Illinois Remediation Funds State Fiscal Year 2024 Annual Report

Illinois Opioid Remediation Advisory Board

Illinois Remediation Funds

State Fiscal Year 2024 Annual Report

November 02, 2024

Dear Reader,

This report provides a comprehensive overview of the activities and plans executed by the Illinois Opioid Remediation Advisory Board (IORAB) during State fiscal year 2024. It is designed to inform stakeholders and partners of the IORAB about the critical work undertaken and the achievements realized over the past year. Furthermore, it outlines the forward-looking goals and introduces the metrics that will be used to monitor our progress.

The development of this report was guided by a clear intention to define the IORAB's vision in addressing the opioid crisis and the thoughtful utilization of the settlement funds. This document outlines our vision and goals, detailing the metrics and results that will guide the Board's future financial decisions and strategic recommendations.

As Chair of the IORAB, I would like to express my deep gratitude to all members, partner organizations, government departments, persons with lived experience, and the public for their dedicated efforts over the last year. Your commitment has been vital in ensuring the safety and promoting the equity of individuals affected by the opioid crisis.

Your continued interest and support are invaluable as we tackle the complexities of the opioid epidemic. The IORAB remains committed to directing settlement funds toward those communities and individuals most adversely affected. Your engagement is crucial as we navigate the challenges ahead and strive to implement effective solutions.

This report marks a significant milestone in our ongoing efforts to combat opioid misuse in Illinois, and I invite you to engage with its contents as we look to a future of meaningful impact and sustained progress.

Sincerely,

David T. Jones

Illinois Chief Behavioral Health Officer

Chair of the Illinois Opioid Remediation Advisory Board

Through October 31, 2024

Contents

Executive Summary 4

Acknowledgements 6

Background 7

Establishing a Fair and Transparent Process for the Use of the Illinois Opioid Remediation Funds 8

Root Causes of Opioid Epidemic  10

Opioid Use Disorder Ecosystem 11

Illinois Opioid Remediation Trust Fund 11

IORAB OPIOID REMEDIATION TRUST FUND VISION 12

RISE GOALS 12

  1. Relieve multi-generational harms 12
  2. Increase access to Harm Reduction services 13
  3. Support Treatment and Prevention services 13
  4. Enhance access to recovery supports 13

IRF Update 14

FY2024 Progress 14

Appendix

A: Opioid Settlement Funding Requirements

B: Recommendation Submission Process

C: Funded Programs/Projects

D: Resource Links

E: Root Causes of Opioid Epidemic: Deep Dive

F: Current Illinois Overdose Program & Policy

G: Linkage Between RISE Goals, Root Causes of Opioid Crisis, Opioid Ecosystem, & the SOAP

H: Glossary

I: References

Executive Summary

Strategic Overview and Funding: With an anticipated $772 million in the Illinois Opioid Remediation Trust Fund (IRF) over the next 15 years, Illinois is dedicated to using settlement funds to eliminate the impacts of opioid misuse in the state and reverse the harm to our communities, particularly those disproportionately affected by the opioid crisis. The Governor's Opioid Overdose Prevention Steering Committee, the Illinois Opioid Remediation Advisory Board, and the Illinois Department of Human Services Division of Substance Use Prevention and Recovery are spearheading these efforts.

Implementation of RISE Goals: These bodies will utilize the RISE goals: Relieve multi-generational harms, Increase access to harm reduction services, Support treatment and prevention services to ensure an accessible, recovery-oriented system, and Enhance access to recovery supports. These goals align with the Illinois State Overdose Action Plan and the requirements of entities that approve funding use, guiding future funding allocations with a focus on historically underserved communities to maximize impact.

Program Initiatives and Outcomes: In State fiscal year 2024, the Illinois Opioid Remediation Advisory Board passed 14 recommendations that allocated over $115 million for new and expanded opioid abatement strategies statewide. Following these recommendations, the Regional Care Coordination Agency, along with the Illinois Department of Human Services' Division of Substance Use Prevention and Recovery, launched seven Notices of Funding Opportunities within a six-month period. This led to unprecedented application submissions, with over 150 applications processed, demonstrating a robust response to the funding opportunities. The application and funding processes were designed to facilitate access for smaller organizations, highlighting the State's commitment to inclusivity and accessibility. (Notices of Funding Opportunities and awardee information are published on the Illinois Opioid Settlements Initiative website.)

Transparency and Public Engagement: The commitment to transparency is underscored by the open nature of the Illinois Opioid Remediation Advisory Board and related Working Group meetings, where the public can observe and offer comments in accordance with the Open Meetings Act.

Analytical and Advisory Framework: The following report and appendices include a root cause analysis of the opioid crisis and a discussion of the opioid use disorder ecosystem. Both of these, inform the Illinois Opioid Remediation Advisory Board and Division of Substance Use Prevention and Recovery's consideration and implementation of recommendations. State fiscal year 2024 was a highly productive year both for the Illinois Opioid Remediation Advisory Board and Illinois Remediation Funds.

Further Information: For more details regarding this report or ongoing initiatives, stakeholders and interested parties are encouraged to contact the State via email at DHS.OpioidSettlementFunds@Illinois.gov.

This report highlights Illinois' strategic approach to mitigating the opioid crisis through robust funding mechanisms, innovative program implementation, and rigorous policy oversight, aiming for long-term societal and health improvements.

If you have strategy recommendations for the IORAB, submit them here:

https://forms.office.com/g/MzBD9WV5zw

Acknowledgements

The work of the Illinois Opioid Remediation Advisory Board was informed by those with lived experience who shared their personal stories, the Governor's Opioid Overdose Prevention Steering Committee, the Substance Use Disorder Advisory Council, presentations and testimony from experts, and stakeholder feedback in consultation with Illinois Department of Human Services Division of Substance Use Prevention and Recovery and Office of Opioid Settlement Administration.

This report was informed by the State Overdose Action Plan and other State plans that address opioid prevention, treatment, and recovery. Preparation of the report also included the collection and consideration of national guidance and evidence-based and culturally appropriate strategies for prevention and abatement.

The Illinois Opioid Remediation Advisory Board members that contributed their expertise to this report include:

  • Illinois Chief Behavioral Health Officer David T. Jones IORAB Chair
  • Jud DeLoss, Illinois Association for Behavioral Health
  • Dr. Bernice Gordon-Young, SMART Recovery Intervention Program
  • Christopher Hoff, DuPage County Health Department
  • Dr. Adrienne Adams, Rosecrance Health Services + IORAB Medical and Research Workgroup Chair
  • Eddy Borrayo, Rincon Family Services
  • Kevin Zeigler, Thresholds
  • Blanca Campos, Community Behavioral Healthcare Association of Illinois + IORAB Workforce and Infrastructure Workgroup Chair
  • Joel K. Johnson, Treatment Alternatives for Safe Communities (TASC) + IORAB Access and Equity Workgroup Chair
  • Laura Lechowicz, Office of the Cook County President
  • Chelsea Laliberte Barnes, Live4Lali
  • Dr. Kathy Yoder, McLean County
  • Donna Nahlik, Chestnut Health Systems
  • Angie Hampton, Egyptian Public Health
  • Jeffrey Carl Ewing, Monmouth-Roseville CUSD #238
  • Ryan Brauns, Rockford Consulting & Brokerage
  • Matt Richards, Chicago Department of Public Health

A special thank you to the federal, State, and local governments, community organizations, families, and individuals who work hard to prevent or mitigate substance misuse. We extend our sincere condolences to those who have lost someone to the opioid epidemic.

Background

In 2022, nearly 4,000 Illinois residents died from a drug overdose, with non-Hispanic Black individuals experiencing the highest overdose fatality rates across all age groups, except those aged 25 to 341 . According to data from the Pew Research Center, the national overdose death rate among Black men rose by 213% between 2015 and 2022, compared to a 69% increase for white men.

Illinois Attorney General

The toll of illegal drug use affects individuals, families, and whole communities. The opioid crisis has manifested itself in the form of multiple public health problems. Opioid overdoses have resulted in thousands of emergency room visits, hospital stays, and immeasurable pain suffered by families and entire communities.

Seeing this epidemic unfold, the Attorney General took action. Beginning in 2016, the Attorney General's office began investigating and taking action against the drug manufacturers, marketers, distributors, and dispensers who helped cause this epidemic to hold them accountable and to prevent prescription opioid drugs from being used illegally and harmfully. The office has negotiated multiple settlements to obtain resources that will be distributed equitably throughout the state to help fund services needed to mitigate the ongoing crisis. As a result of these efforts, to date, more than $1.3 billion in opioid settlement abatement funds are currently expected to come into Illinois through 2038. Pursuant to the Illinois Opioid Allocation Agreement, 55% of these funds will go to fund the Illinois Opioid Remediation Fund.

Illinois Department of Human Services Division of Substance Use Prevention and Recovery

The mission of the Illinois Department of Human Services Division of Substance Use Prevention and Recovery (IDHS/SUPR) is to provide a recovery-oriented system of care along the continuum of prevention, intervention, treatment, and recovery support where individuals with substance use disorder (SUD), those in recovery, and those at risk are valued and treated with dignity and where stigma and accompanying attitudes, discrimination, and other barriers to recovery are eliminated. IDHS/SUPR is firmly committed to addressing the opioid epidemic through prevention, education, harm reduction (response), and treatment.

Additionally, IDHS/SUPR is working to counteract systemic racism and health inequities while promoting diversity throughout its service provision process. This effort seeks to address and dismantle existing institutionalized inequities, aiming to operationalize equity, racial justice, and social justice. The Division is also focused on cultivating a culture of inclusivity that respects and values all individuals, regardless of race, gender, religion, sexual orientation, or ability. (Learn more about SUPR activities in response to the overdose crisis on the SUPR Opioid Resources page.)

1(IDPH May 2022) (IDPH 2023 Statewide Semiannual Overdose Report)

The Regional Care Coordination Agency

In April 2023, IDHS/SUPR Office of Opioid Settlement Administration (OOSA) awarded Advocates for Human Potential, Inc. (AHP) a grant to serve as the Regional Care Coordination Agency (RCCA).

Under the direction of the Statewide Opioid Settlement Administrator (SOSA), the RCCA establishes sub-awards with organizations that provide (a) intervention, treatment, and harm reduction services for Illinoisans with substance use disorders (SUDs) and (b) core abatement strategies to prevent opioid overdoses and improve social drivers of health throughout the state. Organizations receiving sub-awards are tasked with prioritizing care for those most impacted by the opioid crisis, including those who continue to face service inequities when seeking help. The RCCA will play a critical role in equitably implementing essential state resources across Illinois.

Establishing a Fair and Transparent Process for the Use of the Illinois Opioid Remediation Funds

In accordance with the Open Meetings Act, meeting agendas, minutes, and links to meetings and recordings of past Illinois Opioid Remediation Trust Fund (IRF) meetings are available on the DHS/SUPR-IORAB website. Notices of Funding Opportunities and allocations to programs and providers received by IRF are also made accessible on the RCCA's websites.

Executive Order (EO) 2022-19 (accessible), issued by Governor JB Pritzker in 2022, mandates that all funding from the Opioid Settlement Agreement must align with Illinois Opioid Allocation Agreement.pdf (Agreement, accessible). The Agreement governs the distribution of funds from any national multistate opioid settlement across the state. These funds are to be used for forward-looking opioid abatement core strategies designed to combat the overdose epidemic as outlined in the Agreement. These strategies align with recommendations in the Illinois State Overdose Action Plan (SOAP), which provides a comprehensive, equity-centered framework for combatting the opioid epidemic. The EO also established the Office of the Opioid Settlement Administration (OOSA) and the Statewide Opioid Settlement Administrator (SOSA), housed within the IDHS/SUPR, to ensure that the allocation and use of funds are conducted in a transparent and equitable manner.

IRF Governance Structure

Governor's Opioid Prevention and Recovery Steering Committee (Steering Committee): The Steering Committee guides the work of the Illinois Opioid Crisis Response Advisory Council (Council) and the Illinois Opioid Remediation Advisory Board (IORAB), serving as the liaison between its stakeholders and the Governor's Office as well as overseeing the ongoing implementation of the SOAP. The Committee was formed under Executive Order 2020-02 and renewed under Executive Order 2023-08.

Illinois Opioid Remediation Advisory Board (IORAB): The Illinois Opioid Allocation Agreement (Allocation Agreement) establishes that 55% of funds Illinois receives through the opioid settlements - as well as any future settlements - will go to the Illinois Opioid Remediation Fund, 20% of the funds are to be allocated to the State, and 25% of the funds directly allocated to Illinois subdivisions (Local Governmental Units) including all counties and eligible municipalities. (See Appendix A for additional details on the Recommendation Submission Process.)

Pursuant to an additional agreement between the State and the City of Chicago, a portion of the State's 20% share will go directly to the City for abatement purposes.

The IORAB serves as a sub-committee to the Steering Committee. It makes advisory recommendations to the Steering Committee regarding the use of 55% of the proceeds allocated in IRF.

The IORAB has established three Working Groups.

1. Access and Equity

a. The Access and Equity Working Group promotes access to resources that target opioid use disorder prevention, treatment, and recovery. These resources must consider overdose survivors, those at high-risk for overdoses, families, children, and communities impacted by the opioid crisis. In addition, the Working Group will assist the IORAB in ensuring that settlement funds reach communities and populations disproportionately represented in the opioid epidemic and address racial and social inequities.

2. Medical and Research

a. The Medical and Research Working Group provides recommendations to the Illinois Opioid Remediation Advisory Board regarding allocation of the opioid settlement fund. The mission of the Medical and Research Working Group is to determine the best evidence-based treatments and emerging medical practices for opioid use and other substance use disorders through analysis of current and relevant data and to implement a systemic framework that distributes resources to at-risk populations to maximize positive outcomes and reduce health inequities and/or disparities associated with racial, socio-economic, geographical, and other social determinants of health.

3. Workforce Development and Infrastructure

a. The Workforce Development and Infrastructure Working Group provides recommendations to the Illinois Opioid Remediation Advisory Board (IORAB) regarding strategies that can reduce behavioral health workforce shortages and promote equitable organizational practices, with the aim of expanding access to and receipt of evidence-based harm reduction, treatment, and recovery support services for persons with opioid use disorder (OUD) and substance use disorder (SUD).

Root Causes of Opioid Epidemic

To combat the epidemic, SUPR conducted a root cause analysis to guide the next 15 years of Illinois Remediation Fund (IRF) investment. The analysis identified several root causes of the opioid epidemic, several of which have led to the disproportionate impact on Black communities. These causes range from decades-old law enforcement and policy decisions to the effects of international cartels and synthetic drug manufacturing. (More detailed information on the root causes listed below is outlined in Appendix E.)

Root Cause Summary of Supportive Research
The War on Drugs The War on Drugs has had a profound impact on urban communities, particularly since the 1970s. Discriminatory drug policies, such as the disparity in sentencing for cocaine and crack cocaine possession, have led to the mass incarceration of Black and Hispanic individuals (Alexander, 2010).
Overprescribing and Diversion of Prescription Opioids The introduction of prescription opioids for pain management, combined with aggressive marketing and minimized information about their addictive potential, created a perfect storm for the opioid crisis (Dowell et al., 2016). Prescription opioids have also fueled the illicit opioid market, with studies showing that a large percentage of heroin users report first using prescription opioids.
The Role of Fentanyl Overdose fatalities involving synthetic opioids increased nearly six-fold between 2015 and 2020, from 3.1 to 17.8 deaths per 100,000 people across the U.S. Illicit fentanyl, produced and trafficked by cartels, has exacerbated the opioid crisis, leading to a surge in overdose deaths (Jones et al., 2021). The high potency and low cost of fentanyl have made it attractive to drug cartels, who see it as a profitable commodity (Cicero et al., 2021).
Racial Disparities in Overdose Deaths Individuals with a history of discrimination, poverty, and lack of political power have been particularly vulnerable to substance use disorders (SAMHSA, 2021). The stigmatization of substance use as a moral failing has amplified these disparities (Link & Phelan, 2001). Social determinants of health, such as poverty, unemployment, and lack of access to healthcare, are linked to increased substance use disorder (SUD) risk (SAMHSA, 2021). Nationally, the Black population has been disproportionately affected by fentanyl overdoses (CDC, 2021). Since 2015, the overdose death rate among Black men has risen 213% compared to 69% for white men (Gramlich, 2022).
Rural Communities While the War on Drugs devastated urban areas, rural communities simultaneously experienced economic decline, leading to a different type of despair (Case & Deaton, 2015).
Personal and Generational Trauma Exposure to Adverse Childhood Experiences (ACEs), such as abuse, neglect, or household dysfunction, significantly increases the risk of SUDs (Felitti et al., 1998). ACEs can disrupt brain development and increase vulnerability to addiction (Anda et al., 2006). Trauma, including intergenerational trauma, is strongly associated with SUD risk (SAMHSA, 2021).
The Evolving Substance Use Landscape The substance use landscape is constantly evolving, with polydrug use becoming increasingly common (SAMHSA, 2023). The combination of opioids with non-opioid substances creates unique challenges for overdose reversal (Jones et al., 2023).
The Role of COVID Research published in JAMA showed the pandemic was associated with a drop in medical prescriptions for opioids and a recent study has shown that the sudden stopping of opioids increases the risk of suicide as it induces people to substitute illicit opioids like heroin and fentanyl (Warraich, 2022). A lack of the 4Ss (safety, security, stability, and survival) are associated with health and social consequences that perpetuate opioid use, overdose events, and detrimentally impact recovery efforts (Banks, 2022).

Opioid Use Disorder Ecosystem

The opioid ecosystem framework (see America's Opioid Ecosystem in Appendix F) was developed by the RAND Corporation to help federal, state, and local policymakers in gaining a deeper understanding of the complex dynamics involved in opioid-related problems and to explore innovative, evidence-based solutions.

This framework provides a comprehensive 360-degree view of the ten essential services and supports required to address the root causes and impacts of opioid use disorder (OUD) at the individual, family, and community levels. These services include the legal system, illegal supply and supply control, harm reduction, first responders, child welfare, income support and homeless services, employment, education, substance use disorder treatment, and medical care.

Illinois Opioid Remediation Trust Fund

The Division of Substance Use Prevention and Recovery (SUPR) and the Illinois Opioid Remediation Advisory Board have developed a visionary recommendation for the IRF. This initiative positions Illinois as a leader in addressing the extensive harms caused by opioid misuse across the opioid ecosystem.

The strategy is anchored by the RISE goals: Relieve multi-generational harms, Increase access to harm reduction services, Support treatment and prevention services to ensure an accessible, recovery-oriented system, and Enhance access to recovery supports. These goals are closely aligned with the requirements and guidelines of the entities responsible for approving funding allocations.

Over the past year, SUPR has collaborated with the IORAB and other stakeholders to refine this vision and goals. The objectives outlined represent the intended uses of the IRF funds by the IORAB and SUPR, consistent with the approved uses set forth in the Opioid Allocation Agreement and the SOAP.

IORAB OPIOID REMEDIATION TRUST FUND VISION

By 2039, Illinois will eliminate health inequities related to opioid misuse and reverse the harms inflicted on our communities, with a particular focus on those disproportionately impacted by the opioid crisis.

RISE GOALS

Funding from the Illinois Opioid Remediation Trust Fund (IRF) will help Illinois RISE from the opioid crisis and strengthen our recovery-oriented system of care through the following goals:

1. Relieve multi-generational harms associated with structural racism and health inequities, more prevalent in Illinois' Black communities2, that create the context for substance use and overdose disparities.

A. Increase access3 to comprehensive, culturally competent opioid use disorder (OUD) services for Black communities, centering around individuals with lived experience.

i. Increase the number of grants awarded to community-based providers/programs in Black communities, including a more inclusive and prioritized grant application process (5yr=25% over baseline, 10yr=40% over baseline, 15yr=50% over baseline).

ii. Reduce the fatal opioid-related overdose rates within Black communities (5yr=25% reduction from baseline, 10yr=50% reduction from baseline, 15yr=75% reduction from baseline).

B. Establish policies and programs to address social determinants of health4, and ensure consistency in delivering services that promote trauma-informed care5 to decrease intergenerational harms.

i. Increase policies and programs aimed at addressing social determinants of health and decreasing intergenerational harms for Illinois' Black communities (5yr=25% increase from baseline, 10yr=50% increase from baseline, 15yr=75% increase from baseline).

2.  Increase access to Harm Reduction services that meet people using substances where they are in their recovery journey, especially in communities with high overdose and fatality rates.

A.  Increase the distribution of naloxone products6 for historically underserved communities (HUC)7

(5yr=25% over baseline, 10yr=40% over baseline, 15yr=50% over baseline).

i. Reduce the rate of fatality per overdose in HUCs (5yr=25% reduction from baseline, 10yr=40% reduction from baseline, 15yr=50% reduction from baseline).

B. Increase the availability of harm reduction services for HUC.

i. Increase the number of harm reduction grants awarded to community-based providers/programs in Black communities, including a more inclusive and prioritized grant application process (5yr=5% over baseline, 10yr=10% over baseline, 15yr=25% over baseline).

3. Support Treatment and Prevention services to ensure Illinois' recovery-oriented system of care is available, accessible, and attainable to all.

A. Expand mobile and telehealth services in HUC.

i. Increase overdose survival rates through the use of mobile and telehealth services in HUCs. (5yr=10% over baseline, 10yr=20% over baseline, 15yr=30% over baseline).

B. Expand prevention services in HUC.

i. Establish new prevention strategies in Black communities outside of the traditional school-based programs (5yr=5% over baseline, 10yr=10% over baseline, 15yr=25% over baseline).

4. Enhance access to recovery supports, that promote equity in health outcomes.

A. Increased rate of patients receiving Medication Assisted Recovery (buprenorphine, naloxone, methadone)

i. Establish new MAR programs across the state (5yr=5% over baseline, 10yr=10% over baseline, 15yr=25% over baseline).

B. Increase access to recovery support services in HUC.

i. Establish new recovery support services programs across the state (5yr=5% over baseline, 10yr=10% over baseline, 15yr=25% over baseline).

2Illinois non-Hispanic Black individuals are 3.5 times more likely to die from an opioid overdose than a non-Hispanic White individual (IDPH Statewide Semiannual Overdose Report 10-2023).

3"Increase Access" means admission to quality programs and practice that reduce persistent disparities in mental health and substance use services for historically underserved communities and ensure that all people are provided with fair opportunities to lead healthy lives, (SAMHSA's health-equity-fact-sheet).

4Social determinants of health (SDOH) are non-medical factors that affect health outcomes, including racism and health care and quality. Social Determinants of Health | Public Health Gateway | CDC.

5Trauma Informed Care (TIC) is a strengths-based delivery approach "that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment" (Hopper, Bassuk, & Olivet, 2010) SAMHSA's Trauma-Informed Care in Behavioral Health Services, pg. xix.

6We are using the term "naloxone products" to refer to the multiple delivery methods (intranasal, intramuscular, intravenous, subcutaneous) and dosages available (currently 9 delivery methods on the IDPH standing order). We currently support Narcan kits and IM naloxone but will expand in the future.

7The term "underserved communities" refers to populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, as exemplified by the list in the preceding definition of "equity."

The goals and approved uses of the Opioid Settlement Agreement overlap and support the vision for the Illinois Opioid Remediation Trust Fund. (For a full list of funded programs, see Appendix B.)

IRF Update

Estimated total disbursement amounts to the Illinois Remediation Fund*: Below is the estimated funding disbursements to the IRF (55% of the total funding) by calendar year. As the amounts are inconsistent and in flux, IDHS/SUPR estimates the leveling of the expenditures at $42 million per year. This allows programs/providers a stable funding source for the duration of a recommendations' approval.

2024 2025 2026 2027 2028 2029 2030 2031
$48 $44.8 $47.7 $35.9 $51 $51.4 $47.8 $44.2
2032 2033 2034 2035 2036 2037 2038 Total
$40.4 $31.6 $31.6 $31.6 $33.4 $18.8 $18.8 Approx. $577**

*The amounts represent current best estimates and are not final figures.

**$196M has been received so far making the grand total of received and estimated future payments $772M

The strategy is to use the rollover funds from State Fiscal Year (SFY) 2023-2024 and future years for start-up projects (e.g., opioid treatment program start-up, telehealth expansion, etc.) or other one-time investments to renew infrastructure and enhance access to services. Additional recommendations are anticipated in early SFY25 around adolescent treatment and tribal communities.

ANNUAL APPROVED FUNDING FOR THE NEXT 3 YEARS: $34,700,000

ESTIMATED AVERAGE ANNUAL ALLOCATION AMOUNT TO THE END OF FY24: $42,000,000

TOTAL FUNDS APPROVED BY THE IORAB TO THE END OF FY24: $115,350,000

TOTAL FUNDS DISBURSED TO THE ILLINOIS REMEDIATION FUND TO THE END OF FY24: $196,000,000

FY2024 Progress

The following graph shows the work the IORAB, the Steering Committee, and SUPR have engaged in over the past year resulting in the submission of 34 recommendations to SUPR. Of these, 15 were approved by the IORAB, 15 did not meet the criteria, and four are still in progress.

The following IRF funding has been approved and/or issued to date:

Goals Approved Use SOAP Priorities Awards to Date Total Funded Amount
Relieve multi-generational harms Treatment of Incarcerated People Justice-Involved Populations and Public Safety 1 IDOC IGA in progress $6M 
Relieve multi-generational harms Services for Pregnant and Post-Partum People (PPP) with OUD (includes Services for Neonatal-Abstinence Syndrome) Social Equity 4 Supportive Services and Treatment for Accessible Recovery - Together (START) PPP $6M 
Increase access to harm reduction services Naloxone or Other FDA-Approved Drug to Reverse Opioid Overdoses Harm Reduction

1 Access Narcan,

1 Intramuscular Naloxone Distribution Hub 

 $7.5M 
Increase access to harm reduction services Harm Reduction & Syringe Service Programs Harm Reduction 1 IDPH IGA in progress $15M 
Support treatment and prevention services Prevention Programs Prevention

13 Build, Amplify, Support, Empower (BASE) Prevention,

19 Community Integrated Service,

1 IL Prescription Monitoring Program (ILPMP)

 $24.6M 
Support treatment and prevention services Medication-Assisted Treatment/Medication-Assisted Recovery (MAR) Treatment and Recovery

3 MAR Mobile Health Units,

1 Opioid Treatment Program NOFO under development

 $21.8M 
Enhance access to recovery support Bridge Services (warm hand-off) and Recovery Oriented Services Treatment and Recovery

14 Community Outreach and Recovery Support,

7 Warm Handoff and Recovery Support Services,

1 Opioid Training and Technical Assistance Center NOFO under development

 $33M 
Enhance access to recovery support Data Collection and Evaluation Additional Recommendations 1 Opioid Abatement Strategies Effectiveness Evaluator $1.5M 

SUPR worked with the Regional Care Coordination Agency (RCCA) to establish the Notice of Funding Opportunity (NOFO) process, which adheres to the Illinois Grant Accountability and Transparency Act (GATA) and grantmaking requirements. The RCCA designed application and funding processes with the goal of simplifying the application process for smaller organizations at the forefront of the opioid epidemic. These enhancements include extended timelines for organizations to apply, the use of common software (e.g., Excel and Survey Monkey) for submission, and the provision of technical assistance calls to address questions.

The timeline in Appendix B, demonstrates this process, starting with the July 2023 IORAB meeting where the initial set of recommendations was presented and accepted.

Generally, NOFOs are open for at least 45 days, and most for 60 days, to ensure that smaller providers without back-office administrative support have the time and ability to apply for these opportunities. (For additional background information and the financial breakdown of the annual versus one-time funding, see Appendix A.)

Since January 2024, seven NOFOs have been launched; all seven have closed, and three have been announced (see Appendix B for a listing of awardees). These initiatives have resulted in over 150 applications reviewed and $115 million allocated to the programs previously mentioned. All recommendations have met the requirements of the Settlement Agreement and State Overdose Action Plan. Additional NOFOs are planned in the first half of SFY25, and additional recommendations are anticipated throughout the year.

The RCCA also developed two websites to enhance transparency and communication. The Illinois Opioid Settlement website (ilopioidsettlements.com) provides comprehensive information about the settlements, including NOFO announcements, award announcements, and dashboards that display the allocation of settlement funds. The RCCA website (ILRCCA.com) includes funding opportunities outside of the IRF.

The IRF has funded programs that have demonstrated significant improvements in saving lives throughout the state. One such program is Access Narcan (a Naloxone product that reverses opioid overdose). Over the last two fiscal years, this funding has enabled the distribution of 406,776 two-dose units of Narcan across various communities in Illinois. According to the National Institute of Drug Abuse (NIDA), 89% of Narcan interventions have been successful in preventing overdose fatalities.

Another effective initiative is the Illinois Prescription Monitoring Program (ILPMP), which has received funding over the last two years to expand its integration with healthcare providers across the state. The ILPMP enables healthcare organizations to monitor prescribing patterns, ensuring that opiates are distributed appropriately. Since funding from the Opioid Settlement Fund began, the program has seen an average monthly increase of 17% in connections with healthcare providers. Additionally, the number of queries to the system increased from 26% to 55% month-over-month between 2022 and 2024, demonstrating a significant rise in engagement from healthcare providers.

Please direct questions about this report to:

State Opioid Settlement Administrator

DHS.OpioidSettlementFunds@Illinois.gov

If you have strategy recommendations for the IORAB, submit them here:

https://forms.office.com/g/MzBD9WV5zw