Bangor’s public health and community services department is moving forward with a plan to offer sterile syringe delivery for clients of the city’s HIV case management program.
A City Council committee voted Monday to allow the department to apply for syringe service certification, with some councilors cautioning that they like the concept of the pilot program but want its scope to remain narrow in the future.
The discussion comes amid a growing HIV outbreak in Penobscot County that primarily affects people who inject drugs and are homeless. Public health experts in the state have emphasized providing clean needles as a key part of its response, as syringe distribution is widely recognized as an effective strategy to reduce HIV transmission.
“This delivery is to fill a gap,” Jennifer Gunderman, the city’s public health director, told councilors. Some of her department’s clients, who are served by the HIV case managers hired with opioid settlement money last year, aren’t always able to get to a physical needle exchange site when needed, she said. This would allow those case managers to deliver syringes when visiting those clients.
“This is not a brick and mortar. We are not operating a full-scale syringe service provider,” Gunderman said, adding that only a small number of case management clients would need the service.
She first raised the idea of applying to be a syringe service provider in February.
Gunderman’s proposal follows a new provision under state law that opened up a pathway for syringe service providers to have mobile sites and delivery services, which advocates hope will make it easier for people to get clean syringes. The bill was presented by Rep. Ambureen Rana, D-Bangor and went into effect last year without Gov. Janet Mills’ signature.
Access to clean needles remains somewhat limited in Maine, especially for people who don’t have consistent transportation to get to a syringe service program.
The new delivery services would not require any new hires, since the case managers already visit clients at their homes, and the public health department would plan to secure Maine CDC funding for the syringe services, Gunderman said.
The department would plan to offer syringes at one-for-one exchange, according to a memo from Gunderman, with the option to provide up to 50 to a client who has none to dispose of — half of the 100 needles the Maine Center for Disease Control and Prevention allows providers to give out at a time.
The city’s case managers would only deliver needles to clients’ places of residence, not shelters, transitional housing or public property, Gunderman added in the memo.
Beyond helping clients who can’t travel to a syringe exchange, the program would also open the city up to new funding opportunities from the Maine CDC, which sometimes offers money specifically for syringe service providers, Gunderman said.
It also builds more flexibility into Bangor’s syringe service landscape, she said, pointing to the sudden shutdown last year of the nonprofit Health Equity Alliance, which left many community organizations scrambling to fill gaps.
“What we did learn from HEAL is that when one [syringe service provider] has a significant reduction in services, we have a significant gap, and it takes time to scale up. So this also allows us to have something in our back pocket if this ever becomes an issue again,” Gunderman said.
“I think this is a great idea, and probably long overdue,” councilor Carolyn Fish said, although she noted concerns that demand for services could become greater than expected and overwhelm the city. Gunderman assured her that any potential expansion of city-run syringe services would come back to the council in the future for more discussion and approval.
Councilors on the government operations committee voted 4-1 in favor of submitting an application to Maine CDC for certification. Councilors Michael Beck, Susan Deane, Wayne Mallar and Fish voted yes, and councilor Angela Walker voted no.
Gunderman estimated her team would apply for certification status by the end of the summer.
Councilors at the committee meeting also approved a joint application between the local public health department, Penobscot Community Health Care and Augusta-based health care system MaineGeneral for state funding to provide HIV, hepatitis C and STI prevention and testing services.