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healtih
<br />CAREAGENCY
<br />PUBLIC HEALTH SERVICES
<br />May 10, 2023
<br />Ms. Marjorie Katz
<br />CA Department of Public Health
<br />Office of AIDS — Harm Reduction Unit
<br />Dear Ms. Marjorie Katz,
<br />CLAYTON CHAU, MD, PhD, MASL
<br />AGENCY DIRECTOR
<br />REGINA CHINSIO-KWONG, DO
<br />COUNTY HEALTH OFFICER/
<br />CHIEF OF PUBLIC HEALTH SERVICES
<br />405 W. 5T" STREET, 7T" FLOOR
<br />SANTA ANA, CA 92701
<br />www.ochealthinfo.com
<br />Thank you for providing notification of the Harm Reduction Institute's (HRI) application to add home
<br />delivery and collection of syringe needles to the organization's ongoing harm reduction program in Santa
<br />Ana, California. Orange County recognizes the importance of harm reduction through use of sterile needles
<br />to help reduce transmission of infection, including HIV, Hepatitis C, and other injection -related infections
<br />and injuries.
<br />Unfortunately, in practice, Orange County, and specifically Santa Ana, has had negative experiences with
<br />syringe exchange programs, including both the OC Needle Exchange Program (OCNEP) (2016-2018) and
<br />Harm Reduction Institute (HRI) (2019-2022). Both programs understandably operated to reduce transmission
<br />of infection, including HIV and Hepatitis C, and additionally provided harm reduction services through
<br />counseling, referrals, and offering additional harm reduction resources, supplies, and naloxone, however, the
<br />burden of used syringes littering the community was overwhelming.
<br />The OC Needle Exchange Program initially provided needle exchange in the City of Santa Ana, and at one
<br />point in late 2017, OCNEP was distributing over 80,000 syringes in a single day of operation, serving over
<br />200 people in a single 2-hour time frame, while disposing of only 20,000 used syringes per week. OCNEP
<br />proposed to expand its syringe needle distribution through a mobile syringe exchange program — to include
<br />distribution on a weekly basis to cities of Santa Ana, Orange, Anaheim, and Costa Mesa — operating daily
<br />from 10am-5pm, to offer additional public access. In the proposal, OCNEP offered to inspect impacted areas
<br />for syringe litter, install permanent disposal bins in hot spots, provide an email address and phone number for
<br />members of the community to report inappropriately discarded needles (with response within 48 hours of
<br />receipt), and planned annual meetings with law enforcement and the County to address community concerns.
<br />Despite these proposals (which may or may not have been performed), OCNEP was met with significant
<br />community resistance because of the sheer number of improperly disposed used syringe needles that were
<br />found discarded in public settings, public parks, public libraries, public restrooms, near public schools, on
<br />sidewalks, in homeless encampments, and specifically in minority -dominant communities. More than 14,000
<br />improperly discarded needles were found in the homeless encampments in the Santa Ana Riverbed.
<br />As a result of the volume of syringe litter and the associated public health risks, concerns about OCNEP in
<br />2018 expressed by members of the public (including written and oral comments at public meetings) included
<br />(1) OCNEP's failure to properly understand the population it served (i.e., high numbers of unhoused people
<br />suffering from debilitating mental health conditions); (2) OCNEP's failure to demonstrate that the program
<br />actually decreased the spread of HIV and hepatitis in the County, and (3) OCNEP's minimal effort to follow
<br />up on referrals to drug rehabilitation/SUD treatment programs.
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