Public Safety Committee  — Charleston, WV
Date: 2021-02-24
Time: 17:30

10 CITY OF CHARLESTON
 West Virginia
 Council Member – 10th WARD

Keeley Steele Public Safety Committee, Chair
1600 Washington St. E Ordinance and Rules Committee
Charleston, WV 25311
Telephone: 304‐250‐9463
E‐mail: keeleysteele@gmail.com




TO: Public Safety Committee
FROM: Keeley Steele, Chair
RE: Committee Meeting


 There will be a Committee meeting of Public Safety on February 24, 2021 at 5:30 PM
 THE MEETING WILL BE AVALIABLE TO THE PUBLIC VIA VIDEO/CONFERENCE CALL

*Join via internet:
https://us02web.zoom.us/j/85884062439?pwd=L0dWbElPQm1DQitSbGprRFMzYVBVQT09
Passcode: 818251
*Join via Phone: 301‐715‐8592 or 312‐626‐6799
Webinar ID: 858 8406 2439

The agenda will be as follows:

Approval of Previous Minutes

 1. 2‐4‐2021

To Hear From Invited Panelists Concerning Bill No. 7893

 1. Attachments (if required)

Bills

 1. Bill No. 7893 ‐ A BILL to amend the Code of the City of Charleston relating to requiring any
 distribution of hypodermic needles within the City of Charleston to be performed by persons or
 entities that have a certification as a Harm Reduction Program from the State of West Virginia in
 addition to any required state license; eliminating the ability for the Chief of Police to provide
 exceptions, and establishing penalties for violations. REMOVED

Take Up First Responder Survey; Time permitting

 1. Attachments (if required)
Adjournment

*THE AGENDA WAS AMENDED 2‐22‐2021 to remove bill and add survey discussion




KS/ns

10 CITY OF CHARLESTON
 West Virginia
 Council Member – 10th WARD

Keeley Steele Public Safety Committee, Chair
1600 Washington St. E Ordinance and Rules Committee
Charleston, WV 25311
Telephone: 304‐250‐9463
E‐mail: keeleysteele@gmail.com




TO: Public Safety Committee
FROM: Keeley Steele, Chair
RE: Committee Meeting


 There will be a Committee meeting of Public Safety on February 24, 2021 at 5:30 PM
 THE MEETING WILL BE AVALIABLE TO THE PUBLIC VIA VIDEO/CONFERENCE CALL

*Join via internet:
https://us02web.zoom.us/j/85884062439?pwd=L0dWbElPQm1DQitSbGprRFMzYVBVQT09
Passcode: 818251
*Join via Phone: 301‐715‐8592 or 312‐626‐6799
Webinar ID: 858 8406 2439

The agenda will be as follows:

Approval of Previous Minutes

 1. 2‐4‐2021

To Hear From Invited Panelists Concerning Bill No. 7893

 1. Attachments (if required)

Bills

 1. Bill No. 7893 ‐ A BILL to amend the Code of the City of Charleston relating to requiring any
 distribution of hypodermic needles within the City of Charleston to be performed by persons or
 entities that have a certification as a Harm Reduction Program from the State of West Virginia in
 addition to any required state license; eliminating the ability for the Chief of Police to provide
 exceptions, and establishing penalties for violations. REMOVED

Take Up First Responder Survey; Time permitting

 1. Attachments (if required)



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Adjournment

*THE AGENDA WAS AMENDED 2‐22‐2021 to remove bill and add survey discussion




KS/ns




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 MINUTES
 PUBLIC SAFETY COMMITTEE MEETING

 5:30 P. M., FEBRUARY 4, 2021

*IN RESPONSE TO THE COVID-19 PANDEMIC, THE MEETING OF THE PUBLIC SAFETY COMMITTEE
WAS CONDUCTED ELECTRONICALLY. THE MEETING WAS MADE AVAILABLE TO THE PUBLIC AS A
LIVE STREAM VIA ZOOM (PER THE AGENDA).



Keeley Steele, Chairperson, called the meeting of the Charleston City Council
Committee on Public Safety to order at 5:30 p.m., FEBRUARY 4, 2021.

Committee Members Present:
Keeley Steele, Chair
Chuck Overstreet, Vice Chair
Pat Jones
Bruce King
Deanna McKinney
Shannon Snodgrass
Tiffany Wesley-Plear




 1. Approval of Previous Minutes –
Councilmember King moved to approve the minutes of the previous meeting on 1-14-
2021. Councilmember Overstreet seconded the motion. There was no objection and the
minutes were approved.




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 2. Resolution No. 419-21 – Requesting affirmation from the City Government that it
 will actively survey and obtain input from the full membership of the first
 responder community and sanitation workers before taking further action with
 regard to approving, creating, expanding or otherwise acting upon any syringe
 exchange or distribution programs, as well as requesting affirmation that the City
 Council shall be fully included in this survey process –
Councilmember Steele stated that the discussion is not about harm reduction or syringe
exchange. The Committee will be discussing the logistics of how the proposed survey
will be carried out within the Departments. She requested that the meeting to kept to an
hour, so 30 minutes will be spent discussing the resolution and 30 minutes will be spent
discussing how the 2-24-2021 meeting will be conducted. Councilmember Steele stated
that the intention of the resolution is pretty clear, but it had been brought to her attention
that it is missing a “Therefore be it resolved” clause. She asked City Attorney, Kevin
Baker to discuss this and any other possible changes for a Committee Substitute.

Baker added that the Committee could approve to change the document to the format of
a resolution as currently it reads more like a petition because it mentions “signatory
members.” If the resolution was adopted, it would be from the Council body not specific
members. He added that resolutions typically contain “Whereas” clauses that set the
purpose and a resolve clause that sets forth the action that the resolution is directing
take place.

Councilmember King, who submitted the resolution, asked for clarification as to what
should be in the resolve clause. His idea was to get with some IT people and send out a
survey via Survey Monkey via email of a list of about 10 questions to first responders,
Refuse workers and Public Grounds employees. Baker made some clarifications on the
language and added that he wasn’t sure if all of the Refuse and Public Grounds
employees had a City email. Councilmember King replied that they could work with IT
for a workaround.

Councilmember Steele added that if Public Grounds employees were to be included,
then Parking employees (parking garages) should also be included. She also wanted to
work out the timeline and logistics of the survey. She asked the Department Heads
present if an anonymous survey of employees had ever been done before to their
knowledge; if so, how was that done. Chief Hunt replied that the CPD has done
something similar when they vote for members of the Pension Board etc. They do paper
ballots in a physical drop box that is later counted, the timing is coordinated to
accommodate both shifts. He added that names are crossed off as they vote to prevent
multiple voting. Councilmember King replied that electronic surveys can be simple and
anonymous with near-instant results. He added that he thought the questions should be
kept simple, with Yes or No responses. Chief Hunt requested that the survey be kept
open for at least 4 days.

Councilmember Wesley-Plear added that, from her experience, many Refuse workers
did not have personal emails or City emails. She agreed that the survey should be




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simple. Director of Refuse, Jered Lanham, agreed that the vast majority do not have
private emails and paper surveys would work better. Councilmember Snodgrass stated
that they wanted the process to be short and simple, being concerned with Police, Fire,
Refuse and Public Grounds. She added that it is most important that it be anonymous
and that no one could see them filling out the survey. She added that her idea was to
have a City computer available at those locations. Director of Public Works, Brent
Webster, added that they are limited, but with the help of IT, they could probably
dedicate 1 or 2 computers. Councilmember Steele agreed that it would be best to keep
the survey in one format.

Councilmember Steele asked if the questions needed to be determined during the
meeting or at a later time. Baker replied that they could put the questions on the
resolution, but it wasn’t necessary. He read the proposed changes to the resolution thus
far. Councilmember Steele asked who would be responsible for creating the questions.
Baker replied that, as the current resolution was drafted, it would be in the hands of the
Mayor or City Manager to figure it out and execute it. Councilmember Snodgrass stated
that to be fair and make employees feel comfortable, the survey results should come
back to Public Safety Committee, but should not come from the Mayor’s Office.

Councilmember Snodgrass stated that the survey questions should come from the
Public Safety Committee. Councilmember Steele asked how that would happen (a
Committee meeting solely to create the survey etc.). Councilmember Snodgrass replied
that they could work on it after the resolution passes, either by a subcommittee or a full
meeting.

Councilmember Wesley-Plear suggested having the Departments submit questions to
be approved by the Committee so that they aren’t starting from scratch. Councilmember
McKinney agreed.

Councilmember King asked why they weren’t contacted about changing some of the
language in the resolution (the resolve clause, for example) before this meeting. Baker
replied that he did reach out to Councilmember King when the resolution was first
brought to his attention on the Friday before it was introduced. He had suggested that
they could work on the language so that it could be brought to Council and adopted at
the flowing meeting instead of referring it to Committee. He added that Councilmember
King was insistent that it was to be introduced as written at that time. Once referred to
Committee, it is in their hands to adjust the language via committee substitute.

Councilmember King requested that the Public Safety Committee create the survey and
administer it with the help of the IT Department. Councilmember Snodgrass agreed,
adding that they are making it harder than it needs to be. She stated that she thought
the resolution was clear as it stands.

Councilmember Jones asked if the survey could be ready before Council approved the
resolution. Councilmember Snodgrass clarified that the resolution needed to be passed
by the Committee and passed by Council before the survey could be administered.




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Councilmember Overstreet suggested to make the changes proposed by the City
Attorney with the Committee making the questions. Baker read the updated changes.
Councilmember Steele clarified with Baker that the resolution as currently written would
place the responsibility of executing the survey on the Administration as directed by the
Mayor or City Manager. Councilmember Snodgrass again expressed concern that
employees wouldn’t feel comfortable if the survey came directly from the Administration.
She clarified with Baker that he recommended the “signatory” line be changed to reflect
that a resolution is a statement from the whole Council body, not just the sponsors of it.
Otherwise, it reads more like a petition to him.

Councilmember Wesley-Plear suggested that the resolution be written so that the
survey has to be approved by the Public Safety Committee. Councilmember Snodgrass
stated that there is an ex-fire chief on the Committee and they could reach out to those
Department Heads themselves to create questions that would universally apply to all
employees. Councilmember Wesley-Plear cautioned that the questions would need to
be carefully worded so as to not skew the results.

Councilmember Jones suggested to add to the resolution that SOAR should stop their
needle exchange program until they are able to consider the matter. Councilmember
Wesley-Plear stated that they couldn’t name a specific organization. Councilmember
Jones suggested that needle exchanges be stopped unless they are WV State certified
programs. Baker replied that they could put whatever they would like into the resolution,
but it wouldn’t be an enforceable ordinance. They could only request it.

Councilmember McKinney stated that they needed to remember to be respectful. They
do not want to make decisions without including the right people. They should also not
be considering questions without including the appropriate Department Heads.
Additionally, 10 is probably too many questions.

Councilmember King stated that he would like to see a statement in the resolution
asking SOAR to halt their needle exchange program. Baker summarized the current
changes to the resolution per the discussion. Councilmember Snodgrass agreed to the
needle exchange program restriction. Councilmember Steele added that she thought
that would bog down the discussion for the actual bill. Councilmember Overstreet
agreed, and suggested adding in the resolutions that Department Heads would be
consulted. Councilmember McKinney agreed. Councilmember Wesley-Plear agreed
that a particular organization did not need to be named. While she was fine with adding
the previously mentioned clause, she though it would hold up the survey process.

Councilmember King motioned to amend the resolution to add “We would request any
organization currently operating a needle exchange without State certification to
suspend such distribution until such time that Council takes action on pending
legislation.” Councilmember Jones seconded.




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Yeas: Jones, King, Overstreet, Snodgrass
Nays: McKinney, Steele, Wesley-Plear

With the yeas being in the majority, the Amendment was approved.


Baker then read the resolution in its entirety. Councilmember Snodgrass asked for the
last section to be read again.

From the audience, Councilmember Faegre added that there have been a lot of
contradicting statements. She added that it was very intimidating when, several years
ago, many police and fire workers lined Council Chambers opposed to needle
distribution. She added that it was very clear how they felt.

From the audience, Councilmember Pharr added that the conversation around the
resolution had changed since she first saw it, adding that the intent was to gather
information and to speak and listen. It is embarrassing that Councilmembers are
speaking over one another to the point where she doesn’t even know what they are
discussing. They also need to hear from the organizations. She did not agree with the
amendment, and asked if she could have her name removed as a sponsor. She added
that it was disrespectful to be constantly telling someone that they are out of order or
talking over other people. Nikki Smith, from the Clerk’s Office, added that her name
could be removed, and asked that she submit her request via email.

From the audience, Councilmember Knauff asked who from Public Works would be
answering the survey as he was under the impression that it would be Refuse and
Public Grounds. Webster replied that he only spoke to inform the Committee that the
Department was email challenged and to help ensure the process was as easy as
possible for the workers. Councilmember Knauff asked Baker to read the last section
again. Baker clarified that Public Works was included in the language instead of listing
the various departments (refuse, streets, etc.) as they all fall under Public Works.

Councilmember King added that the only thing the resolution does is ask to survey
employees of the City. He agreed that all Members have the responsibility to learn
about the topic. He encouraged members to also visit Heath Right.

Councilmember King motioned to approve the resolution. Councilmember Overstreet
seconded. With the yeas being in the majority, Resolution No. 419-21 Committee
Substitute was approved.



 3. Discussion on how to conduct the meeting on 2/24/2021 in order to take up Bill
 No. 7893
Councilmember Steele asked if the Committee wanted to possibly meet in person for
their next meeting. The majority of the Committee seemed to be in favor with meeting in




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person. Councilmember Wesley-Plear asked how many members of the public would
be able to attend. Councilmember Steele said they will be in a better position to
determine that after the first in-person Council meeting on 2-16-2021. Smith clarified
that if an in-person meeting was to be open to the public, there could not really be a
limit. However, the Committee could meet in person, but allow access to the public via
Zoom or some other live streaming method. Councilmember Steele confirmed they
could decide after the first in person Council meeting. Smith added that the Committee
could potentially meet in Council Chambers, but the number of people present would be
limited. Snodgrass thanked those listening to the meeting. From the audience,
Councilmember Faegre stated that the Ordinance and Rules Committee had meet in
Council Chambers in the past, adding that the room was packed and Committee
meetings were not public hearings. From the audience, Councilmember Knauff asked
what the difference would be between having the meeting at the Convention Center
versus Council Chambers. Smith replied that because of the current socially distanced
guidelines, Council Chambers would only be viable if only the members and a few
invited panelists were present, whereas a completely open in person meeting would
only be possible at the Convention Center.



 4. Discussion on invites to next SOAR event and invites to a "Town Hall" with
 WVDII
Councilmember Steele stated that the West Virginia Drug Intervention Institute had
invited all Councilmembers to their Town Hall meeting, as well as SOAR’s event that
upcoming Saturday. Regardless of their opinions, as public officials they should do their
jobs with integrity by having all the information.




Councilmember Snodgrass motioned to adjourn. Councilmember Jones seconded.
Meeting adjourned




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Committee Substitute for Resolution No. 419-21 - WHEREUPON, the herein
signatory members of the City Council of Charleston, WV are presented with an issue of
ongoing public concern - the distribution and/or exchange of hypodermic syringes for
the purpose of intravenous drug use. These members note City Council notes that the
City’s first responder community, namely police and fire, have not been fully informed of
the status of this issue that impacts their daily work lives. Likewise, other City
employees directly impacted by this issue, such as sanitation and refuse workers,
likewise do not appear to have been fully apprised of the status of this current debate.

 WHEREAS, these signatory Council membersCity Council further notes that
input and cooperation of first responders is considered so critical on this issue that it
was recently cited by the West Virginia Department of Health and Human Resources as
a factor when it considered and rejected the application of a proposed syringe
distribution program within Charleston City limits. These membersCity Council agrees
and believes the additional input of sanitation workers is necessary for good
governance, employee morale and community safety.

 WHEREAS, these signatory members of the Charleston, WV City Council
request affirmation from our City Government that it Public Safety Committee will
actively survey and obtain input from the full membership of our first responder
community and the full membership of our sanitation Public Works workers before
taking further action with regard to approving, creating, expanding or otherwise acting
upon any syringe exchange or distribution programs. We request affirmation from our
City Government that tThe City Council of Charleston, WV shall be fully included in this
survey process, which may be conducted anonymously or in any other way deemed
appropriate for the protection of City workers. This Resolution in no way prohibits any
City Department from enforcing existing laws that revolve around this issue.

 WHEREAS, these signatory members of the Charleston, WV City Council
recognizes the crucial role of our first responders and sanitation Public Works workers
on this issue. We value and seek their expertise and opinions. These signatory
members of the Charleston, WV City Council ask the City Council of Charleston, WV to
adopt this Resolution at the next regularly scheduled meeting of Council and to take any
such further action necessary to effectuate its spirit and purpose.

Now, therefore, be it resolved by the Council of the City of Charleston, West
Virginia:

That the Public Safety Committee is hereby directed to create a survey regarding
opinions about the distribution and/or exchange of hypodermic syringes in order to
obtain anonymous City employee responses; and to work with the Charleston Police
Department Chief, the Charleston Fire Department Chief, and the Director of Public
Works to distribute the survey to the employees of these departments.

And that we request any organization currently operating a needle distribution without
state certification to suspend such distribution until the City Council takes action on the




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pending legislation.




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 4000




No. of HIV Diagnoses among PWID
 3500 3340

 3000 2863
 2586
 2500 2347 2248 2326 2195 2329

 2000
 1500
 Lifetime cost to
 1000 treat HIV infection
 500 $510,000*
 0
 2010 2011 2012 2013 2014 2015 2016 2017
 Year of HIV diagnosis




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 Seattle, WA N. Kentucky & Hamilton County, OH Lawrence and Lowell, MA
 2018 2018
 2017 - 2018
 31 cases (PWID) 159 cases
 157 cases
 21 cases (MSM who inject drugs)




Portland, OR
  2018 - 2019
 42 cases

 Philadelphia, PA
 2018
 71 cases
 Scott County, IN
 2014 - 2015
 215 cases




 Cabell County, WV
 2018 - 2019
 82 cases




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20x 150x




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 West Virginia Drug Intervention Institute, Inc.
 Community Perceptions of Harm Reduction Efforts
 February 22, 2021

West Virginia has the highest fatal drug overdose rates in the nation.1 Reports
nationwide suggest a significant increase in both fatal and non-fatal overdoses since the
beginning of the COVID pandemic in early 2020.2 Data from the West Virginia Office of
Drug Control Policy indicate that since the pandemic, the number of fatal and non-fatal
overdoses has significantly increased in many counties.




In addition to overdose, one of the most concerning outcomes of intravenous drug use
is disease. For example, an increased use of injected drugs leads to increased HIV
rates. As reported by the West Virginia Office of Epidemiology and Prevention

1
  Centers for Disease Control. 2018 Drug Overdose Death Rates.
https://www.cdc.gov/drugoverdose/data/statedeaths/drug-overdose-death-2018.html. Last reviewed
March 10, 2020.
2
  Centers for Disease Control. Overdose Deaths Accelerating During COVID-19.
https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html. Last reviewed
December 18, 2020.


 1

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Services, between 2013 and 2017, “the expected number of cases in Kanawha County
per year is 14 with less than five cases associated with injection drug use.”3 However, a
“[s]ignificant increase in new HIV diagnosis began in 2019[,] driven by cases associated
with injection drug use (IUD).”4 While the total number of HIV diagnoses in the State as
a whole has decreased from 2019 to 2020, cases in Kanawha County have increased.
The West Virginia Office of Epidemiology and Prevention Services reported that since
the beginning of 2019, Kanawha County has had 51 newly diagnosed cases of HIV
associated with injection drug use.5 Additionally, the CDC reported that Kanawha
County had 35 diagnosed cases of HIV in 2020, which is only one case less than the
number of cases recorded in New York City, NY - an area with a population of over 8
million people - in 2019.6 Over 80% of HIV cases recorded in Kanawha County in 2020
report injection drug use. The total cost of lifetime HIV medical treatment in Kanawha
County for those 51 individuals newly diagnosed with HIV since 2019 is $26,010,000.7,8




3
  West Virginia Department of Health & Human Resources Bureau for Public Health, Epidemiology of HIV
in Kanawha County Power Point. Presented on February 11, 2021.
4
  West Virginia Department of Health & Human Resources Bureau for Public Health, Epidemiology of HIV
in Kanawha County Power Point. Presented on February 11, 2021.
5
 West Virginia Department of Health & Human Resources Bureau for Public Health, Epidemiology of HIV
in Kanawha County Power Point. Presented on February 11, 2021.
6
 Centers for Disease Control. Responding to HIV outbreaks among people who inject drugs Power Point.
Presented on February 11, 2021.
7
  Bingham A, Shrestha RK, Khurana N, Jacobson E, Farnham PG. Estimated Lifetime HIV-related
Medical Costs in the United States. Sex Transm. Dis. 2021 Jan 23. Doi:
10.1097/OLQ.0000000000001366. Online ahead of print. Adjusted to 2020 dollars.
8
  https://wvpolicy.org/the-high-cost-of-losing-harm-reduction-in-kanawha-county/


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HIV is not the only concern. According to the US Centers for Disease Control (CDC), 28
of West Virginia’ 55 counties (including Kanawha) are at risk for a Hepatitis C (HCV)
outbreak, largely because of intravenous drug use. Hepatitis C is the No. 1 infectious-
disease killer in the country. In West Virginia, rates of acute Hepatitis B increased 220
percent over seven years — 14 times the national average. In Kanawha County alone,
there was a 322 percent increase in Hepatitis B cases from 2012 to 2015. In 2016,
Kanawha County had the highest number of newly reported cases for both acute
Hepatitis B Infection and acute Hepatitis C Infection. 9

One way to prevent the spread of infectious disease and decrease overdose deaths is
through the implementation and operation of harm reduction programs. As defined by
the CDC, harm reduction is any behavior or strategy that helps reduce risk of harm to
self or others.10 Harm reduction in relationship to substance use disorder (SUD) often
refers to naloxone distribution, sexually transmitted disease testing and treatment,
contraceptives, access to SUD recovery and treatment, and syringe exchange.
Currently, the West Virginia Department of Health and Human Resources (DHHR)
recognizes 18 harm reduction programs throughout the State.11 All of these programs
include some type of syringe service program--more commonly called “needle
exchange.”

Best practices suggest that harm reduction programs include syringe service programs
(SSPs) that provide a wide range of services including linkage to primary care, SUD
treatment, vaccination, and testing as well as needle exchange.12 Some programs
require a 1:1 exchange (clients must return one needle for each needle dispensed).
However, the CDC recommends a needs-based approach that does not limit the
number of needles dispensed versus returned.13

The CDC reports that SSPs result in an estimated 50% reduction in HIV and HCV
incidence.14 And, when combined with medications that treat opioid dependence (also

9
  https://oeps.wv.gov/hepatitis/documents/data/Summary_2016_Acute_HBV-HCV.pdf
10
  Centers for Disease Control. What is Harm Reduction? https://www.cdc.gov/hiv/pdf/effective-
interventions/treat/steps-to-care/my-stc/cdc-hiv-stc-what-is-harm-reduction.pdf.
11
 West Virginia Department of Health & Human Resources Office of Epidemiology & Prevention
Services. WV Programs At a Glance. https://oeps.wv.gov/harm_reduction/documents/about/wv_hrp.pdf.
12
 Centers for Disease Control. Syringe Services Programs. https://www.cdc.gov/ssp/docs/SSP-
Technical-Package.pdf?fbclid=IwAR0RxYold2P24jIHDqRI6yP2tSqeitkeTDDj5lVv2xDmIMFSHHEVrwO1-
aA.
13
 Centers for Disease Control. Syringe Services Programs. https://www.cdc.gov/ssp/docs/SSP-
Technical-Package.pdf?fbclid=IwAR0RxYold2P24jIHDqRI6yP2tSqeitkeTDDj5lVv2xDmIMFSHHEVrwO1-
aA.
14
 Centers for Disease Control. Syringe Service Programs (SSPs) Fact Sheet.
https://www.cdc.gov/ssp/syringe-services-programs-factsheet.html.


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known as medication-assisted treatment), HCV and HIV transmission is reduced by
over two-thirds. These programs also serve as a bridge to other health services,
including HCV and HIV testing and treatment and medication-assisted treatment for
opioid use disorder.15 In addition, the majority of SSPs offer referrals to medication-
assisted treatment, and new users of SSPs are five times more likely to enter drug
treatment and three times more likely to stop using drugs than those who don’t use the
programs.16

Despite documented outcomes and identification of best practices, SSPs are often
controversial due to lack of community support, stigma surrounding SUD, and concerns
about public safety. Some communities are able to overcome these barriers while
others are unable to move forward.

WV DII Initiative
The Kanawha-Charleston area has been embroiled in debate regarding harm reduction
and SSPs over the last three to four years. In response to community interest for
additional conversation on this topic, the WV DII undertook an initiative to:
 ● Provide interested community citizens an opportunity to express their views on
 harm reduction;
 ● Consider those views in the light of national and state scientific research and
 evidence based practices;
 ● Provide WV DII’s harm reduction recommendations for moving forward; and
 ● Share these findings with City and County decision makers.

This report is focused on findings from the Kanawha-Charleston Area. Statewide data is
offered as a comparison.

During January 2021, the West Virginia Drug Intervention Institute, Inc. (WV DII)
conducted an analysis of community opinions on SUD, harm reduction and syringe
exchange. The project did not assess or evaluate any specific program, but examined
community perceptions and attitudes and determined gaps that exist in addressing SUD
(specifically in Kanawha County).




15
 Centers for Disease Control. Syringe Service Programs (SSPs) Fact Sheet.
https://www.cdc.gov/ssp/syringe-services-programs-factsheet.html.
16
 Centers for Disease Control. Syringe Service Programs (SSPs) Fact Sheet.
https://www.cdc.gov/ssp/syringe-services-programs-factsheet.html.


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Survey Methodology
The WV DII developed and released an anonymous, online, short survey available on
the WV DII website (www.wvdii.org/harmreduction). The community was invited to
participate through Facebook promotions (boosted posts on the WV DII Facebook
page), two news stories that aired locally (via WOWK and WCHS) and an Op-Ed piece
published in the Charleston-Gazette Mail. The survey was open to the public from
January 8 through 22, 2021. In addition to three demographic inquiries (age, sex and
zip code), the survey included the following questions:

 ● Have you or a loved one been impacted by intravenous (injection) drug use? Y/N
 ● Do you believe there should be needle exchange programs in your community?
 Y/N
 ● What programs are you aware of in your community that assist people who inject
 drugs? Short Answer
 ● Do you feel your community has adequate resources for persons suffering from
 addiction and intravenous drug use? Why or why not? Short Answer
 ● What are the dangers or harms needle exchange programs pose to the
 community? Short Answer
 ● What do you feel are benefits of needle exchange? Short Answer
 ● Would you be willing to contribute more to this conversation with a follow up
 phone call or by participating in a focus group? Y/N
 ● If yes, please share:
 1. Name
 2. Occupation
 3. Phone Number
 4. City and County of Residence

Questions for both the survey and the listening sessions were created following a meta-
analysis of research on community responses to harm reduction. Survey data were
collected through the online survey development software, SurveyMonkey, and
ultimately exported to Excel.

Individuals wanting to participate in additional discussion (listening sessions or focus
groups in late January) identified themselves at the end of the survey and shared
contact information. Survey participants remained anonymous unless they chose to
provide contact information at the end of the survey. The individuals who provided
contact information were then filtered based on location.




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The first three items on the survey, as noted above, collected demographic information
on age group, sex, and zip code. The information from these items was sorted in Excel,
counting the number of times each response was present.

Following the demographic items, two “yes” or “no” questions were posed. The first
yes-no question asked: Have you or a loved one been impacted by intravenous
(injection) drug use? The second yes-no question asked: Do you believe there should
be needle exchange programs in your community? The results of these questions were
analyzed by counting the number of “yes” responses and the number of “no” responses.
Results were further filtered by county based on the zip code provided by the
respondent.

The next four questions on the survey were open-ended short-answer. Each short
answer was analyzed individually by first reading through each answer as a whole.
After reading through all respondent answers, general categories were determined, and
each answer was filed into a general category. In some cases a response was deemed
to fit into multiple categories and was recorded as such.

Three, one-hour listening sessions were held in late January with a subset of survey
participants. Listening sessions were facilitated by WV DII staff and the conversation
was guided using the protocol outline in Appendix C. Due to the COVID-19 pandemic
and to ensure the health and safety of all participants, the listening sessions were held
via Zoom.

On January 10, 2021, the WV DII was informed that the Virginia Harm Reduction
Coalition (VHRC) posted the survey to social media asking persons outside the State to
complete the survey using Charleston zip codes. The WV DII President contacted the
VHRC and asked them to cease and desist this action because it could threaten the
integrity of the data. The VHRC complied and removed their post.
On January 11, 2020, a clause was added to the survey stating that it was for West
Virginia participants only. Before analyzing the data, additional steps were taken to
ensure the integrity of the data collected. The WV DII team conducted a thorough
examination of IP addresses and removed any of those addresses not associated with
West Virginia. Surveys from non-WV IP addresses were removed and not included in
the data analysis. WV DII also verified zip codes of those completing the survey.

Listening Session Methodology
There were 70 total individuals identifying from Charleston, West Virginia, who provided
contact information. One individual did not provide a telephone number. One individual



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did not provide a name. One individual did not live in Charleston, West Virginia.
Consequently, 67 Charlestonians were recorded. The Charleston individuals were
separated into two groups based on each respondent's answer to the survey question:
Do you believe there should be needle exchange programs in your community? All
respondents answering “yes” were placed into one category, and all respondents
answering “no” were placed into another. The “no” group had 12 individuals, however,
at least one individual out of those 12 provided an incorrect phone number. The “yes”
group had 55 total individuals.

Individuals in the “yes” and “no” categories were sorted based on recorded age group.
Starting with the “no” category, a member from each age group was called and offered
the chance to join a listening session. The same was repeated for the “yes” category.
Voicemails were left for those who did not answer with information on why the individual
was being called and contact information on how to return the call. Those individuals in
the “yes” category were more responsive in returning WV DII calls and signing up to
participate in a listening session.

Three time slots were selected on three separate dates in late January. The time slots
included a lunch time slot as well as two evening slots. Individuals were given their
preferred time slot and date, so long as the listening session group did not exceed six
persons. Ultimately, each listening session consisted of four persons. Out of 12 total
participants, two were staunchly against harm reduction, two described themselves as
“on the fence,” and the remaining eight supported some type of harm reduction or
needle exchange.

Results
In an effort to validate and triangulate data, results have been placed in three
categories:
 1. Summative Survey Data which includes all surveys completed statewide.
 2. Summative Survey Data which includes all surveys completed by Kanawha
 County residents.
 3. Summative Analysis and Reporting of the listening sessions.

In total, 422 survey responses were collected. Five responses indicated ineligible zip
codes. Accordingly, 417 responses were examined.

Responses by West Virginia County
Within the 417 responses, 38 West Virginia Counties are represented, including 80
unique West Virginia cities. Kanawha County had the highest number of responses,



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totaling 267. Over 100 zip codes are represented in the survey results including 16
unique (mailing) zip codes from Charleston, West Virginia. Zip codes responding are
highlighted in the map below. The zip code with the highest number of responses was
25314.




Responses by Sex
Just over 70% of survey respondents recorded their sex as female. Males comprised
28.54% of the survey responses, and less than .5% of respondents recorded “Other” as
their sex.



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Responses by Age
There were 112 responses that indicated an age range of 40-49. That age range
represents the highest number of respondents. A close second, 104 responses
indicated an age range of 30-39.




Responses to Yes-No Questions
When asked, “Have you or a loved one been impacted by intravenous (injection)
drug use?” the majority of respondents (238 total; 57% of all survey respondents)
indicated yes. Specifically looking at Kanawha County, West Virginia, the majority of


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survey respondents indicated that they had been impacted by intravenous (injection)
drug use, with 170 respondents (out of 267 total Kanawha County respondents)
selecting yes.



 HAVE YOU OR A LOVED ONE BEEN IMPACTED BY
 INTRAVENOUS (INJECTION) DRUG USE?




When asked, “Do you believe there should be needle exchange programs in your
community?” the majority of respondents (256 total or 61% of all survey respondents)
indicated yes. Specifically looking at Kanawha County, West Virginia, the majority of
survey respondents indicated that they believed there should be a needle exchange
program in their community, with 153 respondents (out of 267 total Kanawha County
respondents) selecting yes.

 DO YOU BELIEVE THERE SHOULD BE NEEDLE EXCHANGE
 PROGRAMS IN YOUR COMMUNITY?




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Responses to Open-Ended Questions
The first open-ended survey question asked respondents, “What programs are you
aware of in your community that assist people who inject drugs?” Respondents
offered 700 total mentions which were filtered into smaller categories. Across the state,
respondents reported 105 programs (some of these were very general, such as
“DHHR,” or “WV DII”). The top four responses were as follows:

 ● SOAR - 102 mentions
 ● NONE - 94 mentions
 ● Health Right Facilities - 93 mentions
 ● Health Departments (Statewide) - 41 mentions

Specifically in Kanawha County, West Virginia, the top four responses were as follows:
  ● SOAR - 101 mentions
  ● Health Right - 87 mentions
  ● NONE - 39 mentions
  ● Treatment Centers (Generally) - 23 mentions




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The second open-ended survey question asked respondents, “Do you feel your
community has adequate resources for persons suffering from addiction and
intravenous drug use? Why or why not?” Overall, 68% of all respondents did not feel
their community had adequate resources for persons suffering from addiction and
intravenous drug use, while 21% of all respondents did feel adequate resources existed.
In Kanawha County specifically, 68% of respondents did not feel their community had
adequate resources for persons suffering from addiction and intravenous drug use,
while 23% of respondents did feel adequate resources existed.



DO YOU FEEL YOUR COMMUNITY HAS ADEQUATE RESOURCES FOR PERSONS SUFFERING
 FROM ADDICTION AND INTRAVENOUS DRUG USE?
 WHY OR WHY NOT?




As noted in the survey question, respondents were asked to elaborate on their answer
by discussing “why” or “why not.” For all participants who responded “No,” the top six
answers were as follows:
 ● No, more programs, resources, and facilities are needed - 159 mentions
 ● No (no further explanation offered) - 72 mentions
 ● No, stigma plays a large role - 29 mentions
 ● No, more community, county, and state engagement is needed - 19 mentions
 ● No, SSPs lack finances and funding support - 15 mentions
 ● No, the rural setting makes it hard - 15 mentions

Specifically in Kanawha County, the top seven “No” responses were as follows:
  ● No, more programs, resources, and facilities are needed - 112 mentions
  ● No (no further explanation offered) - 42 mentions
  ● No, more community, county, and state engagement is needed - 15 mentions


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 ● No, stigma plays a large role - 15 mentions
 ● No, there is a lack of understanding regarding addiction - 10 mentions
 ● No, mental health needs to be addressed - 10 mentions
 ● No, SSPs lack finances and funding support- 8 mentions

The top five “Yes” responses from all respondents were as follows:
 ● Yes, there are treatment options available - 39 mentions
 ● Yes (no further explanation offered) - 39 mentions
 ● Yes, there are resources available to those who want the help - 17 mentions
 ● Yes, but we need more tailored resources - 10 mentions
 ● Yes, the current programs are enabling - 3 mentions

Specifically in Kanawha County, West Virginia, the top five “Yes” responses were as
follows:
 ● Yes (no further explanation offered) - 39 mentions
 ● Yes, there are treatment options available - 39 mentions
 ● Yes, there are resources available to those who want the help - 17 mentions
 ● Yes, but we need more tailored resources - 10 mentions
 ● Yes, the current programs are enabling - 3 mentions

The third open-ended survey question asked respondents, “What are the dangers or
harms needle exchange programs pose to the community?” The total top four
responses were as follows:
 ● Public Safety (including disregarded needles, waste, and general public
 concerns) - 240 mentions
 ● None - 117 mentions
 ● Increase in Crime and Persons Who Use Drugs - 117 mentions
 ● Enabling and/or Encouraging Persons Who Use Drugs to Continue - 70 mentions

Specifically in Kanawha County, West Virginia, the top four responses were as follows:
  ● Public Safety (including disregarded needles, waste, and general public
 concerns) - 201 mentions
  ● None - 61 mentions
  ● Increase in Crime and Persons Who Use Drugs - 78 mentions
  ● Enabling and/or Encouraging Persons Who Use Drugs to Continue - 40 mentions




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The fourth and last open-ended survey question asked respondents, “What do you
feel are benefits of needle exchange?” The top four responses total were as follows:
 ● Overall Harm Reduction and Decrease in Disease Transmission - 418 mentions
 ● None - 77 mentions
 ● Fewer Discarded Needles / Safe Places to Dispose of Needles - 47 mentions
 ● Lets People Know They Matter / Reduces Stigma - 32 mentions

Specifically in Kanawha County, West Virginia, the top four responses were as follows:
  ● Overall Harm Reduction and Decrease in Disease Transmission - 256 mentions
  ● None - 59 mentions
  ● Fewer Discarded Needles / Safe Places to Dispose of Needles - 23 mentions
  ● Lets People Know They Matter / Reduces Stigma - 18 mentions




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Listening Sessions
Listening sessions are one way for researchers to directly engage with survey
respondents to dig deeper into thoughts and opinions on a particular topic. Typically
listening sessions are small in size to encourage deeper conversation about a topic.
The listening sessions WV DII conducted in January 2021 included four participants per
session (three sessions) for a total of 12 participants. The primary purpose of these
sessions was to find people’s opinions beyond the survey data. The number of
participants in the listening sessions represents 3% of all survey participants. This
number is not overwhelming, but the results do provide a snapshot of community
perceptions and attitudes.

The listening session conversations were guided by six (6) questions. Each participant
was given the opportunity to respond to each of the questions posed. However,



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participants were permitted to “pass” on commenting for any reason (with no
requirement for an explanation). The questions were as follows:

 1. Harm reduction has been in the news lately. With this in mind, what are your
 expectations or hopes for tonight’s discussion?
 2. On a scale of 1 to 5 how important is it for communities to provide HR services (1
 not important at all; 5 imperative)?
 3. What is your number one concern regarding the presence of a syringe service or
 harm reduction program in Kanawha County?
 4. Are there ways to address those concerns through ordinances, programs,
 outreach?
 5. What kind of group or entity do you feel should take the lead role in addressing
 services for persons who inject drugs?
 6. Is there anything else you’d like to contribute to this conversation?

In regard to question one, every participant indicated that they chose to participate in
the listening sessions to learn more about harm reduction and share their perspective
and experiences. In regard to question two, every participant rated harm reduction
services as imperative (“5”). This was the case even if participants disagreed with how
harm reduction was currently operating in the Kanawha-Charleston area.

The third question regarding concerns about harm reduction elicited more discussion.
The most common concerns or themes that emerged from this conversation were:
needle litter, stigma, and enabling. In some cases, participants indicated they did not
personally have concerns, but they were aware of those expressed within the
Charleston community specifically.

Moderators followed up with the fourth question asking how these concerns should be
addressed.
 ● The majority of participants indicated that there must be a mechanism for needle
 disposal in public locations. There was also mention of needle resistant gloves
 for first responders and sanitation workers.
 ● The majority of participants indicated a need for education about harm reduction
 as well as proper needle disposal.
 ● Most participants indicated that ordinances should not preclude organizations
 from operating harm reduction or distributing syringes needed to prevent
 disease.




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 ● Participants discussed 1:1 exchange versus a more low-barrier program where
 there was no requirement for harm reduction participants to return needles.
 There was no consensus on this matter in regard to what is most appropriate.
 ● Almost all participants suggested that these programs should follow national
 (CDC) and state guidelines for optimal effectiveness.

“I agree with X, I think an ordinance would be great – if anything the city could do to get
behind, and support. For the city to say oh this isn’t our problem. Any size of department
that is dedicated to what’s going on – it seems like it’s always the police. There was an
overdose in Davis Park during Festivall and all of these police were diverted there and I
thought it was ridiculous that it was a huge Charleston event and no one from the city
was attempting to hand out and reach out to people struggling during that. Bare
minimum, City to say hey this is really important, look at these numbers, we have to
keep people safe. If the City just takes a stance then I feel like the citizens fall in line,”
said one participant.

“Studies show that needle exchanges actually reduce syringe litter – I think for me,
when we get around a heated topic and thinking: ‘I’m 100% correct and that’s the
attitude I carry with me and so no one learns from me.’ I have to keep reminding myself
that I need to be teachable. I need to look for the opportunity to teach and learn. If
someone found syringe litter – that’s real! So where’s the solution for that? I think
education – finding out where those gaps are and how to fill them without sacrificing
humans. I’m not willing to sacrifice my neighbor for syringe litter. What I am willing to do
is clean them up and educate. All of us are teachable. Education and meeting the
misinformation and being aware of the very real fears,” said another participant.

Question five asked participants to indicate what entities and organizations should be
responsible for harm reduction and addressing intravenous drug use in the community.
Answers varied. However, two very consistent themes emerged. First, participants
believed that no one organization can “own” harm reduction. The second was the need
for public-private partnerships.

“We have Health Right, and we have SOAR,” said one participant (a school counselor).
She went on to explain: “Even with those two organizations--one high barrier [requiring
1:1 exchange] and one low barrier, we still don’t have enough help for those struggling
with addiction.”

“We need everyone working together and less infighting,” said another, an executive
director of a non-profit



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“This should not be a political issue. It’s a public health issue and all hands should be on
deck.” said one participant, a health care provider.

“You won’t hear me say that my concerns are needle litter. I will say that we have two
harm reduction organizations/programs that are happening in Charleston and how those
could get better (and how other programs could get better) would be by working
together and collaborating. I think that would be beneficial. There’s an unfillable hole
here.” said one participant.

“Mental health needs to be involved in a large capacity. I think that if you want to talk
about agency, the obvious choice would be the county health departments but I think
that mental health professionals need to be involved in that – from personal experience,
you’re self-medicating traumas with drugs, so in order for anyone to conquer that
addiction there has to be someone there to address whatever pushed them there in the
first place that then turned that into an addiction issue,” said another participate and
business person.

“I don’t think the criminal justice system should be how they’re involved. I agree that
there should be better avenues for treatment over punishment – esp. engaging in the
mental health aspect. I don’t think that forcing someone into rehab is not going to be
effective and I think that’s what the criminal justice system does. I think that pushing
resources through the criminal justice system is helpful,” said another participant and
community health worker.

“I’m not sure we’re in a position for anyone to take a leading role in that. We have
limited resources – SOAR can’t take a leading role and there’s so many political aspects
– we see it work with local health departments and also with non-profits. I’m not sure
there should be a leading role – I think there should be a collaborative approach and
working together,” explained another participant, a community volunteer.




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Listening Session Themes
 Concerns (Question 3) Addressing Concerns Who should take the
 (Question 4) lead? (Question 5)

 Needle Litter Safe Needle Disposal Kanawha Charleston
 Boxes (and availability of Health Department
 needle resistant gloves)

 Enabling Drug Use Education Regarding Public/Private Partnerships
 Stigma and Harm and Collaborations
 Reduction

 Stigma/Lack of Education on safe needle Health Right
 Understanding of Harm pick-up and disposal
 Reduction

 Ordinances should allow SOAR
 for harm reduction
 activities (not preclude
 them)

 Follow CDC and State
 Guidelines

At the conclusion of each listening session participants were asked if there was
anything else they wanted to share. Some of the comments included the following:

“We must address the SUD crisis in the Charleston Area in a real way, with a real plan,”
said one participant (a school counselor).

“For harm to be as effective as it could be and has been in other places, I think that we
need to have more widely available mental health services and addiction treatment
programs. They’re very limited in this area. Those supports have to be there before HR
can be as effective as it can be,” suggested one participant.

“I want to second the comment that the main concern being a harm reduction program
shut down. I’m worried that somehow it will increase the stigma and people are putting
more and more shame on these people. Unless we have the community all getting
behind it, they’re not going to get better they’re just going to feel more shame. It’s in
everyone’s best interest to try and help each other. Anyway the city or any organization
can do that the better. Regarding the needles, I’m always surprised that this is
something someone’s always up in arms about. I grew up in Charleston and now almost


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30 and it’s so rare that I see a needle. I’d much rather see any other litter – that’s an
issue in itself. It’s easy enough to give someone a place to discard needles in a private
location where they won’t feel the police are after them. And one thing that’s in the
theme of combating the stigma – I have a lot of issues with the perception of the Transit
Area. Any time I talk to people about that area, there’s a horrible “oh we don’t want to go
over there” and I feel like there’s a reason why they want to hang out there. Any other
city would make usage of that space. Just shine more light on that spot and make sure
people have the services they need and address the actual problems. I mean if you
even walk up to the space, they have it blocked off with trash cans and there’s no

welcoming nature. It’s like the city wants it to be closed off and shoved them in the
corner,” said one participant.

“Thank you for allowing me to join in on the conversation. Criminal justice and teachers
are on the front lines. There for the drama and the trauma. We need to track the data –
how many people are getting stuck. More sharps containers would be great. More
mental healthcare in the schools for our children. Advocates on the criminal justice side.
I see it and I live it and I appreciate being part of the conversation,” said another
participant and Charleston business owner.

“For harm reduction to be as effective as it could be and has been in other places, I
think that we need to have more widely available mental health services and addiction
treatment programs. They’re very limited in this area. Those supports have to be there
before harm reduction can be as effective as it can be,” suggested another participant.

Research Conclusions
  1. Kanawha County and the City of Charleston need multiple, accessible harm
 reduction programs. The CDC and the DHHR recommend these programs as
 ways to reduce the spread of the disease, increase testing for disease, treat
 disease, and increase the percentage of persons entering recovery. Two-thirds of
 the survey respondents affirm that the need for these programs exceeds the
 services currently available.

 2. Harm reduction programs must provide clean, safe needles (i.e., syringe
 service or needle exchange) to their clients. SSPs significantly reduce the
 spread of HIV/HCV. The majority of Kanawha County survey respondents
 support needle exchange programs and indicate overwhelmingly that there is a
 need for more SSPs in Kanawha County.




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 3. Each harm reduction program must have operational approval by one or
 more governmental entities. Some entity should provide unified oversight and
 the transparency that survey respondents and listening session participants
 desire.

 4. The community perception that needle litter is a threat to children, to first
 responders, to sanitation workers, and to the safety of the general public
 needs to be addressed. It is insufficient to respond to the community
 perception by simply sharing CDC research indicating needle litter is reduced in
 municipalities and communities where harm reduction programs that include
 syringe service exist.

 5. Many people have an inadequate or misinformed understanding of harm
 reduction programs, SSPs, and addiction science. Program advocates
 believe they are supporting people who are struggling with addiction while
 opponents proclaim that harm reduction programs enable “bad” behavior. Some
 survey respondents and listening session participants used divisive, stigma-laden
 language including: “addict,” “junkie,” “vagrant,” and “cattle,” when referring to
 persons struggling with addiction.

Research Recommendations
  1. Mayor Amy Goodwin should designate a Harm Reduction Task Force. As a
 starting point, the Task Force should be composed of representatives from the
 City of Charleston, the Kanawha County Commission, West Virginia Drug
 Intervention Institute, Health Right, SOAR, the Kanawha Charleston Health
 Department, Charleston Area Medical Center, Thomas Health Systems, and
 other health care facilities. This public-private partnership would bring a unified
 and coordinated harm reduction effort.

 2. The Charleston City Council should adopt the West Virginia Bureau for
 Public Health Harm Reduction Program (HRP) Guidelines and Certification
 Procedures as developed by West Virginia Health and Human Resources.17

 3. The City of Charleston and Kanawha County should launch a three-part
 needle litter campaign.
 a. Expand the availability of syringe disposal boxes in targeted litter
 areas and sharps containers in public restrooms. Areas to be


17
 https://dhhr.wv.gov/oeps/harm-reduction/Documents/HRP_Guidelines_2018.pdf


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 targeted can be identified through Emergency Medical Services, police,
 and fire department reports.
 b. Educate the public on safe needle practices. Public service
 announcements and media outlets can communicate safe needle disposal
 practices and proper protocols if someone is stuck with a needle. The WV
 DII can be supported in creating educational programs for children on the
 importance of not touching needles (if found) using the Don’t Keep Rx
 Around(™) Medication Safety Program or another appropriate
 mechanism.
 c. Implement syringe collection activities. The City can host clean up
 days that include syringe clean up. The proposed Harm Reduction Task
 Force should create a mechanism for (a) receiving notifications from
 community members when needles are found and (b) quickly and safely
 retrieving and disposing of those needles.

4. The City and the County should support a re-invigorated public education
 campaign to provide accurate information about harm reduction efforts.
 The campaign should include these messages:
 a. The importance of dispelling myths about persons addicted to
 substances (using language void of stigma).
 b. Transparent and statistical information about HIV/HCV and overdose
 numbers in the City and the County.
 c. Evidence based information about harm reduction, SSPs, and addiction
 science as essential to public health.
 d. Success stories from harm reduction (transparency in needles
 returned, persons entering treatment, naloxone saves, etc.).
 e. Informational items about proper syringe disposal and what to do if a
 needle is found in your neighborhood.




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 Appendix A
 Online Survey

Instructions: This short survey should take 10-15 minutes to complete. Your answers
are completely anonymous unless you choose to identify yourself. Please limit your
short answer responses to 120 words or less.

Male/Female
Age Group
Zip Code

 1. Have you or a loved one been impacted by intravenous (injection) drug use? Y/N
 2. Do you believe there should be needle exchange programs in your community?
 Y/N
 3. What programs are you aware of in your community that assist people who inject
 drugs? Short Answer
 4. Do you feel your community has adequate resources for persons suffering from
 addiction and intravenous drug use? Why or why not? Short Answer
 5. What are the dangers or harms needle exchange programs pose to the
 community? Short Answer
 6. What do you feel are benefits of needle exchange? Short Answer
 7. Would you be willing to contribute more to this conversation with a follow up
 phone call or by participating in a focus group? Y/N
 8. If yes, please share:
 a. Name
 b. Occupation
 c. Phone Number
 d. City and County of Residence




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 Appendix B
 Consent Form


 WV Drug Intervention Institute
 Consent Form for Listening Session

 Contact Information



  Last Name First Name Middle Initial



  Group Occupation



  Email Phone


 The WV Drug Intervention Institute would like to take the time to thank you for
agreeing to participate in one of our listening sessions focusing on harm reduction and
needle exchange. The general purpose of the listening sessions is to determine the
attitudes and perceptions of harm reduction and identify gaps in services in and around
Charleston, WV. Prior to beginning the session, please take the time to read our
consent form in order to make an informed decision to participate. If at any time you
have any questions, please contact either Dr. Susan Bissett, Susan@wvdii.org, or
Charlee Fox, Charlee@wvdii.org.
 As a participant in one of our listening sessions, you will be asked a series of
questions related to harm reduction. Each session is 60 minutes in duration, with an
average of six participants, and will be recorded for analysis and reporting purposes.
Listening sessions are to take place via private Zoom call unless otherwise specified. All
recordings of the sessions will be kept within the WV Drug Intervention Institute and will
only be accessible by WV Drug Intervention Institute.
 During the session, sensitive questions may be asked. If at any time you are
uncomfortable with answering, you may skip that question and participate again when
you feel comfortable.

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 Your confidentiality is of utmost importance to us. In order to maintain this when
reports are generated, names and identifying information will be removed to protect
your identity. In the case that a direct quote is to be used, names will be removed.
Reporting an analysis may be released to the public.


By signing this consent form, I agree and understand the following:


 ● Participation is voluntary and compensation will not be provided.
 ● Direct quotes may be used, but names and identifying information will be
 removed/redacted when reports are generated.
 ● Reports may be released to the public.


I have had the chance to read this form in its entirety and have had the opportunity to
ask questions. I agree to participate in my scheduled session.




Participants Name - Print Date:



Signature:




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 Appendix C
 Protocol and Questions for Listening Sessions

1. Susan Introduces herself and Charlee
2. Purpose of tonight’s session is to help the WV DII gain a better understanding of
 community perceptions of harm reduction and needle exchange in Charleston
 and Kanawha County (Objective about the study)
3. Review Consent Form (recording session and why) and common definitions
4. Ground Rules
 a. Everyone has a voice and is allowed to have a difference in opinion
 b. Civil and open conversation
 c. You have the right not to answer a questions (simply indicate you wish to
 pass)
 d. Moderator will keep time and move us forward from one topic to the next
 (this is not an effort to squelch anyone’s voice but to keep us within the
 hour time frame)
 e. Everyone’s time is valuable
5. Introductions --name, organization, location in Kanawha County
6. Harm reduction has been in the news lately. With this in mind, what are your
 expectations or hopes for tonight’s discussion?
7. On a scale of 1 to 5 how important is it for communities to provide HR services (1
 not important at all; 5 imperative)?
8. What is your number one concern regarding the presence of a syringe service or
 harm reduction program in Kanawha County?
9. Are there ways to address those concerns through ordinances, programs,
 outreach?
10. What kind of group or entity do you feel should take the lead role in addressing
 services for persons who inject drugs?
11. Is there anything else you’d like to contribute to this conversation?




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MINUTES
 PUBLIC SAFETY COMMITTEE MEETING

 5:30 P. M., FEBRUARY 24, 2021

*IN RESPONSE TO THE COVID-19 PANDEMIC, THE MEETING WAS MADE AVAILABLE TO THE
PUBLIC AS A LIVE STREAM VIA ZOOM (PER THE AGENDA).



Keeley Steele, Chairperson, called the meeting of the Charleston City Council
Committee on Public Safety to order at 5:30 p.m., FEBRUARY 24, 2021.

Committee Members Present:
Keeley Steele, Chair
Chuck Overstreet, Vice Chair
Pat Jones
Bruce King
Deanna McKinney
Shannon Snodgrass
Tiffany Wesley-Plear


*The link to the video of the full meeting is provided in the minutes. A link to download
the file will be made available upon request to the Clerk’s Office. Timestamps will be
noted for each section for anyone wishing to view the full record.
 https://charlestonwv.civicclerk.com/Web/Player.aspx?id=1199&key=-1&mod=-1&mk=-1&nov=0




 1. Approval of Previous Minutes – 0:06:27-0:06:56
Councilmember King moved to approve the minutes of the previous meeting on 2-24-
2021. Councilmember McKinney seconded the motion. There was no objection and the
minutes were approved.
 1
 2. To Hear from Invited Panelists – 0:07:10-1:36:33
Councilmember Steele stated that they will be hearing from 7 invited speakers. With the
exception of Dr. Daskalakis, they will hear from all panelists before having a question-
and-answer session.

   Dr. Demetre Daskalakis, Director, Division of HIV/AIDS Prevention, CDC –
 Presentation: 0:07:10-0:33:28 Discussion: 0:33:29-0:56:38
Dr. Daskalakis gave a presentation to the Committee concerning responding to HIV
outbreaks among people who inject drugs.

Councilmember McKinney asked if his presentation was about needle exchange or
harm reduction. Dr. Daskalakis replied that harm reduction taken broadly means
strategies that can reduce the risk of infectious disease and other complications for
people who inject drugs. He believes it is a toolkit to interrupting HIV transmission
(including testing, medications and syringe availability), adding that they all work
together. A holistic approach to harm reduction is important, however, there are issues
getting people who inject drugs into care and services. The idea is to use the toolkit to
lead to the other services that are critical, such as through HIV testing intervention that
includes an assessment for other social needs, through treatment connected to medical
services including comprehensive medical health and a trust in individuals that provide
those gateway services (which could be a syringe service program).

Councilmember Steele asked if he was familiar with the program in Cabell County. Dr.
Daskalakis replied that he couldn’t speak specifically about various programs, but he
could say that the toolkit for Campbell County revolved around launching a full toolkit of
strategies to interrupt HIV transmission.

Councilmember Overstreet stated that he had spoken with the Fire Chief from
Huntington in Cabell County and they have a one-to-one needle exchange program,
and confirmed that Dr. Daskalakis had previously stated that their HIV cases were
decreasing.

Councilmember Snodgrass asked who had previously invited him to Charleston for his
initial presentation earlier in the year. Dr. Daskalakis replied that the invitation came
from the Chief of Staff of the Mayor’s Office. She asked for clarification at the end of his
written presentation which states that the findings are the views of the authors and not
necessarily the CDC. Dr. Daskalakis replied that it is standard language to include
because he is speaking extemporaneously. However, the current technology he is
presenting is a toolkit that is recommended by the CDC. Councilmember Snodgrass
stated that when looking at population, West Virginia has proportionally way more
needle exchange programs (13) than states with larger populations (such a Florida with
around 4). She asked if he thought there was correlation between more needle use and
HIV cases. Dr. Daskalakis added that different jurisdictions will have different needs; the
vulnerably for HIV outbreaks is also a consideration not just the size of the population in
an apples-to-apples comparison. The history in West Virginia shows that there is a
vulnerability. Councilmember Snodgrass asked if accountability would be key for

 2
tracing, testing etc. Dr. Daskalakis replied that the first step to achieving
epidemic/outbreak control is to establish trust and creating an environment where
individuals feel they can pursue care. In general, mandatory testing/strategies don’t do
much beyond pushing HIV further underground. He added that having accountability is
to identify strategies that are appropriate for an area and its culture to launch all of the
science in a way to prevent HIV transmission and ultimately provide people with the
care they need to potentially lead them to drug treatment.

Councilmember Wesley-Plear asked what are the must-haves for the toolbox. Dr.
Daskalakis replied that the 3 he presented are the ones that are needed to
interrupt/control an outbreak: diagnose (inventive and creative ways to improve testing),
treatment (it keeps people healthy and prevents HIV transmission) and create an
environment where syringes are available through a comprehensive program (so that
individuals have access to clean equipment).

Councilmember Jones referenced a letter sent to the Committee from Heath Right that
operates a comprehensive harm reduction program. He asked how many such
programs are needed in a city the size of Charleston. Dr. Daskalakis replied that he
couldn’t comment on any specific programs, but when looking at an outbreak scenario
(which the City is currently having), it is critical to not say that 1 program is enough until
the outbreak is controlled.

Councilmember Snodgrass asked if he got paid to come to Charleston. Dr. Daskalakis
replied no. She asked if he usually brings in the crime factor. Dr. Daskalakis replied that
when they talk about syringe service programs people often ask if they increase crime,
so that is commonly included in the presentation. That data is obtained from multiple
sources, including Baltimore and New York.

Councilmember King asked if the CDC tracks the number of overdoses that occur from
needles provided by SSPs. Dr. Daskalakis replied that they cannot track an overdose
based on the syringe used. Councilmember King asked if the CDC tracked lives saved
by naloxone doses given by SSPs. Dr. Daskalakis replied that it is hard to directly
connect a naloxone dose with prevention at the CDC level, but can be tracked locally.
Councilmember King asked if the numbers were total cases in Kanawha County or only
from intravenous drug use. Dr. Daskalakis replied that the numbers he presented were
related to injection drugs, but the number of total cases can be obtained from the State.

Councilmember Steele asked on behalf of another Councilmember if most of the
programs he had spoken about all over the country were overseen by medical directors.
Dr. Daskalakis replied that there is a lot of variability (some are and some are not).




 3
  Dr. Christine Teague, Ryan White HIV/AIDS Program - 0:56:39-1:08:13
Dr. Tate explained that the Ryan White Care Act provides federal funding for
comprehensive patient care, support and early intervention services (including outreach,
education, testing and linkage to care) regardless of an individual’s ability to pay.

  Dr. Susan Bissett, WV Drug Intervention Institute - 1:08:14-1:15:09
Dr. Bissett explained that the Institute’s mission is to reduce overdose deaths due to
opioids and drugs in West Virginia through advocacy, prevention, education, research
and collaboration. She discussed their recently completed public survey that analyzed
community opinions and perceptions on SUD, harm reduction and syringe exchange,
specifically in Kanawha County.

  Eric Smith, President of the local chapter of the Fraternal Order of Police -
 1:15:10-1:21:04
Smith gave the Committee an overview of his background as a retired Police Officer. He
stated that the issue is with SOAR and their needle distribution, and expressed concern
over needle litter and accidental needle sticks.

  Jennifer Depond, RN - 1:21:05-1:32:04
Depond shared with the Committee her experience as a nurse that cares for pregnant
women with substance abuse disorders, particularly as to how it effects children. She
added that comprehensive care is vital.

  Shawn Wanner, Fire Chief, Charleston - 1:32:05-1:34:19
Chief Wanner stated that their biggest concern was needle litter. He could not support
an agency handing out needles, unless it was a controlled exchange program that had
accountability.

  Emily Hannah, Director of the Mayor’s CARE Office - 1:34:20-1:36:33
Hannah spoke to the Committee about potential survey questions she had submitted to
the Committee at the request of the Chair. She added that the CARE Office houses the
Quick Response Team, the Homeless Outreach Coordinator and the Mental Health
Coordinator. In her opinion, a survey that creates a foundation to allow for further
information sharing and collaboration would be helpful as opposed to just an up/down
on the issue.



 3. Question and Answer with Panelists – 1:36:34-2:40:03
Councilmember McKinney stated that she thought they were there to discuss harm
reduction, but everything she had heard from the panelists concerned needle exchange.
Councilmember Steele replied that the bill that was introduced specifically takes up
syringe service programs, not the entirety of harm reduction. She added that while there
needs to be an overarching conversation, the survey questions are meant to specifically
survey first responders, public grounds and refuse workers about their feelings about
syringe service programs. The bill was first enacted in 2015 when the program first

 4
began, and was amended in 2018. It was decided that it would be best to reexamine
that bill in light of current events and organizations operating within the City.
Councilmember McKinney stated that it was disrespectful to spend all this time on only
one piece. Councilmember Steele added that syringe programs have to go through a
certification process. Councilmember Wesley-Plear added that she would like to draft a
bill with Councilmember McKinney to address the remainder of harm reduction.

Councilmember Steele asked Dr. Bisset if she would do any part of the survey
differently. Charlee Fox, also with the WVDII, conducted the meta-analysis that helped
them develop the questions. She replied that she would add race as a demographic
component to the survey. Fox added that similar surveys averaged around 4 questions,
so she was satisfied with their choice of 6 questions.

Councilmember Snodgrass stated that she would probably disagree on their conclusion
that the majority of people believed that there should be more needle exchange
programs from the question “Do you believe there needs to be more resources?” Dr.
Bissett replied that she was probably looking at 2 different questions. From the resource
question Councilmember Snodgrass referenced, it was obvious that people felt there
was not enough adequate resources particularly during the listening sessions. Their
conclusion came from the survey question “Do you believe there should be needle
exchange programs in your community?” Councilmember Snodgrass replied that the
average citizen of the population didn’t take this survey. Dr. Bisset stated that they could
only report from who responded, and that it was also mentioned during 2 Council
meetings and 2 Public Safety meetings. Fox added that most other surveys are also
open a lot longer (2-4 months) as opposed to their time constraint of 2 weeks.

Councilmember Wesley-Plear asked how long it took them to analyze their data. Fox
replied that she worked anywhere from 10-14 hours a day, 5 days a week, for about 3
weeks. Councilmember Wesley-Plear asked if they had a way of blocking an IP address
from taking the survey again. Dr. Bisset replied that it wouldn’t block multiple IPs, but
they could be removed during data analysis.

Councilmember Snodgrass stated that citizens cared about fire, police and roads. There
is a population that is in long-term iv-drug abuse, and she would hope that they can get
into rehab instead of encouraging long-term addiction. She added that the former
needle exchange program at the Kanawha-Charleston Heath Department became a
needle distribution program. Smith added that they would finding needles everywhere.
In response to Councilmember Snodgrass, Smith and Lieutenant Myron Boggess (CFD)
both agreed that more people were attracted to the City directly because of that needle
exchange program. Boggess was not able to recall offhand the number of house fires
for those years, adding that most of the house fires for the current year did not seem to
come from abandoned houses. Boggess added that when they did respond to fires at
abandoned houses, they had to sweep the floor with water to wash away the needles,
but that has not been as much of a trend after Health Right took over and there was
more accountability.



 5
Councilmember Wesley-Plear asked if that trend had recently started again, and
Boggess replied that they had started to see that again although perhaps not as bad as
previously. Smith agreed.

Councilmember King added that, during the time Kanawha County Health Department
was operating their program, Charleston was the only municipality within Kanawha
County that allowed needle exchanges. He asked if they recalled an increase in people
coming to Charleston during that time to commit crimes, etc. Smith replied that people
from other counties (Logan, Mingo, etc.) specifically said they came to Charleston
because of the needle distribution. Smith added that the homeless population
skyrocketed during the same time as that program. Smith could not say if it also
attracted drug dealers.

Councilmember Snodgrass asked if given that illegal drugs were going into needles that
had been distributed, did they think that would lead to a rise in crime. Smith replied yes,
that drugs and crime go hand and hand. Councilmember Snodgrass asked if needle
distribution and increase in crime was a risk to Officers. Smith replied that the CPD had
more Officers shot at and had shot more people since 2017 than in his entire 21-year
career.

From the audience, Councilmember Pharr asked had they had noticed if needles and
syringes were found concentrated more in one part of town over another. Boggess
replied that he couldn’t accurately answer that because he is stationed in one part of
town, but needles are very present in the West Side/North Charleston area.
Councilmember Pharr asked if they saw families (when responding to fires). Boggess
replied that he wasn’t sure, but he did know that they did respond to a lot of overdoses
in the area in occupied homes. He added that they also responded to a tremendous
amount of them well in boarded-up properties. He added that they have responded to
situations with children and family members present.

Councilmember Wesley-Plear asked if having drug paraphernalia was an arrestable
offense. Smith replied not for syringes; however, it is in other cities. Smith added that he
had anecdotally heard that people know this and come to Charleston for that reason.
Councilmember Wesley-Plear stated that they should remember that they are
discussing people that have a chronic disease, and to be respectful of that they need to
lessen the stigma to truly do their part to improve their community. Councilmember
Steel agreed, and added that they need to be mindful of the language and terminology
they use when they are talking about people in active addiction.

Councilmember Steele confirmed that Smith was speaking for the membership of the
Fraternal Order of the Police, not the Police Department (although the Order
encompasses about 95% of the Police Department as well as 12 other Departments).
Councilmember Wesley-Plear confirmed with Smith that the Order is an additional
organization (by application with dues), and that firefighters agree that there needs to be
some sort of program like Health Right or hospital care for getting people help. He
added that there needs to be accountability to any such program.

 6
Councilmember King asked Depond to explain what happens to a newborn when they
are born in relation to addiction. Depond replied that 40-60% of babies born to opiate-
dependent mothers experience withdrawal. For mothers that used stimulants, babies
are high need (crying, jittery don’t eat normally, etc.). She added that it is traumatizing to
experience a newborn going through withdrawal. There is not a lot of long-term data
available. Depond added that babies may go through their treatment and into a home
still with needs.

Councilmember Wesley-Plear asked how to better build trust so that people can get
help. Dr. Teague replied that it comes back to meeting people where they are (access
and be present with them). She added there is huge mistrust in the medical community.
She added that SOAR is one of the few ways that she has been able to engage with the
people she has been tasked to take care of, because that is where she frequently sees
people that she only previously saw briefly before they were discharged. It affords her
the opportunity to provide education and other options. Dr. Teague added that she
works with both SSPs, and that she thinks there is room for improvement in both areas.
Her concern with Health Right is that they have turned people away because they are
on probation for not returning the correct number of needles. She would like to see a
solution to the waste that is being seen. While there does need to be accountability, she
does not think they are meeting the full needs of the people. She would like to have the
Health Right program improved and replicated on the West Side.

Councilmember McKinney asked if it was appropriate (for a program) to go into a
community without introducing themselves. Dr. Teague replied that it would have been
best. While she does not represent SOAR, she did not think it was done with an intent
to be deceptive. Councilmember McKinney asked if Dr. Teague was over SOAR, how
would she have introduced it to the community and to what type of accountability would
she hold herself. Dr. Teague replied that she would come to them (presumably,
Councilmembers) explaining that they would like to come in and develop a program,
asking for their input and volunteers.

Councilmember Pharr confirmed that Dr. Teague had previously stated data of 25%
African American and female and 75% white and male were from all of their enrolled
patients from their service area of 19 counties pre-2018. Since 2018, an overwhelming
number of their new cases are white male. She added that there is a high stigma in the
African American community to be tested.

Councilmember McKinney asked what where the next steps after testing. Dr. Teague
replied that they do rapid testing with double confirmation. They also try to do immediate
medical care while they are with them. Councilmember McKinney asked how effective
the testing was as well as getting people to come back to get treatment. Dr. Teague
replied that there had been 8 identified positives over the 3-month period, adding that
the numbers dropped overall once the investigation started. Of those 8, 1 has since
passed away, 2-3 have returned to the clinic at least once and they have been unable to
locate 3 (but if they return, they will be remembered and encouraged to get treatment).
Dr. Teague shared a success story with the Committee that showed that having a

 7
presence and patience is key.

Councilmember Steele asked on behalf on a Councilmember not present if given the
changes in HIV cases, if there was talk within her program to start any type of syringe
exchange program. Dr. Teague replied that she felt that at a minimum, as an HIV
service provider, they needed to be able to make sure the people that they identify as
positive be given syringes, but they had not been given approval to do that.

Councilmember Pharr stated she felt like the African American community is not part of
this outreach, and would suggest that her group partner with some African American
organizations. Dr. Teague agreed, and added that they had previously worked with the
Partnership for African American Churches.

Councilmember Pharr asked on behalf of a Councilmember not present where the
needs-based program on the West Side Dr. Teague previously referenced was located.
Dr. Teague replied that she was referring to SOAR.

Councilmember Pharr asked Dr. Bisset, concerning the last question of the Research
Conclusions Section, if “addict” is considered stigma-laden language. Dr. Bisset replied
that technically it is, along with “junkie”. Appropriate terms would be “person in active
addiction” or “person struggling with addiction.” Councilmember Pharr added that she
struggles with that since “addict” comes from “addiction.” Dr. Bisset stated that it is
considered a best practice from the NIH, the CDC and SAMHSA in an effort to make the
person seem more human and more than their addiction. Councilmember Wesley-Plear
added that it is important to her to use terminology that is respectful.



 4. Recess
Councilmember Overstreet motioned to recess for 5 minutes. Councilmember McKinney
seconded. With the yeas being unanimous, Councilmember Steele declared the
Committee in Recess.

Councilmember McKinney motioned to reconvince the meeting. Councilmember
Snodgrass seconded. With the yeas being unanimous, Councilmember Steele declared
the Committee reconvened.



 5. To Take Up Survey Questions – 2:41:26-3:32:05
Councilmember Steele explained that the Committee had before them 2 sets of
recommended questions provided by Councilmember King and Emily Hannah, CARES
Director, to use as a starting point. Councilmember Steele added that, in her research, it
seemed like the less questions the better. Councilmember Steele added that the survey
will have to go through the City’s IS Department, and that they are short-staffed at the
moment. Councilmember Snodgrass added that the questions submitted by

 8
Councilmember King have been vetted by the Chiefs of Fire and Police and the
Directors of Refuse and Public Grounds. She added that they wanted the questions to
be Yes or No to be able to represent all employees. Councilmember Steele added that
she had a problem allowing the general group of people that the survey is for to approve
the survey questions. Councilmember Snodgrass stated that the Committee suggested
that they go to the Departments to do that. Councilmember Steele stated that her
suggestion was to ask how the survey might get done, not for them to ok the actual
questions. Councilmember Snodgrass added that it will be going to the employees that
they supervise. Councilmember Steele asked who came up with the questions, and
Councilmember King replied that he and Councilmember Snodgrass did.

Councilmember King motioned to vote on all of the questions he submitted as a whole.
Councilmember Snodgrass seconded the motion. Councilmember McKinney stated that
they are supposed to be doing something for the community, and everyone on the
Committee should be able to agree, disagree or amend on each question.
Councilmember Steele asked for clarification as to which Department Heads they spoke
with, who had questions and who did not respond. Councilmember Snodgrass stated
that after the last Public Safety meeting, they were able to get the resolution approved
and did not want to have to wait many more weeks. She stated that she spoke to the
Fire Chief, the Police Chief and Brent Webster (Public Works) mainly to make sure the
questions were written as to be appropriate for their employees. She added that they
didn’t comment one way or the other. Councilmember Overstreet stated that he thought
it was suggested at the last meeting they should consult the Department Heads.
Councilmember McKinney added that she thought they were going to get their opinions
on how to do the survey and the Committee would create the questions.
Councilmember King withdrew his motion.

Councilmember Wesley-Plear suggested that the questions that mention the Health
Department’s needle program be taken out because of the turnover in Refuse means
that most employees wouldn’t have been there in 2018 and wouldn’t necessarily know
about it. Councilmember Snodgrass replied they could then choose to answer “Don’t
Know.” Councilmember Snodgrass added that it is a reference point when talking about
needle exchange programs.




 9
 “Do you believe the Health Department’s needle program in 2018 was good for
 the City of Charleston?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 The Committee agreed to strike “in 2018.”
 Yeas: Overstreet, Jones, Snodgrass, King, McKinney
 Nays: Wesley-Plear, Steele
 With the Yeas being in the majority, the question was approved.

 “Do you believe the Health Department’s Needle Program led to an increase in
 crime?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Snodgrass, King
 Nays: Wesley-Plear, Steele, McKinney
 With the Yeas being in the majority, the question was approved.

 “Do you believe needle programs increase or decrease the likelihood of an
 accidental needle prick for the public at large, refuse employees, and first
 responders performing their job duties?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Councilmember Wesley-Plear requested that the “and” be changed to “or.” The
 Committee agreed.
 Yeas: Overstreet, Jones, Wesley-Plear, Steele, Snodgrass, King, McKinney
 Nays: None
 With the Yeas being unanimous, the question was approved.

 “Do you believe that needle programs increase or decrease syringe litter
 throughout the community?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Wesley-Plear, Snodgrass, King, McKinney
 Nays: Steele
 With the Yeas being in the majority, the question was approved.

 “Do you believe that needle programs result in an increase in the number of
 intravenous drug users coming into the City of Charleston from outside areas?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Snodgrass, King
 Nays: Wesley-Plear, Steele, McKinney
 With the Yeas being in the majority, the question was approved.

 “Do you believe participants in a needle program should be required to meet with
 a medical professional during each visit to the program?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Snodgrass, King, McKinney
 Nays: Wesley-Plear, Steele
 With the Yeas being in the majority, the question was approved.


 10
 “Do you believe participants in a needle exchange program should be required to
 return their used needles to receive new ones?”
 Councilmember King motioned to vote for approval of the question.
 Councilmember Steele suggested that they put “all” in front of “used.”
 Councilmember McKinney suggested that “to receive new ones” be removed.
 Councilmember Steele suggested changing “needle exchange program” to
 “syringe service program.” The Committee did not agree to any proposed
 changes, and the question was voted on as originally read.
 Yeas: Overstreet, Jones, Snodgrass, King
 Nays: Wesley-Plear, Steele, McKinney
 With the Yeas being in the majority, the question was approved.

 “Do you believe additional needle programs are needed in the City of
 Charleston?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Wesley-Plear, Steele, Snodgrass, King, McKinney
 Nays: None
 With the Yeas being unanimous, the question was approved.

 “Prior to this survey, have you been asked for your opinion regarding needle
 exchange programs in the City of Charleston?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Wesley-Plear, Snodgrass, McKinney
 Nays: Steele, King
 With the Yeas being in the majority, the question was approved.

 “Do you believe that needle programs increase or decrease syringe litter
 throughout the community?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Wesley-Plear, Snodgrass, King, McKinney
 Nays: Steele
 With the Yeas being in the majority, the question was approved.




 11
 “Have you personally, do you work with, or do you know of someone who has
 been accidently pricked by a discarded needle?”
 Councilmember Jones suggested to remove “have you personally.”
 Councilmember Steele suggested the question be “Have you ever had to have
 an HIV test, or know of anyone who has, because of being pricked by a
 discarded needle.”
 Councilmember McKinney suggested to remove “HIV” from Councilmember
 Steele’s suggestion.
 Councilmember Steele suggested that the question be discarded.
 Councilmember Wesley-Plear suggested that the question read “Have you been
 accidently pricked by a discarded needle in Charleston?” The Committee decided
 to vote on that change.
 Yeas: Overstreet, Jones, Wesley-Plear, Snodgrass, King, McKinney
 Nays: Steele
 With the Yeas being in the majority, the question was approved.

 “Have you ever encountered discarded needles personally or while on the job or
 on a call?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: Overstreet, Jones, Wesley-Plear, Steele, Snodgrass, King, McKinney
 Nays: None
 With the Yeas being unanimous, the question was approved.

 “Do you feel comfortable publicly stating your opinion regarding needle exchange
 programs?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Yeas: None
 Nays: Overstreet, Jones, Wesley-Plear, Snodgrass, Steele, King, McKinney
 With the Nays being unanimous, the question was not approved.

 “Have you been stuck by a needle in the course of your work with the City of
 Charleston?”
 Councilmember Wesley-Plear motioned to vote for approval of the question.
 Councilmember Wesley-Plear suggested the question replace “Have you
 personally, do you work with, or do you know of someone who has been
 accidently pricked by a discarded needle?”
 The Committee agreed to the change.

 “Do you know how to properly handle syringe litter?”
 The Committee was satisfied with the question.

 “Are you interested in information about proper disposal?”
 The Committee did not want to include the question.




 12
  “Provide your thoughts on how syringes and syringe litter affect your professional
 duties.”
 The Committee did not want to include the question.

  “What ideas do you have to address syringes and syringe litter?”
 The Committee agreed for this to be the last question.

  “Where do you encounter syringes? (i.e., bagged garbage, street litter, pat down,
 overdoses, etc.)”
 Councilmember Wesley-Plear suggested replacing this question with “Have you
 ever encountered discarded needles personally or while on the job or on a call?”
 The Committee agreed.

  “Describe your understanding of harm reduction and syringe programs.”
 The Committee did not want to include the question.

  “Are you interested in education and training on harm reduction and syringe
 programs?”
 The Committee did not want to include the question.

Councilmember Jones motioned to accept the questions as discussed (reproduced
below). Councilmember Wesley-Plear seconded. With the yeas being unanimous, the
questions were approved.




Councilmember Jones motioned to adjourn. Councilmember McKinney seconded the
motion. Meeting adjourned.



 13
 Survey Questions
1. Do you believe the Health Department’s needle program was good for the City of Charleston?
 a. YES, NO, or DON’T KNOW

2. Do you believe the Health Department’s Needle Program led to an increase in crime?
 a. YES, NO, or DON’T KNOW

3. Do you believe needle programs increase or decrease the likelihood of an accidental needle prick
 for the public at large, refuse employees or first responders performing their job duties?
 a. INCREASE or DECREASE

4. Do you believe that needle programs increase or decrease syringe litter throughout the
 community?
 a. INCREASE or DECREASE

5. Do you believe that needle programs result in an increase in the number of intravenous drug users
 coming into the City of Charleston from outside areas?
 a. YES, NO, or DON’T KNOW

6. Do you believe participants in a needle program should be required to meet with a medical
 professional during each visit to the program?
 a. YES or NO

7. Do you believe participants in a needle exchange program should be required to return their used
 needles to receive new ones?
 a. YES or NO

8. Do you believe additional needle programs are needed in the City of Charleston?
 a. YES or NO

9. Prior to this survey, have you been asked for your opinion regarding needle exchange programs in
 the City of Charleston?
 a. YES or NO

10. Have you been stuck by a needle in the course of your work with the City of Charleston?
 a. YES or NO

11. Do you know how to properly handle syringe litter?
 a. YES or NO

12. What area of the City have you encountered discarded syringes?


13. What ideas do you have to address syringes and syringe litter?




 14