Division of Mental Health and Substance Abuse Services s5

Scott Walker Duncan Shrout Governor Chairperson

Scott Stokes Vice Chairperson State of Wisconsin Mary Rasmussen Secretary State Council on Alcohol and Other Drug Abuse 1 West Wilson Street, P.O. Box 7851 Madison, Wisconsin 53707-7851

STATE COUNCIL ON ALCOHOL AND OTHER DRUG ABUSE MEETING MINUTES March 3, 2017 9:30 a.m. Sheraton Hotel Madison 706 John Nolen Drive, Madison, WI 53713 Connection Room No. 1, 1st floor Hotel General Information: 608-251-2300

Members present: Duncan Shrout, Joyce O’Donnell, Ryan Shogren (Brad Schimel), Norman Briggs, Michael Waupoose, Subhadeep Barman, Susan Hackworthy (Dave Ross), Mary Rasmussen, Joseph Hoey (Sen. Janet Bewley), Brenda Jennings (Tony Evers), Luke Petrovich (Sen. Devin LeMahieu), Sandy Hardie, Rep. Jill Billings, Roger Frings (Ted Nickel), Jennifer Malcore (Linda Seemeyer), Julie Burtness (for Autumn Lacy [John Litscher]), Jennifer Fyock (Craig Harper), Caroline Krause (Rep. John Nygren)

Members excused: Scott Stokes, Kristi Sullivan, Sue Shemanski

Ex-officio Members present: Matthew Sweeney (Rick Chandler), Mishelle O’Shasky, Mike Ayers (John Scocos), Mishelle O’Shasky, John Shaw

Ex-officio Members excused: Ray Allen, Randall Glysch, Kevin Reilly, Eloise Anderson, David Galbis- Reig, James Boullion (Laura Gutierrez), Katie Roberts

Staff: Mai Zong Vue, Alexandra Wright, Chino Amah Mbah, Bernestine Jeffers, Mike Derr, Raina Haralampopoulos, Sarah Coyle, Faith Boersma, Christy Niemuth, LeeAnn Cooper, Lorie Goeser, Patrick Cork, Colleen Rinken

Guests: David Macmaster, Thai Vue, Kay Vue, Bill Lauer, Harold Gates, Catherine Scheier, Karen Kinsey, Irene Secora (via Skype)

------Duncan Shrout called the meeting to order at 9:30 a.m.

Introductions: Members, staff, and guests introduced themselves.

Approval of December 9, 2016 minutes: The December 2016 meeting minutes were moved for approval by Norman Briggs, seconded by Michael Waupoose. Several corrections were suggested by Norman Briggs, and DHS prevention specialist Christy Niemuth. The motion was approved unanimously, subject to those corrections.

Public input: No public input was offered today.

www.scaoda.state.wi.us Committee Reports:

Executive Committee - Duncan Shrout highlighted the February 13th Executive Committee meeting. The Committee adopted a motion recommending that the State Legislature revise state law converting the no- longer-existent Law Enforcement & Crime Commission position on SCAODA to an 8th citizen position. Norman Briggs moved that the Council support this motion (found on p. 16 of the meeting packet), Mary Rasmussen seconded. Briggs suggested that under bullet point No. 1 of Rationale for Supporting Motion, the verbiage be changed from “substance abuse” to “substance use disorder” to reflect current terminology. Council members approved, with Roger Frings abstaining. In addition, Shrout reminded citizen members that if their membership expires in July and they are interested in continuing to serve, they must contact the Governor’s office and express their interest to the appointment secretary with a letter of intent and picture. The committee will announce availability of vacant citizen positions with a press release in the near future.

Diversity Committee - Thai Vue, vice chair of the Diversity Committee, reported on Sandy Hardie’s behalf. Three meetings were reported to the council, and future dates were also announced and are available in the packet. He summarized that committee members have been discussing the upcoming Mental Health Conference, development of training videos, diversity receptions, proposed improvements to the committee website, defining the term ‘diversity,’ peer specialists, budget items, and the division’s name change from DMHSAS to DCTS. At noon, committee member Harold Gates will be presenting on CLAS (culturally and linguistically appropriate services) standards.

Intervention and Treatment Committee – Norman Briggs reported that the Youth and Adolescents Subcommittee intends to address the shortage of adolescent-specific treatment services throughout the state. Currently, many adolescents must go out of state to receive the services they need. Scott Caldwell of DCTS provided background information on the adolescent services framework at the February meeting, and the committee will use that information to create recommendations in the future. The committee’s ad hoc Workforce Development Sub-committee has released an internal report on its workforce survey, and will have a final analysis completed by June, to be reported at the June SCAODA meeting. Committee member Caroline Miller led a discussion on recovery support services in the continuum of care. Briggs also highlighted the DOC’s recommendations to the Governor’s Taskforce on Opiates. Training will be offered to peer support specialists throughout the state as part of peer support certification. Medicaid reimbursement rates need to be increased for individuals who are certified counselors, as they are currently underfunded, but research also needs to be done on how the rate increases will affect the workforce and state budget. (Rep. Jill Billings requested that in June the Council and DHS staff report on the status of Medicaid rates, as well as the status of the Substance Abuse Block Grant.) Michael Waupoose discussed the needs of providers when they take on Medicaid patients, and how their reimbursements are affected.

Planning and Funding Committee – Joyce O’Donnell reported that Steve Fernan retired from the Committee, and members honored his time and commitment at the January meeting. Committee members continued discussing how trauma informed care can be incorporated into best practices. Also, committee members also discussed the funding report’s five recommendations, and noted that follow up action needs to be taken regarding the first (developing greater revenues for supporting AODA treatment and prevention). Perhaps instead of focusing on increasing taxes, committee members suggested focusing on how existing tax revenues are distributed. Duncan Shrout announced that due to scheduling conflicts, mental health recovery public hearings and SCAODA public hearing will be combined during the Fall Mental Health & Substance Use Disorder Recovery Conference. He encouraged all Council members to attend next fall’s public hearing. The Committee also invited Norman Briggs to highlight the workforce survey issued out by the Workforce Development Sub-committee (noted in the paragraph above) and discuss possible implications on the nature of substance use disorder services across Wisconsin. Prevention Committee – Christy Niemuth of DHS reported that in January, the Prevention Committee published the 2016 Epidemiological AODA Profile (a/k/a Epi report). There were some printing issues, but more copies will be available soon. She also announced the publication of fact sheets which highlight the contents of the profile. The committee also produced an LGB fact sheet. The next Prevention Conference is June 13th and 14th in the Wisconsin Dells, and will celebrate 30 years of Wisconsin Youth Coalitions. There will be a SCAODA public forum on June 13th. The Methamphetamine Summit is working with the Department of Justice to address the methamphetamine epidemic in the northern part of the state. The ad-hoc Prevention in the Workplace Sub-committee is slated to start this year. The Parents Who Host Lose the Most campaign is starting later this spring. Alcohol Awareness Month is coming up in April. The committee received a final evaluation for the PFS grant from the UW Population and Health Institute, which found that in the 9 counties that had the funding, there were reductions in both OWI injuries and deaths. Struggles continue with Prevention Specialist Certification; those services are not Medicaid reimbursable, so there is reluctance to obtain that certification, especially with all the requirements needed. The committee supporting incentives for achieving certification to promote more interest, and committee members are working with DSPS and DHS for rule changes, support, and guidance. Susan Hackworthy asked about the OWI component and how ignition interlock devices play into it, then mentioned a 24/7 sobriety program that judges can order in lieu of the devices. Michael Waupoose asked if there was a reason why transgender populations weren’t represented in the LGB fact sheet. Christy responded that Chino Amah-Mbah was working on transgender-specific resources to be posted on the website. Waupoose also asked about specific LGB populations, and she responded that the data collected was not broken down by race/ethnicity. Waupoose asked if it would be helpful to advocate to the DSPS for prevention specialist recommendations. Niemuth replied that it would be very useful. Duncan Shrout encouraged thinking about how educators could be included in the prevention specialist certifications.

Expanding Council’s Constituency with Recovery Groups: Duncan Shrout stated that given the Council has frequent guests that are in recovery, over time the group should look more seriously at engaging with more recovered individuals in Wisconsin. Shrout is open to suggestions. Michelle O’Shasky asked how to make the Council process more welcoming to people in recovery, how to include the criminal justice system, and how to identify leadership across the state. David Macmaster offered his support to the recovery community. Waupoose noted the difference between membership from recovery groups as opposed to the voices of people in recovery – sometimes the members of those groups are not necessarily in recovery themselves. He also mentioned that several voices of recovery are already present on the council, but it’s not always obvious who those people are. Jennifer Malcore responded that there is someone on the Governor’s Task Force on Opiate Abuse that represents the recovery community. Council members suggested that a new citizen slot on the Council be filled by someone offering a recovery voice.

Initial Report from the Governor’s Task Force on Opiate Abuse: Jennifer Malcore gave a brief overview of the initial report. An updated full report from all Task Force members will be finished by the end of the year. Committee members and guests shared a lengthy discussion about several topics, including medication assisted treatment. Subhadeep Barman expressed that MAT (medication-assisted treatment) must be individualized in order for it to be successful. Michael Waupoose stated that we need best practices for transitioning MAT patients so that they no longer need that treatment. The group discussed treatment courts and the TAD (treatment alternatives and diversion) program. John Shaw also discussed the needs of individuals with disabilities who have substance use disorders. Lorie Goeser explained that the DOJ and DOC are looking at best practices for trauma-informed care. Joe Hoey, on Sen. Bewley’s behalf, requested the opportunity to provide input on the proposals that the Task Force has put forth. Malcore summarized the legislative bills proposed by Rep. Nygren that are currently being considered – they are listed on page 79 of the packet. They incorporate most of the Task Force’s recommended legislation included in the report. She also announced the opening of a recovery high school in Wisconsin. Mary Rasmussen asked if there was any place for SCAODA to work parallel with the task force. Malcore responded that adding Sen. Bewley and Rep. Billings to the Task Force was to ensure that there was a membership overlap across both groups, but added that the Task Force is open to SCAODA-run presentations at future Task Force meetings. Duncan Shrout suggested that the Task Force also present at a future SCAODA meeting this year. The bills in their entirety are available online at www.legis.wi.gov. Shrout observed that the Task Force’s list of recommended expenditures in the initial report seems insufficient to accomplish what is proposed, and suggested narrowing the scope. He also suggested that SCAODA and the Wisconsin Council on Mental Health are added to the resources section of the Task Force Report.

Agency Reports:

Department of Revenue – Matthew Sweeney updated the group on the state of drug, tobacco, and alcohol tax revenue collections. He will present a report covering the entire fiscal year at the September 2017 SCAODA meeting. He also presented a bill on powdered alcohol taxation.

Department of Health Services – Jennifer Malcore spoke about the need for raising Medicaid reimbursement rates in Wisconsin, and how bordering states have higher rates than Wisconsin. DHS will allocate $5 million through CCS (Comprehensive Community Services) programs to cover more treatment through the counties. Also, DHS submitted a State Targeted Response to Opioid Crisis Grant (STR) application with the federal SAMHSA seeking $15.7 million over two years to address opioids abuse. The grant program is part of the federal 21st Century Cures Act.

Department of Public Instruction - Steve Fernan retired in January 2017, and Brenda Jennings took over his position on SCAODA. Jennings noted that AODA program grant competition for K-12 school districts is underway, with proposals due April 21st. The Heart of Successful Schools conference runs in Appleton from December 6-8. Joyce O’Donnell asked if DPI is addressing trauma, and Jennings replied that last year, trauma sensitivity in schools was one of the agency’s main focuses.

Department of Safety and Professional Services – James Boullion was not able to attend, but sent a brief email stating that the Substance Abuse Counselors Certification Review Committee met on 2/15 and started rewriting SPS 160-168. A draft proposal will be put out by May. Michael Waupoose stressed the importance of ensuring high-quality substance use disorder treatment by increasing the availability of treatment, with licensure of substance use counselors (with attendant protections) as one vehicle for this. He also asked for suggestions from other SCAODA members for the June Council meeting, with the Intervention & Treatment Committee adding input before then. A group consisting of Waupoose, Mishelle O’Shasky, Rep. Billings, Sandy Hardie and Joe Muchka will come up with suggestions for the June meeting.

Department of Veterans Affairs – Mike Ayers presented and summarized VORP grant activities to the group. It is currently slated to expire in September 2017, but DVA is looking to get it extended into a permanent program. He also introduced Colleen Rinken of DHS, the VORP coordinator for the state. She oversees the clinical coordination and outreach from DHS. Outreach workers in VORP are trained in motivational interviewing. He also noted a concerning lack of detox services available to veterans, with overcrowded centers.

Diversity Committee Video and Presentation: Harold Gates gave a presentation on behalf of the Diversity Committee. Handouts included the CLAS Self-Assessment Tool and the Cultural Competence and Diversity Executive Briefing PowerPoint slides, which were distributed to meeting attendees. Gates’ presentation included a summary of the slides. These materials will be posted on the SCAODA website. Wisconsin Council on Mental Health Criminal Justice Committee update: Norman Briggs provided this update. He and Mishelle O’Shasky focused on concerns raised regarding the lack of medications being dispensed to persons upon their release from correctional institutions or programs, as well as the short prescription periods, difficulty in getting people connected to community based treatment resources, long waiting lists, etc. This concern continues to be addressed by the Mental Health Council’s Criminal Justice Committee.

Secretary’s Council and Child Welfare Update: Norman Briggs reported that a committee has been created within the DCF to reduce the effects of the opioid crisis in the child welfare system. The Governor’s Task Force was a significant driving force of this being created. Joyce Allen of DHS is on that committee. The committee’s next meeting is next week.

Substance Abuse Block Grant Annual Report: Mike Derr reported that the process for developing the next two-year application and plan are in progress, and will be due on September 1st. Bureau of Prevention Treatment & Recovery staff are currently developing a needs assessment, and have convened a stakeholder workgroup to assist with the assessment and prioritizing various indicators. The stakeholder workgroup had its first meeting on Feb. 28th. By the June 2nd meeting, a draft needs assessment will be completed and shared with the Council, along with proposed Priorities under the SABG Plan. Derr invited Council members to contact him with questions, comments, and suggestions.

Announcements: Copies of the 2016 Epi Report and 2016 DCTS Annual Report are available upon request. A reminder for Council members to submit their travel reimbursement forms.

Next Meeting Agenda Items: The next meeting will be held on June 2, 2017 at the WI Department of Agriculture, Trade, and Consumer Protection on the far-east side of Madison. Topics will include: (1) ambulatory detox services in northern Wisconsin; (2) public records and state ethics training; (3) updating status of council memberships/composition; (4) 2018-19 Substance Abuse Block Grant application needs assessment and priorities review; (5) workgroup update on licensure of and training for substance abuse counselors; (6) update on the status of Medicaid reimbursement rates; and (7) the Intervention & Treatment Committee workforce sub-group full report on the workforce survey. David Macmaster announced the completion of a tobacco integration project. Administrative rule DHS Chapter 75 changes are being discussed and considered by DHS staff across several divisions.

Adjournment: The meeting adjourned at 2:09 p.m.