuss new HEDIS measures) is Thursday, June 20th at 1:30 PM. (Note: Information on this webinar was emailed to the Council on June 17th). Council members asked if MAT could be beneficial to chronic pain patients who have been cut off from their opioids. It was noted that providers need to be educated about opioid tapering for people with chronic pain and whether MAT might help this process. Director Kirby suggested that the Prescribing Practices Committee explore this issue.
  • The Robert Wood Johnson Foundation offered a webinar on Medicaid and justice-involved populations: https://www.shvs.org/wp-content/uploads/2019/05/Justice-InvolvedPopulations.pdf.

Illinois Opioid Crisis Response Advisory Council Membership Survey Results

Dr. Sue Pickett, Deputy Director of the Center for Research and Evaluation at Advocates for Human Potential, Inc., gave the following presentation on the Council membership survey administered in May (see attached report):

  • The goal of the survey was to obtain Council members' feedback on the Council's functioning and effectiveness. A total of 74 Council members-approximately 32% of all current Council members-filled out a survey. The majority of survey respondents report that the Council functions well as a group, that Council materials and information are useful and relevant to their own work, and that they plan to continue to participate on the Council.
  • Survey respondents feel that Council and Committee activities are addressing Action Plan strategies except for strategies #4 (increase the impact of prevention programming in communities and schools), #6 (increase access to care for individuals with OUD) and #7 (increase the capacity of deflection and diversion programs statewide).
  • Survey results offer several important recommendations for next steps and future Council activities:
    • Increase the diversity of Council membership by reaching out to people with lived experience of OUD, families, front-line providers, Downstate and rural groups, and African Americans who reside in Chicago's South and West sides.
    • Create an Equity Committee to ensure that the Council and Committees are reaching diverse populations impacted by the opioid crisis.
      Re-structure Council meetings to provide opportunities for open discussion and dialogue.
    • Offer presentations on specific topics such as co-occurring mental health disorders, special populations and progressive therapies.
    • Discuss and disseminate data on what Illinois has accomplished regarding Action Plan strategies.
    • Incorporate the "bigger picture": engage and encourage state leadership to interact with the Council and discuss how the Council fits into and can play a role in shaping state opioid efforts.
  • In response to these recommendations, we are creating an Equity Committee that will be responsible for exploring how Council and Committee activities are impacting diverse populations and what we can do to reach out to and encourages these groups to participate on the Council. If you would like to serve on the Equity Committee, contact Sue Pickett at spickett@ahpnet.com. Over the summer, we will restructure the format of Council meetings to include more time for open discussion. We also will discuss strategies to engage people with OUD and other groups, such as convening meetings in the evening and other locations. SUPR will continue to meet with Deputy Governor Flores and other state leaders to discuss how the Council can support state opioid efforts.

Committee Reports

Committee Chairs gave a brief review of their work to date and future activities. Note: In 2017, the Task Force charged the Council to develop recommendations for each of the Action Plan strategies. The Chairs refer to these recommendations in their respective updates.

  • MAT Committee: Chair Ron Vlasaty shared that the MAT Committee's recommendations for Strategy #6 (increase access to care for people with OUD) including providing training and technical assistance to encourage providers to deliver MAT. In response to that recommendation, the MAT Committee is developing a toolkit to support Illinois providers who are interested in delivering MAT. Two subcommittees are leading this effort. The PreOpening Doors Subcommittee focuses on what needs to be in place before a provider can start delivering MAT. The Implementation Subcommittee focuses on what providers need to do to continue to successfully deliver MAT. A draft toolkit outline and components have been completed; these include an overview of the three forms of MAT, reimbursement mechanisms, navigating networks and community education and awareness. The final outline will be completed this summer.
    • Discussion: Council members noted that this toolkit will be useful in helping providers who are interested in delivering MAT understand what's involved and make the decision to move forward. We need to be sure that the needs of rural providers are addressed.
  • Children and Families Committee: Co-Chairs Carie Bires and Julia Zhu noted that the Children and Families Committee's recommendations focused on implementing activities to better meet the needs of children and families impacted by OUD (see attached handouts). For example, the committee recommended that the Helpline include texting, social media and other non-verbal forms of communication. Recognizing that there are several workgroups across state agencies that are focusing on children and families affected by SUD/OUD, the committee decided in November 2018 to bring these groups together and serve as a clearinghouse for cross-systems information sharing and collaboration. Goals for future work include obtaining data on the number of Illinois children whose caregivers have Illinois Opioid Crisis Response Advisory Council 6/17/2019 Meeting Minutes 4SUD/OUD disaggregated by race and geography, providing professional development opportunities to increase awareness of and education on OUD/SUD for family service providers, and implementing recommendations from prior and ongoing state agency workgroups.
  • Prescribing Practices Committee: Chair Mike Nelson noted that the Prescribing Practices Committee's recommendations addressed Strategy #1 (increase Prescription Monitoring Program (PMP) use) and Strategy #2 (reduce high-risk opioid prescribing through provider education and guidelines). Many of these recommendations were addressed by SB772, such as PMP integration in electronic medical records. The committee also reviewed and provided recommendations for SB336 (Opioid Alternative Pilot Program) and CMS' Pain Management Guidelines. Future work will focus on provider education on opioid tapering and strategies to increase the number of DATA waivered physicians in Illinois.
    • Discussion: Council members noted that PMP use increased dramatically after passage of SB772 (e.g., 10,649 new users joined the PMP in January 2018). Go to https://www.ilpmp.org/MonthlyStats.php to view data on PMP use. Other information on the PMP, including PMPnow can be found at: https://www.ilpmp.org/. It was suggested that a presentation on myPMP, which is currently undergoing beta testing, would be a good topic for a future Council meeting.
  • Criminal Justice Populations Committee: Chair Sherie Arriazola shared that there is wide representation of criminal justice providers on the committee, and the participation of these individuals has allowed the committee to develop recommendations across the continuum of pre-arrest to re-entry services. The committee's initial work was incorporated in Strategy #7 (increase the capacity of deflection and diversion programs statewide) and Strategy #9 (decrease the number of overdose deaths after an at-risk individual's immediate release from a correction or other institutional facility). Committee recommendations for these strategies included increased naloxone distribution and linkage to Medicaid and recovery supports at community re-entry. Future work will continue to focus on ensuring that incarcerated individuals get connected (or re-connected) with Medicaid at re-entry and increasing the number of correctional facilities that provide MAT.
  • Public Awareness & Education Committee: Chair Karel Homrig reviewed this committee's work to date (see attached handouts). Recommendations focused on Strategy #3 (increase the accessibility of information and resources). The committee identified primary target audiences for messaging (youth, people with OUD, people who have been prescribed opioids) and key core messages (basic facts about opioids and opioid misuse, naloxone, safe disposal). Committee members provided input and feedback on statewide media campaigns messaging campaigns. They recently developed a survey to help identify clergy's and educators' information needs. Future activities will involve reviewing the A Dose of Truth campaign's research to identify data that might help inform other Committee's messaging and education efforts.

IDPH Opioid Dashboard Overview

Sarah Brister and Dejan Jovanov, IDPH, gave the following presentation on the IDPH Opioid Dashboard (see attached handouts):

  • The Dashboard https://idph.illinois.gov/OpioidDataDashboard/ was released in March 2018. Its purpose is to integrate and share opioid data with the public and partners to inform efforts to combat the opioid epidemic statewide. The Dashboard currently provides information on opioid morbidity, mortality, prescription trends and Naloxone distribution locations. Data sources include hospital discharge data, vital record deaths and the PMP.
  • The Dashboard has five sections: opioid mortality and morbidity by county, demographic trends in morbidity and mortality, prescription opioid data, opioid mortality trends by opioid type, and naloxone distribution. Data from 2013-2018 are currently available. Data are updated quarterly.
  • Maps and graphs can be created for a variety of indicators (e.g., age, race, sex, opioid type). Most indicators can be filtered by year, geographic location and demographics. The Dashboard Tutorial provides information on how to use the Dashboard and create maps and graphics: https://www.youtube.com/watch?v=ojZ38aC9gIM.
  • Future additions to the Dashboard include: SUPR treatment data, syndromic surveillance data, mortality data from the State Unintentional Drug Overdose Reporting System, and additional PMP measures.
    • Discussion: Council members recommended including Department of Corrections data to identify individuals who overdose at re-entry. IDPH is working with ICJIA to merge these data into the Dashboard. Ms. Brister and Mr. Jovanov shared that the data workgroup is trying to understand all data needs and how that data might be incorporated in the Dashboard, including naloxone distribution and administration outcomes and post-treatment data. Council members suggested adding a link to the Google Earth drug disposal map https://www.google.com/earth/outreach/specialprojects/RXtakeback/.

September Council Meeting

  • Director Kirby announced that the Council will not meet in July and August. The next meeting will be Monday, September 16, 2019.
  • Note: Please review the roster that is included in the Council membership survey report.

Send any corrections to Sue Pickett at spickett@ahpnet.com