The Republican chair of the House Health and Family Services Committee is speaking out against a bill proposed by Senate Majority Floor Leader Damon Thayer, which would force local health departments with syringe exchanges to operate with a one-for-one model — only dispensing one clean needle for each used needle returned by a patient.
Rep. Kim Moser, R-Taylor Mill, told Insider Louisville that Thayer’s bill is “misguided” on several fronts, as it not only prohibits local health departments from following best practices recommended by public health experts but would harm the state’s efforts to prevent a costly outbreak of communicable diseases and direct more individuals with a dependence on opioids to treatment.
“I disagree wholeheartedly with forcing the health department to do one to one because it makes no sense,” said Moser.
Louisville was the first local government to approve and create a syringe exchange in the summer of 2015 after legislation passed in the General Assembly allowing them, and within a year 11 more counties authorized an exchange. As of today, there are now 50 syringe exchange sites within 45 counties.
The five syringe exchanges operated by Louisville’s Department of Public Health and Wellness use a needs-based model that allows the number of new needles dispensed to be greater than the number returned and commensurate with the patient’s weekly drug use.
The one-for one model that would be mandated by Thayer’s bill is regarded by public health experts as a “practice to avoid” that “results in sharing of needles,” according to the website of the Kentucky Cabinet for Health and Family Services and the Kentucky Department of Public Health.
Moser noted that Kenton and Campbell County, where her northern Kentucky district is located, are two of the 54 counties in the state that the Centers for Disease Control and Prevention has identified as being especially vulnerable to an outbreak of HIV and hepatitis C infections among intravenous drug users.
“The point of the needle exchange program is to deal with our high rate of hepatitis C and any communicable diseases,” said Moser. “Northern Kentucky a couple of years ago was 19.5 times the national average of hepatitis C. And the cost is untenable, at $80,000-plus per treatment for hepatitis C, versus a six-cent needle.”
Moser added that the services provided by syringe exchanges go far beyond just needles, as the state battles a raging opioid crisis.
“They start out with building a relationship, they are touch points for individuals to get treatment, testing and so forth,” said Moser. “They’re having a really high success rate of getting individuals into treatment, actually, and it’s not really just about exchange exchanging needles.”
Thayer, a Republican from Georgetown, has long been a critic of syringe exchanges, and vowed in 2016 to push legislation that would end them unless a bill was passed to force such exchanges to operate on a one-to-one model. Thayer repeated this week that he is “philosophically opposed to needle exchanges,” saying that they amount to the government promotion of illegal behavior.
Asked if Thayer’s bill would have any success if it was passed and made its way to the house, Moser said, “I would do my best to work with Senator Thayer and continue educating folks about the need for these programs.”
“From a public health standpoint, the health department is statutorily required to reduce communicable diseases,” said Moser. “And this is the only issue that the legislature gets involved with telling the health department what treatment to do. So that’s interesting to me.”
In northern Kentucky, Grant County’s health department operates a needs-based syringe exchange, while a mobile unit operates in both Campbell and Kenton County, with the later county using a one-for-one model. Fayette County’s health department, which followed Louisville with the second syringe exchange in 2015, used a needs-based model.
Of the 54 counties in Kentucky that the CDC warned were especially vulnerable to an HIV or hepatitis C outbreak — which amount to nearly one in four of the counties nationwide — 25 have no syringe exchange.
Beth Fisher, the spokeswoman for the Cabinet for Health and Family Services, noted that while the Bevin administration did not write the section of its public health page calling a one-for-one model a “practice to avoid” — this was taken from a report of health experts on harmreduction.org — she said “this is information routinely shared with communities implementing” syringe exchange programs, and “they are best practice standards designed with input from national public health experts.”
Thayer did not respond to a request for comment.