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About Street roots. (Portland, OR) 1998-current | View Entire Issue (Jan. 20, 2012)
WWW. Needle exchange programs rely on local support after the feds bail on fu n d in g BY AMANDA WALDROUPE S T A F F W R IT E R or the second time in two years, Congress is reversing its policy on federal funding for syringe exchange programs, leaving many in health care business wondering how far local money can continue to carry the harm reduction programs. While Portland and Multnomah County’s needle exchange clinics don’t expect a direct hit from the federal funding ban, shrinking state and local dollars are another issue altogether. Kathy Oliver, the executive director of Outside In, a Portland-area homeless youth agency operating a needle exchange that is frequently used by young injection drug users, worries in particular about $63,000 in one-time money from the City of Portland that may be cut this year. The total budget for Outside In’s needle exchange clinic is $190,000, meaning the money from the city represents a pretty hefty chunk of change (much of the rest of the clinic’s budget comes from Multnomah County). The elimination of it would mean more than cutting administrative waste or other ways of not harming the clinic’s efficacy. “We would have to cut staff, cut hours,” Oliver says. Oliver says she is “cautiously optimistic” that the city funding will be preserved. When the Portland Housing Bureau eliminated funding for the clinic in its 2011 budget proposal, despite the fact that the clinic had received city dollars since Vera Katz was mayor, Mayor Sam Adams put the $63,000 back into the city’s budget. “He is an advocate for the program,” Oliver says. Kim Toevs, director of Multnomah County’s HIV/STD/Hep C program, is less fearful that F funding for the county’s four clinics will be cut. Much of the budget for the county’s c lin ic s — c lo s e to $260,000 - comes from state and county general fund dollars. “Oregon has been proactive and forward thinking for many years about needle exchange,” she says. Syringe or needle exchange clinics are walk-in facilities that provide clean needles to people, mostly injection drug users. According to the North American Syringe Exchange Network, there are at least 221 needle exchange programs in 33 states and Washington D.C. Needle exchange clinics have relied on private donations or money from local governments to fund their operation. For 21 years, Congress has banned federal agencies from funding needle exchange clinics. In December 2009, President Barack Obama signed a law lifting the ban on federal funding. The Obama administration’s position is that needle exchange clinics are an evidence-based practice that lowers the transmission of HIV and other infections among injection drug users. The decision was supported by multiple comprehensive studies, including eight federally funded research reports that concluded that syringe exchange programs, as part of a comprehensive HIV prevention strategy, “are an effective public health intervention that reduces HIV transmission without increasing the use of illicit drugs. Research has also shown that syringe exchange programs are important in preventing the transmission of hepatitis B and C.” That’s according to the information Congress reviewed when it overturned the ban in 2009. The Community AIDS and Hepatitis Prevention Act, which overturned the ban, also cited data from 81 cities across Europe, Asia, and North America that found that, “on average, HIV prevalence a m o n g in j e c t io n d r u g u s e r s in c r e a s e d b y E -Q percent per year in the 52 cities without syringe exchange programs and decreased by 5.8 percent per year in the 29 cities with syringe exchange programs.” “I think there’s still a lot of stigma around " I t Is a step back In tbe barm redaction m o d e l In Oregon webre been re a lly fortunate that we liaoe great organisations and counties and a state that supports It/" — J U L IE E A G E R -M E S U E A M P A R T N E R S H IP S P R O J E C T people who inject drugs,” says Julie Lager- Mesulam, director of the Partnerships Project which promotes HIV advocacy and services. Lager- Mesulam said the ban ignores the harm reduction benefits of the exchange and instead adopts a posture of punishing the user. “It is a step back in the harm reduction model. In Oregon we’ve been really fortunate that we have great organizations and counties and a state that supports it,” Lager-Mesulam said. Toevs says the county never applied for federal funding. She says lifting the ban was particularly helpful to communities where there is demand for needle exchange clinics, but a lack in local funding and political will to implement such a program. Congress put the ban back in place in its budget bill in December. Putting the ban back in place is widely seen as a partisan issue, with Republicans See CASUALTY, page 7 Inside Park restrooms in crosshairs of Corporations Barred fo r life aren't people - city’s budget except in politics woes A special commentary on the fallout o f Citizens United A n interview with Bruce Western on how prison hurts all o f us more than we know Portable toilets; a cost-saving plan? Page 3 Page 4 k r i h > rÆ 11 fcC: r ' j Page 8
