CLARK COUNTY — Clark County commissioners voted to accept the county health officer's declaration of an HIV epidemic at a public hearing Thursday.
Declaring an epidemic would allow the the county to establish a needle-exchange program. But first, commissioners have to petition Indiana Health Commissioner Dr. Jerome Adams to declare a public health emergency.
The declaration comes after county health Officer Dr. Kevin Burke sent two letters to commissioners outlining why the county needs a needle exchange.
In one one of those letters, Burke told commissioners the exchange is needed because “Clark County has 25-30 percent higher rates of HIV and hepatitis C compared to the state,” and that an increase in those rates is often related to intravenous drug use.
Burke reiterated Thursday that Clark County's proximity to metro Louisville and to Scott County where “infections have exploded” as another reason Clark County is experiencing an epidemic.
A needle exchange, he said, would encourage more drug users to get into a rehabilitation program. It could also lower the amount of used needles found on the streets.
Barb Anderson, executive director of Haven House in Jeffersonville, said people staying at the shelter sometimes volunteer in the community. In one month, she said, one man collected around 100 dirty needles in Jeffersonville.
Carolyn King, a Jeffersonville resident who works as a community liaison in the mayor's office in Austin, the epicenter of Scott County's epidemic, spoke in favor of needle exchanges. Scott County is considered to have one of the fastest growing epidemics in the world, King said.
"It's a very expensive proposition if we don't do this," she said, adding that she lost a grandchild to IV drug use in the past year.
King said a needle exchange would not condone drug use, but instead help users get treatment. It's the only evidence-based method of reducing drug use and infection, she said.
Costs and funding for a needle exchange program weren't made clear Thursday, but state Rep. Ed Clere, R-New Albany, told commissioners that legislation prohibits state funding for local needles exchanges. Clere is chairman of the House Public Health Committee and authored the legislation allowing needle exchanges in the state.
Burke said there could be philanthropic resources for funding and materials.
"We have to work out the logistics to how to do this but we are sensitive to the cost and the taxpayers concerns,” Burke added.
Burke said he thinks a mobile needle exchange would save money and be best to serve the county. Though statistics are hard to track, Burke said about 80 percent of the need is in the southern 20 percent of the county.
According to state statute, a needle exchange program can only be authorized for one year. After that year is up, the county has to reevaluate and decide whether it needs to declare an epidemic again.
Clark County Sheriff Jamey Noel said typically he would be opposed to a needle exchange program, but that he has seen the problem first hand from a law enforcement side.
Noel said 15 years ago as an undercover officer he wouldn't haven been able to buy heroin even if he had all the money in world. Today, heroin is cheap and readily available.
"I do agree that this is an issue," Noel said, adding that he hopes the program wouldn't go beyond one year.
Commissioner Bryan Glover asked Burke what the end goal of a needle exchange program would be, noting that other states have programs that have lasted 15 years.
'I don't have a good answer to that question," Burke said. "In a sense we want to do this and see how well we utilize it. In a sense it's a pilot."
While commissioners voted to adopt the epidemic declaration, a resolution will have to be drafted and signed. Then it's up to the commissioners to petition the state.
Burke said once details like funding and location are ironed out, he will give commissioners the opportunity to suggest changes and ask questions.
"I just want to make sure that moving forward, if we move forward, that we have a comprehensive plan that says 'here are the steps we are going to take and here's what we hopefully get as a result,'” Glover said.
The next commissioners meeting is schedule for Aug. 13 at 5 p.m. Commissioners are expected to sign and pass the resolution at that meeting. Until then, they can start taking steps to petition the state.