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West Virginia Health Right has cleared a required procedural hurdle in its bid to continue offering a syringe service program at its East End and Covenant House locations.

Health Right, a free clinic in Charleston, will receive a statement of support from the Kanawha County Commission following a public hearing held Thursday during the commission’s regular meeting.

Nobody spoke against Health Right’s request to continue running its syringe program, and the three commissioners were unanimous in their support.

A law passed by the Legislature earlier this year requires harm reduction programs seeking to offer syringe services to obtain a license from the Office of Health Facility Licensure and Certification, as well as written letters of support from local officials.

In addition to receiving support from the county commission, Health Right will need letters from the Kanawha County Sheriff’s Office and the Kanawha-Charleston Board of Health.

Health Right, which has operated a syringe exchange program since 2011, is the first known entity in the state to apply to continue offering the service under the new law. Some health agencies, including those in Mercer and Marion counties, have been forced to halt services because of an inability to meet the law’s requirements. Failure to adhere to the law could result in heavy fines.

Beyond requiring providers to obtain a license and local support, the law prohibits needs-based, no-barrier syringe service programs — which, U.S. Centers for Disease Control and Prevention officials say, are proven to best reduce rates of HIV, hepatitis and endocarditis among people who inject drugs. Among other things, they say, needs-based programs do not limit the amount of syringes distributed, require users to present identification or operate on a 1:1 model.

Health Right currently operates on a 1:1 model, meaning one syringe is given for every syringe that’s returned. The program also requires a form of identification, in an attempt to add accountability to the program, Health Right CEO and Executive Director Angie Settle has said. All syringes distributed through the program are labeled with a barcode to make them easier to track.

While not defined as needs-based, Settle has said the Health Right program does meet a necessary need. Settle declined to comment for this report.

The CDC has called the current HIV outbreak in Kanawha County the “most concerning” in the nation. According to the state, as of Oct. 21, Kanawha County reported 40 total cases of HIV, with 31 of those involving injected drug use. In 2020, there were 44 total cases, with 40 tied to IV drug use. In 2019, there were 28 total cases, including 14 tied to IV drug use.

According to documents provided by the West Virginia Department of Health and Human Resources through a Freedom of Information Act request, Health Right distributed about 7,700 needles per 100,000 residents in Kanawha County in 2020. That was among the lowest rates of all certified syringe-service programs operating in the state at that time.

During Thursday’s meeting, Settle said about a third of her program’s clients — about 15-20 people — end up in substance use disorder treatment each month. About 64% of clients for the syringe service program are enrolled in medication-assisted treatment at the clinic.

State lawmakers weren’t alone in trying to regulate syringe service programs this year. The Charleston City Council passed an even more stringent law that includes criminal charges and fines for anyone operating an unapproved program.

To meet the requirements of that law, Health Right sent letters to every house within a two-block radius of its Covenant House and East End locations, notifying residents of the syringe programs.

On Nov. 18, Settle will appear before the City Council — where the mayor and 25 council members previously voted to pass the restrictive ordinance — and appeal to them to grant approval for the syringe programs, which have been heated topics at previous council meetings.

By Jan. 1, the clinic must submit its completed application to the state for Health Facility Licensure and Certification and DHHR approval.

If the County Commission hadn’t moved in support of Health Right on Thursday, Settle said Kanawha County — home to the highest rates of HIV and hepatitis spread in the state — would be without any syringe program.

“If you don’t give us the letter of support,” she said, “we would not qualify to become certified with the state, and then our program will close.”

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

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