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Syringe Exchange and the Federal Funding Ban: Current Policy, Future Challenges. Daniel Raymond Policy Director Harm Reduction Coalition www.harmreduction.org raymond@harmreduction.org (212) 213-6376 x29. Current Federal Policy.
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Syringe Exchangeand the Federal Funding Ban:Current Policy, Future Challenges Daniel Raymond Policy Director Harm Reduction Coalition www.harmreduction.org raymond@harmreduction.org (212) 213-6376 x29
Current Federal Policy Blanket prohibition on use of federal funds to distribute syringes since 1988 • Labor/HHS Appropriations • Authorizing bills Last major campaign to lift the federal funding ban failed in 1998
Ban in Appropriations Labor/HHS/Education Appropriations: SEC. 505. Notwithstanding any other provision of this Act, no funds appropriated in this Act shall be used to carry out any program of distributing sterile needles or syringes for the hypodermic injection of any illegal drug.
Ban in Authorizing Legislation • HOPE Act of 1988 (authorizing HIV/AIDS prevention funding): ban with exemption based on Surgeon General determination (42 USC 300ee-5) • Ryan White CARE Act of 1990: complete ban (42 USC 300ff-1) • ADAMHA Reorganization Act of 1992: applies HOPE Act ban language to SAMHSA substance abuse prevention & treatment block grants to states (42 USC 300x–31) • Runaway, Homeless, and Missing Children Protection Act of 2003: complete ban in Runaway and Homeless Youth funding (42 USC 5752)
Options for Lifting the Ban • Remove annual rider from FY 2010 Labor/HHS Appropriations • Community AIDS and Hepatitis Prevention Act (H.R. 179): “Notwithstanding any other provision of law, nothing shall prohibit the use of Federal funds to establish or carry out a program of distributing sterile syringes to reduce the transmission of bloodborne pathogens, including the human immunodeficiency virus (HIV) and viral hepatitis.”
Current Advocacy • Federal Ban Working Group: nearly 50 advocacy groups coordinating strategies • Grassroots mobilization in key districts • Key targets: freshmen and Blue Dog Democrats, moderate Republicans • 81 co-sponsors to CAHP Act
Advocacy Challenges • Crowded legislative agenda • Close vote on DC local funding ban in 2007 • Syringe exchange still framed as controversial and politically risky • Congressional leadership reluctant to risk a close vote
Syringe Exchange Landscape • 186 known programs operating in 36 States, the Indian Nations, Washington DC, and Puerto Rico • Broad diversity in size, service delivery models and settings, organizational type, data collection methods, program philosophy, and operational constraints (legal/political)
Funding issues • 61% of syringe exchange programs receive some public funding (city/county/state) • Total SEP budget in 2007 (70% reporting): $19.6 million (including $14.4 million in public funding) • 56% of programs report lack of resources/lack of funding
After the Ban What questions do we need to be asking to guide and prepare health departments, community organizations, planning groups, and the CDC for the next steps after the federal funding ban is lifted?