01.14.2025 Minutes

Illinois Opioid Remediation Advisory Board

Medical & Research Working Group Meeting

January 14, 2025
12:00 PM - 1:00 PM

Virtual Meeting Held Via Zoom

Meeting Minutes

Medical and Research Working Group Members

Katherine Austman, MD, Gibson Area Hospital and Health Services (Chair)
Adrienne Adams, MD, North Shore
Geoff Bathje, PhD, Sana Healing Collective, Chicago Recovery Alliance
Lia Daniels, Illinois Hospital Association (IHA)
Michael Dennis, PhD, Lighthouse Research Institute, Chestnut Health Systems
Nicole Gastala, MD, Illinois Department of Human Services (IDHS)/Substance Use Prevention & Recovery (SUPR)
Michael Isaacson, Kane County Health Department
Katharine (Kitty) Juul, Southern Illinois University (SIU)
Dan Lustig, PsyD, MA, Haymarket Center
Jessica Perillo, Health Management Associates
Doug Smith, PhD, University of Illinois
Katie Unthank, Egyptian Health Department
Brent Van Ham, Southern Illinois University School of Medicine
Lindsay Wilson, CDC Foundation
Leslie Wise, PhD, Illinois Department of Public Health (IDPH)

Welcome and Roll Call

Mr. Jim Wilkerson, Interim State Opioid Settlement Administrator (SOSA), introduced the new Working Group chair, Dr. Kate Austman. Dr. Austman opened the meeting and welcomed the group. Sue Pickett, PhD, facilitator, Advocates for Human Potential (AHP), Inc., conducted roll call. All members were present except for Lia Daniels, Michael Dennis, Michael Isaacson, Katharine Juul, and Brent Van Ham. Quorum was established.

Review and Approval of November 19, 2024 Meeting Minutes

Dr. Austman called for a motion to approve the November 19, 2024 meeting minutes. Dr. Lustig made a motion. Katie Unthank seconded the motion. All members present voted in favor of approving the minutes. The motion passed.

Settlement Funding Update

Mr. Wilkerson introduced Verella Olguin who will assume the role of SOSA. Ms. Olguin introduced herself. Mr. Wilkerson provided the following updates related to remediation funds.

Mr. Wilkerson, Interim State Opioid Settlement Administrator (SOSA), introduced Verella Olguin, who will assume the role of SOSA. Ms. Olguin introduced herself. Mr. Wilkerson provided the following updates related to settlement funds.

  • To date, more than $237 million (M) has been disbursed to the Illinois remediation fund. $127.3M was disbursed in calendar year 2024 and $44.8M is projected to be disbursed in calendar year 2025. The amount of settlement funding disbursed each year varies. To keep funding for programs consistent over time, they are allocated to annual and one-time investment funds.
  • Mr. Wilkerson reviewed recommendations that were funded via expansion of services in fiscal years 2023 and 2024 including Community Intervention Services, Access Narcan, and the Illinois Prescription Monitoring Program (ILPMP). SUPR is working on an intergovernmental agreement with the Illinois Department of Corrections (IDOC) to provide services to individuals that are incarcerated.
  • Recommendations that were developed as NOFOs and awarded include IM Naloxone and other Food and Drug Administration-approved Drugs to Reverse Overdose, Opioid Abatement Strategies Effectiveness Evaluator (OASEE), and Community Outreach and Recovery Supports (CORS), Services for Pregnant and Post-partum People and their Families, Warm Handoff Programs and Recovery Services, and BASE Prevention Programs and mobile MAR services. A NOFO for the Opioid Training and Technical Assistance Center (OTTAC) recently closed. Recommendations for harm reduction are being funded through an intergovernmental agreement with IDPH and NOFOs.
  • Recommendations currently being developed into NOFOs include Tribal Community Services, Youth and Family Services, Contingency Management, and Telehealth Expansion.
  • Mr. Wilkerson reviewed the difference between the annual allocation amount and the one-time investment balance. The annual allocation amount is the grand total for settlement funding divided by 18 years. With additional funding received in FY24, the annual allocation amount is now $43M. The current annual spending is $32M. Money that is not spent during a fiscal year is placed in the one-time investment fund, which is currently $74M. Funded one-time investments include Opioid Treatment Programs, Capital Investment, and

Discussion:

  • A Working Group member asked how funding was disbursed from the one-time investment balance. Mr. Wilkerson responded that the process for disbursement of funds to subrecipients is the same as for the multi-year grants except the subrecipient only receives the money one time.
  • Dr. Pickett reviewed the roles of the IORAB Working Groups and the SOSA in reviewing recommendations for the use of opioid settlement funding. The IORAB Working Groups develop and finalize recommendations which are sent to the SOSA for review. The SOSA considers the following criteria to determine if a recommendation should move forward: it must provide general benefits across the state, it must not duplicate existing services, and the services recommended must qualify as an approved use of funds that cannot be funded via existing resources including Medicaid. The SOSA may edit the recommendation based on the Opioid Settlement Agreement and share these edits with the Working Groups for approval. Funding amounts for recommendations are determined based on estimated costs and needs. The SOSA then submits the recommendation and any supporting information to the IORAB. The IORAB reviews, discusses, and then votes on whether a recommendation should be forwarded to the Steering Committee or should be returned to the Working Group for more information. The Steering Committee reviews the recommendation for alignment with the State Opioid Action Plan and determines if it can be funded with settlement funds. The Steering Committee votes on whether the recommendation should be approved.

 Recommendations that are approved by the Steering Committee go to the Attorney General (AG) for certification.

  • Dr. Randi Moberly, Senior Program Director at AHP, described the Illinois Regional Care Coordination Agency (RCCA)'s sub-award administration. After recommendations are certified by the AG, IDHS/SUPR creates a scope of work (SOW). The RCCA uses this SOW to develop a NOFO that is released on the RCCA website. The RCCA reviews applications received in response to the NOFO and determines which organizations should receive awards. The RCCA sends applicants that are finalists a notification of intent to award (NOIA). Once organizations that receive NOIAs accept awards, the RCCA sends out notices of non-award (NONA) to applicants that will not receive funding. After these notices are issued, the RCCA announces awarded organizations publicly. During the award phase, the RCCA executes agreements between the subrecipient (awardees) and AHP.
  • The NOFO dashboard provides information about the status of each NOFO, the dates of the application period, the date of notification for applicants, the date of announcement of awardees, and the beginning and end dates for the initial period of performance.
  • The RCCA collects monthly, quarterly, and annual performance metrics to assess the work of awarded organizations. The Opioid Abatement Strategies Effectiveness Evaluator will collect monthly data from awarded program to assess the impact of programming and determine barriers to implementation. This information will be reported on the RCCA website and provided to the IORAB biannually.

Discussion:

  • A Working Group member asked for a link to the NOFO dashboard and if there were approved recommendations that had not been released as NOFOs. Dr. Moberly responded that she would provide this link and shared that four approved recommendations (telehealth expansion, opioid treatment programs, services for tribal communities, and services for youth and families) have not been translated to NOFOs yet.

Priority Recommendations for the IORAB

Mr. Wilkerson described the Automated Chest Compressions Devices (ACCD) Recommendation which would provide funds for Emergency Medical Services (EMS) in Illinois to acquire ACCDs and X Series Monitor/Defibrillators equipped with Real BVMs (bag valve masks) Help. These devices can be attached to patients who may be in cardiac arrest to perform cardio-pulmonary resuscitation (CPR). This equipment can be used to revive patients that are experiencing cardiac arrest related to an opioid overdose. The recommendation also includes a request for funding for additional equipment such as pumps and ventilators to monitor the effects of naloxone. The recommendation came from a community organization and was for approximately $10M as a one-time investment.

Discussion:

  • Dr. Austman stated that she reviewed the resources listed in the recommendation and they did not show better outcomes related to use of ACCDs, rather the outcomes were equivocal. She noted that people need to have knowledge and experience to use ACCDs effectively and that there are concerns that these devices may be unsafe and cause complications. Dr. Austman noted that the research provided as support for this recommendation was not conducted with patients experiencing opioid overdose but with patients experiencing cardiac arrest for a variety of reasons.
  • A Working Group member indicated that they supported Dr. Austman's statements and discussed that safe drug consumption sites often have oxygen available for respiratory distress related to overdose. They do not have ACCDs, which are more costly.
  • A Working Group member echoed these concerns about the applicability of ACCDs to opioid overdose. They stated that more information about how frequently chest compressions are used to treat opioid overdose and how often EMS workers become fatigued when doing chest compressions would be helpful.
  • Dr. Austman stated that there might be other medical equipment such as IV pumps and ventilators that was more beneficial for opioid overdoses and therefore more appropriate for funding through opioid settlement funds.
  • Dr. Austman asked for a motion to not support the recommendation. Geoff Bathje made a motion. Dan Lustig seconded the motion. All Working Group members who were present voted not to support this recommendation. Dr. Austman noted that if feedback was sent to the people who submitted the recommendation it should recommend that they include research supporting the use of ACCDs for opioid overdose. Mr. Wilkerson said that they would bring this feedback to the organization that submitted the recommendation.
  • Mr. Wilkerson shared that a recommendation to use opioid settlement funding to support a pilot project to distribute higher dose (8 mg) naloxone nasal spray had been discussed by the IORAB and sent back to the Medical & Research Working Group for more information. This recommendation is now defunct as it has been funded by another source.

Public Participation

No members of the public participated

Adjourn

  • Dr. Austman called for a motion to adjourn the meeting. Doug Smith made a motion. Leslie Wise seconded the motion. All members voted to approve the motion. Dr. Austman adjourned the meeting.
  • The next meeting of the IORAB Medical & Research Working Group will be held on April 4, 2025 from 12:00 -1:00pm.