Illinois Opioid Remediation Advisory Board
Access & Equity Working Group Meeting
August 8, 2023
Virtual Meeting Held Via Zoom
Meeting Minutes
Access & Equity Working Group Members
Joel K. Johnson, TASC, Inc. (Chair)
Ty Bechel, Bechel and Associates
David Gomel, PhD, Rosecrance
Mike Tyson, Take Action Today
Shane Pettigrew, Illinois State Police
Wyvetta Grainger, Community Member
Rebecca Estrada, Illinois Department of Commerce and Economic Opportunity (DCEO)
Stacey Stottler, Illinois Community College Board
Don Otis, Comprehensive Behavioral Health Center of St. Clair County
Jonnell Benson-Cobbs, DPN, Serenity Treatment and Counseling Center
Tim Devitt, PsyD, Private Practice
Gail Richardson, West Side Opioid Task Force
Debbie Holsapple, Jefferson County Comprehensive Services
Michelle Saddler, Kittleman & Associates, LLC
Charles Stratton, Department of Human Resources, Sangamon County
James L. Grafton, Administrator, Rock Island County
Jennifer Lehman, Burlington Community School District
Diana Bottari, MD, Advocate Aurora Health
Michelle Kavouras, PCC Community Wellness Center/New Directions Addiction Services
Blanca Campos, Community Behavioral Healthcare Association
Allison Arwady, MD, Chicago Department of Public Health
John Werning, Chicago Recovery Alliance
Mark Mulroe, A Safe Haven Foundation
Melissa Hernandez, Puerto Rico Project
Michael Wahl, MD, Illinois Poison Center, Illinois Health and Hospital Association
Welcome and Roll Call
Joel Johnson welcomed the group and called the meeting to order. Sue Pickett, PhD of Advocates for Human Potential, Inc. (AHP), facilitator, conducted roll call. All members were present except for Ty Bechel, David Gomel, Mike Tyson, Wyvetta Grainger, Rebecca Estrada, Stacey Stottler, Don Otis, Michelle Saddler, Charles Stratton, James Grafton, Jennifer Lehman, Blanca Campos, Allison Arwady, Mark Mulroe, Melissa Hernandez, and Michael Wahl. Quorum was not established.
Review and Approval of July 11, 2023 Meeting Minutes
The July 11, 2023 meeting minutes were reviewed. There were no edits to the minutes. The group agreed to vote on approval of the minutes by consensus. Dr. Bottari made a motion to approve the meeting minutes. Ms. Richardson seconded the motion. All working group members in attendance voted in favor of the motion. The motion passed.
Priority Recommendations for the IORAB
Mr. Johnson asked the group to consider strategies to put forward as recommendations. As a follow-up to last month's discussion, Sherrine Peyton, Statewide Opioid Settlement Administrator (SOSA), said that a recommendation about an Overdose Prevention Site (OPS) could not be funded unless legislation passes. The working group discussed OPSs:
- Representative Ford has proposed legislation related to an OPS pilot (HB0002), but there has been no action on the Bill in the last two months. If legislation passed, the group would have time to make a recommendation.
- Legislation passed amending the Drug Paraphernalia Control Act. Fentanyl test strips are legal and not considered drug paraphernalia.
- A member asked whether research or literature review regarding OPS best practices could be considered as a recommendation. This information could support OPS start-up (for example, addressing anticipated logistical barriers of an OPS) or advocacy efforts. The group discussed a potential proposal:
- Ms. Peyton stated that Substance Abuse and Mental Health Services Administration (SAMHSA) released a Harm Reduction Framework that may be helpful, and the SAMSHA summit she will attend may provide information. Mr. Johnson noted that they could add information about lessons learned from existing OPSs in other states. Dr. Pickett shared that preliminary data on the OPS in New York City show reduced emergency services costs. The West Side Heroin/Opioid Task Force is leading a project to engage and educate West Side community members about OPS; reports from this project could be a resource. An AHP team member will review research and share with the group.
- Ms. Peyton said that an OPS-related recommendation would fall under harm reduction; one of the approved uses is syringe service, and other evidence-informed programs to reduce harms, as well as space, are outlined. This is the language that should be included in a recommendation. Consumption by smoking would be covered by this type of recommendation.
- Mr. Johnson asked members to consider what OPS-related recommendations to propose before the September meeting. He will discuss this with Blanca Campos, who visited the OPS in New York. Another working group member noted that she has also visited the site. Members should send their ideas and any OPS-related resources to Dr. Pickett, who will distribute materials to working group members.
Access and Equity in Core Recommendations
Ms. Peyton reviewed the recommendations approved by the IORAB at the July13th meeting. In preparation for the Steering Committee meeting, Ms. Peyton asked the working group to provide feedback regarding access and equity issues pertaining to each strategy.
Core Strategy A. Naloxone and Other FDA-Approved Drug to Reverse Overdose. $3M ($1M a year for 3 years) to establish a system for intramuscular naloxone acquisition, supplies, and distribution for all seven regions.
- A working group member asked why intramuscular naloxone was called out in the recommendation. Ms. Peyton stated the IORAB approved additional funding for Access Narcan, which distributes nasal spray naloxone, at a prior meeting. Coalitions and IORAB members saw a need for intramuscular naloxone funding.
- A working group member recommended that mail programs and mobile efforts be included, especially for rural areas of the state.
Core Strategy B. Mobile Medication Opioid Use Disorder (MOUD). $15M ($5M a year/ for 3 years) with a rolling application to increase access to mobile services that provide medication assisted recovery, treatment, healthcare and recovery support services in areas with highest overdose rates and gaps in service. This includes purchasing the vehicle, staffing, security, insurance, and other related costs. Ms. Peyton asked the working group where mobile units are needed. A working group member said that mobile units are needed throughout the state.
Core Strategy C. Pregnant and Post-partum People (PPP) and their Families (wrap-around services). $6M ($2M/year for 3 years) to pilot comprehensive wrap-around services to PPP with opioid use disorder (OUD), and their families based on regional needs. Ms. Peyton asked the group to email Dr. Pickett (spickett@ahpnet.com) if they were aware of regions where this is needed.
Core Strategy E. Expansion of Warm Handoff Programs and Recovery Services. $6M ($2M/year for 3 years) to expand recovery services in high impact areas and procure new services where there is no provider, but services are needed based on data. Ms. Peyton asked if there were communities where this is particularly needed.
- A working group member said that one of the barriers to access and equity in delivering warm handoff and outreach services is that the services are delivered through a fee-for-service draw-down contract. Sometimes the money is returned because organizations can't provide enough billable hours within this sector; and sometimes services aren't tracked because organizations don't have the infrastructures to do this. Ms. Peyton stated that NOFOs for these funds will not be fee-for-service grants.
- Dr. Pickett noted that there were several questions in the chat about reimbursement, contracting, RFPs, and NOFOs. Ms. Peyton said that these will all be NOFOs through the Regional Care Coordination Agency (RCCA). They are expense-based, but organizations that are awarded may ask for some funds up front, because the payments are coming from the intermediary, not the state. Mr. Johnson noted that the group should be aware of accounting and revenue challenges to expense-based contracting, such as those related to workforce expenses. She said she has talked to the RCCA about financial technical assistance and will ensure it is offered.
Core Strategy F. Treatment for Incarcerated Populations. $6M ($2M /year for 3 years) to provide evidence-based MOUD services for those incarcerated or transitioning out of incarceration as well as training for the criminal justice system.
Core Strategy G. Prevention Services (selected, indicated, and harm reduction). $15M ($5M/year for 3 years to fund regional and local coalitions and/or organizations to coordinate and/or implement prevention programs, strategies, and efforts that focus on any of the following affected by the opioid crises: youth (pre-school+), individuals and families affected by the opioid crises, and disparately impacted schools, communities, or groups.
Core Strategy I. Data and Evaluation. $1.5M ($500K/year for 3 years). Up to $50K per sub-grantee/per year to conduct community-based participatory evaluation and/or to evaluate the effectiveness of innovative strategies funded by settlement dollars.
CORS Model Recommended Change. SUPR/OOSA Updated Recommendation: Open the CORs Model qualifications to recovery, peer organizations and harm reduction programs (certification not required), and treatment organizations; adjust the funding amounts per award to allow for more grantees and make the program a 3-year cycle ($5M/year) by adding $10M to make it a 3-year grant.
Capital Improvement Recommendation. Use of Opioid Settlement Funds for capital projects that support the Core Abatement. Ms. Peyton said funding amounts and the process for requesting, administering, and monitoring the funds are to be determined. She anticipates that the request for capital projects may go out in FY 2025.
Other
* Members inquired about funds that are paid directly to municipalities and how can those dollars be accessed. Ms. Peyton stated that all counties receive a portion of the State's 25% based on Census data. Municipalities and towns also receive funding based on their size. They are required to spend the money on approved abatement strategies. A working group member asked if they could spend the money based on their priorities or if they need to distribute it across the strategies. Ms. Peyton clarified that they could spend the money based on their own priorities as long as the priorities are part of the approved list. Reports are turned into the Attorney General's office and are turned into the Office of Opioid Settlement for tracking. A dashboard displaying how funds are used will be posted online. A working group member asked if there was a way to hold counties accountable if they are not dispersing funds in an equitable way. Peyton suggested that one could start by contacting their local attorney general's office or health department to find out what local entity is receiving direct payments.
Public Participation
- A member of the public expressed concern that their program won't receive funding because the local gatekeeper is opposed to harm reduction. Ms. Peyton stated that if funds dispensed directly to local entities are spent on something not on the core abatement list, the issue can be discussed with the Attorney General's office.
- A member of the public asked a question about the big three/Johnson & Johnson settlement, which states that 70% of the dollars that localities receive go to opioid abatement. He asked if it was Ms. Peyton's role to confirm that the 70% are being spent on opioid abatement. Ms. Peyton explained that her role is not to monitor the local entities' spending, but she assists the role of the Attorney General's Office with the task through local entities' quarterly reporting of spending.
- A member of the public asked if there is a learning lab for counties to share strategies. Ms. Peyton said that virtual open houses are being planned and will be announced in the Fall.
- A member of the public commented about a local entity developing a Request for Proposal (RFP) that is not very user friendly, so their small organization was unable to respond. Ms. Peyton said that individuals can feel free to email her with examples of RFPs (user-friendly and those that are not easy to respond to inform the state process of creating accessible user friendly applications; sherrine.peyton@illinois.gov).
- A member of the public provided this resource in the chat.
Adjourn
Mr. Johnson asked for a motion to adjourn the meeting. Ms. Richardson made a motion to adjourn the meeting. Mr. Pettigrew seconded the motion. All working group members present voted in favor of the motion. The motion passed. The next Access & Equity Working Group meeting will be held via Zoom on September 12, from 10:30am-12:00pm.
