The Connecticut General Assembly
OFFICE OF LEGISLATIVE RESEARCH
November 28, 1995 95-R-1334
FROM: John Kasprak, Senior Attorney
RE: Needle Exchange Programs
You want information on needle exchange programs operating in Connecticut, including available data on usage of these programs.
A 1990 public act authorized the state Department of Public Health (DPH) to establish a demonstration needle and syringe exchange program. That program was established in New Haven in November 1990 and continues in operation by the city's health department. Statistics for FY 1995 indicate the program served 1,454 new and returning clients. Over 31,000 needles were distributed during that year with 96% returned.
Subsequent legislative acts in 1992 and 1994 expanded the needle exchange program to other locales. Currently, six needle exchange programs are operating throughout the state; in addition to New Haven, they are in Bridgeport, Windham County, Hartford, Danbury, and Stamford. The Danbury and Stamford programs began operations this year.
Demonstration Program—PA 90-214
PA 90-214 required the Department of Health Services (now known as the “Department of Public Health” (DPH) to establish a demonstration needle and syringe exchange program with the health department of the Connecticut city with the highest incidence of human immunodeficiency virus (HIV) or AIDS-related complex among intravenous drug users. The program had to: (1) be in, and established with the assistance of, the local health department; (2) be incorporated into existing AIDS prevention and outreach projects in the city; (3) provide for free and anonymous exchanges of needles and syringes, with program participants receiving the number of needles and syringes equal to those returned, up to five per exchange (since amended to 10; see below); (4) require the marking of needles and syringes distributed and a check on return rates; and (5) offer education on transmission and prevention of HIV and assist participants in getting drug treatment services. DPH, with assistance from the selected health department, had to establish protocols in accordance with the above provisions.
The demonstration program had to have a mechanism for the local health department and DPH to evaluate its effectiveness. The program had to monitor: (1) return rates of the distributed needles and syringes, (2) behavioral changes of participants, (3) participation rates and the number and status of those entering treatment as a result of the program, and (4) the incidence of intravenous drug use to see if the program has had an effect.
The act also required the selected city health department to submit an evaluation report to DPH and to the legislature's Public Health and Appropriations committees.
The selected city for the demonstration needle exchange program was New Haven (see Attachment 1—OLR Report 92-R-0037, January 16, 1992 for details on the New Haven program).
Expansion of Needle Exchange Program—PA 92-3 (May Special Session)
PA 92-3 of the May Special Session expanded the demonstration needle and syringe exchange program to two more cities (Hartford and Bridgeport). Under the legislation, the participating cities (including New Haven) must have had the highest total number of AIDS cases among intravenous drug users as of December 31, 1991. The act also allowed DPH to authorize up to three additional exchange programs in Connecticut, as determined by the state health commissioner. As with the New Haven program, DPH must establish protocols for the needle exchange programs with the assistance of the local health departments of the cities selected.
The act amended some of the existing procedures and criteria on program evaluation and reporting. It also modified a requirement of the New Haven program that all needles and syringes distributed be marked and checked for return rates by requiring such procedures only for the first year of the programs.
This act removed the limit on the number of needle exchange programs DPH may authorize. It also allows the DPH commissioner to set up needle exchange programs through local organizations as well as local health departments (see CGS § 19a-124).
The act also increases the cap on the number of needles and syringes that may be exchanged at any one time, from five to 10 (see CGS § 19a-124(b)).
Related Act—Decriminalization of Needle Sale and Possession
PA 92-185 decriminalized the sale and possession of hypodermic needles and syringes by removing the prohibition against their sale or purchase without a prescription in quantities of eight or fewer. It also amended the definition of drug paraphernalia to exclude needles and syringes in quantities fewer than eight.
PA 92-11 (May S.S.) increased the allowed quantity to 10 and made the corresponding change in the drug paraphernalia law (see CGS § 21a-65).
CURRENT CONNECTICUT NEEDLE EXCHANGE PROGRAMS
Six needle exchange programs (N.E.Ps) are operating currently in the state. They are located in New Haven, Bridgeport, Hartford, Windham County, Danbury, and Stamford. The oldest program is New Haven's, operating since November, 1990. The newest is Stamford's, started in June, 1995.
The contractors of all of the programs maintain the needle and syringe exchange programs as part of their existing HIV/AIDS Prevention Education and Street Outreach activities. In collaboration with the state DPH, these contractors maintain a protocol in accordance with subsection (b) of PA 94-16 (see Attachment 2). Under the protocol (1) all programs provide free and anonymous exchanges of needles and syringes with participants receiving equal number of needles and syringes for those being returned up to a maximum of 10 per exchange; (2) all contractors are checking all needles and syringes distributed to monitor the return rate; and (3) all contractors offer education on HIV transmission and prevention, offer bleach kits (to sterilize needles), and assist program participants in getting drug treatment services.
Following are descriptions and some details concerning the individual N.E.Ps for fiscal year July 1, 1994 to June 30, 1995. (See Attachment 3 for further data on the individual programs.)
The state's largest operating program is the New Haven's N.E.P., run by the AIDS Division of the New Haven Health Department. The program, which began in 1990, works in collaboration with the Yale Community Health Care Van which is staffed with four full-time equivalent positions. It served 1,454 new and return clients in FY 1994-95, distributing 31,025 needles. Returned needles total 29,875 for a 96% return rate.
The Hartford N.E.P. began operations in March, 1993, by the Hartford Health Department/AIDS Division. It has three staff persons that come from the Urban League, Latinos Contra SIDA, and AIDS Project Hartford. The program served 6,187 new and return clients in FY 1995. Total needles distributed were 30,168 with all returned for a 100% rate.
The Bridgeport N.E.P., begun in May, 1993, is operated by the Bridgeport Health Department/AIDS Division. It is staffed with two full-time and one half-time positions. In FY 1995, it served 1,193 new and return clients. The program distributed 12,275 needles, with 12,074 returned (98%).
Windham County's N.E.P. has been operated by the Windham Regional Community Council since May, 1993. It is staffed by two half-time equivalent individuals and served 4,697 new and return clients in FY 1995. There were 30,522 needles distributed with 25,605 returned for an 94% return rate.
Danbury's program, under the direction of Danbury Health Department's AIDS Division, became fully operational in March of this year. Clients, as reported for FY 1995, totaled 20. Twelve needles were distributed with six returned for a 50% rate according to reported data on the new program.
Stamford's N.E.P. has only been operating since June, 1995. Its staff include one full-time equivalent and one half-time position and is operated by the Stamford Health Department. It served 20 clients in FY 1995 with 20 needles distributed and 12 returned (60%).