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Health Right starts pilot project for retractable needles (copy)

Angie Settle (left), CEO of West Virginia Health Right, demonstrates how a retractable needle works in March 2018. After holding public forums Thursday, Charleston City Council will soon vote on whether to support West Virginia Health Right’s bid to continue offering syringe services at its Covenant House and East End clinics.

After holding public forums Thursday, Charleston City Council will soon vote on whether to support West Virginia Health Right’s bid to continue offering syringe services at its Covenant House and East End clinics.

While syringe service programs have previously spurred heated, sometimes acrimonious and often long debate between city councilmembers, only four of Charleston’s 26 representatives — Mary Beth Hoover, Naomi Bays, Ben Adams and Bobby Brown — attended the public forums. None asked questions.

Attendance was light at Thursday’s forums, held at the Roosevelt Community Center, and no one spoke against Health Right’s proposal of continuing to offer its syringe service programs.

“Our program has been around 10 years, and everything we have historically done has worked,” said Angie Settle, executive director and CEO of West Virginia Health Right. “We are not here to expand, we only want to continue offering the services we have been, and this is what the law now says we have to do.”

“The law” Settle is referring to is a previously passed city ordinance that criminalizes and fines any entity found distributing syringes in the city without prior council approval. The ordinance — which took months to create and pass — was meant to target Solutions Oriented Addiction Response, a grassroots harm reduction agency.

SOAR at the time operated a no-barrier, needs-based syringe program, which means the group did not require any documentation or paperwork to utilize the services and did not limit the number of syringes distributed to clients. It was the only program of its kind in the city.

Now, in order to run any sort of syringe program in Charleston city limits, agencies have to meet a number of requirements. Health Right is the first organization in the city to undergo the process.

Settle said the agency had to send letters to all the homes in a two-block radius around its East End and Covenant House locations to inform neighbors of the syringe service program and the public forum. Now, with the public forum done, Charleston City Council will vote on a resolution at its next meeting to either endorse Health Right’s syringe programs or end them.

Settle said whatever the decision, Health Right will follow.

“We will follow the city ordinance however we are told to do so,” Settle said. “We will always operate under the letter of the law.”

The city ordinance — much like its statewide counterpart, Senate Bill 334 — is broadly written and in some places unclearly defined. There is still confusion on the intent of the law and how it should be interpreted, including a requirement to have 90% of needles returned, said Settle.

Today, Settle said the clinic has “a 98% return rate,” meaning 98% of all syringes distributed are returned to the clinic. It’s unclear if the “90%” in the city ordinance refers to an individual’s returns or total returns for the program.

Health Right currently operates on a 1-to-1 model, meaning one syringe is given for each returned. Clients are required to show an ID to use the syringe services. While they are limited to 30 syringes each visit, there is no limit on how many visits they can make in a day or week.

Based on best practices outlined by the Centers for Disease Control and Prevention, needs-based syringe services are the most efficient at preventing disease spread between people who inject drugs. Those programs require no ID or syringe returns to access new ones, and also don’t limit the number of syringes available. Many rely on second-hand distribution, where people can receive clean syringes to distribute to friends who inject drugs to prevent infection.

Comparatively, Health Right’s services are considered to be high-barrier by many, including Hunter Starks, a local advocate and activist for harm reduction programs. Starks asked Settle whether Health Right would change its rules on syringe access to be more needs-based if the law changed to allow that.

“No, no, no … Health Right is a medical home; our number one goal is not to be a needle exchange program,” Settle said. “While I am proud of that program, it’s unfair to act as if that’s all we do.”

The syringe program makes up a small portion of Health Right’s services, which include dentistry, optometry, psychiatry, gynecology and other clinical services.

Currently, however, Health Right’s syringe program is the only one known to be operating in Kanawha County, which is in the middle of “the most concerning HIV outbreak” in the country, according to the CDC. Health officials have said a recent Hepatitis B spike is unfolding, as hepatitis C and HIV cases continue to be reported here.

Settle said those at Health Right know they alone cannot stop this spread. The recent laws at both the city and the state level have placed more restrictions on the program than ever before through “no action of [Health Right’s] own.”

“Our community has spoken up time and time and time and time and time again about [syringe service programs] and part of running a harm reduction program is having community buy-in,” Settle said. “The temperature regarding this subject is not anything we can touch [to try to expand our services].”

Settle said she felt there was “a boomerang effect” after some in the area began advocating in 2020 for more accessible syringe services. The community, she believes, did not have buy-in, and as a result the city council ordinance being passed in response has made syringes less accessible in Charleston than ever before.

Starks said they support Health Right and its role in confronting disease spread and community help, but wants people to understand how great the need is compared to what Health Right is capable of providing.

“There is a problem right now, and a lot of people are unable to access services they need and that is a real problem,” Starks said. “It would do a lot of good for our community if we had more here for people. Health Right is good, but the community needs more.”

Public comments on Health Right’s application to continue offering syringe services at the East End and Covenant House locations can be submitted to the city clerk’s office before the next city council meeting on Monday, Dec. 6.

Caity Coyne covers health. She can be reached at 304-348-7939 or Follow @CaityCoyne on Twitter.

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