By Lynn Sygiel, editor, Charitable Advisors
For more information about Indiana’s Next Level Recovery Initiative, visit: https://www.in.gov/recovery/
Jim McClelland first tried to retire five years ago after leading Goodwill of Central Indiana for 41 years. He planned to travel a bit with his wife, Jane, and maybe write a book.
Those plans changed in 2017 when Gov. Eric Holcomb called on McClelland to spearhead Indiana’s Next Level Recovery initiative, a statewide effort to address substance abuse. McClelland became known as the state’s “drug czar” and wore the mantle with gusto.
Last week, a reflective McClelland retired again, and was quick to credit his experience in the nonprofit sector for some of his successes in the state’s response to the growing opioid crisis.
Goodwill’s focus was on poverty, but the nonprofit found it could not just tackle it internally. Poverty wasn’t a stand-alone problem, but rather it was intertwined with multiple health issues, and a collaborative effort with other nonprofits and community groups was needed.
“Just like at Goodwill, social problems are interrelated,” McClelland said. “They tend to reinforce and compound each other. But as a society, we have tended to treat them individually, in isolation from the others. We’ve been lousy at connecting the pieces. We don’t solve the problems, if we don’t address all of them.”
But addressing them all would be a daunting task. It wasn’t the magnitude of the opioid crisis that was a surprise, but its complexity.
“There were hundred different things we needed to be doing all at once. It was extraordinarily complex,” McClelland said.
During his tenure as drug czar, McClelland spoke with over 150 groups across the state — including a number of nonprofits — and encouraged public and private groups to work collectively. In response, he has seen communities step up and form substance use disorder coalitions (SUD) to bring people together and focus on prevention, treatment and recovery.
“They’re bringing people together from business, education and health care, local government, law enforcement agencies, the courts, philanthropy, faith-based organizations, community-based organizations,” McClelland said. “They get to know each other, they get to learn from each other, and they can sometimes begin to see is how they can work together, leveraging their resources and their capabilities to help cause some good things to happen that otherwise wouldn’t happen.”
“They also gain an appreciation for different perspectives. You know, public safety typically has have a different perspective from the medical side, but they need to understand each other’s perspectives and have some respect for each other, and I’ve seen a lot of that developing.”
McClelland has been not only these groups’ cheerleaders, but he helped secure state funds for 10 coalitions. In early 2019, Indiana awarded 10 groups one-year $75,000 grants to support efforts locally to combat the drug crisis. The organizations were in Bartholomew, Cass, Clark, Dearborn, Hancock, Howard, Knox, Marion, Scott and St. Joseph counties. Recipients were selected from applications received in response to a request-for-funding announcement from the Indiana Family and Social Services Administration.
In Howard County, Paul Wyman, a county commissioner, saw the problem and decided to do something about it. In 2017, after the number of overdose deaths in Howard County spiked to a record high of 44, he organized a summit of community leaders and the nonprofit resource center Turning Point Systems of Care was born.
“Wyman had the ability to get a lot of people to come together. He brought about 100 people together and said, ‘We need to organize ourselves, and we need to attack this.’ He led it, and is still leading it, along with everything else that he does,” said McClelland.
As a result, the Howard County coalition hired two staff members — a coordinator and a navigator who connect people with services and provides continuity in the relationship. The group recognized that so many people needed help and wanted help but had no idea where to go.
“Everywhere in a local community where you see some really good things happening, there’s always strong local leadership, and it comes from different places,” said McClelland. “To me the coalitions are (one area) where we need to continue a strong emphasis.”
Bill Corley, a coach/consultant with Integrity Health Strategies, has led the INSTEP coalition, a nonprofit which coordinates the resources of 75 providers in the Greater Indianapolis area and serves as a hub for resources. Corley, who served for 25 years as president and CEO of Community Health Network in Indianapolis, said McClelland was the communicator in chief.
While McClelland would be the first to say he is not a health care guy, not only was he a great communicator, but he asked good questions, said Corley.
“That’s just a wonderful characteristic to have. He didn’t go into the job thinking that he knew everything, because he knew that he did not know everything,” said Corley. “When he communicated, he explained the why. The ‘why are we doing this.’ It should be obvious that people were trying to save people’s lives, but it’s more than that, it’s a social problem and people needed to understand why he was doing things.”
McClelland is also a great connector, never missing an opportunity to share what was going on in another part of the state.
“And that is extremely valuable to the rest of the state,” said Corley.
Getting all the providers to work together resulted in INSTEP hosting the SUD (substance use disorders) coalition summit in August on behalf of FSSA. The summit provided and opportunity for SUD coalitions like INSTEP to compare similarities, differences and common challenges for how others are addressing SUD issues in their communities. Now, Corley said, there is a desire to do it again and involve other groups in the state.
As McClelland exits his position, he is proudest of the number of people who responded to the all-hands-on-deck request.
“It’s just been really gratifying to see so many people who are willing to contribute. Some of them in a big way, some of them in small ways, but there are so many people really.”
In addition to coalition work in counties, efforts from LaPorte to Redkey were driven by local individuals.
Take for example, Larry Smith, a recovering addict. He pulled together a recovery support group built around exercise and physical fitness. Now in four communities, he has worked with existing fitness facilities to establish programs in the LaPorte area.
In Jay County, Randy Davis, a retired United Methodist pastor, lost a member of his congregation (substance use disorder). In 2014, he decided to do something to help support people who were struggling and formed volunteer recovery support groups. According to McClelland, under Davis’ tutelage, there are now at least 35 groups in various towns in Indiana and Ohio. Manned by volunteers, Davis now has a paid staff to keep them going.
McClelland’s work will continue under new leadership. Douglas Huntsinger was named to the post last week. As deputy director for drug prevention, treatment and enforcement since 2017, he stepped right into the position.
McClelland’s message to Huntsinger is that the state is on a good path.
His advice? “Keep bringing the pieces together. Continue to support strong local coalitions. So much of what needs to be done on the prevention side and the recovery needs to be done on a local level.
“We also need a lot more recovery housing, that’s been a really tough nut to crack because of the lack of capital.
“Yes, we got a long way to go,” McClelland said. “We have also seen a resurgence in meth, it’s not the kind of meth that was made in the kitchens and bathrooms of people a few years ago. This stuff is mass produced in Mexico. It’s high impurity, it’s very low in price, and it’s everywhere. It’s all over the country. We need to make sure that our infrastructure is able to deal with addictions of other types.”
“I can look back over three years, and say, ‘My gosh. We put together the strategic approach.’ I look at it now, there’s not a whole lot about it I would change.”
Some Next Level Recovery highlights
By Lynn Sygiel, editor, Charitable Advisors
There’s not a whole lot about his work as “drug czar” that Jim McClelland would have changed, except to have quickened the pace.
“I’d love to see things move faster than they do, but I’m pretty much that way on everything,” McClelland said. “We have, I am told, compared with the usual pace in state government, moved with lightning speed. It’s kind of hard for me to believe sometimes, but we’ve gotten a lot done.”
In 2017, over 1,800 Hoosiers died of overdoses, and the number one priority of McClelland’s initiative, Next Level Recovery, was to keep people alive.
“Our death rate peaked in November of 2017, and then began a gradual decline. It is still declining, but much more gradually. We were down 12.9 percent last year, and nationally, it was down about 5.1 percent. So, we were like 2.5 times (better than) the national percentage. We are still declining greater than the national rate,” said McClelland.
Here are some highlights of the state’s efforts.
Legislation: McClelland credits the Indiana General Assembly with passing a series of drug-related bills. In 2017, he said, Indiana had the 10th highest opioid prescription rate in the country. In that year, the legislature limited first-time prescriptions to seven days for anyone under 18.
“We’ve had great legislative support. We’ve had a number of bills over these three years that passed both houses unanimously or maybe with one or two negative votes. The chief justice and all the other members of the Indiana Supreme Court have been incredibly helpful and supportive.”
Prescribing practices: Another tactic, undertaken by the Family and Social Services Agency (FSSA), was to provide doctors with comparisons of their prescribing practices. Awareness letters were sent to doctors who received payments through Medicaid. This effort resulted in a 26 percent drop in prescriptions from that group of doctors.
State-data base: Additionally, doctors are now required by law to check before prescribing an opioid. To aid this effort, the state paid for the integration of INSPECT with the electronic health record systems and pharmacy management systems around the state. That task is close to being completed.
“It has made it a really easy process that used to be laborious and time consuming,” McClelland said.
The Indiana Department of Health and the Indiana Hospital Association and Indiana Medical Association also developed new prescribing guidelines to manage acute pain. Basically, these guidelines suggest that doctors should attempt non-pharmacological approaches first, and if those don’t work, they should start with the lowest dosage for the shortest duration.
Disposal options: More safe disposal options have made it easier for people to get rid of excess meds.
“So, you take the lower prescribing rates, and a greater number of more convenient safe disposal options, and you have fewer pills available for non-medical use. That has helped,” McClelland said.
525 foundation launches Rx drop box effort South Bend-based Beacon Health System is taking steps to prevent unwanted prescriptions from falling into the wrong hands. The health system is partnering with the 525 Foundation, a national advocacy group based in St. Joseph County, to install drop boxes for unwanted or outdated medications at several hospitals and a supermarket chain in northern Indiana. Read More
Access to treatment: Timely access to treatment has been enormously important. To support this effort, the state invested in an interactive system to connect drug users with treatment facilities in order to make the process easier for drug users in desperate need of care. To support that effort, the and Indiana 211 streamlined the treatment search. The program, called OpenBeds, provides real-time data of beds available for facilities that cater to addictions.
Education: The Next Level Recovery website was launched and pulls together many of the programs and services at a one-stop site.
A new exhibit designed by the Indiana State Museum, FIX: Heartbreak and Hope Inside Our Opioid Crisis — the will share ways for Indiana communities to come together and shift the conversation and reduce the stigma surrounding opioid use disorder. Its goal is to show how all can play a role in finding solutions to this devastating crisis. Exhibit opens Feb. 1.
