Opioid Steering Committee Minutes 11.07.2024

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

4th Quarterly Meeting Pursuant to Executive Order 2023-08

Date and Time

November 7, 2024
10:00 AM to 11:30 AM

Meeting Location

Springfield: 600 E. Ash, Building 500, Conference Room 2C
Chicago: 401 S. Clinton, Chicago, IL Training Room 1
and Teleconference

Roll Call

Voting Members

Name Organization Present Absent
Lt. Governor Juliana Stratton (chair) Lt. Governor X
Tiffany Blair (representing Secretary Dulce Quintero) Illinois Department of Human Services (IDHS) X
Director Dr. Sameer Vohra (co-chair) Illinois Department of Human Services (IDHS) X
Director Brendan Kelly Illinois State Police (ISP) X
Dr. Arvind Goyal (representing Director Whitehorn) Illinois Department of Healthcare and Family Services (DHFS) X
Luke Tomsha Public Member, The Perfectly Flawed Foundation X
Sherie Arriazola-Martinez Public Member, Illinois Opioid Crisis Response Advisory Council Member X

Other State Agencies Represented

Name Organization Present Absent
Director Laura Garcia IDHS/Division of Substance Use Prevention and Recovery (SUPR) X
Director Heidi Mueller Illinois Department of Children and Family Services X
Jessica Reichert Illinois Criminal Justice Information Authority (ICJIA) X
Debi Joy (Representing Acting Director Vickery) Illinois Department of Juvenile Justice X
Tiffany Clark (Representing Acting Director Latoya Hughes) Illinois Department of Corrections X

Agenda

I. Call to Order and Welcome
  a. Director Vohra called the meeting to order at 10:05 AM.

II. Roll call
  a. Dr. Sue Pickett of Advocates for Human Potential Inc. (AHP) conducted roll call.
  b. A quorum was established.

III. Approve Agenda and Meeting Minutes
  a. Motioned by Mr. Tomsha
  b. Seconded by Dr. Goyal
  c. All in favor
  d. No opposition
  e. No abstention

IV. Chairs' Remarks

  1. Director Dr. Sameer Vohra
    1. Director Vohra discussed provisional drug overdose data recently released by the Centers for Disease Control and Prevention (CDC). This data indicated that there was a 12.7% decrease in the number of overdose deaths in the United States between May 2023 and May 2024. This is the first decline in drug overdose deaths in five years and it provides hope that the work in Illinois and across the nation is having an impact. Preliminary data from Illinois indicates that there were 3,502 drug overdose deaths in the state during 2023, this is an 8.3% decrease from the number of overdose deaths in 2022 and represents the first decline for Illinois since 2018. IDPH realizes that there is still work to do to prevent overdose deaths and is working with harm reduction and other cross-sector partners to prevent overdose deaths with a focus on increasing equity.
  2. Chief Tiffany Blair (representing Secretary Dulce Quintero)
    1. Chief Blair noted that although overdose deaths are decreasing, DHS is committed to funding efforts to reduce overdose deaths especially in populations such as older African American men that have not experienced this decrease.
    2. Chief Blair noted that Kathleen Monahan from the Illinois Division of Substance Use Prevention & Recovery will present on the work of the Illinois Jails Learning Collaboration which supports jails to provide medication assisted recovery (MAR) at the February meeting of this steering committee.
    3. Illinois DHS will provide an update related to the request to identify paths for opioid settlement funds to provide housing.
    4. DHS is working with Dr. Sue Pickett of AHP to create a state opioid action plan (SOAP) implementation report with a targeted completion data of 11/22/24. This report will provide information about the strategies that have been accomplished during the two years since the publication of the SOAP.
    5. Chief Blair thanked Jim Wilkerson for his work as interim state opioid settlement administrator (SOSA). DHS is interviewing candidates for a permanent SOSA position.
    6. DHS has received a state opioid response 4 grant that will sustain projects such as the jail learning collaborative and support new programs focused on treatment for youth, expand prevention services, and provide support for people re-entering the community from jail or prison to reduce their risk of overdose.

V. New Business
Illinois Police and the Opioid Crisis: Examining Discretion, Stigma, and Knowledge in Officer Interactions with People with Opioid Use Disorder: Jessica Reichert, M.A., Manager, Illinois Criminal Justice Information Authority, Center for Justice Research & Evaluation & Dr. Brandon del Pozo, Assistant Professor, The Warren Alpert Medical School of Brown University

  1. Ms. Reichert gave an overview of ICJIA.
  2. Stigma related to substance use includes blaming people who use drugs (PWUD) for lack of willpower and beliefs that PWUD may lie, steal or act aggressively. Stigma can negatively impact on the well-being of PWUD and may decrease the likelihood that they will seek help.
  3. Police officers often encounter PWUD. They have varying levels of knowledge, beliefs, and attitudes toward PWUD, treatment, and harm reduction. Prior research has found that police have stigmatizing attitudes towards PWUD. The presence of stigmatizing beliefs in police has been associated with increased use of force.
  4. Ms. Reichert described her research group's 2021 online survey of 248 Illinois police officers from 27 departments. The officers surveyed were a diverse sample from small, medium, and large forces and rural, suburban, and urban areas. This survey included questions related to police officers' stigma, discretion, knowledge, attitudes, and beliefs about PWUD. The police officers surveyed included 248 officers from 27 departments. 48% of these officers had responded to 26+ overdoses, 29% knew a person with OUD, and 14% had a person they cared about die from an overdose. Most people who responded were White males with a bachelor's degree and 8 or more years of policing.
  5. There are three publications from this study that Dr. Reichert can share via email. Contact her at Jessica.Reichert@illinois.gov for these publications.
  6. Analyses of survey responses showed that officers held stigmatizing views related to PWUD. These views included that PWUD were responsible for their condition and that they need to be on guard for what PWUD might do. Many officers who completed the survey indicated that harm reduction measures acted to prolong opioid use disorder. However, survey results showed that officers supported officers with substance use problems returning to duty after treatment. As a result of this research, Ms. Reichert and her team recommend that all officers receive training to help dispel myths about PWUD, promote a public health approach, and promote deflection or diversion efforts to improve outcomes.
  7. This research found that most officers reported being influenced by their supervisor and stated that they are willing to take directions from treatment providers related to discretion in decision making. Based on these findings, Ms. Reichert and her team recommend that supervisors champion treatment referrals and that police collaborate with treatment providers to provide services such as referral to medication assisted recovery (MAR).
  8. Officers' responses to survey questions indicated that they supported linking PWUD to treatment and believed that treatment can conserve resources and reduce crime. Many officers did not see the benefits of MAR. While over half of respondents stated that administering naloxone was an officer duty, many respondents did not.
  9. A committee member asked Ms. Reichert if they asked survey respondents how they felt about the decriminalization of substance possession and use. Ms. Reichert responded that the survey did not include questions in this area but that she expected that the responses would vary.
  10. A committee member discussed the lasting negative impact of the war on drugs related to increased stigma towards PWUD and the need to work with police leadership to change problematic policies. He asked Ms. Reichert for recommendations for talking to police officers about decriminalization of substance use. Ms. Reichert responded that talking to people with lived experience (PWLE) has been shown to decrease police officers' stigmatized attitudes. She stated that research is ongoing, and they are moving closer to identifying best practices for effective stigma reduction training and education for police officers. She agreed that due to the hierarchy in the police department, having leadership that champions stigma reduction is important.
  11. A committee member asked Ms. Reichert if she had presented this information to the Illinois Opioid Remediation Advisory Board (IORAB). Dr. Reichert indicated that she had not but would be willing to do so.
  12. Lt Governor Juliana Stratton thanked the group for their work. She discussed that many people are struggling related to news this week and we should think how to best support these individuals.

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. Jim Wilkerson, the interim state opioid settlement administrator (SOSA), described work completed related to recommendations for the 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 the end of state fiscal year 2024. 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 Opioid Settlement website.
  2. The Treatment for Incarcerated Population recommendation will be funded via an intergovernmental agreement (IGA) with the Illinois Department of Corrections (IDOC). They are finalizing this agreement so IDOC can begin service provision.
  3. There has been a change related to processes for implementing the Harm Reduction recommendation. Harm reduction services will be funded via IGA with IDPH but also via NOFOs for harm reduction agencies released through the regional care coordination agency (RCCA).
  4. NOFOs for recommendations related to Pregnant and Post-partum People and their families, Warm Handoff programs and Recovery Services, BASE Prevention Programs, and Mobile Medication Assisted Recovery (MAR) 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.
  5. The NOFO for the Opioid Training and Technical Assistance Center (OTTAC) has launched and is open. It is available on the on the Illinois Regional Care Coordination Agency website. There is additional NOFO now open on this website related to Mobile MAR as additional funding was available. NOFOs will be posted for the Opioid Treatment Programs (OTPs) and Telehealth recommendations.
  6. Mr. Wilkerson discussed that the annual allocation amount for remediation funds has increased as there have been additional settlements in fiscal year 2024. The new amount is $43 million (M) per year. The current annual amount spent not counting today's recommendations is $32M.
  7. Any money not spent each year goes into a one-time investment fund which is currently $74M. Funded one-time investments include OTPs, Capital Investment, and Telehealth Expansion. Money taken from the one-time investment balance does not impact annual allocation amounts.
  8. Mr. Wilkerson described the vision and goals that were developed for the annual SOAP implementation report based on the recommendations that were approved by the Illinois Opioid Remediation Advisory Board (IORAB). The vision includes for Illinois to eliminate the impacts of opioid misuse and reverse the harms to communities, especially those disproportionately impacted by the opioid crisis. This vision is to be achieved via goals with the acronym RISE, specifically 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.
  9. SUPR is completing an IORAB annual report in November. The report will include a root cause analysis, vision and goals, a list of accomplishments by the IORAB, SUPR, and the RCCA, and a list of funded recommendations and programs across abatement strategies and SOAP priorities.
  10. Lt Governor Stratton asked how we can make information about the population served by the awardees available to promote health equity. Mr. Wilkerson described that the NOFO process considers data that indicates where funding is needed based on IDPH's seven regions. Lt. Governor Stratton described that it would be helpful to have information about both the region where the funding was awarded, the organizations awarded, and the population these organizations serve. Mr. Wilkerson said that some of this information will be in the annual report, and they can do a presentation at the next meeting. He noted that awardees are posted on the IL RCCA website.
  11. Lt Governor Stratton asked why there is one-time investment funding-does this occur because money is not being spent? Mr. Wilkerson responded that while some opioid organizations negotiated repayment to occur over several years; other organizations paid all settlement funding upfront resulting in a large initial sum of money. NOFOs are rolling out but funded organizations may not have a full calendar year to spend so some money was returned. Also, leadership determined that they wanted to have a consistent amount of funding available each year. Therefore, excess funds are placed into the one-time investment fund to be used for costs that are not ongoing.
  12. Mr. Wilkerson described the three recommendations that the committee would be asked to vote on today.
    1. 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. The recommendation will include best practices but also emphasizes the importance of guidance from local indigenous communities.
    2. 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. This recommendation focuses on funding new and innovative ways to engage youth and their families in services.
    3. Recommendation C. Contingency Management. 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. Illinois Remediation funds shall be used to pilot a contingency management program. Contingency management (CM) involves encouraging or discouraging a behavior to increase or decrease its frequency, respectively. The IORAB and steering committee previously voted to approve this recommendation. Today, the steering committee is asked to vote on the funding amount.
  13. Director Vohra opened the floor to discussion of Recommendation A. Services for Tribal Communities
    1. A committee member mentioned that they were pleased to see this recommendation. She asked who brought this recommendation forward and if there could be indigenous representation on the IORAB. Mr. Wilkerson responded that this recommendation came from a member of the public and was reviewed and endorsed by the working groups. They do not currently have indigenous representation on the IORAB but would be interested in working towards achieving that. He noted that members of the indigenous community would be involved in the development of the NOFO. The committee member stated that she will provide the names of some organizations that could provide input
    2. Dr Vohra asked for a motion to vote for approval of Recommendation A. Services for Tribal Communities.
      1. Motioned by Sherrie Arriazola Martinez
      2. Seconded by Dr. Arvind Goyal
      3. Governor Stratton, Chief Blair, Director Vohra, Dr. Goyal, Ms. Arriazola Martinez, and Mr. Tomsha voted in favor of the recommendation.
      4. No opposition
      5. No abstention
      6. The recommendation was approved.
  14. Director Vohra opened the floor to discuss Recommendation B: Youth and Family Services.
    1. Dr Vohra asked how discussions occurred with schools and community groups that serve children and adolescents during the development of the recommendation. Mr. Wilkerson said that these groups will be engaged in developing the NOFO.
    2. Dr Vohra asked for a motion to approve Recommendation B: Youth and Family Services
      1. Motioned by Sherrie Arriazola Martinez
      2. Seconded by Lt Governor Juliana Stratton
      3. Lt. Governor Stratton, Chief Blair, Director Vohra, Dr. Goyal, Ms. Arriazola Martinez, and Mr. Tomsha voted in favor of the recommendation.
      4. No opposition
      5. No abstention
      6. The recommendation was approved.
  15. Director Vohra opened the floor to discussion of Recommendation C: Contingency Management.
    1. A committee member stated that the evidence that contingency management (CM) is an effective treatment for opioid use disorder (OUD) is limited; there is more evidence that CM is an effective treatment for Stimulant Use Disorder. This board member stated that this recommendation may be difficult to sustain due to the need for rewards that are effective. Mr. Wilkerson responded by reminding the group that the CM recommendation has been approved; they are now voting solely on the amount of money to be attached to this recommendation. The evaluator will assess whether CM is viable and is an effective use of funding.
    2. Lt Governor Stratton asked if they knew where the pilot programs would be launched. Mr. Wilkerson noted that where the pilot programs will be launched will be determined when NOFOs are developed and approved. The RCCA will consider health equity data in making these decisions.
      1. Dr Vohra asked for a vote to approve the funding amount for recommendation C: Contingency Management.
        1. Motioned by Dr. Goyal.
        2. Seconded by Chief Blair.
        3. Lt. Governor Stratton, Chief Blair, Director Vohra, Dr. Goyal, Ms. Arriazola Martinez, and Mr. Tomsha voted in favor of the recommendation.
        4. No opposition
        5. No abstention
        6. The motion to approve the funding amount for recommendation C passed.

VI. Member Updates

  1. Mr. Tomsha mentioned that a group of harm reduction providers received a grant to visit a New York city and several syringe exchange programs.
  2. Lt Governor Stratton acknowledged comments in the meeting chat including that syringe service providers are underfunded and many pay for syringes out of pocket.

VII. Public Comment

  1. None

VIII. Adjournment

  1. Director Vohra called for a motion to adjourn the meeting.
  2. Motioned by Lieutenant Governor Stratton.
  3. Seconded by Mr. Luke Tomsha.
  4. All in favor
  5. No opposition
  6. No abstention
  7. Director Vohra adjourned the meeting at 11:26 AM.
  8. The next meeting will be held February 25, 2025, from 10:00 - 11:30 AM