07.18.2024 Minutes

Illinois Opioid Remediation Advisory Board

July 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 4.18.24 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 April IORAB meeting minutes. All members except Jeffrey Ewing, Dr. Kathy Yoder, and Kevin Zeigler were present. Quorum was established. The ex officio roll call was taken. All ex officio members were present except Secretary Dulce Quintero and Director Brendan Kelly. Jennifer Epstein attended on behalf of Chief of Staff Laura Vaught; Andrea Law attended on behalf of Attorney General Kwame Raoul; and Anoushah Alie attended on behalf of State Representative LaShawn Ford. All IORAB members who were present approved the agenda and the meeting minutes.

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

Chief Jones reviewed the role of the IORAB and provided an update about funding.

  • The IORAB makes advisory recommendations to the Governor's Opioid Prevention and Recovery Steering Committee (Steering Committee) regarding the use of the 55% of settlement proceeds that are allocated to the Illinois Opioid Remediation Trust Fund. Recommendations must align with opioid core abatement strategies as established in the Illinois Opioid Allocation Agreement pdf.
  • Illinois was recently awarded the Certified Community Behavioral Health Clinic (CCBHC) Demonstration Grant. CCBHCs will increase access to integrated care, including treatment for Opioid Use Disorder (OUD), across the state. The Illinois Department of Healthcare and Family Services (HFS) is leading the implementation of this project which will begin on October 1, 2024. More information is available on the HFS website.

Illinois Prescription Monitoring Program: Craig Berberet, Illinois Department of Human Services (IDHS), IL PMPnow Team

Mr. Craig Berberet provided an overview of the Illinois Prescription Monitoring Program (PMP) Opioid Settlement Fund (OSF) project which expanded use of Illinois PMPnow.

  • The IL PMPnow is a secure one-to-one online connection that allows healthcare providers to access PMP data quickly, including during patients' appointments.
  • The goals of the IL PMPnow OSF project were to (1) increase connection points by working with different vendors and health systems, (2) increase the number of monthly patient queries, and (3) develop and build an online tracking system capturing use of PMPnow across the state.
  • IL PMP implemented a statewide outreach plan and tracked progress via an online dashboard showing the number of organizations and users connected to PMPnow. The dashboard allows filtering and can generate reports by region and month.
  • During the project, March 2023-June 2024, the PMPnow team supported 1,164 new connections between healthcare providers and PMPnow. The numbers of PMPnow queries increased with over 124 million in 2023 and 131 million projected to occur during 2024.

Discussion:

  • An IORAB member asked what other measurements the team uses to assess the impact of the PMPnow program. A PMP team member reported that they track the number of opioid prescriptions dispensed; this information is used to identify prescribers with high-risk prescribing practices and provide education. They also track the number of PMPnow connections that return patient data.
  • An IORAB member asked about opportunities to use data about rates of prescriptions for medications for opioid use disorder (MOUD) to inform prevention strategies at the county and zip code level. The PMP team responded that the IL PMP dashboard, which includes county-level data about MOUD prescriptions as well as other metrics, is used for strategy development. Recent legislation, Illinois General Assembly - Full Text of Public Act 102-0751 (ilga.gov), allows counties to create agreements to access deidentified PMP data.
  • An IORAB member asked about the percentage of Illinois healthcare organizations that have connected to PMPnow. The PMPnow team responded that this is a difficult number to calculate as there is no comprehensive list of all Illinois healthcare organizations. Identifying small providers is a challenge as they are not required to register with the state. The team is now working to identify providers based on specialty, starting with those most likely to prescribe opioids.
  • An IORAB member asked if methadone and/or opioid treatment program (OTP) data is available via PMPnow. An IL PMP member shared that the availability of this data depends on the patient granting permission for information sharing and the software provider.
  • An IORAB member stated that some providers have indicated that PMP data is less useful now as prescription opioids are no longer a primary cause of overdose and fatalities. Mr. Berberet responded that the IL PMP has approximately 80,000 unique users and adapts as needs change.

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.

  • The list of finalized national opioid settlements remains the same as it was at the April IORAB meeting. There are updates related to the settlements with Kroger and Purdue Pharma. Illinois signed a proposed settlement agreement with Kroger; this agreement is now being circulated to local governments for signature. Kroger will determine if there is sufficient sign-on for the agreement to be finalized. Kroger's settlement is for $1.2 billion nationally and $40M (million) for Illinois.
  • The Supreme Court rejected Purdue Pharma's national settlement in June; this plan was dissolved. A court in New York is working with stakeholders to develop a new bankruptcy plan.
  • More than $196M has been disbursed to the Illinois remediation fund to date. $86.3M has been disbursed during 2024, additional money is expected this calendar year. The projected amount of money to be received through 2038 is $772M. However, this amount is subject to change as additional settlements are in process.

Discussion:

  • An IORAB member asked if the numbers given for Purdue and Kroger were reflected in the projected amount to be disbursed, $772M. Ms. Law stated that these amounts were not included.
  • Chief Jones stated that the current understanding is if interest is earned on opioid settlement funds it is deposited into general revenue funds. Any updated information on this will be shared in future IORAB meetings.

Working Group Updates

Medical & Research: Adrienne Adams, MD, Chair

The Medical & Research Working Group voted to endorse the telehealth recommendation that will be discussed at today's IORAB meeting. The group also developed a recommendation to enhance prevention and intervention efforts for Illinois youth and families, including adolescents with opioid use disorder. The State Opioid Settlement Administrator (SOSA) is reviewing this recommendation.

Access & Equity: Joel K. Johnson, Chair

The Access & Equity Working Group developed the telehealth recommendation the IORAB will discuss at today's meeting. This recommendation supports the expansion of telehealth and technology to increase access to prevention, treatment, harm reduction, and recovery support services for rural and under-resourced communities in Illinois.

Workforce Development & Infrastructure: Blanca Campos, Chair

The Workforce Development & Infrastructure Working Group reviewed the telehealth recommendation and recommended that "harm reduction" be added to the services that would be supported. The group also began developing a recommendation to increase outreach, education, and training for high school, undergraduate and graduate students, and others about career opportunities in behavioral health. The draft recommendation includes support for scholarships, training guides, videos, and field experiences.

Office of Opioid Settlement Administration Updates: Douglas Washington, Office of Opioid Settlement Administration

Mr. Washington shared a list of approved recommendations and discussed the procurement process. The estimated annual funding cap for implementing these recommendations is $42M.

  • Grantees implemented the approved recommendations for Community Intervention Services, Access Narcan, and the IL PMP via expansion of services during state fiscal years (SFY) 2023 and 2024.
  • Three Notice of Funding Opportunity (NOFO) processes have been completed and awardees have posted on the ilopioidsettlements.com website.
  • The recommendations for Treatment for Incarcerated Populations and Harm Reduction will be implemented via intergovernmental agreements (IGAs) with the Illinois Department of Corrections (IDOC) and the Illinois Department of Public Health (IDPH) respectively.
  • NOFOs for four recommendations-Pregnant and Postpartum People and their Families, Warm Handoff Programs and Recovery Services, Build, Amplify, Support, Empower (BASE) Prevention Programs and Mobile Medication Assisted Recovery (MAR)-have closed and applications are being reviewed.
  • NOFOs for the Opioid Training and Technical Assistance Center (OTTAC) and Opioid Treatment Programs (OTPs) are under development and will be released in the next quarter.
  • The Steering Committee approved the Contingency Management (CM) recommendation at their July 2024 meeting. A NOFO for CM programs is under development.
  • The Capital Improvements recommendation is being negotiated with other state agencies.
  • IORAB activities during SFY2024 included: 15 recommendations approved, 7 NOFOs released, funds awarded to 16 organizations, and two IGAs and three NOFOs developed that will be released in calendar year 2024. A total of $115M has been allocated to these programs.
  • An IORAB member discussed that delays in announcements of awards can be difficult for applicants and asked if the process could be expedited. Director Garcia said that the NOFO and procurement process is mandated by the Grant Accountability and Transparency Act (GATA). The Regional Care Coordinating Agency (RCCA) receives applications; each application must be reviewed by three people. The RCCA is working on changes to expedite the review process.

New Funding Recommendations

The IORAB discussed and voted on the following recommendation.

  1. Recommendation A. Telehealth Expansion
  • Illinois Remediation funds shall provide initial/start-up funding to support telehealth expansion - including technology, resources, and education - to increase access to prevention, treatment, harm reduction, and recovery support services and immediate access to medication assisted recovery (MAR). These supports will focus on addressing the unmet needs of individuals with OUD across the state, especially in rural areas and historically underserved communities.
  • Funding request: $5M over 3 years (one-time investment)
  • An IORAB member asked for more information about the intended recipients of the telehealth expansion funding as the recommendation references both clients and providers. Director Garcia shared that treatment providers would be able to apply for this funding; but there may be limitations related to licensure. IDHS will work to address any limitations when developing the scope of work.
  • Ms. Nahlik made a motion to approve the recommendation for telehealth expansion. Dr. Gordon-Young seconded the motion.
  • Chief Jones opened the floor for discussion. An ex officio member recommended that the IORAB consider the sustainability of telehealth services after award funding ends. Additional workforce investment, such as having mobile medication assisted recovery (MAR) units visit areas served via telehealth could be beneficial. Mr. Johnson shared that the option of leasing vehicles is included in the recommendation and that the awarded start-up funds can be used to generate sustainable revenue via billing.
  • 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.

Public Comments

  • A member of the public asked how harm reduction agencies, who are not able to bill for services, could work towards sustainable telehealth services such as purchasing rather than leasing vehicles. Director Garcia will gather more information about regulations related to purchasing vehicles and provide additional information.
  • Chief Jones encouraged people to submit questions or comments related to the IORAB to Jim Wilkerson at jim.wilkerson@illinois.gov

Chair Closing Remarks and Adjournment

Chief Jones requested a motion to adjourn the meeting. Dr. Adams made a motion to adjourn the meeting. Dr. Young seconded the motion. The motion passed and the meeting was adjourned. The next meeting will take place on October 17, 2024 from 2:00pm-4:00pm.