Minutes - DPAC June 6, 2023

Iowa Drug Policy Advisory Council Meeting Minutes

1:00 – 3:30 p.m., Tuesday, June 6, 2023

In-Person: Pape State Office Building, First Floor Conference Room
215 E. 7th Street, Des Moines, Iowa 50319
Backup: Join virtually at https://meet.google.com/cwp-khxc-ite
Or dial: ‪(US) +1 501-803-2115 PIN: ‪588 530 302#

Called to Order: June 6, 2023 at 1:04pm

Adjourned: June 6, 2023 at 2:57pm

Voting Members Present: Dale Woolery, Terra Kinney, Jason Feaker, Kevin Gabbert, Barb Anderson, Patrick Coughlin, Nicole George, Sharon Greer, Jeff Wright, Katrina Carter, Dave McDaniel, Kelly Cunningham, Rex Mueller

Voting Members Absent: Ryan Moore, Chris Wilson, Janee Harvey, Steve Michael

Non-Voting Guests Present: Stephan Bayens, Lt. Col. Jonathan Borg, DeMario Luttrell, Flora Schmidt, Paula Noonan, Michaela Ramm, Debbie McClung, Kevin Protzmann, Lindsey Browning, Kevin Paulsen

ODCP Staff Present: Susie Sher

Welcome

Director Woolery called the meeting to order and welcomed attendees.

Approval of the September 13, 2022 and December 13, 2022 minutes
Minutes from September 13, 2022 were approved. Motion by Sheriff McDaniel, second by Terra Kinney.

Minutes from December 13, 2022 were approved. Motion by Jason Feaker, second by Sheriff McDaniel. 

Alignment

Commissioner Bayens gave an update on alignment. He gave background information on the need for alignment and how it affects DPS and ODCP. The three pieces of alignment that affected DPS were ODCP, MVE, and the State Fire Marshall regulatory officials. The Governor decided to place ODCP within DPS due to the nature of the relationship and business conducted. Commissioner Bayens anticipates DPS being able to give ODCP a larger platform. He stated that business will continue and probably not look much different as far as the Council is concerned. He stated that enforcement, treatment, and prevention are all important and the business of DPAC will continue. He reiterated that prevention and education are important and help reduce the demand for drugs in Iowa. The role of the Council will not be diminished due to alignment. The Governor believes in a comprehensive approach to substance use issues, so the Commissioner will continue to voice what the Council deems important. Dale assured the Council that the work they do and the input they provide is appreciated. He wanted to make sure the Council knows their voices will still be heard. 

HF 595

The genesis for HF 595 started with this Council, in response to the rise in fentanyl and opioids here in the state of Iowa. Historically, heroin wasn’t a big problem in Iowa. As a result, the law hadn’t advanced since the 1980s. Recently, the state started seeing heroin, fentanyl, and other opioids. In some respects, it has mirrored the effects that methamphetamine had on the state. In the early 2000s, overprescribing of opioids was limited by federal law. However, opioids from the southern border have replaced prescribed opioids and are causing large numbers of overdoses. In order to address the problem, the state had to change the law. 

The first part of HF 595 brings the weights for certain levels of penalty into line with other drugs. Another piece of the bill addresses trafficking causing death or serious injury. The bill was modeled after the federal law involving delivery of a controlled substance causing death or serious injury. It addresses causation – just have to show it was a contributing factor. Now, attorneys can prosecute without having to take the cause federally. 

Last year, the DCI lab analyzed over 100,000 pills last year. The DEA estimates 4 to 6 out of 10 counterfeit pills have a lethal dose of fentanyl in them. The Commissioner talked about a rural Iowa case involving overdose deaths that needed to use the federal system to prosecute. This case highlighted the need for state law to mirror the federal law. 

Access to opioid antagonists – two parts – DPAC spent a lot of time talking about opioids and how to address the problem. The law opens up access to products including naloxone. It allows for first responders, community organizations, health organizations, etc. to distribute or leave behind these products. 

Kevin Gabbert stated he thinks this law will greatly increase the number of naloxone kits distributed into our communities. He also plans to have a naloxone application available later this year to have naloxone directly shipped out to organizations. 

Lindsey stated that the Attorney General’s Office already received a question about whether mental health providers would be able to distribute. They determined that they can. The Polk County Medical Society is planning to discuss distribution at a future meeting. Flora stated that IBHA members are interested as well. She stated they are happy it will also be over the counter but are also concerned that funding for it will go away. It may be cost-prohibitive to purchase it over-the-counter for most people. 

IHHS is distributing naloxone through pharmacies, online applications, and is looking into opioid settlement funds. They are working with the Pharmacy Board to continue to offer naloxone for free, using insurance. 

IHHS is creating protocols to track kits distributed, the number of administrations and the outcome, and the number of trainings given. Incorporating YourLifeIowa information is required and how that is done will be determined soon. The State Opioid Response grant is paying for it. IHHS takes the position of helping people until they are ready to make a change. 

Kelly questioned whether this is encouraging substance use or sending a message that there is no risk with substance use. 

Dale stated that the goal is to interrupt the cycle of addiction and get people into treatment. The bill requires referral information to be distributed with naloxone. This is one tool that the legislature has approved. Shared and common goals are reducing addiction and reducing deaths. In the meantime, we want to save lives. 

So far this year, Iowa is seeing an 8% decrease in overdose deaths. IHHS believes the increase in education and access to naloxone are contributing. 

Legislative Updates

Flora talked about the Governor’s appropriation to the IHHS. $13M of state funding will be put forward for substance use and mental health treatment provider rate increase. This has been IBHA’s top priority for years. These funds will be matched by federal funds. Nici talked about her program and the need for these rate increases. They are very happy for this funding. They are a women and children program and they are seeing a large number of people needing treatment. She stated that they will have an increase in quality of employees and services, as well as quantity of services eventually. 

Patrick talked about negotiating rates with Medicaid. He doesn’t know how it will work with them not having a set rate. Flora stated that $3M is dedicated to residential services. They are still working on the details. 

Barb stated that DOE is doing a new therapeutic classroom grant. Also, HF 602 requires that schools include the YourLifeIowa website and 988 phone number on student IDs for grades 7 through 12. 

Flora also talked about HF 671. She explained that when Iowa now joins a compact, for those that use staff across state lines, they only need to get licensed in one state. Anything we can do to build workforce is important. 

Lindsey wondered how early intervention saves the state money. She thinks a study of the value added would be a good thing to do, to measure the impact of the funds spent.

Susie Sher gave an update on the upcoming Iowa Drug Control Strategy and Drug Use Profile. She also showed a new website about Emerging Drugs in Iowa. 

Nici mentioned an article she just read about teenagers and huffing that may need to be looked into. 

Other Business and Public Comment
Dale reminded the Council that they are being used as the Advisory Board for the State Crisis Intervention Program grant. The next meeting for that group is scheduled for June 27th. No other business was discussed. An opportunity for public comment was provided, but no one offered comments. 

Adjourn
Meeting adjourned. Motion by Patrick, second by Barb. Next meeting September 12, 2023.