For the first time, Ohio’s state operating budget includes a dedicated line item that will fund harm reduction, including syringe services programs (SSPs) across the state. This funding was proposed and then ushered through budget deliberations by Senators Dave Burke (R-Marysville) and Nickie Antonio (D-Lakewood). While many harm reduction initiatives, such as naloxone access and Good Samaritan laws, have been passed in the last several years in response to the opioid crisis, state general revenue dollars have never been dedicated to SSPs, until now.
Syringe services programs prevent the spread of HIV and hepatitis C by providing sterile equipment to people who inject drugs, as well as safe disposal for used injection supplies.
The national Harm Reduction Coalition describes harm reduction as “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.” Syringe services programs prevent the spread of HIV and hepatitis C by providing sterile equipment to people who inject drugs, as well as safe disposal for used injection supplies. The programs also frequently offer HIV and hepatitis C screening, wound care, fentanyl testing strips for overdose prevention and naloxone for overdose reversal and connections to other programs and services for clients. SSPs can connect clients who are ready to engage in treatment for substance use disorders to detox and be connected with residential treatment services, often more quickly than if someone is seeking treatment on his/her own.
Primarily in response to a growing crisis related to injection drug use of opioids, there are now 19 SSPs operating in 21 Ohio counties.
Primarily in response to a growing crisis related to injection drug use of opioids, there are now 19 SSPs operating in 21 Ohio counties. This is up from six programs operating in seven counties just three years ago. The state is experiencing an increase in HIV and Hepatitis C infection attributed to injection drug use and there are 11 counties in Ohio that the U.S. Centers for Disease Control and Prevention has identified as vulnerable to HIV and hepatitis C outbreaks. Only four of the state’s SSPs are located in the vulnerable counties.
Only four of the state’s SSPs are located in the vulnerable counties.
While the Ohio Department of Health (ODH) does direct some support for supplies to a few SSPs around the state that utilize federal HIV prevention and early intervention services funding, up until now, Ohio’s 19 SSPs have operated with private and local public dollars. Based on research Community Solutions released earlier this year, we know that every one of these programs has a degree of budget challenges, including some that are entirely run by volunteers, and all operate on limited schedules (ranging from a few days a month, one day a week, two days week etc.).
The new harm reduction line item (GRF ALI 440529, for the budget nerds out there) in the ODH budget will be funded at $50,000 per year in 2020 and 2021. Funding amounts of up to $15,000 per year can be distributed to local health departments that operate harm reduction programs, including SSPs. Any health department awarded the funding must be accredited or in the process of becoming accredited by the Public Health Accreditation Board. There is a requirement in state law that all local public health boards in Ohio become accredited by 2020.
Funding amounts of up to $15,000 per year can be distributed to local health departments that operate harm reduction programs, including SSPs.
It’s quite evident that awards of up to $15,000 will quickly consume the annual available amount of $50,000. What we know is that dollars are stretched thin at most SSPs around the state and any increased funding will be fully leveraged. This opportunity also allows the state’s SSPs to show how far these dollars can go to reduce incidence of infectious disease and increase access to other supportive services, which in turn supports efforts to increase future funding.
Will they only be allocated to existing SSPs or can they be used for start-up costs for areas that are in need of a program?
There are still some unknowns about how these dollars will be allocated. Will they only be allocated to existing SSPs or can they be used for start-up costs for areas that are in need of a program? Will any additional funding supplement the new line item? Is it possible to use these funds for innovative methods such as distribution via pharmacy or vending machine, as long as the health department still has oversight?
Community Solutions will provide updates as to how these dollars are spent throughout SFYs 2020-2021.
 Harm Reduction Coalition, https://harmreduction.org/about-us/principles-of-harm-reduction/
 130th General Assembly File No. 25, HB 59, §101.01, eff. 9/29/2013.