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After nearly six months of debate, the Charleston City Council voted 25-1 Monday to further restrict syringe programs.

Councilman Robert Sheets cast the only dissenting vote. The new ordinance is potentially stricter than statewide legislation signed into law last week by Gov. Jim Justice.

Kanawha County is home to “the most concerning HIV outbreak” in the country, according to the federal Centers for Disease Control and Prevention.

Those operating syringe service programs in the city will be required to obtain a certification or license from the state. That policy is in line with state law. Solutions Oriented Addiction Response, a grassroots harm reduction program operating on the West Side that lacks certification and was the initial target of the city’s legislation, must stop operations by next week.

A public hearing is required in communities where syringe programs plan to operate. Notices must be sent to everyone within a 2-block radius.

The council voted 14-12 to require programs to practice a “goal of a 1:1 return ratio,” referring to the exchange of used syringes for new ones, with at least 90% of the syringes distributed required to be returned. That amendment was one of several introduced by Councilwoman Jennifer Pharr, who said she was trying to target consequences of “collateral damage” — needle litter and crime — she said came from syringe service programs.

The ordinance does not specify whether the 90% return rate applies to people or those operating the programs. A requirement of 90% returns from people would be stricter than general 1:1 return ratios, where people can receive the same number of syringes they return.

West Virginia Health Right, operating in Charleston’s East End, runs the city’s only state-certified syringe program. The clinic practices a 1:1 exchange.

“Whatever the law is, we will follow the letter of the law,” Health Right CEO Angie Settle said Tuesday. “I don’t know where we’re at, but whatever the law is, we’ll do it. Just tell us and we’ll do it.”

State law allows programs to operate with the goal of reaching a 1:1 ratio. Rule-making is still underway for Senate Bill 334. Some terms and definitions have not been released by agencies finalizing the language.

Charleston City Attorney Kevin Baker said Tuesday that municipalities have the right to make public health and safety regulations stronger than the state’s, but not lighter.

“The wrinkle in this that’s a little confusing is the state law already really set forth the process in how municipalities participate in the regulation of [syringe service programs],” Baker said. “The fact that they gave municipalities and counties so much oversight would tend to make me think they probably didn’t expect cities and counties to do their own restrictions.”

Under SB334, those operating syringe service programs must get approval from both the municipality and county in which they plan to operate.

Questions remain about the enforcement of the city ordinance. At the state level, the Department of Health and Human Resources and the Office of Health Facility Licensure and Certification will oversee syringe programs.

Charleston’s new ordinance does not specify who’s responsible for enforcing return ratios. SB334 carries civil monetary penalties for groups that violate rules. The city ordinance makes violations a criminal misdemeanor. An amendment from Councilman Will Laird to remove criminal penalties failed.

At Monday’s meeting, Baker said criminal penalties likely would make city police responsible for enforcement. It’s not clear how that enforcement will happen. Charleston Police Chief Tyke Hunt could not be reached for comment Tuesday.

Kanawha County recorded 36 HIV cases in 2020 tied to intravenous drug use, more than double the rate from 2019 and nearly 10 times that of 2018. Hepatitis, endocarditis and fatal drug overdoses also are on the rise, according to the CDC.

Reach Caity Coyne at, 304-348-7939 or follow

@CaityCoyne on Twitter.

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