Lifting of ban on federal funding for needle-exchange programs has the potential to help Kentucky fight disease, but not yet

By Melissa Patrick
Kentucky Health News

U.S. Rep. Hal Rogers and Senate Majority Leader Mitch McConnell, Kentucky’s top Republicans in Congress, played a key role in lifting a longstanding ban on federal funding for needle-exchange programs in the budget deal enacted in December.

Rep. Hal Rogers, Sen. Mitch McConnell
(Getty Images photo by Win McNamee)

McConnell and Rogers said they acted to help thwart the spread of disease from increased intravenous drug use in Kentucky, but the change has had no immediate effect because no federal money in the state is allocated for needle exchanges.

“We don’t have a pot of federal money that we can re-direct to needle exchange programs,” said Scott Lockard, Clark County’s public health director and president of the Kentucky Health Departments Association.

Most departments’ “federal funding is tied to specific programs with specific guidelines and we don’t have the flexibility to reallocate any of that to needle exchange,” Lockard said. “On down the road it may be beneficial, but there is nothing immediate that is going to help health departments fund their programs.”

Kentucky’s needle-exchange programs are part of the anti-heroin bill the General Assembly passed in 2015. It is intended to prevent the spread of disease and steer drug users toward treatment. The law requires local government approval and funding, requirements that have discouraged needle exchanges. Fewer than 10 localities have them, and the Scott County Fiscal Court is the latest to delay action.

Kentucky suffers more than 1,000 drug overdose deaths each year and leads the nation in cases of hepatitis C. Dirty needles are also blamed for the spread of HIV, which leads to AIDS.

Rogers spokeswoman Danielle Smoot confirmed that there is no new federal money at this time to support needle exchange programs.

“What I understand is that the federal dollars that go through the state to the counties can be used for these programs,” Smoot said. “The whole purpose of this is that it just relieves the restrictions on the money.”

But it’s not that simple, because the federal dollars allocated for public health come with restrictions.

Deputy Health Commissioner Kraig Humbaugh reaffirmed what Lockard said, explaining that the state Department of Public Health applies for federal grant awards, but these grants are always earmarked for a specific purpose and there is little leeway on how the grants can be used.

However, Humbaugh said, “It has the potential, certainly, to help communities decide to operate a syringe exchange program. … We will keep our eyes open for potential opportunities for grant awards that might be out there … or it could be that opportunities may come up for direct funding for the local health departments.”

McConnell spokesman Robert Steurer said in an email that the intent of the law may help open up some federal dollars for needle exchanges. He said the U.S. Department of Health and Human Services “is developing guidelines to implement the flexibility provided in the omnibus language, and we have to wait for those guidelines before determining how Kentucky may benefit. The intent of the language makes clear that federal funds should flow to certain areas based on the approval of needle exchange programs at the state and local level, the rate or risk of an outbreak of Hep C and/or HIV, among other factors.”

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