Fayette County might soon join a small but growing group of counties throughout the state who have instituted a needle exchange program.
County commissioners, during a special public hearing Tuesday afternoon, voted unanimously to apply to the Indiana State Department of Health for assistance in establishing a needle exchange program within Fayette County, due in part to the widespread intravenous drug use in the county and the rising numbers of residents infected with either Hepatitis C or HIV.
The public hearing comes on the heels of Fayette County Health Officer Dr. Wayne White declaring a public health emergency in June for the county, due to its increasing numbers of Hepatitis C cases. The county was identified earlier this spring in a report by Dr. Beth Meyerson, an assistant professor of applied health science at Indiana University Bloomington and co-director of the IU Rural Center for AIDS/STD Prevention, one of several counties at high-risk for the possible spread of HIV.
"Our local health officer, Dr. Wayne White, has issued an emergency in his official capacity, stating there is a Hepatitis C epidemic in Fayette County and that the cause of that stems from intravenous drug use," Commissioner Frank Jackson stated at the start of the hearing. "That's why we are here."
Jackson went on to make clear to those in attendance, which included State Rep. Cindy Ziemke (R-Batesville) and House of Ruth Director Sharon Cranfill, among others, that the needle exchange program the county is seeking is not due to a law enforcement problem, but rather a public health problem.
"The law enforcement side of this situation is being very well addressed. Since October (2014), the multiple task force comprised of state, local and other officers, have made 188 felony arrests dealing with heroin, other drugs and dealing. An absolutely tremendous job," Jackson said. "What we are here for today is to address the public health problem. At the end of 2014, the Fayette County Health Department had a 74 reported Hepatitis C cases to the health department. As of the middle of last month, that number had already been reached."
Commissioners did make a previous trip to Scott County — the first Indiana county to have an emergency needle exchange instituted, due to an HIV epidemic the county is experiencing from intravenous drug use — with local health department officials, according to Jackson, as part of their research into whether Fayette County should seek such a program.
What commissioners saw, according to Jackson, is a program that can help address some of the drug problems within Fayette County, while at the same time possible stop the spread of communicable disease through dirty needles.
"Think of the analogy of a moth to a flame," he said. "The moth is the addict, the flame is the needle exchange program. That's what draws the addict in. Once the addict comes into this program, they are signed in, they are assessed, there are representatives from the Bureau of Motor Vehicles there, there are representatives from the State Board of Health, helping them get a birth certificate and identification so that representatives from the Family Social Services Administration can get them signed up for the HIP 2.0 program."
Once getting signed up for the HIP program, through the needle exchange, will allow for those infected with Hepatitis C to receive the needed medical treatment they need, while the exchange will help cut down on the sharing of needles by drug addicts, in turn cutting down the spread of Hepatitis C and HIV, Jackson continued.
Fayette County's plan, for those who would utilize the needle exchange, would be to provide a sharps container to individuals in order for them to place their dirty needles into. Those individuals would then, in order to receive clean needles from the county, have to turn in the same number of dirty needles that are being issued to them. Those in the program would also be tested for Hepatitis C and HIV.
Being enrolled in HIP would also allow drug addicts to seek rehabilitation and counseling opportunities, something not available to some due to lack of health insurance.
"I know to some people, it's enabling a sin," Jackson said. "I know to some, it's enabling a detrimental practice. But I want to emphasize, they're going to do this (intravenous drug use) whether they have clean stuff or not. We're trying to get them in and keep them from transmitting communicable diseases and, in the process, get them the help, insurance and counseling to get off this. There have been so many deaths here in Fayette County ... this are human beings with lives, families and people who care about them."
No one in the audience spoke out against such a program, which Fayette County Health Department Nurse Paula Maupin expects to last — if approved by the state — for at least a year and likely longer.
Several, however, including local Economic Development Group Director Dan Parker, spoke in favor of the program, with all acknowledging that the issue of drugs and disease in Fayette County is one that can no longer be ignored.
"I'm here as a concerned citizen who has compassion for these people who have problems, and I admire what the commissioners and the health department is doing," Parker said. "I feel that doing nothing is wrong. I'm sure you'll be criticized for doing this, but this is something I believe will help. Having been to Scott County, to the one stop clinic, and seeing for myself the methods and process that they have put into place, I was impressed. I feel if we have the numbers comparable to Scott County, we need to take some action."
Those sentiments were echoed by Ziemke.
"I applaud all the efforts of commissioners and how you are working on this," she said, while also pledging her support to the county's application. "I've worked on this legislation and in support of this legislation this year at the statehouse. I feel it's vital ... I'm so encouraged that the community of Connersville, as well as the school corporation and law enforcement, is working so hard to try to combat this. This is one more piece that I feel is so necessary. Again, this is a public health step that needs to be taken."
Local resident Betty McDivitt told commissioners that the importance of rehabilitation needed to be stressed with the needle exchange program, as well.
"The addiction cycle is the same as the domestic violence cycle," she said. "It will continue to perpetuate unless there is an intervention. So, I really like the part about having them come in, have contact with services they need, the insurance which can provide counseling. That's a big problem with addictions in the past, is not having that available."
Rehabilitation was once concern of Connersville Police Detective Scott Phillips, a member of Task Force Connersville, who expressed to commissioners that he felt rehabilitation should be a mandated part of the program.
"Is there any rehabilitation that goes with this program?" he asked.
"There is the opportunity for rehab," Maupin told him. "Each interaction you have with a person, positive encounter, it's more encouraging and it just pushes them more toward that goal ... it isn't mandated. It's encouraged. We give them the resources and information."
If rehab was mandated, those who would utilize the program likely wouldn't come, Jackson said. However, if 10 percent of residents utilizing the program can be reached and seek rehab, that is better than not doing anything at all, he added.
Overall, the theme of the hearing was the county is facing a health problem which must be addressed and addressed immediately.
"The first thing to fixing a problem is understanding you have a problem," said Commissioner Zane Badore. "The county has a problem and the drug user has a problem. We have to bridge the gap, come together and figure out a way to fix the problem."
The county's application will now go to Dr. Jerome Adams and the ISDH, which could approve it, send it back to the county for revision, or deny it. In light of Tuesday's action by commissioners, the application will be sent as soon as possible to the state. No further details on a location for a needle exchange clinic, or how much funding would be received for its operation, was available Tuesday.
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