10.17.2024 Minutes

Illinois Opioid Remediation Advisory Board

October 17, 2024
2:00 - 4:00 PM

Virtual Meeting Held Via Zoom

Meeting Minutes

Illinois Opioid Remediation Advisory Board Members

Dr. Adrienne Adams, NorthShore/Endeavor Health
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 7.18.24 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 July IORAB meeting minutes. All members except Jeffrey Ewing, Angie Hampton and Dr. Kathy Yoder were present. Quorum was established. The ex officio roll call was taken. All ex officio members were present except Chief of Staff Laura Vaught and State Senator Sally Turner. Jennifer Epstein attended on behalf of Chief of Staff Laura Vaught; Andrea Law attended on behalf of Attorney General Kwame Raoul; and Anousha 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)/IORAB Chair

Chief Jones reviewed the IORAB vision and goals developed for the upcoming annual report.

  • In the next 15 years, Illinois will eliminate the impacts of opioid misuse and reverse the harms to our communities, especially those disproportionately impacted by the opioid crisis. This will be achieved through RISE goals:
    • Relieve multi-generational harms
    • Increase access to harm reduction services
    • Support treatment and prevention services to ensure an accessible recovery-oriented system
    • Enhance access to recovery supports
  • SUPR will publish an annual report documenting Illinois remediation fund activities in State Fiscal Year (SFY) 2024 in November. The report will include a root cause analysis, vision and goals, accomplishments, and a list of funded recommendations and programs.

Regional Care Coordination Agency Process and Website: Dr. Randi Moberly, Advocates for Human Potential, Inc.

Dr. Randi Moberly described the work the Regional Care Coordination Agency (RCCA) conducts related to Illinois opioid settlement funding.

  • IDHS/SUPR contracted with AHP to serve as the RCCA for work related to the IORAB and the use of settlement funds. The RCCA supports IDHS/SUPR's Office of Opioid Settlement Administration through sub-awards administration, creation and management of websites, and coordination of 7 opioid regional advisory coalitions that inform the state of local needs and priorities.
  • For sub-awards administration, the RCCA oversees the use of funds from the 55% of national multistate opioid settlements that goes into remediation funds. After a recommendation is approved by the steering committee, IDHS/SUPR creates a scope of work and sends it to the RCCA to create a notice of funding opportunity (NOFO). The RCCA creates a NOFO and uses a Grant Accountability and Transparency Act (GATA)-compliant merit-based review process to determine which applicants receive funding. The RCCA then announces awardees, manages the disbursement of funding, and provides training and technical assistance to help awardees comply with all funding requirements.
  • The Illinois Opioid Settlements Initiative website (ilopioidsettlements.com) includes information about opioid settlements negotiated by the Illinois Attorney General. The RCCA plans to add dashboards with information about Illinois opioid settlement funding to this website.
  • The Illinois RCCA website (ilrcca.com) describes programs administered by the RCCA and coalition activities. This website will include a dashboard showing the status of each NOFO (application open, awarded, being implemented) and relevant dates.
  • AHP is working on improving access to the recommendation and application processes, including adding links to forms to submit a recommendation, definitions of frequently used terms, notifications about changes in anticipated announcement dates, technical assistance resources, and a help desk system to increase responsiveness to questions about the application process.

Discussion:

  • An IORAB member asked how people with lived experience are incorporated in the review process for funding applications. The AHP team responded that they select at least 3 reviewers for each application from a diverse pool including people with lived experience.
  • An IORAB member stated that they appreciated that the processes established by the RCCA were transparent and clear and allowed organizations that did not receive awards to request additional information or appeal the decision.
  • An IORAB member asked if AHP could share information about the number, type, and quality of organizations that have engaged in the NOFO process. Dr. Moberly responded that the amount of engagement varies based on the services to be provided and noted that the application process is very competitive. AHP is developing methods to share information about applicants more broadly.

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 and disbursement to the remediation fund.

  • The list of finalized national opioid settlements remains the same as it was at the July IORAB meeting. The Kroger and Purdue Pharma settlements are ongoing. As it currently stands, Kroger's settlement may result in an additional $22-23 million (M) for settlement funding over an 11-year period. For Purdue Pharma, there is ongoing mediation with the Sackler family through 11/1.
  • More than $237M has been disbursed to the Illinois remediation fund to date. A total of $127.3M 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. These numbers do not include the potential settlements from Kroger and Purdue.

Working Group Updates

Medical & Research: Adrienne Adams, MD, Chair

  • Dr. Adams reported that the working group developed the Youth & Family recommendation and reviewed and endorsed the other two recommendations to be discussed during today's IORAB meeting. Dr. Adams stated that this working group will continue to address disparities related to opioid overdoses.

Access & Equity: Joel K. Johnson, Chair

  • Mr. Johnson reported that the working group endorsed the Youth & Family and the Tribal recommendations. They did not endorse the Local Health Department Infrastructure recommendation due to concerns about the funding amount and the use of settlement funds for data versus direct services.

Workforce Development & Infrastructure: Blanca Campos, Chair

  • Ms. Campos reported that this working group reviewed and endorsed the three recommendations to be discussed at today's IORAB meeting. This group is refining a recommendation to increase outreach, education, and training for high school, undergraduate and graduate students, and others about career opportunities in behavioral health and hopes to present the recommendation at the next IORAB meeting.

Office of Opioid Settlement Administration Updates: Jim Wilkerson, Statewide Opioid Settlement Administrator (SOSA), Office of Opioid Settlement Administration

Mr. Wilkerson reviewed information about the use of settlement funding and described the recommendations that the IORAB will consider at today's meeting.

Illinois Settlement Funds Update

  • The following recommendations have been approved and awarded via expansion of services: Community Intervention Services, Access Narcan, and Illinois Prescription Monitoring Program (IL PMP). ILPMP will join SUPR on April 1, 2025, and no longer receive remediation funds. Recommendations related to IM naloxone, the opioid abatement strategies effectiveness evaluator, and community outreach and recovery supports (CORS) have been approved and awarded via NOFO. A recommendation related to treatment for incarcerated people will be awarded via an intergovernmental agreement with the Illinois Department of Corrections. Recommendations for harm reduction services will be launched this fall via an agreement with IDPH and NOFOs. NOFOs have been awarded for pregnant and post-partum services, warm handoff services, prevention programs, and mobile medication assisted recovery (MAR). A second NOFO for mobile MAR services was launched yesterday to meet demand. The NOFO for the opioid training and technical assistance center (OTTAC) will launch next week. NOFOs for opioid treatment programs (OTPs) and telehealth services will launch after the harm reduction NOFO. Additional information about these awards is available at ilrcca.com and ilopioidsettlements.com.

Annual Allocation Amount

  • The annual allocation amount was determined by dividing the grand total of the award by 18 years. Additional settlement funding received in FY24 brings the annual allocation amount to $43M. Current annual spending is $32M, not inclusive of today's recommendations. Annual funding that is not spent goes into a one-time investment balance, which currently totals $74M.

New Funding Recommendations

  • Recommendation A. Services for Tribal Communities: This is a request for $3M over 3 years or $1M per year. This recommendation seeks to address the unmet needs of Tribal communities impacted by the opioid crisis. Opioid settlement funds will establish substance use prevention, harm reduction, treatment, and recovery support services that honor the beliefs, customs, and values of indigenous people that live in Illinois.
  • Recommendation B. Youth and Family Services: This is a request for $3M over 3 years of $1M per year. This recommendation seeks to fund a full system of services, including prevention, treatment, harm reduction, and recovery supports.
  • Recommendation C. Contingency Management: As previously approved, Illinois Remediation funds shall be used to pilot a contingency management program. The IORAB is now asked to vote on the funding amount for the program. This request is for $1.5M over 3 years ($500,000 per year) to fund 4-5 pilot programs. This funding is for start-up costs; it is a one-time investment and will not impact on the annual allocation amount.

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

  • Chief Jones asked for a motion to approve the Tribal Recommendation. Mr. Hoff made a motion and Dr. Adams seconded. Chief Jones opened the floor for discussion.
    • An IORAB member asked if settlement funding would supplant existing funds. Mr. Wilkerson discussed that the settlement funding will not supplant funded services but address gaps.
    • An IORAB member asked how many organizations could receive this funding. Mr. Wilkerson responded that multiple organizations could be funded.
    • IORAB members asked how the funding amount of $3M was determined and if this would be enough to meet needs considering the large number of people from indigenous populations in need. Mr. Wilkerson responded that if the funds are insufficient to meet needs, then they will return to the IORAB and ask for additional funding.
    • Director Garcia described that representatives from tribal communities would be involved in drafting the scope of services for this recommendation. This recommendation is focused on developing culturally-appropriate services.
    • Chief Jones called for a vote to approve the recommendation. Dr. Pickett took a roll call vote. All members voted to approve the recommendation. The motion passed and the recommendation will move forward to the Steering Committee.
  • Chief Jones called for a motion to approve the Youth and Family Services recommendation. Ms. Laliberte Barnes made a motion and Dr. Adams seconded this motion. Chief Jones opened the floor for discussion.
    • Board members discussed that innovative ideas may not be evidence-based as they have not been the focus of research; evidence-informed practices should be included in the NOFO.
    • An IORAB member discussed that treatment for adolescents in Illinois has been decimated due to lack of funding. They asked if this funding would be available for out-of-state providers or solely in-state providers. Director Garcia stated that all NOFOs have specified that providers should be in Illinois and this specification will be included in future NOFOS.
    • Chief Jones called for a vote. Dr. Pickett took a roll call vote. All members voted to approve the recommendation. The motion passed and the recommendation will move forward to the Steering Committee.
  • Chief Jones called for a motion to approve the funding amount for the contingency management recommendation. Mr. Hoff made a motion and Dr. Gordon-Young seconded the motion. Chief Jones opened the floor for discussion.
    • A board member asked if the NOFO could specify that most of this funding should go directly to incentives, not program management or evaluation. The board member discussed that organizations have difficulty obtaining incentives. Mr. Wilkerson discussed that this was the intent of the recommendations while remaining within parameters for compliance.
    • A board member discussed that Cook County is in favor of the cash incentives. A board member asked what types of agencies would qualify for the CM pilot.
    • A member noted that the language in the recommendation should be changed from "clean" to "negative" urine test.
    • Chief Jones called for a vote to approve the recommendation. Dr. Pickett took a roll call vote. All members voted to approve the recommendation. The motion passed and the recommendation will move forward to the Steering Committee.

Public Comments

  • An ex officio IORAB member discussed that while there was evidence that CM was effective for other substance use disorders there was no evidence that CM was effective for OUD. Chief Jones responded that he was aware of effective use of CM for OUD, although the research may not be published.
  • Members of the public discussed how to balance funding across agencies that had already received settlement funding and those who have received no funding. They would appreciate a larger conversation about this issue. Director Garcia noted that IDHS must follow the procurement process for opioid settlement funding and suggested reviewing this process in a future meeting.
  • An ex-officio member discussed the importance of making the application and funding process more equitable. They stated that while large agencies have received multiple awards, other smaller agencies with histories of serving impacted communities have not received funding. It was noted that OTTAC will provide technical assistance to all agencies that apply for funding.
  • Chief Jones encouraged people to submit questions or comments related to the IORAB to Jim Wilkerson at jim.wilkerson@illinois.gov
  • Director Garcia thanked Chief Jones for his leadership of the IORAB, and his work in Illinois to improve our behavioral health service.

Chair Closing Remarks

Chief Jones thanked the group.

Adjournment

Chief Jones requested a motion to adjourn the meeting. Dr. Gordon-Young made a motion to adjourn the meeting. Ryan Brauns seconded the motion. Chief Jones adjourned the meeting. The next meeting will take place on January 30, 2025 from 2:00pm-4:00pm.