Minutes of the DuPage County HOPE Taskforce

January 18, 2019

The Heroin Opioid Prevention and Education (HOPE) Task Force met on Friday, January 18, 2019

The meeting was called to order by HOPE Taskforce Co-Chair, Greg Hart at 9:00AM. The following is a list of members in attendance.

Task Force Member Name

Title Attended

Greg Hart DuPage County Board Member X Bob Berlin DuPage Co. State’s Attorney X Daniel Guerin Chief Judge – 18th Judicial Circuit Dr. Richard Jorgensen DuPage Co. Coroner X Dr. Darlene Ruscitti DuPage Co. Regional Office of Education X James Mendrick DuPage Co. Sheriff X Grant Eckhoff DuPage County Board Member Jeff York DuPage Co. Public Defender X Dr. Lanny Wilson Vice-President, DuPage County Board of Health Karen Ayala Executive Director, DuPage Co. Health Dept. X Bernadine Howard Program Manager, DuPage Co. Probation Dept. X Ed Sailer DuPage Police Chief’s Association X Jim Burke DuPage Fire Chief’s Association X Rich Veenstra Mayor of Addison X Mark Piccoli Director, DUMEG Dr. Aaron Weiner Director of Addiction Services, Edward Elmhurst

Health Christin Kruse Associate Vice President of Advancement - AMITA X Jim Scarpace Executive Director, Gateway X

Michele Worobiec Chief Counsel, TASC Allison Johnsen Manager, Business & Program Development,

CDH/Delnor Lisa Schvach Community Development X Brad Gerke Community Member X

Health Department and DuPage County Staff:

Penny Chanez, Christopher Hoff, Scott Kaufmann, Rabia Mukhtar, Mila Tsagalis, Nansi Angelopoulos, Tim McGavin, Anthony Romanelli, Robert Toerpe. Michaela Rusch

Public at Large: Deb Lewin (Path to Recovery), Don Kalish (Path to Recovery), Leslie Kawar

(Path to Recovery), Julie Nardes (Alkermes)

.

Co-Chair Comments:

Mr. Hart welcomed everyone and thanked County Board Member, Grant Eckhoff for his previous leadership serving as Co-Chair of the taskforce. Mr. Hart is now the new co-chair for the taskforce along with Dr. Lanny Wilson, Vice President of the Board of Health.

II. Acceptance of the Minutes

Mr. Hart asked for consensus to accept the minutes of the November 16, 2018 meeting as presented. The minutes will be filed as presented.

III. Public Comment

Mr. Kalish from Path to Recovery spoke on the agency’s support of families who have a member of their family who suffers from substance use disorders and the assistance they offer including addressing insurance concerns, educational resources and assisting in navigation of the systems. Ms. Lewin, Executive Director of Operations also shared that they offer at their location in Plainfield, addiction counselors, guided meditation, a library and NARCAN is available and emphasized that education is key for families

IV. HOPE Taskforce Purpose and Objectives

Co-Chair Hart reviewed with members the existing taskforce Charter and Framework (see addendum 1) and asked members to share any changes or additions to these documents.

Members were in agreement that no changes were needed to the Charter.

Suggested language that members expressed that they would like to see included in the Framework.

Overarching themes from Impact DuPage

Dr. Jorgenson – Support of legal push to hold pharmaceutical companies liable

Addition of the language: promote job training and workforce development programs supporting those in recovery.

Support of the State’s Attorney’s efforts to pursue legal methods to hold pharmaceutical companies accountable for the distribution and the recovery of tax dollars to recoup costs associated with the Opioid Epidemic.

V. Presentation – Opioid Response – U.S. Department of Health & Human Services,Substance Abuse and Mental Health Services Administration (SAMHSA).

Mr. Hart introduced Captain Jeffrey Coady, Psy.D,, ABPP – SAMHSA Regional Director who will be the guest speaker for today’s meeting.

Dr. Coady commended the task force on the work they are doing to address the opioid/heroin crisis in DuPage County. Dr. Coady discussed and shared information with members to assist them in the work the taskforce is doing. The following is a summary list of the topics Dr. Coady covered. A copy of Dr. Coady’s presentation is included in the minutes.

• The importance of action at the local level• Federal level: seeing progress at the taskforce/County levels. Dr. Coady expressed that

now is the time to double down. The opioid crisis has shifted. Dedicated attention isneeded for all substance use issues.

• Recovery is critical and spoke on the importance and the steps needed for followthrough for a path to recovery.

• Spoke on pain and pain management – in a broader lens and what that means• Shared that federal monies at many levels are available to address the work being done

to address the issue, including a variety of grant dollars.• Spoke on mental health and the connections• Communities moving to discuss broader stakeholders; aging population, childcare

servicing agencies.• Stigma is a huge issue for those with substance use disorders.• Consistent messaging critical.• Syringe services program leads to higher percentage of treatment. Keeps communities

safer including for the risk of an increase in HIV and Hep C. cases• Fentanyl test strips for communities• Suicide discussions and assistance• Recovery supports – safe and affordable housing for those on medication assisted

treatment.• Stressed the importance in public private partnerships including having the business

sector and Chamber of Commerce included in the conversation.• Addiction training needed• Discussed drop in centers at the Fire Department. Crisis Center the fire departments.

Celebrate successes in the community.

VI. Pilot Project Updates - Bernadie Howward

First Offender Court Unified for Success ( FOCUS) – to provide participants the necessary oversight, structure, discipline, counseling, treatment, education, and support to achieve the successful completion of probation and promote their road to recovery and rehabilitation.

Members were provided a copy of the new brochure for F.O.C.U.S.

Budget being worked on based on grant funding

Current probationers in the system:

• 57 high risk • 97 medium risk • 18 low risk

Educational speakers are scheduled to being addressing F.O.C.U.S. participants in April.

Treatment Navigation - Karen Ayala

Work continues to connect individuals to the appropriate care/providers.

Chief Sailor added that individuals are coming in to police departments seeking assistance and they are seeing an increase in families of individuals suffering from substance use disorders. NARCAN is being provided free of charge and information on RAMP UP the manufacturing training program for those in recovery is also being provided.

RAMP UP

Lisa Schvach provided the following update

• All seven students remain in engaged and none have dropped out. • 4 area manufactures came out and met with the seven students. • Possible job placements upon completion. • Great confidence boost. • Funding opportunities: Dislocated worker grant – feedback wanted if it should pursued

VII – Next Steps and Other Updates

James Mendrick shared that the Sheriff’s office recognizes the correlation with drug usage and mental health issues and has made changes in their patrol response. Changes include coordination with the Health Department crisis response team to assist on calls where an individual may have mental health issues and providing educational information on the scene to families.

Dr. Ruscitti informed taskforce members that the Regional Office of Education received $500,000 in funding for the purpose to train school personnel in Mental Health 101. Dr. Ruscitti was pleased to report that all DuPage County schools will now have a staff representative trained in the basics of metal health.

Dr. Jorgenson provided current statistics his office is seeing.

• 13% increase in deaths in 2018• Seeing an increase in Synthetic opiates vs. grown.

Mr. Hart commented that to allow time for the work being worked upon by the subcommittees it was recommended to have the full task force meet on a quarterly basis vs. monthly. Task force members were in agreement and set of dates will be determined and sent to the members at a later date. The dates will also be posted online.

There was no further discussion.

Meeting was adjourned at 10:30AM.

1. Reduce Access to Drugsa. Expand RxBox and other drug take back programs

i. Provide education for patients on importance of disposing properly of medicationsand engaging hospice providers for the same

ii. Provide community education on importance of disposing medications properlyb. Provide education or technical assistance to healthcare organizations on how to set-up

take back programsc. Reduce supply of illicit drugs through law enforcement

2. Reduce Opioid Use and Misusea. Reduce the number of opiates prescribedb. Increase use of Prescription Drug Monitoring Program (PDMP) by prescribers in DuPage Countyc. Educate consumers about identifying opioid medications and advocating for alternativesd. Increase use of non-opioid treatment optionse. Promote consistent safe prescribing messages and policies used by healthcare providers and

health systemsf. Promote and provide safe prescriber training

3. Increase Overdose Responsea. Make naloxone more accessible to first respondersb. Make naloxone more accessible to bystanders and those most at-risk for overdosec. Communication campaign to increase awareness of 911 Good Samaritan Law and provision of

treatment and harm reduction resourcesd. Expand overdose follow-up provided by hospitals, fire departments, police departments, and

social workers

4. Integrated Mental Health & Substance Use Disorder Treatment and Recoverya. Increase treatment community capacityb. Increase primary care and other healthcare provider referral to treatmentc. Coordinate with criminal justice system partners to increase screening and referral to treatmentd. Increase availability of Medication-Assisted Treatmente. Promote integration of mental health and substance use disorder treatmentf. Promote job training and workforce development programs supporting those in recovery

5. Substance Use Prevention and Educationa. Enhance and promote prevention efforts (i.e. evidence-based curriculum for youth and messaging

for general population)b. Promote substance use disorder stigma reduction campaigns

Cross-cutting Goals of the Taskforce Communication (i.e. media, social media, health promotion) Data collection (i.e. Illinois Youth Survey, DuPage Narcan Program, EMS, Morbidity and Mortality) Evaluation of efforts

FRAMEWORK

1/2019

Addendum #1

• Jeffrey Coady, Psy.D., ABPP• CAPT, United States Public Health Service

• SAMHSA Regional Administrator (5)

The Way Ahead in Addressing the Opioid Crisis

DuPage Heroin-Opioid Prevention & Education (HOPE) TaskforceJanuary 18th, 2019Wheaton, IL

HHS Opioid Strategy

HHS Response • SAMHSA: Grants for prevention, treatment, and recovery services• CDC: Data tracking, PDMPs, Prescriber guidelines; community prevention grants• FDA: Reviewing what should come off market, and looking at non-addictive pain

alternatives.• NIH: Research on treatment of addiction, overdose, and non-addictive pain

therapies.• CMS: Medicaid and Medicare policies and payments for prescriptions and for

treatment.• HRSA: CHC SUD treatment funds; tele-health grants; NHSC; community planning grants• OASH: National Pain Task Force; National Pain Strategy; Grants for opiates & women;

the Surgeon General Report “Facing Addiction in America.”• ACF: Foster care for children impacted by opioids• OCR: Clarifying HIPAA rules regarding information sharing • IHS: National Committee on Heroin, Opioids, and Pain Efforts (HOPE)

Plan to Address the Opioid Crisis: FY 18 Increased Resources

Substance Abuse Treatment: $3.18B, an increase of $1.05B from FY17 New $1B Opioid grant program $50M set-aside for tribes 15% set-aside for states hardest hit Includes prevention, treatment, and recovery language

MAT PDOA increased by $28M (total: $84M) PPW increased by $10M (total $29.9M) CJ increased to $89M ($70M for Drug Courts) BCOR (peer specialist training programs) increased by $2M (total: $5M) MFP: addiction psychiatry, addiction medicine, psychology ($1M increase to total of

$4.5M) Reinstatement of Drug Abuse Warning Network (DAWN) at 10M

• CSS-SMI: training on EBP, psychotropic use, management of risk of metabolic syndrome, Assisted Outpatient Treatment

• Policy Lab EBP website established• Mental Health TTCs established and supplemented to address TA/T assistance for children’s

issues: school-based positive environment programs, identification of mental health issues in children/adolescents and assisting affected youth/families, integrated care in schools

• Total: 1.56 B 71M• Mental Health Block grant: 722.5 M• CCBHCs/integrated care: 150M 50M to organizations in the 24 states with planning grants• Work with CJ system• Transitional age youth: Family Tree (CSAT), Healthy Transitions, CMHI• Suicide: Zero suicide/youth programs, AI/AN Programs, for Lifelines of 5M• Increased funding for MHFA and Crisis Intervention Training (AWARE: 71M) 6M

• NCTSI: 63.9M 10M

Strategic Plan: Addressing SMI and SED

Strategies to Address the Opioid Epidemic

CommunityPrevention

Clinical Practice

Crisis Services

Recovery Support

Workforce

1. Strategic Planning

2. Community & Provider Education

3. Harm Reduction

4. Medication Disposal

1. CDC Pain Management Guidelines

2. Screening & Assessment

3. Medication Assisted Treatment

4. SUD Levels of Treatment

5. PDMP6. Tele-Health

1. Naloxone distribution & education: 1st

responders, patients, family

2. ER overdose education (MAT initiation)

3. Detoxification4. Link ER/Detox

to treatment

1. Access to Health Care

2. Safe & Affordable Housing

3. Education & Employment

4. Social & Community Connections

1. Data 2000 Waiver (MD/PA/APRN)

2. Clinician Support & Continuing Education

3. Recruitment & Retention Plans

4. Integrated Care Competencies

5. Peer Recovery

Jeffrey Coady, Psy.D., ABPPCAPT, United States Public Health Service

SAMHSA Regional AdministratorJeffrey.Coady@samhsa.hhs.gov

Thank You!