November 14, 2023

Illinois Opioid Remediation Advisory Board

Access & Equity Working Group Meeting

November 14, 2023

Virtual Meeting Held Via Zoom

Meeting Minutes

Access and Equity Working Group Members

Joel K. Johnson, TASC, Inc. (Chair)

David Gomel, PhD, Rosecrance

Mike Tyson, Take Action Today

Shane Pettigrew, Illinois State Police

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

Charles Stratton, Department of Human Resources, Sangamon County

James L. Grafton, Administrator, Rock Island County

Diana Bottari, MD, Advocate Aurora Health

Blanca Campos, Community Behavioral Healthcare Association

John Werning, Chicago Recovery Alliance

Mark Mulroe, A Safe Haven Foundation

Christopher Hoff, DuPage County Health Department

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. Shane Pettigrew, Blanca Campos, Mark Mulroe, and Christopher Hoff were not present. John Werning, Michael Wahl, Debbie Holsapple, and Jonnell Benson-Cobbs arrived after roll call. All other members were present. Quorum was established.

Review and Approval of October 10, 2023 Meeting Minutes

The October 10, 2023 meeting minutes were reviewed. There were no edits to the minutes. Mr. Johnson called for a motion to approve the meeting minutes. Mr. Stratton made a motion to approve the meeting minutes. Ms. Richardson seconded the motion to approve the meeting minutes. All working group members in attendance voted in favor of the motion. The motion passed.

Office of Opioid Settlement Administration Updates

Mr. Johnson said he recently met with Illinois Department of Human Services/Division of Substance Use Prevention and Recovery (IDHS/SUPR) Director Garcia, IDHS/SUPR Chief of Staff Dr. Rafael Rivera, and working group chairs. Recommendations that aimed to make the procurement process more equitable are not actionable because they would require a change in law, which is not allowed through the use of opioid settlement funding (OSF). The meeting included discussion of the Illinois Opioid Settlement Funding Overview document, which provides information on the settlement, the recommendation and procurement process, and approved strategies. Dr. Rivera reviewed the document with the working group.

  • The first section describes the OSF governance structure. The IORAB is the Advisory Board to the Governor's Steering Committee, and the working groups inform the IORAB.
  • The next section provides information on the recommendation process. In the absence of a Statewide Opioid Settlement Administrator (SOSA), all recommendations are currently being sent to Director Garcia and Chief of Staff Dr. Rivera.
  • All approved recommendations are subject to the state procurement process (SPP) and the Grant Accountability and Transparency Act (GATA). Recommendations will result in a competitive funding opportunity, an expansion of services, or an internal/interagency agreement. When Notice of Funding Opportunities (NOFOs) are available, they will be announced on an OSF website that is currently in development.
  • The next section discusses how funding amounts are determined. GATA rules require that a NOFO be put out again after three years. Recommendations can be re-submitted to request more funding.
  • The document includes a chart on overdose abatement strategies implemented in Illinois with state or federal funds. If the strategy is already funded, other funding options for a recommendation may be considered, as funding can't be supplanted. Mr. Johnson noted that some state agencies also have their own procurement rules. If the chart needs to be corrected, members should email Dr. Pickett (spickett@ahpnet.com).
    • A working group member asked about the case in which strategies are implemented in Illinois, but there is a need to scale up and add services that aren't billable. Dr. Rivera said that the recommendation must focus on what is not billable. The Office of Opioid Settlement Administration (OOSA) will always work with the submitter to develop a viable recommendation for OSF or find alternative funding.
    • In the case of the Illinois Prescription Monitoring Program (ILPMP), there were no longer funds to continue reaching the prescribers it was required to reach, which is why OSF could be used for expansion.
  • The Appendices include the core abatement strategy recommendation submission form. Completed forms should be sent to Tracey Loggins (Tracey.Loggins@illinois.gov). Dr. Rivera stated that two recommendations recently fell through the cracks for a period of time and are currently being reviewed. If there are questions about a recommendation's status, individuals should follow up to inquire. Working group members discussed the following:
    • A question was asked about strategy prioritization. Recommendations are reviewed as they come in without prioritization.
    • Increasing the relative value units (RVU) standard for opioid use disorder (OUD) so the payment is higher for treating clinicians could incentive providers to treat OUD. OUD treatment requires a skill set and should be reimbursed appropriately. Dr. Rivera said this would be a legislative change and is not possible with OSF. Dr. Pickett added that the Workforce Development and Infrastructure working group is developing recommendations that support the workforce.
    • Implementing core abatement strategies is an innovation for some organizations and should be incentivized beyond billable hours. A working group member asked if OSF could be used for additional associated costs. Dr. Rivera said the answer requires review of individual abatement strategies; recommendations must also follow GATA rules
    • Members discussed the purpose of the working group. A working group member said equity is increased by empowering those with the least power and least amount of opportunity
    • Working group members asked if there is a list of all submitted recommendations. Members expressed concern about proposals from peer-led organizations falling through the cracks. Dr. Rivera stated that the upcoming website will provide full transparency on the recommendations that have been approved. The meeting minutes are available and can be requested from Dr. Pickett (spickett@ahpnet.com). It would be difficult to provide information on all submissions because of the iterative process that follows. There is a system in place to prevent proposals from falling through the cracks. Each submission is logged and tracked by Tracey Loggins
    • Feedback or questions on the recommendation form should be sent to Tracey Loggins who will set up a meeting or phone call (Tracey.Loggins@illinois.gov).
  • Dr. Rivera reviewed Schedule A, core abatement strategies, and Schedule B, approved uses. OOSA reviews every strategy against this list to ensure they are included.
  • Mr. Johnson said that if there are additional questions about the document, they can be discussed at the next meeting.

Priority Recommendations for the IORAB

Mr. Johnson asked if there were any more recommendations the group wanted to begin to discuss, or come prepared to discuss, at the next meeting. There was no further discussion about recommendations. He asked the group if future meetings should be 90 minutes long or shortened to 60 minutes. Members expressed interest in 60-minute meetings. Mr. Johnson called for a motion to change the meeting length to 60 minutes. Dr. Bottari made a motion to change the meeting length to 60 minutes. Dr. Wahl seconded the motion. The motion carried. Dr. Pickett will send the group an updated calendar invite.

Public Participation

  • member of the public said that if an overdose prevention site (OPS) was set up as a study, legislative change wouldn't be needed. A 501c3 could be set up, and funding could potentially go to a 501c3 overseen by a syringe services program (SSP). This workaround could be considered by the working group, as was done by New York's Research for a Safer New York. The member of the public may forward the policy and procedures related to Research for a Safer New York to Dr. Pickett who will forward them to the group (spickett@ahpnet.com). There was discussion about whether the working group had considered this idea before. A working group member clarified that they had discussed OPS education and readiness activities.
  • member of the public asked about the website/database timeline. Dr. Rivera stated they are trying to get this completed as quickly as possible. The member of the public added that an opportunity to learn from service providers implementing OPS in other states would be beneficial.

Adjourn

Mr. Johnson asked for a motion to adjourn the meeting. Dr. Gomel made a motion to adjourn the meeting. Dr. Wahl 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 December 12, 2023, from 10:30am-11:30am.