01.30.2025 Minutes

Illinois Opioid Remediation Advisory Board

January 30, 2025
2:00 - 4:00 PM
Virtual Meeting Held Via Zoom

Meeting Minutes

Illinois Opioid Remediation Advisory Board Members

Dr. Adrienne Adams, NorthShore/Endeavor Health
Dr. Katherine (Kate) Austman, Gibson Area Hospital & Health Services
Eddy Borrayo, Rincon Family Services
Chelsea Laliberte Barnes, Wolf Pack
Ryan Brauns, Rockford Consulting & Brokerage
Blanca Campos, Community Behavioral Healthcare Association of Illinois
Jud DeLoss, Illinois Association of Behavioral Health
Dr. Bernice Gordon-Young, SMART Recovery Intervention Program
Angie Hampton, Egyptian Health Department
Christopher Hoff, DuPage County Health Department
Dr. Miao Jenny Hua, Chicago Department of Public Health (CDPH)
Joel K. Johnson, Treatment Alternatives for Safe Communities, Inc.
Laura Lechowicz, Office of the Cook County President
Donna Nahlik, Chestnut Health Systems
Dr. Kathy Yoder, McLean County

Illinois Opioid Remediation Advisory Board Ex Officio Members

Dr. Inger Burnett-Zeigler, 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

Director Garcia called the meeting to order and welcomed the group. Director Garcia welcomed Dr. Inger Burnett-Zeigler, the new Chief Behavioral Health Officer (CBHO) for IDHS. Dr. Burnett-Zeigler will serve as the chair for the Illinois Opioid Remediation Advisory Board (IORAB). Director Garcia asked for a motion to approve the agenda and minutes from the 10/17/2024 meeting. An IORAB member asked for clarification on the amount of time allocated to the recommendation review process, updates from the Office of Opioid Settlement Administration (OOSA), and discussion and voting on new recommendations. Director Garcia responded that there were 15 minutes for the recommendation review process, 10 minutes for the OOSA updates and 20 minutes for discussion and voting on new recommendations. The IORAB member asked that if there were no updates or changes to the recommendation review process, this information could be shared in a document rather than in the meeting to maximize the time for discussion of new recommendations and voting. An IORAB member asked if the IORAB could receive information about all recommendations that were submitted to the OOSA. Director Garcia replied that these requests and potential changes to address them will be considered. Joel Johnson made a motion to do roll call, approve the agenda, and approve the minutes from the prior IORAB meeting. Jud DeLoss seconded the motion.

Roll Call and Approve Agenda and 10.17.24 Meeting Minutes

Dr. Sue Pickett, facilitator, of Advocates for Human Potential (AHP) conducted the roll call of the IORAB and a roll call vote for approval of the meeting agenda and the 10/17/2024 IORAB meeting minutes. All members except Eddy Borrayo, Dr. Bernice Gordon-Young, and Dr. Kathy Yoder were present. Quorum was established. The ex officio roll call was taken. All ex officio members were present except Secretary Dulce Quintero, Chief of Staff Laura Vaught, State Senator Sally Turner, Attorney General Kwame Raoul, and State Representative LaShawn Ford. Dr. Leslie Wise attended on behalf of Chief of Staff Laura Vaught; Andrea Law and Susan Ellis 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, except for Ms. Laliberte Barnes, approved the agenda. All IORAB members who were present approved the meeting minutes.

Dr. Hua and Dr. Austmann are not included in vote counts as they were not formally appointed to the IORAB at the time of this meeting.

Chairperson's Welcome Remarks: Laura Garcia, Director, Chair

Director Garcia introduced Verella Olguin who has assumed the role of Illinois Statewide Opioid Settlement Administrator (SOSA) at SUPR. Director Garcia also introduced two new IORAB members. Dr. Katherine Austman, a double-board certified family and addiction medicine physician at Gibson Area Hospital and Health Services and Dr. Jenny Hua, Medical Director and Interim Deputy Commissioner of Behavioral Health at CDPH.

Process for Recommendation Submission: Dr. Randi Moberly, AHP, Inc.

Dr. Randi Moberly, Director of the Illinois Regional Care Coordination Agency (RCCA) provided an overview of how recommendations are approved and translated into notice of funding opportunities (NOFOs).

The process for creation, approval, and funding of a recommendation is as follows. Recommendations can be submitted to the SOSA by IORAB Working Groups as well as other entities. The SOSA reviews the recommendation to ensure that it aligns with approved uses documented in the Allocation Agreement and with the State Overdose Action Plan and does not supplant other funding or duplicate other recommendations. The IORAB reviews and votes on the recommendation. If approved, the recommendation moves to the Steering Committee. The Steering Committee then votes on the recommendation. Recommendations that are approved by the Steering Committee move to the Attorney General's (AG) office for certification.
After a recommendation is certified by the AG, IDHS/SUPR creates a scope of work (SOW). The RCCA translates this SOW into a NOFO. For the solicitation phase, the RCCA releases the NOFO, reviews applications, and selects finalists. During the notification phase, the RCCA sends finalists a notice of intent to award (NOIA). Finalists have time to review the proposed contract and accept the award. Once finalists have accepted awards, the RCCA sends notices of non-awards (NONA) to applicants that will not be awarded. In the awards phase, subaward agreements are reviewed and executed by the subrecipient and the RCCA. During the implementation phase, the period of performance begins and the subrecipient starts work.
The IL RCCA NOFO Status Dashboard shows the current phase of each NOFO and the dates that each phase opened and closed.
The RCCA will collect monthly and quarterly data from funded programs to assess outcomes described in the NOFO and will share biannual reports on the Illinois Regional Care Coordination Agency website. The Opioid Abatement Strategies Effectiveness Evaluator (OASEE) will collect and analyze data from funded programs to assess impact, the extent to which disparities are addressed, and barriers to implementation and will provide reports.

Discussion:

An IORAB member stated that funding recipients have expressed concern that the RCCA's oversight is more stringent than the oversight for other projects funded via settlement money. Dr. Moberly responded that this difference may be due to regulations requiring additional documentation. The RCCA is adjusting messaging to clearly communicate the administrative needs related to receiving funding and offering training and technical assistance to help sub-recipients with the administrative burden.
An IORAB member asked how many recommendations had been received from all sources. Mr. Wilkerson responded that about 3-5 recommendations are received for each IORAB meeting. Director Garcia shared that the number of initial recommendations that were processed was included in the Illinois Remediation Funds State Fiscal Year 2024 Annual Report. SUPR can provide an update on the number of recommendations that have been processed at the next IORAB meeting.

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 settlement from Kroger has been finalized. It will bring close to $41M into Illinois during an 11-year period. A total of $22.5M, 55% of the total amount, will be allotted to the remediation fund.
An updated settlement agreement with Purdue Pharma would bring up to $154M to Illinois if it is finalized. A total of 55% of this amount would be allocated to the remediation fund over a 15-year period. This is an agreement in principle, and these are best estimate numbers that are not final.
To date, $243M has been disbursed to Illinois Remediation Fund. This total includes an additional $22.5M from the Kroger settlement.

Discussion:

An IORAB member stated that the board should use additional money from the Kroger settlement to increase the amount of money allotted to current settlement funds sub-recipients and NOFOs that are in development. The IORAB member explained that the federal funds available for this work may decrease, so these increases could offset the impact of this change. Director Garcia acknowledged this statement and recommended that the SOSA review this suggestion.

Working Group Updates

Medical & Research: Kate Austman, MD, Chair

Dr. Austman reported that the Working Group reviewed the capital infrastructure recommendation and voted to endorse it. The Working Group also reviewed a recommendation to use settlement funds to purchase automatic compression devices for use in cardio-pulmonary resuscitation and voted not to endorse it at this time.

Access & Equity: Joel K. Johnson, Chair

Mr. Johnson reported that the Working Group reviewed the recommendations for capital investment and overdose prevention sites (OPS) and voted to support both recommendations.

Workforce Development & Infrastructure: Blanca Campos, Chair

Ms. Campos reported that the Working Group reviewed the recommendations that will be voted on today. The Working Group is developing a recommendation to use settlement funding to increase or provide administrative support related to grant writing and management for organizations interested in applying for settlement funds. She stated that they hope to present this recommendation at the next IORAB meeting.

Office of Opioid Settlement Administration Updates: Jim Wilkerson, Interim SOSA, Verella Olguin, SOSA

Director Garcia thanked Mr. Wilkerson for his work as SOSA. Mr. Wilkerson reviewed information about the use of settlement funding and described the recommendations that the IORAB will consider.

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 has joined SUPR and no longer receives remediation funds.
Recommendations related to intra-muscular (IM) naloxone, the opioid abatement strategies effectiveness evaluator, community outreach and recovery supports (CORS), services for pregnant and post-partum people and. NOFOs have been awarded for services for pregnant and post-partum people and their families, warm handoff programs, BASE prevention programs, and mobile medication assisted recovery (MAR) have been approved and awarded via NOFOs. A recommendation related to treatment for incarcerated people will be awarded via an intergovernmental agreement with the Department of Corrections. A second NOFO for mobile MAR services was launched yesterday.
The NOFO for the opioid training and technical assistance center (OTTAC) has closed and applications are being reviewed. The harm reduction NOFO is open and can be viewed on the RCCA website. NOFOs are being developed for recommendations for services for tribal communities, youth and families, and contingency management. Additional information about awards and the settlement funds is available on Illinois Regional Care Coordination Agency and the Illinois Opioid Settlements Initiative websites.
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. The current annual spending is $34M, not inclusive of today's recommendations. Annual funding that is not spent goes into a one-time investment balance, which currently totals $56.4M. Currently funded one-time investments include capital investments and telehealth expansion.

New Funding Recommendations (Action Items)

Recommendation A. Capital Investment

This is a request for $20M from the one-time investment fund. This recommendation seeks to add funding to the previously approved capital investment recommendation. Due to restrictions on the agency partnering with IDHS/SUPR to implement the recommendation, funds can only be used to support permanent supportive housing for people affected by opioid use.

Recommendation B: Overdose Prevention Sites

This is a request for $1.5M over 3 years, or $500,000 per year, to fund pilot overdose prevention sites (OPS) across Illinois to reduce overdose deaths with a focus on historically underserved communities.

Board Recommendations and Discussion: Director Laura Garcia

Director Garcia asked for a motion to approve Recommendation A. Capital Investment for $20M from the one-time investment fund. Jud DeLoss made a motion. Angie Hampton seconded the motion. Director Garcia opened the floor for discussion.
An IORAB member asked which agency was partnering with IDHS/SUPR on this recommendation. Director Garcia responded that the Illinois Housing & Development Authority (IHDA) is the partner.
An IORAB member asked if the language in the recommendation could be expanded from building housing to include renovating, converting, or improving existing facilities. Director Garcia stated that while there is funding available for remodeling and purchasing building, IDHS/SUPR currently only has a mechanism to fund permanent supportive housing. IDHS/SUPR is working to establish this mechanism and then additional funding opportunities for capital improvement will be brought to the IORAB. The IORAB member asked if the allocated $20M was limited to new construction. Mr. Wilkerson confirmed that the money could be used to either build new buildings or renovate existing buildings if the purpose was to provide permanent supportive housing.
An IORAB member asked if there was a specific agency identified to receive the funding. Director Garcia said that a specific agency to receive the money has not been identified.
An IORAB member asked if this recommendation allowed IHDA to put out a NOFO for agencies providing permanent supportive housing to receive these funds to build or renovate housing for individuals with opioid or substance use disorder. Mr. Wilkerson confirmed that this was correct.
An IORAB member asked how many grants would be funded. Rafeal Rivera, Chief of Staff at IDHS/SUPR, responded that the number awarded will depend on the number of proposals.
An IORAB member recommended that the word "build" in the recommendation be replaced with "create" to indicate that it did not have to be a new build. Director Garcia confirmed that this change would be made.
Director Garcia called for a motion to vote on the recommendation with the language amened from "build permanent supportive housing" to "expand, create, or develop permanent supportive housing." Angie Hampton made a motion. Christopher Hoff seconded the motion. All members that were present voted to approve the recommendation. The motion passed.
Director Garcia called for a motion to discuss Recommendation B. Overdose Prevention Sites. Chelsea Laliberte Barnes made a motion. Blanca Campos seconded the motion. Director Garcia opened the floor for discussion.
An IORAB member stated that the proposed funding amount was $1.5M, with $500,000 being the limit per award. The IORAB member noted that implementing OPS will involve high liability and recommended increasing the funding amount to $1.5M for up to 3 awards. Another IORAB member agreed that the funding amount should be higher based on information related to costs for an OPS in New York City.
An IORAB member asked how many OPS would be funded with this award, as the amount seemed appropriate for one site. The IORAB member asked if the award was intended for a specific area within the state and if it would be funded via a NOFO process. The IORAB member expressed agreement that the funding amount should be increased.
An IORAB member asked if legislative change was needed to create an OPS in Illinois. Director Garcia responded that IDHS/SUPR believed legislative change might be needed and is investigating this issue.
An IORAB member said that they had previously made a recommendation to fund OPS to the IORAB and it was rejected because it was illegal. The IORAB member asked if there had been changes that legalized OPS and if the IORAB should ensure the legality of OPS prior to voting. Director Garcia responded that IDHS/SUPR had verified that opioid settlement funding could be used to support an OPS. She noted that the IORAB could vote to approve a recommendation before the mechanism to implement it is in place, as they had done for capital investment.
An IORAB member noted that there is evidence that OPS are a sound public health strategy to save lives. The IORAB member asked to make a motion to increase funding to $2M for up to 3 organizations for a total of $6M per year. The IORAB member asked how people with lived and living experience were involved in the development of this recommendation. Director Garcia said that the entity submitting the recommendation has expertise in OPS. She noted that if the recommendation were passed, people with lived and living experience would work on the development of the scope of work.
Director Garcia asked for a motion to vote to amend the recommendation to include up to $2M per year for up to 3 organizations for a total of $6M a year. Chelsea Laliberte Barnes made a motion. Joel Johnson seconded.

An IORAB member asked for the evidence behind the amount of $2M per organization. Another IORAB member responded that this amount was based on the costs of existing OPS and suggested that the language be amended to be "up to $6M" per year to allow flexibility.
Director Garcia called for a vote on amending the recommendation a second time. Dr. Pickett stated that the recommendation would now read "up to $6M per year for up to three sites." Dr. Pickett took a roll call vote. All members voted to approve the amendment.
An IORAB member stated that if this funding amount was increased it would exceed the amount other projects had received. Another IORAB member stated that he was concerned that approving this amendment would require $18M to be set aside for OPS, which would decrease funds available for other projects. The IORAB member stated that they would like more information about costs. Director Garica noted that the IORAB could vote to increase OPS funding at future IORAB meetings.
Mr. Wilkerson noted that it may take time to start implementing the OPS if legislative changes were needed and that data from the OPS might not be available for a year after that. He noted that increasing funding for the OPS would decrease the funding available for the other initiatives. The IORAB could increase funding for OPS in the future.
Director Garcia asked for a motion to approve the recommendation with the amendment that the funding amount would be up to $2M a year for one to three organizations. Chelsea Laliberte Barnes made a motion. Dr. Jenny Hua seconded. Dr. Pickett conducted a roll call vote. All IORAB members present voted yes with these exceptions: Mr. Brauns, Mr. DeLoss and Mr. Hoff voted no, and Ms. Hampton abstained.

Public Comments

An IORAB member stated that there was a need to have more time for discussion during meetings. The IORAB member requested additional information about the recommendations including who submitted them. The IORAB member proposed that the IORAB have an optional board meeting in between the quarterly meetings to provide time for discussion and deliberation. The IORAB member suggested that meetings limit time spent on the presentation of processes to changes or updates in procedures. Director Garcia stated that Dr. Burnett-Ziegler and the SOSA will consider these requests and what changes could be made in compliance with the Open Meetings Act.

Chair Closing Remarks and Adjournment

Director Garcia thanked the group and asked Dr. Burnett-Ziegler to provide closing remarks. Dr. Burnett-Ziegler thanked the IORAB for the thoughtful discussion of the recommendations and ideas for improving board processes. Director Garcia stated that tomorrow is the last day she will be Director at SUPR and thanked the group for their work. Dr. Gordon-Young made a motion to adjourn the meeting. Ryan Brauns seconded the motion. Director Garcia adjourned the meeting. The next meeting will take place on April 24, 2024 from 2:00pm-4:00pm.