Sayings. It was more same. All. Its place. In Christ. Just want why is downtown? With All right. Good evening and welcome to our Municipal Corporation Committee meeting for Wednesday. MAY 2020. 26 at Five-thirty. Thank you very much for joining us this evening. I'm filling in for councilor Jared Evans this evening. We'll have introductions for counselors to my left. Thank you. MADAM Chair, Mike District. 24. Thank you. MADAM Chair, Josh Thing District. 21. Thank you. MADAM Chair,
Brian Mowery District. 25. Thank you. MADAM Chair, Jesse Vann district, their team. Thank you. CHAIRWOMAN Jones, Renee District 15 party Thank you. CHAIRWOMAN Allie Brown District 10 and I'm Kristin Jones representing District 18. First up, we have proposal number one, 40 2026. With 3 news, the Marion County Public Health Department, safe syringe access and support programs by adopting the declarations of the director of the Marion County Public Health Department and approving the program. Before we hear the presentation, I will let my colleague introduce himself. Thank you. MADAM Chair run gives the district apologize for my delay. Absolutely. Thank you so much. We'll let you take it away. Thank you very much.
Everyone. Hear me. Okay. Hey, good evening, everyone. And thank you. MADAM Chair, members of committee for allowing it to some of your time tonight. Most you probably expected to see my predecessor, Madison wi trial in this chair this evening. But she's since transition out of her role. And I've been honored to take over our program. I know I have very big shoes to fill in the next couple years, but I'm really grateful to be here. Those have not met yet. My name is currently Van Slyke and I'm just really got to be among so supported us over the years. And thank you again for your time tonight. So those MAY remember that in 2018, the Marion County Public Health Department sought council's approval to launch a certain services program in response to a 10 fold increase in a queue hepatitis c cases related to injection drug use in previous outbreaks,
evidence to show the increase in hepatitis c often precedes outbreaks of hiv related to injection drug use. If not break some for that of the 2015 infamous Scott County occurred here in Indianapolis. We be looking at over 500 new cases in the span of the year at a cost of nearly 500 million dollars. So our primary goal is safe. Syringe is prevent the transmission of infectious diseases through injection drug use for providing a unique access point for people who inject structure receive health care and recovery services. Course, at our core or syringe exchange program. So we provide sterile supplies, naloxone and charts containers for participants. However, over the years we've been able to expand and provide testing
hiv, hepatitis c and sexually transmitted infections. Referrals for health insurance that when a person is ready for ready and interested in treatment, I should say they have a few barriers as possible. We've also been able implement consultations for we care vaccinations in referrals for social services. In JANUARY of this year, we were able to actually hire our first full-time nurses here with me this evening. Daria. And so she's been able to help us implement more of these programs as long alongside excuse me are 2 full time peer support specialist. Since launching in 2019. We have served over 5,800 unique individuals at over 39,000 visits. We sir folks at 5 geographic locations throughout the city with considerations to accessibility by public transportation, biking and foot paths. Nearly half of our clients unfortunately aren't stably housed in one in 5 are actually without shelter
entirely. So we've increased our provision of hygiene supplies as well as blankets and warm clothing in the winter. And as most of you probably know, Indiana is very unpredictable when it comes to weather. So we try to have those available at all points throughout the year as well as ponchos and rain for thunderstorms and we even have a closet available to our clients with clothing and shoes available as well. Since 2019, we watch as the put it on the street has transition from heroin to fentanyl. And so response that we've grant a pardon, the locks and distribution efforts, I talk about more in our next slide. There is an argument that the best first responders to overdoses are people who use drugs themselves. They are already at the scene. We know how long the person's been down. They likely know what
the Houston, how they used it. It's our goal that this relieve the burden on first responders to hopefully prevent burnout and free up resources that they're able respond to other emergencies. We've been able to distribute over 90,000 doses of naloxone directly into the hands of people who are most likely to use it. We actually teach all of our use both in for muscular and information on the and our clients have reported back to us that they've able to reverse over 3,700 overdoses. That's over 3,007 or times. Impd did not have to respond and secure a scene and also 3,700 instances where somebody got a second chance at life. Our program, a staff of peer recovery coaches, which actually think is one of our greatest strengths. We have one full-time coach on staff into supplemental coaches throughout the week. So every time a person visits are change, they're interacting
with a peer recovery. Coach. Since 2019, 684 individuals have been formally connected to treatment programs. A 2021 survey of safe syringe demonstrated that the primary reason people are trying to our program other than syringes is our staff. The non-judgmental welcoming environment that we strive to create every day is what keeps people coming back to us. Some of the vision is not be one of the greatest predictors of treatment success and because of the non coercive approach to treatment found at harm reduction programs, studies have shown that people who participate insurance services are actually 5 times more likely to enter treatment. In 2023 say France is recognized by the National Alliance of City County and Health officials as a model practice, which means our program sets a standard for others from services, telepathy across the United States. This is due to
our evidence based practices, policies and partnerships. Our program models actually available online as a resource for others to learn and build from. And we view that as a national success are vital partnerships include up program expansions with the data center and step up actually honored to have Kerry o'Brien and Xstrata here tonight from the Damian Center. Excuse these partnerships have allowed us to access additional pockets of people use drugs as well as provide access to additional resources such as hiv prep, navigation services have seek your delegation, lgbtq bus services as well as reentry services. In 2023, we received a substantial award in partnership with Eskenazi Health primary care from the substance abuse and mental
Health Services Administration that has a lot of connections cafe inside of our college corner location within safe syringe. This program has also allowed us to play in Eskenazi Health Clinic nurse that helps us with any stations testing and directly care for substance use hepatitis c treatment and more. This is a to our full time nurse on staff and has also become another familiar face for our participants, the trust and hopefully be more likely to engage in services in the future. Also established a unique partnership with health net to provide certain services at their health net Southwest location the fall 2025, that's actually we're at today. This access point is actually only one of a handful of syringe services hosted within an uh will allow for direct access to primary care,
behavioral health, women's health and dental services. Beginning in SEPTEMBER of 2021, we partner with the Indiana Department of Health Laboratory tests are and just collected program for substances contained inside the one of the first programs in the to do such testing. Fentanyl has dominated our drug supply since 2021. But a recent data has actually shown a rise in cocaine and meth and methamphetamine. The supply as well. We're able to track the appearance of emerging substances in the 75 furnish information to our partners. Some substance has able to see recently is the animal tranquilizer silencing that many of you MAY have heard of before. We've also been determining which of your underwear is an animal tranquilizer. That's actually asked me to be 100 to 300
times more potent and xylazine and there are new substance on the block we've been seeing recently is Cychlorphine. This is a synthetic opioid that's estimated to be 4 to 10 times more potent than fentanyl. The ability to track the substances has actually allowed our staff feel the pride, appropriate education and interventions for participants since we know it's there. Our program has also recently launched individual pair from the the testing, testing that allows participants to bring us individual syringes or other items like baggies or cookers that we can swab test for them. Partisans are able to receive a full report of what was found or they can just ask for our staff members to review this with one of the next time they come to our change. This program allows parties take control service. Cub overdose can actually make
more informed choices. Earlier, I mentioned that our primary goal is paint an hiv outbreak related to injection drug use. And so far we've successfully been able to do that. The increase in diagnosis in 2021 2022. That you see on our site here, it was expected due to decreased outreach and testing from the covid-19 pandemic in 2020. Historically in Marion County. Hiv has primarily been limited to sexual transmission. And that trend has continued prior to the launch of safe syringe in 2018, the percentage of new hiv cases reporting injection drug use was 6.4% However, most recent data in 2024 only 2.3% of new cases reported injection drug use. And this really proud of as a former viral hepatitis nurse, epidemiologist the rate of acute hepatitis c infections, rose from 0.6 to 8.5 per
100,000 people between 2013 2018 and 2024, acute hepatitis c cases reported at just 3.5 cases per 100,000. I'm proud to say this demonstrates ever reach our relation with fewer than half the number of new hepatitis e transmission occurring since our programs launched. And 2018, we promise that's a threat to grant funding for the 3rd first 3 years for operation. And not only have we been able to keep that promise, actually able to remain entirely grant funded through 2029 at a minimum. The Marion County Public Health Department has raised over 4 million dollars for our program directly since 2018, not including grant funds that are shared with other programs and in kind cost. 30 years of cost benefit. Study showed that for every one dollar spent on certain services at
the $7 and $0.58 is saved on hiv treatment, cost alone. And our own cost-effective analysis that was performed by Myers and staff are as part of our Fairbanks Foundation Grant. It was estimated that 4.2 million dollars or saved in Marin County per year in hiv and hepatitis have see treatment costs locally. This also included are bulky start-up costs of the program. This analysis also showed us that up to 45%. 25 fewer overdose deaths occur per year, which no price can really be assigned. And with all the state and mine ask that you please consider that the station's program receive another two-year renewal. I think you for your time attention and it's okay with you, MADAM CHAIRMAN, happy to take any questions forgiving eye cancer. My calling to be
happy assist as well. Thank you, Carly. Thank you for your work. Appreciate it. Yes, come from. This is amazing. In a previous life. I worked for 3 and a half years doing drug and hiv and STDs, drug and alcohol treatment centers and prisons and jails. So what you're doing is is so important that was before safe syringe. And that was before all the funding that could to Ryan White and all the stuff that made it harder. So if 2 questions for you, one is when people are bringing their syringes and our asking for them to be tested, which I love that that's happening. Are they finding out often that what they think they're injecting? They're not because that's as you talk about that ranks that are much stronger. That's extra scary, right? So are we seeing a lot of that where people are being
mis-sold? Absolutely. A lot of our most recent reports are actually we've calling it synthetic soup. A lot of our producers actually saying 12 to 15 plus different substances each time, Which leads to overdosing cause. I don't know what they're using. Yes, that but I. a pro. I will say are full time peer recovery. Coach Tierney has had many participants say. You know, I'm not even getting when I'm paying for. So why am while my continuing mission encouraged them turn in their drug dealer that sales, right? We can. We can handle that and then my other question is when we're we're testing people in these populations, right? If we're coming across somebody who has high risk for other situations, not our partner with like the Damian Center. Are we able to say, hey,
this isn't necessarily for, you know, share, but did you know there's prep or theirs and getting them connected to those programs, thus reducing the risk and other forms. Yeah, absolutely. We have in the news with each the Davidson So we spent a lot of time with one another and refer each other. 2 are participants as well. So if they can get something from us at Marion County, we have no problem sending him to our our friends across street. Fantastic guy. And to Stickley will be voting to keep this going. So thank you for that. Thank you for your Thank you. Thank Letter Thank you, Sure. Kind of follow up on the question is had. When he said testing is that? I go out here and get a needle that has reloaded in for you to you and say, hey, what's in this? He contests it. Tell me. And then let me go about my way to go. Use it. So we too, that we offer test strips at our site. So
that's a little bit faster of a detection. These at individual preference intestine can take up to a month to get results back. So our participants often will use whatever substance they believe they're using. It will have a different intended reaction to them and they will bring whatever is left over and share with us and say I expected to go up and I went down. Can you tell me what was in here? That way they can decide if they want to continue seeing who they're saying. So the new test it to you. John. What is the giving back? What is ever left over? We don't test or what happens with stuff. know that that stays within a Department of Health Laboratory. They just send us report fiscal report back and lows. And then it's stuff of it.
Russia like an enabling people to come get tested so they know if they're shooting up for Thank you confused there. Thanks quick action. Yes, survey. Thank you for the presentation like 6 where it's one left the country people like invest in. Were to say to national studies that that. Hear you see if that specifically see the new year with these individuals? They are about or So that's just a guess from a national study. It's very hard for our program to get the 100% numbers on that since we are anonymous and even with the passing of Senate bill 91 still try to Putin stands on as possible. The number that shared with you, the 684 who we know for a fact Tierney or whomever else on our team was able to connect them directly with services. So often times stay. We give them information
and they go about their way later down the line. Maybe a week later, the next day they reach out to those services. So we don't always get a clear understanding on. If they follow through referrals are until they often come back and share with us after the fact like his mother, you know, I'm doing well and thank you for your time and services. They allowed me to recover. So this is it's it's individual since the. Getting program back 20, yes. Thank COUNCILMAN Gibson. Thank you, MADAM Chair and thank 2 married have public health department, your partners up with this program and trying to keep us our community safe. I'm grateful to the National Assembly for extend a lot JULY first and 2020 2031. So grateful for
that. I noticed one of the changes in the law was about the one for one exchange. And I guess it's got a lot do with the syringe testing. Is that is that can make it as something separate. The one for one exchange. The one for one change was implemented It's my understanding the intention was to decrease any syringe litter as well as I believe intention was to not get folks more than what they're coming back with for us. But since then, yes, we have we now give them whatever they get back to us. So good. So when they because conduct themselves in this legal activity what they're doing. But guess the out for the public to deal is, other words, the other bring that back to know to get clean syringe. Correct? Okay. Good in terms insurance. And
noticed that. A great don't have insurance. So how do you help them connect with getting road and coverage that they MAY qualify for. if they are ready and willing or wanting, we have we discussed covering kids in families with the Marion County Public Health partner, that we can refer them to Eskenazi. Health also has their own partners that they're able to assist with if they're not able are wanting to have a chat with us about it right then and there we can refer them to other folks. Thank you for the great work Thank you. Thank you. Council around. Sorry. Wasn't the other councilmembers that this just popped in my head. Are we because you're doing testing? Do we see people coming in with needles for
diabetics medication, glp ones and other things that that are injected subcutaneously. Yes, though. See sometimes get the I stepped as type one, sometimes get the medication with insurance, but you don't get the needles in the up to purchase them. And then even though he was emt and incredibly smart about this would reuse needles because it sure save money. So is that something you're seeing to is people using legally prescribed drugs, not having enough Ninos in bringing those in for an exchange. Not as often for the change. What we do have folks that will I give us their used to dispose of safely, especially with the rise of glp one use. Councilor just about. Thank you, MADAM Chair, and thank you for that presentation. Yet strong
advocate for type of program. You know, my father actually passed away a fentanyl overdose using drugs a lot more when she didn't use that. All, of course, but he is the more risky way because he didn't have access to programs like this. It could probably still be alive if you a program, not in the state. I did want to ask in terms of your slides for about the people served. I was a little bit surprised by the demographics. It seems like far far more white people using the service than you would think from looking at, you know, just general population is that you think of trouble to who's using intravenous drugs specifically whether explanations do you have like, why is it not better serving? You know what our city looks like. And first, I want to say
I'm so sorry for your loss. I would have to say sudden he's been a public health for several years now. I think there's unfortunate still a lot of mistrust with our minority communities in even our participants. The first couple times they seem a little uncertain that were not. Lying to them or, you know, we're not the cops gonna come around the corner, you know, but I'm fortunate thing. Fees are a lot of systemic issues that not just us but a lot of folks will have to combat over the years. Yet that makes sense would love to think through how the council, the partner better too help, you know, publicize the program and make it clear this isn't an excuse to send someone to jail or anything. Thanks. Thank you.
Thank you. CHAIRWOMAN Jones picking back up a counselor. Browse question. I was looking at the demographics and then I was kind of curious to know about the age range in do see here. So is there some type of education that heard? You mention it earlier about there was an education that was being provided with you. Expound a little bit more on that. Sure. Just clarify, is there something specific education was the only news, guess, around the syringe? Because, you know, when I look at this number is says the ages of 15 29 1 judge ruling dangerous continues to increase nationally and in the state of Indiana. And so I guess for me, you know, how, you know, when you provide education about syringes, are drug use hiv in
all of that? How are we going about doing that? You know, especially for this age group because age 15, I mean, understand nowadays everything hands. But age 15, I will clarify that our programs do not allow anyone under the age of 18 participate or even be near our any of our sites. If we have anyone present with children, we awesome to leave. As far as education. Those I will say we really hit on you MAY have heard Madison in years past kind of describe this is the cool aunt of the so change world. We do try to be non coercive non-judgmental. Just kind of straight up, if you will, with
folks, you know, especially are people that have lived experience that are now seeing a different way of life can share, you know. I was living this way you don't have to. If you continue to do x, y z, you are at a higher risk for infection or things of that nature. So we try to base it off whatever demographic. We're talking to are. Unfortunately, sometimes folks just aren't aren't quite ready there to even the right to have a conversation about anything education And I would agree with that with thanks for all the hard work that you all are doing around This is very informational and I would be happy to really support continuing the work so great job keep doing it. You know, doing the great work that you either know. Think you Thank you, COUNCILMAN. Thank you. MADAM Chair.
Just quick follow-up here. I'm looking at slight 6 again with 684. People engaged with recovery programs. It looks like since the program began in 2018. The costs a little over 4 million dollars. So we can say that's 4 million dollars. Roughly $6,000 per person. The engages with a recovery program. Just curious what your thoughts on that? Think that's a. Appropriate spend per individual. I'm sorry. Do you mind clarifying your question for me? Are you saying? We have say $6,000 so that the entire program since 2018. As costs us 4 million dollars over 4 Million. But let's just say for millions views and And since. The program began in 2018,
684 individuals have engaged with a recovery program. I the 4 million dollars we've raised it. Okay. Yes. I said you're saying now so that for me and dollars goes towards salaries. Are mobile unit upkeep of cost for the syringes and other supplies I would say that the 6 for engaged. I don't. I do know that I could come fairly exact number on how much we spend on those folks. I know we have a multitude of resources that were able to refer them out, too. Sometimes insurance covers there say sometimes it doesn't. So Turkey to put a number on it. I don't know if mine. Is your question. Can you please come to the mic? come to the microphone give us your name. Please. Thank
you much here. you're fine to stay here. Welcome to give just enter this year's record community center. It sounds to me your question is like? Do you work $6,000 or out? Work. It I So we want to put a cost on getting someone necessarily rehabilitated. But kind of you our job as sending the taxpayer dollars are off, I guess in this case, you know, it's it's grand dollars. So literally saying that right now councilor around. Thank you. So, yeah, I literally just said that. Thank So the question is. Is that the best way to spend $6,000? Yeah, it's a great question. And I think it's about multiple different outcomes as well as recovery. But it's also about of 0 visits because we prevented someone from getting from
using sterile syringe. It's about prevention. Casey infection each other's a c infection? Costs The life and cost of infections like or a $600,000. So I think you have to think about it about love more than just or how how it One more story. Covered for sure. And with the most of your grants come from. Our grant steam admittedly juice looks through applications for us and see what we We qualify for. A lot of partnerships with a snotty health since we're under the health and hospitals corporation together. So there's anything we can jump in on together. We will unfortunately, as of recently innings centrifuge programs are becoming much more limited for grant funds. So our participation, we try to fit in wherever we can. But
Samsung has offered a some grants. The for Banks Foundation has been very wonderful for us, too, as well as the Health Foundation of Greater Indianapolis. Ok, thank you. Thank you. Thank you. Council Thank you. MADAM Chair. I too want and thank you for the work that you're doing. I was drawn to the previous 2 slides to what my colleague just referred to and the number of people served and the number overdoses reversed. I think that's really kind of a true reflection of the work that you're doing, that it's not just the individual that our engagement recovery, but the number of people that are served and the number of overdoses that that have reversed. And I think that even in putting that in context with almost 3800
widows been reversed. We really can put a value individuals lives. And so thank you for the work they continue do. And I'm more than happy to support you guys going forward. Thank Thank you. Council. Thank you. MADAM Chair. regard to the 3,007 17 overdose reversals. Are there any type of programs? These people can get involved? So they're not repeating that overdose or follow up with How do you do that? So the way that we retrieve that data is when a time someone utilize our exchange, we if they utilized the locks. And since they last saw and we of 9-1-1, was called. So we we can also better understand. The burden, if you will, on our ems services we asked them
if it's them that overdosed or if it was a friend and then we obviously always encourage whenever you're ready. We're here for you for our recovery coaches. But with the non it in on a minute, you accuse me of our program. We just keep trying to tell people we're here for them. And then when they're ready for their for them as well. Any other comments, questions from counselors? Anyone, the public who wishes to proposal number one, 40 2026. We'll take a motion. second. It's been moved and second into proposal. Number one, 40 2026. To the full council with do pass recommendation. All those in favor say Aye. Aye opposed, say nay. The ayes have it. Thank you very much. Thank you for you all being here with us this evening. Appreciate your advocacy and work. Thank you so much. I phone. Thank you.