Two years ago, CalHEP & Project Inform led an advocacy effort (with support from partners like the California HIV Alliance and Drug Policy Alliance) to convince the legislature and Governor to allocate $3 million per year in state funds to create and maintain a clearinghouse of supplies for authorized syringe exchange programs in the state. Our advocacy was successful and the great folks at California Department of Public Health Office of AIDS (OA) and North American Syringe Exchange Network have developed the clearinghouse with those funds. Here is an excerpt from OA’s monthly report with results to date, which I thought many of you would find of interest. It’s nice to have this overview of how our advocacy leads to real impacts on the ground!
The CDPH, OA recently completed data collection among the 39 syringe exchange programs (SEPs) supported by the California Syringe Exchange Supply Clearinghouse. CDPH/OA launched the Supply Clearinghouse after the California State Legislature provided ongoing state General Fund of $3 million each year starting in July 2015 to purchase syringes and other harm reduction supplies for California SEPs. This program represents the first time the State of California has made funding available to all authorized California SEPs, and reflects a growing understanding of the value of such programs in providing an essential safety net of culturally competent services. A preliminary review of the data shows:
• Because the Clearinghouse eliminated supply shortages, 13 SEPs were able to remove prior restrictions on the number of syringes they are able to provide to program participants, in line with the Centers for Disease Control and Prevention (CDC) recommendation to ensure a new, sterile syringe for each injection.
• Five SEPs reported that material support from the Clearinghouse prevented their programs from closing;
• 60% of programs reported increasing services to program participants by expanding program hours, adding new locations and/or expanding outreach; and
• 82% of SEPs reported offering both HIV and HCV testing, and 79% distributed the opioid overdose reversal medication naloxone
According to one program, “Not having to ration supplies boosts our relationship with clients, since we can meet their needs and adjust for planning ahead It also boosts staff morale, knowing we will not let our clients down. Having more supplies also means we can do more and bigger outreach sessions and hit additional situational populations, such as homeless encampments An important part of our work is to reduce improperly disposed of syringes. With the Clearinghouse, we are able to give out more bio-hazard containers for safe disposal (this was previously a challenge due to the expense of the disposal boxes).”
Despite these successes, providing a baseline level of supplies to SEPs does not necessarily allow them to completely stabilize their operations or expand their services sufficiently to meet local need. 69 percent of SEPs surveyed reported staff shortages as a major operational concern, and 54 percent listed lack of funding as a major challenge.
In addition to its impact in California, the Supply Clearinghouse order volume has helped to reduce prices for the 297 SEPs across the U.S. who participate in the Buyers Club established by the North American Syringe Exchange Network (NASEN), which is the lead agency for the Clearinghouse. The increase in supply volume has opened the door for price reductions on some of NASEN’s most popular items. These price reductions have been applied to all NASEN Buyers Club customers. The California Syringe Exchange Supply Clearinghouse model and its impact on the Buyers Club have influenced other states such as Washington, Colorado and Illinois to initiate the development of a similar statewide purchasing agreement.