Aliyya Swaby Photo
Myers-Lytell on the beat.
After 26 years of pioneering efforts to help intravenous drug users avoid contracting HIV/AIDS, New Haven government is getting out of the needle exchange business.
The city formally ceased its exchange program Sunday. As of Dec. 31, the city laid off the three remaining health department employees working on the program. Until the program closed, staffers parked a van in neighborhoods throughout the city and distributed between 1,200 to 1,600 clean syringes a week to users who brought in dirty needles to trade in, according to George Bucheli, one of the three laid-off workers.
Mayoral spokesman Laurence Grotheer confirmed the closing of the program. He said the city’s health department is handing off the program — and the state money that funds it —to the Yale School of Medicine, which will run it out of its existing community health care van.
Yale hasn’t formally signed on yet to do that. Discussions about a handover began only in mid-December, according to medical school Director of Clinical and Community Research Frederick L. Altice.
“We’re ready to take it over. They basically came to us and requested us to take over the contract. It was very last-minute; it was well into December,” Altice said.
Altice created the medical school’s health care van effort in 1993. The van, a 40-foot mobile medical clinic, makes an estimated 7,000 annual visits to low-income New Haven neighborhoods each year. Its bilingual staff offers “services in primary and HIV care, substance use disorders, mental health, and case management to stabilize those in crisis or in need,” according to the school’s website. Altice said the staff already distributes syringes; it will be able to add the needle exchange — swapping clean needles for dirty ones that users bring in — to the existing operation.
Grotheer said the city made the decision to hand off the program in anticipation of the DPH’s plan to overhaul its funding for supporting clean-needle programs by the end of this year. The state Department of Public Health (DPH) assured the city that this year’s money could be transferred to Yale, Grotheer said.
New Haven’s was the last city government in the state still running a program, Grotheer noted. Hartford and Bridgeport had previously transferred its programs to the AIDS Connecticut and Greater Bridgeport Adolescent Pregnancy organizations.
New Haven — first through community volunteers, then through government — experimented with one of the first needle exchange efforts to combat the AIDS epidemic in the late 1980s and early 1990s. A study on those local efforts by Yale School of Medicine researchers convinced other communities across the country, including New York, to adopt their own versions in order to save lives by preventing the spread of HIV through needles shared by drug users.
New Haven government’s official program began in 1990. Click here to read a story about the history and success of the city program.
The program was already winding down and encountering internal tensions throughout 2016, said Bucheli.
Bucheli at work in the van.
In July, longtime health department employee Ambritt Myers-Lytell filed a state Commission on Human Rights and Opportunities (CHRO) complaint charging that her supervisors were harassing her because she’s gay.
Meanwhile, “we were running out of supplies,” said Bucheli, who began handing out free needles in New Haven with ACT-UP activists in 1990 and joined the city government program in 1993. “We were running out of Narcan kits.” He said staff was told it could no longer hand out needles to people who came to the main Meadow Street health department offices. Bucheli said that some of the people who use the service come from outside New Haven; changing buses, they weren’t always able to make it in time to the neighborhood drop-off sessions. Bucheli said he was vocal about changes in the program and had conflict with his supervisors: “I was pissed. Someone out on medical leave; someone was on furlough. We were trapped in the office; we couldn’t’ serve people in the office. By protocol for safety reasons, needed two [staffers on the] van.” As a result, he said, the van wasn’t going out on the street as often as usual.
On Dec. 1, the health department’s director and a security guard escorted Bucheli out of the office. He was placed on administrative leave. He said he was told he had made threats against people and appeared to be suicidal or homicidal — all of which he denied. He said he has filed a CHRO complaint.
Yale’s Altice said that a needle exchange — through which users trade dirty needles for clean ones, rather than simply showing up to obtain needles — protects the public by ensuring that infected needles are removed from circulation. It also can help the users themselves be part of a solution, he said. “They become part of the collective process. There is a sense of ownership that happens with many clients in the field. They feel they are contributing to keeping the community safer.”
In the middle of an opiate epidemic, when there have been numerous heroin deaths... where is the PLANNING for the seamless transfer of services?! We need Narcan easily available right now!!!