A publication of the Kentucky Center for Public Service Journalism

Mobile syringe access exchange program begins next week in NKY, open house in Covington Thursday

By Mark Hansel
NKyTribune managing editor

The Northern Kentucky Health Department (NKY Health) hosted an open house for its mobile syringe exchange unit Tuesday at the St. Elizabeth Healthcare Urgent Care Newport/Ft. Thomas on Grand Avenue in Newport.

The NKY Health mobile syringe access exchange program begins in Campbell County and Kenton County next week. The Kentucky Fire Commission has provide this command center to serve as the program’s mobile unit at both locations (photos by Mark Hansel).

NKY Health will begin operating a mobile syringe access exchange program in Campbell County and Kenton County next week.

The open house provided an opportunity for media and members of the general public to see the mobile unit before it begins providing services.

Another open house takes place Thursday at St. Elizabeth Healthcare – Covington, located at 1500 James Simpson Jr. Way, from 1–3 p.m.

The Kentucky Fire Commission has partnered with NKY Health to provide a command center to serve as the program’s mobile unit at both locations.

“We are proud that our mobile command center can provide such a needed service in our community,” said Ronnie Day, Executive Director of the Kentucky Fire Commission. “These efforts are right in line with our mission to enhance the safety and education of our citizens.”

Dr. Dora Savani, an infectious disease specialist and consultant to St. Elizabeth Healthcare, said the mobile unit demonstrates that people in the region are serious about trying to curtail this major addiction epidemic, fueled by opioid dependency.

“I am so excited and hoping that we are going to decrease, the rate of drug use with this,” Savani said. “It will give us the opportunity to see these patients and educate them, but more importantly, is risk reduction. We want to decrease the rate of Hepatitis C, Hepatitis B, HIV and in addition, endocarditis.”

Hepatitis and HIV have gotten much of the attention, among those with addiction issues, but Savani said endocarditis is also a serious problem. The reuse of dirty needles, covered in bacteria, can lead to extremely serious infections and endocarditis.

“We are having a major epidemic of young kids having to have open-heart surgery and their heart valves exchanged because of infection,” Savani said. “When you see these young kids in the ventilator, in the ICU, extremely ill spending more than a month in the hospital. This is the first step of decreasing the rate of those infections in our community.”

A two-year snapshot o f the impact of the syringe exchange access program in Grant County. Source: NKY Health (click to enlarge).

Dr. Lynne Saddler, District Director of Health for NKY Health, said having a mobile syringe access exchange program, while not what she was advocating for, is definitely a step in the right direction.

“We’ve had a rural syringe access exchange program operating in our Grant County Health Center for a little over two years,” Saddler said. “That’s where we like to operate the programs because we are able to provide a wider variety of services, however, being able to provide any services to this population is really important to us in our effort to stop the spread of diseases in Northern Kentucky.

“Being able to just get started to doing that is critical because we know a large part of it is trying to get people who inject drugs to stop sharing needles and syringes and also trying to get those brought into us, so we can properly dispose of them and keep them away from our first responders.”

A stationary unit in the NKY Health Centers that could provide a more complete range of services is the ideal solution, but Saddler said the mobile unit will be a useful tool.

“The mobile unit will have our public health nurses because we really, truly believe that what this population needs is medical care and linkage to medical care,” Saddler said. “If we can open that door and be a touch point for those services, we just feel like it’s best delivered in Northern Kentucky by our public health nurses.”

The Newport and Covington programs will be two of more than 40 syringe access exchange programs operating in Kentucky. NKY Health also operates a comprehensive syringe access exchange program at its Grant County Health Center in Williamstown, Kentucky, now in its third year.

Advocates for a syringe exchange access program in Nothern Kentucky at Tuesday’s open house. Left to right, Dr. Dora Savani, Gary Blank associate vice president and COO at St. Elizabeth Healthcare, Dr. Lynne Saddler, district director of health at NKY Health and Garren Colvin, president and CEO of St. Elizabeth Healthcare.

State law requires approval from the Board of Health as well as the city and county in which such a program operates. The Newport Board of Commissioners authorized the syringe access exchange program in February, while Campbell County approved it in 2016.

Covington and Kenton County governments also authorized the program in 2016, however, operation could not begin until the program was operational in two other Northern Kentucky counties.

While addiction is a problem statewide, and across the country, Saddler said having these programs in a mobile unit in Northern Kentucky’s largest urban core areas is very important.

“So far what I have gotten is calls about rumors that because it’s a mobile unit, we’re going to be driving all over the countryside parking it in neighborhoods,” Saddler said. “I reassure them that there is no way we are going to do that because of the approval we would have to have from cities and wherever we would be parking it. Right now we only have approval for this location in Newport and the location in Covington.”

In an editorial in the NKyTribune, Newport Mayor Jerry Peluso said a more widespread program is necessary to deal with the scourge of addiction in the region.

“For this program to reach a level of success, more cities need to participate and allow the mobile unit into their community,” Peluso said.” This drug epidemic should be a concern for all elected officials in all 36+ communities within Boone, Campbell, and Kenton counties.

Garren Colvin, president and CEO of St. Elizabeth Healthcare, said the health risks related to intravenous drug use pose a risk to the community as a whole, not just users. The mobile unit is a major first step in working to prevent an infectious disease outbreak.

“Sometimes we have knowledge of issues before the public and we know how bad the threat of Hepatitis C could get, especially if it turned to HIV, so this is a major leap in the direction of stemming an outbreak,” Colvin said.

Cathy Templeton, a registered nurse with NKY Health shows some of the products and services that will be offered at the mobile unit, including, Narcan, an HIV test and sharps containers.

“Our Hepatitis C rate is 20 times the national average and the other issue is with the program that has been established in Grant County, we have identified that 70 percent of the people using that service are employed with health insurance,” Colvin said. “That tells you it’s a broad brush of people affected by the opioid addiction and the only way to make our community healthier is to immediately cut the Hepatitis C rate in half, by implementing a syringe access exchange program.”

Colvin said St. Elizabeth Healthcare agreed to provide the space for the mobile unit because of its responsibility to the community and its own employees.

“As the CEO of St. Elizabeth Healthcare, one of my main duties is to take care of the associates in our house and this a sure-fire way to protect each and every one of our associates, by reducing the Hepatitis C rate in our community,” Colvin said.

The unit has the ability to serve two clients at once. When clients begin using the program, a computer database can keep track of whether they have brought needles back or if there are any other health issues that health workers need to be aware of.

When people come in to exchange needles, NKY Health professionals will ask how many times a day they use, in order to determine how many needles that receive, which can be up to 40 per visit.

If they are only using a couple of times a week, they are asked to take a lesser amount, but it is important that they get a sufficient supply to ensure they are not reusing needles.

The nurses will also check to see if they have had HIV testing in the past three months, if they have not, the one minute test is offered onsite.

Those who test positive can be connected with a case manager who can get them into a care program to improve their health and reduce the risk of the spread of infection.

There is also information about Hepatitis C, sexually transmitted diseases and counseling and the number for the 24-hour helpline is also provided.

Stephanie Vogel Director of Population Health for the Northern Kentucky Health Department said in addition to the exchange of needles, participants also receive sharps containers for used needles to be exchanged during the next visit.

There is a three-strikes-and-you’re-out rule, which results in disqualification from services for those who fail to return used needles, but workers are not going not going to ask how many are in the containers. Vogel said the reason they are sharing is that they don’t have access to the needles and that’s what continues to perpetuate that behavior and spread the infectious diseases.

“The goal is to stop the sharing of needles and if they are not able to continue in the program, they are going to continue to share needles,” Vogel said. “They realize when we tell them they have to bring the needles back or they are jeopardizing the program. They are much more willing to bring them back, because they get it.

The mobile unit will also offer Narcan, and instruction on how to use the product, which reverses the effect of an overdose.

Colvin said the implementation of the mobile syringe exchange access program is just the first step and the ultimate goal is still to implement a program inside the health centers.

“If the service was land-based where people were utilizing the facility for many, many issues, then obviously it’s a lot more anonymous,” Colvin said. “At least we know that people who are coming here are coming to get healthier, so I’m excited about that, but I won’t stop until we can get this land-based in every one of our counties.”

The mobile unit will be onsite at the Newport/Fort Thomas location on Tuesdays and the Covington location on Thursdays, from 1 p.m. to 4 p.m.

For more information on the syringe access exchange program, click here.

Contact Mark Hansel at mark.hansel@nkytrib.com

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