04.18.2024 Minutes

Illinois Opioid Remediation Advisory Board

April 18, 2024
2:00 - 4:00 PM

Virtual Meeting Held Via Zoom

Meeting Minutes

Illinois Opioid Remediation Advisory Board Members

Dr. Adrienne Adams, Rosecrance
Eddy Borrayo, Rincon Family Services
Ryan Brauns, Rockford Consulting & Brokerage
Blanca Campos, Community Behavioral Healthcare Association of Illinois
Jud DeLoss, Illinois Association of Behavioral Health
Jeffrey Carl Ewing, Monmouth-Roseville CUSD #238
Dr. Bernice Gordon-Young, SMART Recovery Intervention Program
Angie Hampton, Egyptian Health Department
Christopher Hoff, DuPage County Health Department
Joel K. Johnson, Treatment Alternatives for Safe Communities, Inc.
Chelsea Laliberte Barnes, Wolf Pack
Laura Lechowicz, Office of the Cook County President
Donna Nahlik, Chestnut Health Systems
Matthew Richards, Chicago Department of Public Health
Dr. Kathy Yoder, McLean County
Kevin Zeigler, Thresholds

Illinois Opioid Remediation Advisory Board Ex Officio Members

David T. Jones, Chief Behavioral Health Officer (CBHO)
Secretary Dulce Quintero, Illinois Department of Human Services (IDHS)
Laura Vaught, Chief of Staff, Illinois Department of Public Health (IDPH)
Director Brendan Kelly, Illinois State Police (ISP)
Dr. Arvind Goyal, Medical Director, Illinois Department of Healthcare and Family Services (HFS)
Jennifer Parrack, Chief of Programs and Support Services, Illinois Department of Corrections (IDOC)
Kwame Raoul, Attorney General
State Representative Patrick Windhorst
State Representative LaShawn Ford
State Senator Sally Turner

Call to Order/Welcome

Chief Jones called the meeting to order, welcomed the group, and reviewed the meeting agenda.

Roll Call and Approve Agenda and 1.18.24 Meeting Minutes

Dr. Sue Pickett, facilitator, of Advocates for Human Potential (AHP) conducted the roll call of the Illinois Opioid Remediation Advisory Board (IORAB) and a roll call vote for approval of the meeting agenda and the January IORAB meeting minutes. All members except Ryan Brauns, Bernice Gordon-Young, Angie Hampton, and Kathy Yoder were present. Quorum was established. The ex officio roll call was taken. All ex officio members were present except Secretary Dulce Quintero, Chief of Staff Laura Vaught, Director Brendan Kelly, and State Senator Sally Turner. Andrea Law and Susan Ellis attended on behalf of Attorney General Kwame Raoul; Tiffanie Clark attended on behalf of Jennifer Parrack, and Anousha Alie attended on behalf of State Representative LaShawn Ford. All IORAB members who were present, except Laura Lechowicz, voted to approve the agenda and the meeting minutes. Laura Lechowicz voted to approve the agenda and abstained from the meeting minutes vote.

Chairperson's Welcome Remarks: David T. Jones, Chief Behavioral Health Officer (CBHO)/Chair

Chief Jones gave a review of the recommendation process.

  • The IORAB makes advisory recommendations to the Governor's Opioid Prevention and Recovery Steering Committee. Recommendations must align with opioid core abatement strategies as established in the Illinois Opioid Allocation Agreement. Recommendations are submitted to the Statewide Opioid Settlement Administrator (SOSA) or State designee. The SOSA aggregates and presents recommendations at public meetings. The SOSA ensures that each recommendation is an allowable strategy in the Illinois Opioid Allocation Agreement, is not included in a recommendation that is pending or included in an open funding opportunity and would not supplant an existing effort before moving recommendations to the IORAB.
  • To date, 34 recommendations have been submitted. Of these, 18 met the requirements; 15 have been approved by the IORAB and 3 will be voted upon at today's meeting. Thirteen recommendations did not meet the requirements and three are in progress.

Open Meetings Act and Conflict of Interest Presentation: Rachel A. Diamond, Illinois Department of Human Services, Associate General Counsel

Ms. Diamond provided an overview of the Open Meetings Act (OMA) and conflicts of interest.

  • OMA is a state law that requires that meetings of public bodies be open. IORAB meeting notices and agendas must be posted on the IDHS website 48 hours in advance of the meeting. Meeting minutes must be taken and include a list of members in attendance and a record of votes taken. The public must be given the opportunity to speak at the meeting. The definition of a public meeting applies only when a majority of a quorum is gathered. This is the smallest number of members of a public body to control action when a quorum is present. Nine members of the IORAB members establish quorum and five members establish a majority of a quorum. Quorum must be present to discuss public business, including deliberation and voting. IORAB members cannot discuss committee business outside of meetings.
  • OMA requires that the IORAB appoint one member to serve as a designee; this person is responsible for staying apprised of OMA requirements. All IORAB members are required to complete the OMA training once and the designee must complete OMA training annually. Information can be found on the IORAB website: Member Training Requirements
  • IORAB members should be transparent about any personal involvement or conflicts of interest that may affect funding regulations. Potential conflicts of interest should be discussed with the IORAB Chair and/or the Illinois Department of Human Services (IDHS) Ethics Officer at DHS.EthicsOfficer@Illinois.gov. Questions may be submitted to interim Statewide Opioid Settlement Administrator (SOSA) Jim Wilkerson (Jim.Wilkerson@Illinois.gov) who will forward the question to Ms. Diamond or another member of the Counsel team.
  • Discussion:
    • An ex-officio member asked if subcommittee meetings are also required to be open to the public. Ms. Diamond said yes, subcommittee meetings (i.e., working group meetings) are subject to OMA. The ex-officio member asked if IORAB members who are voting on a recommendation need to recuse themselves from a vote when they don't know whether or not their organization will apply to a related notice of funding opportunity (NOFO) in the future. Ms. Diamond said they do not need to declare a conflict of interest in this case.
    • An IORAB member clarified that if a recommendation is submitted to the Steering Committee and approved, an IORAB member's organization may respond to the subsequent NOFO. Ms. Diamond said this would not be a conflict of interest because there is a competitive process for funding the recommendation.

Office of Attorney General Kwame Raoul, National Opioid Settlements Update: Andrea Law, Deputy Bureau Chief, Health Care Bureau

Ms. Law provided an update on the national opioid settlements.

  • Two additional national settlements have been finalized, Publicis Health and Endo. The Publicis Health settlement was entered in Illinois in February. There have been longstanding investigations and negotiations with Endo. Endo has been in bankruptcy since 2022. There is an opioid settlement to be effectuated as part of the bankruptcy plan. The bankruptcy court issued its order confirming the bankruptcy plan on March 22, and the plan will be effective in the near future. Both settlements will involve one-time payments that will come this calendar year.
  • To date, more than $118 million has been dispersed to the Illinois Remediation Fund. The grand total of received and estimated fund distributions is $772 million.
    • An IORAB member asked if the interest that accrues on these funds stays in the Illinois Remediation Fund for distribution. Chief Jones will get more information and provide an answer at a later date.

Working Group Updates

Medical & Research: Adrienne Adams, MD, Chair

Dr. Adams stated that at the January IORAB meeting, the IORAB asked the Medical & Research Working Group to review the research on 8 mg naloxone to help inform the discussion on this recommendation. At the March working group meeting, the group learned that the interim SOSA is expecting to receive new research on 8 mg naloxone, so the review is on hold until this new research is received. The contingency management (CM) and the Opioid Treatment Program (OTP) recommendations that will be voted on today were submitted by the working group. Dr. Adams received a letter from the Illinois Health and Hospital Association with recommendations submitted by individual hospital and health systems. Some of the recommendations have been approved by the IORAB and Steering Committee and some are addressed by new legislation. The working group will have a more in-depth discussion about these recommendations at their May meeting.

Access & Equity: Joel K. Johnson, Chair

At the January IORAB meeting, there was a discussion about the working groups' role in the recommendation review process and a request for greater transparency. In response, the Chairs, Mr. Wilkerson, and Dr. Pickett met to develop strategies to increase the working group's involvement in the review process. Chairs and Mr. Wilkerson will meet as needed to review the recommendations that have been submitted to the Office of Opioid Settlement Administration. Chairs will decide which recommendations are relevant to their working group; these recommendations will be shared with the respective working group(s) before they are presented to the IORAB. All working groups will continue to develop new recommendations. The Access & Equity working group voted to support the training and supervision recommendation that will be voted on today. They are in the process of developing technology-related recommendations that align with the approved use of funds to expand telehealth to increase access to treatment and recovery supports. The group is drafting a recommendation that will fund telehealth services and increase capacity to provide telehealth services and anticipate presenting this recommendation at the July IORAB meeting.

Workforce Development & Infrastructure: Blanca Campos, Chair

As with other working groups, the Workforce Development & Infrastructure Working Group had discussions about their new role in reviewing recommendations and the group's request for greater transparency. They also discussed how to strengthen the recommendation supporting training and supervision for the behavioral workforce. As future recommendations for settlement funds are reviewed, paid field training experience will be added, when appropriate, as an additional component.

Office of Opioid Settlement Administration Updates: Jim Wilkerson, Interim Statewide Opioid Settlement Administrator

Mr. Wilkerson shared a list of approved recommendations and discussed the procurement process used to implement the strategies. The Notice of Funding Opportunity (NOFO) for three approved recommendations are closed and have completed their merit reviews. NOFOs for Build, Amplify, Support, Empower (BASE Prevention Programs) and the Pregnant and Postpartum People (PPP) and their Families are currently open. NOFOs for the Warm Handoff Programs and Recovery Services and Mobile Medication-Assisted Recovery (MAR) will be released during this fiscal year.

New Funding Recommendations

  1. Recommendation A. Training and Supervision
    • Illinois Remediation funds shall be dedicated to support paid training experiences/field training experiences and the expansion of dedicated clinical supervision (when not reimbursed or funded by other means).
    • Paid experiences should include, but not be limited to, entry-level and early career clinicians, peer support specialists, harm reduction providers and individuals working toward licensure or certification within a Substance Use Prevention and Recovery (SUPR) licensed or funded organization.
    • This recommendation will add funding to the Opioid Training and Technical Assistance Center (OTTAC) for the administration of the paid experiences. This will allow smaller organizations to apply and receive funding.
    • Field training experiences should also be considered and funded by, where appropriate, each proposed recommendation submitted by the IORAB.
    • Funding request: $3 million over 3 years ($1 million per year).
  2. Recommendation B. Contingency Management (CM)
    • CM involves rewarding or punishing a behavior to increase or decrease its frequency, respectively.
    • CM used with opioid use and other substance use disorders has been widely researched and shown to be effective. This includes improving retention, medication compliance, reducing opioid use, and co-occurring stimulant/other drug use.
    • Recommends the IORAB support a pilot to trial CM across the state. The recommendation will support start-up costs for program set-up acquiring staffing, implementation tools and resources, and incentives. Due to the complexity of the program, funding will be considered at a future meeting if the IORAB approves pursuing the pilot program.
    • Funding request: to be determined; SUPR will collect additional information to determine the cost.
  3. Recommendation C. Opioid Treatment Program
    • Illinois Remediation funds shall be dedicated to establishing partnerships between opioid treatment programs (OTPs) and federally qualified health centers (FQHCs), hospitals, clinics and public departments of health. Partnerships created between existing OTPs and medical entities to start new satellite OTP locations within medical sites will also be supported.
    • These partnerships will enable OTPs to increase access to methadone to priority populations as well as in Medication-Assisted Recovery (MAR) "desert" regions of the state.
    • Funding is for start-up expenses only for one year (two years will be considered for health organizations that have not completed the regulations process).

Board Recommendations and Discussion: David T. Jones, CBHO/Chair

The IORAB discussed and voted on the three recommendations.

  1. Recommendation A. Training and Supervision
    • Chief Jones called for a motion to approve the recommendation. Ms. Campos made a motion to approve the recommendation. Mr. Johnson seconded the motion.
    • An IORAB member asked how the funding amount was determined. Mr. Wilkerson said that funding for other recommendations was a consideration. The current funding recommendation will allow the initiative to begin; if more funding is needed, the IORAB may be asked to consider more funding.
    • An IORAB member asked if field training experiences will be coordinated through the OTTAC or if organizations will be able to set up field training experiences and then direct individuals to apply for funding. Mr. Wilkerson said organizations would be able to set up field training experiences and direct individuals to apply for funding. In some cases, the OTTAC could provide supervision.
    • An IORAB member asked if funds could be used to support student training or if the recommendation was intended for individuals in the workforce. Mr. Wilkerson and another IORAB member clarified that the recommendation supports student internships and field training.
    • Chief Jones called for a vote. A roll call vote was taken by Dr. Pickett. All members present voted in favor of the recommendation. The motion passed.
  2. Recommendation B: Contingency Management (CM)
    • Chief Jones called for a motion to approve the recommendation. Mr. Hoff made a motion to approve the recommendation. Dr. Adams seconded the motion.
    • Some IORAB members asked for clarification regarding the stage of the recommendation. Chief Jones stated they want to ask for approval for the concept of CM, and the recommendation will come back to the IORAB before it moves to the Steering Committee.
    • Some IORAB members expressed concerns about the recommendation, noting that the recommendation language was stigmatizing. Other IORAB members commented that CM studies have been conducted on abstinence-based models and the recommendation should be implemented with a harm reduction approach.
    • Some IORAB members asked why the proposal was brought to the IORAB without a funding request. Mr. Wilkerson said they still need to determine how much funding will be required. Determining the funding amount will take a lot of time and effort. Director Garcia said that Mr. Wilkerson will need to consider different populations and regions of the state to come up with a cost. Director Garcia said that if the IORAB doesn't believe opioid settlement funding should be used for CM, then the State will not need to spend time determining the costs. Chief Jones said the capital funding recommendation was also brought the IORAB without a funding request. He said that given the level of complexity, approving the recommendation is better as a two-step process.
    • An IORAB member expressed that approving the recommendation without a funding request would be confusing to the public. Director Garcia said SUPR will take this into account.
    • Chief Jones called for a vote. Dr. Pickett conducted a roll call vote. All members present voted in favor of the recommendation. The motion passed.
  3. Recommendation C: Opioid Treatment Program
    • Chief Jones called for a motion. Ms. Laliberte Barnes made a motion. Mr. DeLoss seconded the motion.
    • Chief Jones called for vote. Dr. Pickett conducted a roll call vote. All members present voted in favor of the recommendation. The motion passed.

Public Comments

A member of the public asked about the grant application process. Mr. Wilkerson will contact the individual with more information.

Chair Closing Remarks

Chief Jones thanked the group.

Adjournment

Chief Jones requested a motion to adjourn the meeting. Ms. Nahlik made a motion to adjourn the meeting. Ms. Laliberte Barnes seconded the motion. The motion passed and the meeting was adjourned. The next meeting will take place on July 18, 2024 from 2:00pm-4:00pm.