EXECUTIVE ORDER NUMBER 27 - Office of the Governor of Alabama

WHEREAS, the United States is experiencing a drug-overdose epidemic with deaths rising among men and women of all races and ages, and of these drug-related deaths, more than three out of five involve an opioid;

WHEREAS, Alabama has not avoided the devastation of this national epidemic – The Centers for Disease Control and Prevention reported a 19.7-percent increase in the state’s drug-overdose death rate from 2013 to 2014;

WHEREAS, local medical examiners’ reports verify that the use of heroin and prescription opioids has greatly worsened Alabama’s increasing overdose-death rate, and other powerful opioids, including fentanyl and carfentanil, are now present in Alabama, contributing to the state’s overdose deaths;

WHEREAS, the use of heroin is linked to initial misuse of prescription opioids, and nearly 30,000 Alabamians over the age of 17 are estimated to be addicted to prescription painkillers or heroin;

WHEREAS, opioid misuse and addiction affect other critical concerns for our state, including crime, child welfare, disease, infant mortality, neonatal abstinence syndrome, and overcrowding of jails and prisons;

WHEREAS, prevention, treatment and recovery-support services for substance-use disorders are extremely limited in Alabama; and

WHEREAS, notable efforts have been made across the state to address select aspects of the drug-overdose crisis, but the complexities of this epidemic require systemic change and the development of a unified, comprehensive strategy to guide, support and evaluate this change.

NOW THEREFORE, based upon these considerations, and for other good and valid reasons related thereto, I, Robert Bentley, Governor of the State of Alabama, by virtue of the authority vested in me by the Constitution and laws of the State of Alabama, do hereby create the Alabama Council on Opioid Misuse and Addiction (the Council).

BE IT ORDERED, that the Council shall study the state’s current opioid crisis and identify a focused set of strategies to reduce opioid-related deaths in Alabama. The Council shall consist of the following members, or their designees:

The State Health Officer;
The Commissioner of the Alabama Department of Mental Health;
The Chair of the Alabama Board of Medical Examiners, and another physician appointed by the Board;
The Secretary of the Alabama Law Enforcement Agency;
The Commissioner of the Alabama Department of Corrections;
The Chairman of the Alabama Drug Abuse Task Force;
The Executive Secretary of the Alabama Board of Pharmacy;
The Chairman of the Alabama Health Care Improvement Task Force Quality of Care Committee;
The Superintendent of the Alabama Department of Education;
The Commissioner of the Alabama Department of Insurance;
The Director of the Alabama Department of Economic and Community Affairs;
The Commissioner of the Alabama Medicaid Agency;
The Alabama Administrative Director of Courts;
The Executive Director of the Alabama Board of Pardons and Parole;
The President of the Alabama Methadone Treatment Association;
The Director of ServeAlabama;
A representative of the Jefferson County Pills to Needles Collaborative;
Two House members appointed by the Speaker of the Alabama House of Representatives;
Two senators appointed by the President Pro Tem. of the Alabama Senate;
Two individuals, in recovery from opioid addiction, appointed by the Recovery Organization of Support Specialists;
Two family members, of persons who are or have been addicted to opioids, appointed by the Council on Substance Abuse-NCADD; and
Additional individuals as deemed necessary by the Governor.

BE IT FURTHER ORDERED, that the State Health Officer and the Commissioner of the Alabama Department of Mental Health shall serve as co-chairs of the Council. The co-chairs shall have authority to:

Oversee implementation of this Executive Order and the work of the Council;
Establish the Council’s agenda and convene meetings;
Create committees and workgroups as necessary, which may include members of the Council and additional community representatives;
Ensure collaboration with the Alabama Health Care Improvement Task Force in the development of strategies to address the state’s opioid crisis; and
Identify additional support as needed.

BE IT FURTHER ORDERED, that the purpose of the Council shall be to:

Advise and assist the Governor in the development of a comprehensive, coordinated strategy to combat Alabama’s opioid crisis;
Gather and review data outlining the problem facing Alabama, including the threat of synthetic opioids;
Review actions already taken in Alabama to combat the opioid crisis;
Review the actions of other states and the National Governors Association Compact to Fight Opioid Addiction; and
Develop a strategic plan to abate the opioid crisis in Alabama.

BE IT FURTHER ORDERED, that the Council shall develop and submit a strategic action plan to the Governor as soon as practicable, including recommendations for policy and for regulatory and legislative actions to address the overdose crisis in Alabama, such as:

Clear goals, objectives, and metrics for measuring progress in combatting the addiction and overdose crisis and reducing opioid-overdose deaths in the state;
Assessments of available data and current data-sharing agreements;
Proposals to expand the use of data needed to address the issue;
Recommendations for increasing access to appropriate treatment for opioid disorders;
Ways to increase awareness of the overdose epidemic, reduce the stigma associated with substance-use disorders, and improve prevention education;
Strategies to improve the Prescription Drug Monitoring Program and its utility in fighting opioid abuse;
Strategies to improve prescribing practices and ensure that prescription opioids are available only in appropriate circumstances;
Recommendations to improve coordination and collaboration with relevant stakeholders;
Recommendations for funding to improve access to naloxone and to substance-use prevention, treatment, and recovery support services; and
Reviews of any obstacles to driving down the rate of opioid addiction and overdose deaths in Alabama.

BE IT FURTHER ORDERED, that Alabama’s National Governor’s Association Learning Lab Team on Strategies for Reducing Overdose Deaths from Heroin and Fentanyl shall serve the Council as subject-matter experts, and shall be responsible for presenting related proposals to the Council and helping the Council develop the strategic action plan required by this Executive Order, in conformity with evidence-based practices and findings from the Council’s examination of the problem. The Learning Lab Team consists of:

Sarah Harkless, Director of Substance Abuse Treatment and Development, Alabama Department of Mental Health, Team Lead
Foster Cook, Director of Governmental Affairs and Special Projects, University of Alabama at Birmingham Substance Abuse Programs
Nancy Bishop, State Pharmacy Director, Alabama Department of Public Health
Karen M. Smith, Associate Director of Clinics/Ancillary Services and Mental Health Programs, Alabama Medicaid Agency
Edwin Rogers, Investigator, Alabama Board of Medical Examiners
Denise Shaw, Drug Court, Mental Health Court, and Veterans Treatment Court Specialist, Alabama Administrative Office of the Courts

BE IT FURTHER ORDERED, that state agencies and other state-funded entities shall cooperate with the Council and provide information requested by the Council.

BE IT FURTHER ORDERED, that the Council shall assemble for its first meeting within six weeks of execution of this Executive Order, and members may participate in meetings by conference call.

BE IT FURTHER ORDERED, that the Council will continually monitor and evaluate implementation of the state’s strategic plan and provide periodic plan updates and recommendations to the Governor as necessary.

BE IT FURTHER ORDERED, that an annual report shall be submitted to the Governor in October of each year to provide a detailed evaluation of the Council’s activities and of initiatives undertaken to combat Alabama’s opioid-use epidemic.

BE IT FURTHER ORDERED, that this Executive Order shall become effective immediately upon its execution, and shall remain in effect until amended or modified by the Governor.

DONE AND ORDERED this 15th day of December, 2016.

Robert Bentley
Governor

Attested

John H. Merrill
Secretary of State

The signed executive order is available here.