Opioid Steering Committee Minutes 08.23.2024

Governor's Opioid Overdose Prevention and Recovery Steering Committee Meeting Minutes

Juliana Stratton - Lt. Governor
Dr. Sameer Vohra - Director, Department of Public Health
Dulce Quintero - Secretary, Department of Human Services

3rd Quarterly Meeting Pursuant to Executive Order 2023-08

Date and Time

August 23, 2024
3:00 PM to 4:30 PM

Meeting Location

Teleconference
Phone Number: +1 312 626 6799 US (Chicago)
Meeting ID: 824 7846 6620
Passcode: Illinois

Roll Call

Voting Members

Other State Agencies Represented

Agenda

1. Call to Order and Welcome
   1. Secretary Dulce Quintero called the meeting to order at 3:02 PM.
2. Roll call
   1. Dr. Sue Pickett of Advocates for Human Potential Inc. conducted roll call.
   2. A quorum was established.
3. Approve Agenda and Meeting Minutes
   1. Agenda for 8/23/24
      1. Motioned by Director Mueller
      2. Seconded by Mr. Tomsha
      3. All in favor
      4. No opposition
      5. No abstention
   2. Minutes for 5/30/24
      1. Motioned by Dr. Goya
      2. Seconded by Sherrie Arriazola Martinez
      3. All in favor
      4. No opposition
      5. No abstention
4. Chairs' Remarks
   1. Director Dr. Sameer Vohra
      1. Director Vohra discussed the CDC report that over 107,000 people in the United States died from drug overdoses in 2023. Even one death is challenging, but this number is the first reduction in overdose deaths since 2018. While we are moving in the right direction, there is still work to be done to prevent overdose deaths in Illinois and across the country.
      2. Director Vohra provided an update on the cluster of medetomidine overdoses that occurred in May. Investigation into this cluster is being led by the Chicago and Oak Park Departments of Public Health. On May 11, Illinois Poison Control informed IDPH and Chicago DPH that people had reported to multiple hospitals with symptoms of an opioid overdose; however, these individuals were not responding to naloxone. Investigation into these cases, including toxicology testing, showed that this lack of response was related to the presence of medetomidine, a powerful veterinary anesthetic that is not approved for use in humans. A public health investigation conducted in collaboration with the CDC identified 12 confirmed, 26 probable, and 140 suspect cases of medetomidine toxicity between May 11-17. Information about the symptoms and presentation of medetomidine toxicity will be published. The response to this overdose cluster was a successful collaboration across local, state, and federal organizations and community partners.
   2. Secretary Dulce Quintero
      1. Secretary Quintero highlighted work done by Health Management Associates (HMA) in collaboration with IDHS/SUPR to help county jails provide harm reduction services and Medication Assisted Recovery (MAR). HMA conducts a learning collaborative with staff at county jails to treat opioid use disorder (OUD) and reduce overdose mortality among people who are incarcerated through one-one-one coaching, guidance on evidence-based clinical practices and policies, and convening of stakeholders to support the development of integrated treatment.
      2. There are currently 26 active counties, representing 57% of the population of Illinois. A total of 1,160 detainees have received MAR in jail between January 2022 and June 2024. As of June 2024, 91% of detainees who were on MAR in the community continued to receive it while in jail.
      3. Other accomplishments include jails moving from having no MAR to offering all 3 FDA-approved medications, increased amounts of detainees receiving MAR, while in custody, jails developing processes for universal screening for substance use disorder (SUD), jails creating relationships with community treatment providers, and jails holding trainings for Narcan distribution.
      4. Kathleen Monahan, IDHS-SUPR's Statewide Opioid Response Administrator, will provide a complete update about harm reduction and MAR in county jails at the next steering committee meeting.
5. New Business
   1. Office of Opioid Settlement Administration Updates: Jim Wilkerson, Interim Statewide Opioid Settlement Administrator, Department of Human Services, Division of Substance Use Prevention and Recovery
      1. Mr. Wilkerson provided an update about activities related to the Illinois opioid remediation funds. To date, more than $196 Million (M) has been disbursed to the fund. Totals disbursed by calendar year are as follows: $86.3M, 2024; $80M, 2023; $29.7M, 2022. Approximately $772M in payments is expected during the next 15 years; however, this amount is subject to change.
      2. Mr. Wilkerson described work completed related to recommendations for use of the settlement funds during the prior year. The following recommendations were approved and funded via expansion of services: Community Intervention Services, Access Narcan, and Illinois Prescription Monitor Program (IL PMP). IL PMP has joined SUPR so it will no longer be funded via the remediation funds after state fiscal year 2024.
      3. Recommendations that were approved and awarded via notice of funding opportunity (NOFO) are as follows: Intra-muscular (IM) Naloxone and other FDA-approved Drugs to Reverse Overdose, Opioid Abatement Strategies Effectiveness Evaluator, and Community Outreach and Recovery Support (CORS). Announcements about these awardees can be found at the Illinois Illinois Opioid Settlement website.
      4. The Treatment for Incarcerated Population recommendation will be funded via an intergovernmental agreement (IGA) with Illinois Department of Corrections (IDOC) and the Harm Reduction recommendation will be funded via an IGA with IDPH.
      5. NOFOs for recommendations related to Pregnant and Post-partum People and their families, Warm Handoff and Recovery Services, and BASE Prevention Programs have closed, and notices of awards have been issued or will be issued in the next few weeks. Awardees will be posted on the Illinois Opioid Settlement website once they have signed contracts.
      6. SUPR is working with Advocates for Human Potential, Inc. to issue NOFOs for the Opioid Training and Technical Assistance Center (OTTAC) and the Opioid Treatment Programs (OTPs). These NOFOs will be posted on the Illinois Regional Care Coordination Agency website.
      7. The recommendation related to Contingency Management will be reconsidered at the October Illinois Opioid Response Advisory Board (IORAB) meeting. SUPR is negotiating with other state agencies related to the Capital Improvements recommendation.
      8. The IORAB and Steering Committee completed the following activities during 2024: supported the development of 15 approved recommendations, issued 7 NOFOs, issued awards to 44 organizations, and worked to develop 2 IGAs with IDOC and IDPH. An additional 3 NOFOs are in development with an anticipated launch date during calendar year 2024. Over $115M has been allocated to these programs. More information will be available in the Illinois Remediation Fund Annual Report which will be released this fall.
      9. Mr. Wilkerson presented the following recommendation developed by the IORAB Access & Equity workgroup:
         1. Recommendation A: Telehealth Expansion. Illinois Remediation funds shall address the unmet needs of individuals with OUD across the state, especially in rural areas and historically underserved communities. The recommendation is to 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). The funding request is for $5M over 3 years (one-time investment).
            1. A committee member asked if money would go to providers or service recipients. Mr. Wilkerson responded that the intention is for the money to go through providers to people receiving services who are in need.
            2. A committee member asked how the recommendation considered patient privacy and confidentiality, including the Health Insurance Portability and Accountability Act (HIPAA). Mr. Wilkerson responded that providers will be required to use software that is HIPAA-compliant and that providers may use the money to create private spaces for people to engage in telehealth.
            3. A committee member stated that the recommendation should include the following uses of funding: payment for medications for people without complete insurance coverage and prescribers' time. Director Garcia responded that they will examine how providers propose implementing telehealth within the limitations determined via legislation. While this recommendation focuses on start-up costs for telehealth, they will continue to look for ways to support expanded and sustainable telehealth.
            4. A committee member stated that smaller harm reduction organizations that are doing community-based work often do not have the administrative infrastructure to apply for and maintain grant funding and asked if there has been consideration for additional supports for these organizations. Mr. Wilkerson discussed that the Opioid Training and Technical Assistance Center (OTTAC) will provide support to smaller organizations to apply for funds. Director Vohra discussed building partnerships that allow grant money to flow from larger to smaller organizations. Secretary Quintero discussed the Hub & Spoke model which allows smaller organizations to expand telehealth services with less administrative burden. The committee also discussed that organizations providing harm reduction cannot bill insurance for these services which limits their ability to make services sustainable.
               Secretary Quintero called for a motion to approve the recommendation, which was followed by a roll call vote.
               Recommendation A: Telehealth Expansion
               1. Motioned by Sherrie Arriazola Martinez
               2. Seconded by Dr. Goyal
               3. Secretary Quintero, Director Vohra, Dr. Goyal, Ms. Arriazola Martinez, and Mr. Tomsha voted in favor of the recommendation.
               4. No opposition
               5. No abstention
6. Member Updates
   1. Mr. Tomsha mentioned that AuguFood & Drug Administration (FDA) recall of an over-the- counter product, Diamond Shruumz-brand chocolate bars, cones, and gummiesst is overdose awareness month and August 31 is international overdose awareness day. Organizations in Illinois are recognizing this via events, including a community conversation held by Illinois Harm Reduction & Recovery Coalition.
   2. Director Vohra gave the floor to Dr. Sarah Patrick of IDPH to discuss a Food & Drug Administration (FDA) recall of an over-the- counter product, Diamond Shruumz-brand chocolate bars, cones, and gummies. Dr. Patrick noted that these products are sold at vape shops in Illinois and have been linked with severe illness. They are working to ensure these products are removed from the shelves and asked the committee to help build awareness. Secretary Quintero offered to assist with conducting outreach.
   3. A committee member asked for more information about funding pathways for housing in Illinois to determine if opioid settlement funding could be used to support people with OUD who need housing. Director Garcia said that the CORS team, Home Illinois, and cannabis funding have been used for housing. Director Garcia will prepare additional information about funding pathways for housing.
7. Public Comment
   1. None
8. Adjournment
   1. Secretary Quintero called for a motion to adjourn the meeting.
   2. Motioned by Luke Tomsha
   3. Seconded by Dr. Goyal
   4. All in favor
   5. No opposition
   6. No abstention
   7. Secretary Quintero adjourned the meeting at 4:01 PM.
   8. The next meeting will be held November 7, 2024, from 10:00 - 11:30 AM