A new structure was unveiled at a ribbon-cutting ceremony Friday in Charleston. It wasn’t a school, business or hospital. Instead, local activists celebrated a humble disposal box, intended to collect used syringes.
A grassroots HIV and recovery group installed Charleston’s second sturdy sharp container amid ongoing concerns over the city’s growing HIV outbreak.
“Let this be the first action to get us united on a path to meeting this growing need for expanding harm-reduction in our community,” said Stacy Kay with Solutions Oriented Addiction Response, or SOAR.
Kay said SOAR will be responsible for clearing out the box on a regular basis.
This event comes just days after the Centers for Disease Control and Prevention released a report that says the capital city needs more clean needles to curb the spread of HIV, which has gotten worse in recent years.
The CDC’s recommendation didn’t come as a surprise to SOAR and those that study infectious diseases. But state and local laws passed this year do limit who can give out clean needles.
SOAR shut down its health fairs days before the city ordinance passed. The group continues to criticize the city’s move.
“We simply cannot punish those who are hurting the most, criminalize the helpers, and hope that this will all just go away,” Kay said.
The CDC’s findings also say the city could use more public sharp containers for IV drug users to properly dispose of used needles.
“It helps to do something,” Kay said.
State epidemiologist Shannon McBee told WVPB she thinks the city and state can get behind these recommendations.
“I think there’s options for us to minimize improper or unsafe disposal of used syringes within the current context of our laws,” McBee said.
The only other sturdy sharps container in Charleston is outside the local health department. McBee, activists and the CDC pointed out that there is a constant law enforcement presence near that container, which could deter folks from disposing of their syringes there.
The new box is located on Charleston’s East Side near a park commemorating those who have died of AIDS.
“The struggle to overcome AIDS started in an ocean of stigma,” said Carl Maxwell, the president of the Living AIDS Memorial Garden. “Too many people thought that the people who first acquired AIDS were unworthy or somehow deserved it. That wasn’t true then, and it’s certainly not true now. We’re excited to be a part of the solution.”
Charleston’s city council revamped a local code Tuesday night regarding syringe service programs.
Programs that give clean needles to IV drug users will have to obtain a state license, get approval from the city council, and limit the number of needles given to participants.
Those requirements are already outlined in a recent state law, Senate Bill 334. But the new city code goes a few steps further.
The city would also require a public meeting be held in any neighborhood where a syringe program hopes to set up shop.
Some council members said Charleston’s West Side community wasn’t consulted when a local needle exchange program came to their neighborhood.
Solutions Oriented Addiction Response, or SOAR, set up health fairs in a church parking lot on the West Side.
Council member Jennifer Pharr said she’s spoken with SOAR. While the grassroots organization was welcomed by a church in the neighborhood, Pharr says that wasn’t enough.
“I said, ‘You’re not being a good neighbor. You didn’t speak to the community and ask if it was okay to set up in their backyard,” Pharr said.
The ordinance also slaps misdemeanor criminal charges on anyone giving out needles illegally. State law would only apply civil charges. Anyone in violation of the city’s syringe law would be fined $500 to $1,000.
A sticking point of both city and state law is an adherence to a one-to-one distribution model. That means participants must bring back their used syringes to receive clean ones.
State law only stipulates that programs have a one-to-one “goal.” The city council wanted something more specific. Members debated the reasons why someone with substance use disorder might not be able to bring back every single needle, every single time.
“To say that if you get 10 you have to bring all 10 back or you get nothing, that’s pretty cold,” said Council Member Deanna McKinney. “This is an illness that people do have, let’s not forget that.”
McKinney supports a one-to-one approach, mostly. She thinks it will hold participants accountable, but she wants some leniency, too.
“You don’t want to be too restricted to where you can’t get the help that you need. And you don’t want to be too loose to where you don’t get help at all,” McKinney said.
The final ordinance requires programs to collect 90 percent of the needles it distributes.
When it comes to the mission of syringe service programs — which is to curb the spread of HIV and other blood-borne illnesses — the Centers for Disease Control and Prevention says restrictive, one-to-one models are not as effective.
The final version of the ordinance passed almost unanimously. Council Member Robert Sheets was the lone member to vote against it.
SOAR’s program recently shut down its health fairs due to the impending city decision and concerns from West Side residents.
“A lot of people are wondering what groups like SOAR will do next. We’re still figuring that out,” Joe Solomon of SOAR wrote to West Virginia Public Broadcasting. “For now, we’re shocked the council voted to arrest nurses and pastors for doing what the CDC says we need to do.”
Health Right operates the only active needle exchange program in the city. Health Right’s Executive Director Dr. Angie Settle said these new requirements will not shut her program down.
“We’ll follow the letter of the law. Whatever the ordinance says, we will do it,” Settle said.
The clinic already operates with a one-to-one distribution model.
The city code goes into effect this weekend, preempting state law that begins mid-July.
Syringe service programs in Charleston have been controversial for years. And this wouldn’t be the first time that the city passed an ordinance on the issue.
But Monday night could be another turning point for the matter, as council members decide what specific guidelines harm reduction programs must follow. The meeting starts at 7 p.m. at Charleston’s convention center. Current city code requires approval from the police chief. It doesn’t say much about how a program should actually operate.
New language would require programs to track needles more closely, and limit the number of needles a participant can take.
That’s been a dividing point for council members. Some want less needles, under the assumption that it would reduce unsightly trash. But council member Keeley Steele has a different concern.
“There is a certain contingency of the council that wants us to take a hard line on the one-to-one model. And I am not one of those,” she said.
Steele sides with CDC guidelines that say restricting needles hinders the mission of syringe programs, which is to curb the spread of infectious disease.
“I want harm reduction organizations to fit into a model that clearly works through science,” she said.
Steele represents the East End. Her ward isn’t far from Health Right, Charleston’s only active needle exchange program.
Another program, ran by grassroots volunteers, had been operating in the city. Solutions Oriented Addiction Response or SOAR held large-scale health fairs in a church parking lot on the West Side.
Council member Deanna McKinney represents a ward in that area. She has seen these events, where organizers set up shop and people flock to receive life saving supplies.
“When I went there, I didn’t see any accountability,” she said.
Organizers say they offer compassion and second chances at these events. Volunteers handed out needles as well as overdose reversal treatments like naloxone. But McKinney saw an influx of people she didn’t know.
“They were just people coming from different angles… how do you keep up with the people that’s coming to you?” she said.
She wants to support those with substance use disorder. In her mind, this ordinance will give her community a say in what happens in their neighborhood and still provide essential services to those in need.
“I pray to God that we make the right decisions, and actually help the people and not just give them tools to keep damaging their bodies and keeping them in the trauma that they’re in,” McKinney said.
McKinney doesn’t want Charleston to go without a harm reduction program. But SOAR has recently called off its health fairs, due to concerns from West Side residents. With no visible presence, the program can’t offer much help.
That’s what worries Steele. Not the number of needles that will or won’t be in the streets, but that if programs shut down, plenty of folks will lose a trusted resource.
“Everyone wants to make sure that folks that need help feel safe. And if you make them feel safe they’ll come for help, but if you don’t make them feel safe, they will not,” Steele said.
Monday night will bring debate to the council’s floor. But most of the provisions in this ordinance are already covered in new state law, signed by Gov. Jim Justice signed on Thursday that would require syringe programs to get a state license and approval from local elected officials.
The city ordinance would add more restrictive language on needle distribution. The city ordinance mandates a one for one exchange. State law mandates a “goal” of one to one exchanges.
The city ordinance would also fine anyone distributing needles unlawfully with a misdemeanor and $500 to $1000 fine.
The Charleston City Council has postponed a vote on whether to regulate syringe service programs operating in the city.
The council met Monday night in part to consider a local bill that would potentially criminalize harm reduction programs happening in the capital city.
The topic brought out a crowd of more than 100 people, many who took to the podium to speak to their elected officials. Doctors, clergy, those in recovery and those who love someone with a substance use disorder spoke out against the bill.
They told the council that this bill could shut down the life saving efforts of Solutions Oriented Addiction Response, or SOAR. The Charleston based grassroots group hands out overdose reversal medications and clean syringes at its Saturday health fairs in a West Side church parking lot.
Cathy Kunkel, who volunteers for SOAR, told council members that the group offers compassion and second chances to some of Charleston’s most vulnerable.
“I talk to people that are grateful to be treated as if their lives matter. And that is why harm reduction programs work. By getting people in the door without stigma, SOAR is able to provide access to Naloxone, HIV testing and treatment referrals,” Kunkel said.
SOAR volunteers and supporters say the stakes couldn’t be higher. The Centers for Disease Control and Prevention said Kanawha County has the “most concerning” HIV outbreak in the nation.
Joe Machin and the Kanawha County Commission filed a congressional inquiry into the full evidence the CDC has on the outbreak.
Kyle Vass / WVPB
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Kyle Vass / WVPB
Artist and activist Crystal Good speaks in support of SOAR.
Dr. Shelda Martin said she’s seen the number of HIV cases worsen in her daily work. She is director of CAMC’s Ryan White Program, which provides services and primary care to those with HIV.
“So far this year at SOAR events, we’ve tested 120 patients, nine are positive. Compare that to thousands of tests we’ve done in the last 20 years, where we find one or two positives [a year],” Martin said. “What I’m saying is as an HIV provider, in this community, I have never seen this.”
Martin and the CDC say syringe service programs are essential to curbing the spread of HIV and other blood-borne illnesses.
But West Side residents spoke in favor of more regulation. Christy Day said she supports efforts to help those with substance use disorder. But she asks why this program would operate in her neighborhood without her input.
“That was wrong, that was not neighborly,” she said.
Day noted that needle distribution isn’t happening in some of Charleston’s more affluent neighborhoods.
“If we want to have SOAR, that’s fine,” Day said. “Let’s take it to the South Hills, let’s take it to the East End. Open it up. Let’s have more distribution, not just in my neighborhood.”
The bill is a rewrite of current city code. Previously, the city police chief had to deem a harm-reduction program lawful to continue operating. New code would take the chief out of the decision-making process. Instead, programs would need to obtain a state license and abide by a limited one-to-one needle exchange.
The city council voted 14-12 to postpone the bill. Council members cited impending state legislation that could conflict with the city ordinance. State legislators are still considering Senate Bill 334, which would also regulate syringe service programs. That bill passed the Senate and is now in the House judiciary committee.
The council will take up the bill again on April 19.
A grassroots harm reduction program in Charleston connects those with substance use disorder to a host of services: food, menstrual products, HIV testing and medical referrals. It also hands out sterile syringes, with the goal of curbing blood-borne illnesses. But that particular service has come under fire from the City of Charleston. Elected officials cite concerns over needle litter and potential pricks. A proposed ordinance that will be taken up Monday could limit syringe programs in the city.
Charleston’s public safety committee advanced the ordinance to the full city council with a 5-2 vote. The council will take up the ordinance Monday at 7PM. In a statement to WVPB, Mayor Amy Goodwin did not indicate how she would vote.
Health reporter June Leffler spoke with Joe Solomon of Solutions Oriented Addition Response ahead of a health fair this Saturday.
Leffler: SOAR is having an event this Saturday, can you tell me what services are provided and what is the general vibe of your event?
Solomon: SOAR’s next big event is this coming Saturday and it will mark a year of SOAR either going out in the community or setting up relatively large health fairs. I mean, that’s what it has evolved from, from driving around meeting people where they are to connecting with so many people that we had to ask people to meet all together in a social distance kind of way when the pandemic struck. And so now we’re meeting in the sanctuary of a church, well a church parking lot. And it’s kind of like a bazaar of mercy and compassion. And everyone is given a smile, and asked how they are, and a genuine kind of love and warmth. As you come and enter. You can of course, get a mask if you don’t have one, or if you need more hand sanitizers, period products, and so on. And as you go down the line, there’s a lot of snacks, lots of water bottles that we give out too. And then as you go, you have options to get HIV testing and referral to care. And as you keep going, there’s someone that says, “Hey, if you’ve got syringe returns, we’re here to take them.” And we just collected over 100 pounds of syringe returns over the last, I don’t know how long actually it’s been since we did our last drop, but a truck just picked up over 100 pounds yesterday. We also give out really sturdy containers at that same table. And then you keep going and there’s a table with recovery coaches, and they can help you with all kinds of things. Whether you’re ready for abstinence based treatment, or like a 12 step program, or a medication assisted treatment program. Or where you need help troubleshooting things like getting ID or Medicaid or SNAP, they’re there to help. And then down the line you go and you can get as much Naloxone as you need. This is the largest Naloxone hub in the state. So we give out about 1000 doses every other Saturday. And we hear about 30 to 40 overdose reversals every two weeks. So 30 to 40 people that are still with us, thanks to this program and the people that are saving those lives with this Naloxone. And the last stop on the way here is our syringe service table and our other sterile equipment that we have available. And this is our station where we can help prevent the spread of HIV and Hep C, which have run rampant through our community these past couple years.
Leffler: Joe, you said there are a ton of services that are at your events. But the one that is being called into question by the city is your syringe services. The City of Charleston is working towards an ordinance that would regulate operations like yours that hand out syringes. The public safety committee passed language that would require organizations like yours to have a license and abide by a one to one exchange. If this becomes city ordinance, what would happen to SOAR?
Solomon: Well, we should really be asking what would happen to our people. Kanawha County now leads the state in overdoses. We’ve lost someone every three days for the past five years, just in this county. Our valley is also home to the nation’s most concerning HIV outbreak. According to the CDC, both of these things should be reckoning moments to race forward as a city. And what we see in City Hall is a chance for us to race backwards. So the risk of these stigma driven worst practices is that we have to turn people away.
Leffler: So on Monday night, the city council will take up this proposed ordinance. Will you be reaching out to council members? Just what will you be doing before Monday?
Solomon: Well, we’ll be busy. I think the city council has unfortunately a few members that give the impression that harm reduction is “us versus them.” And harm reduction is about everybody. It’s about protecting everybody. The concerns of council largely have to do with syringe litter. If you’re a parent and you find a syringe in a sandbox, that’s scary stuff. And we care about that stuff too. It’s why we’re the largest distributor of disposable containers and why we collect so many syringes. This bill that the city council has proposed does nothing for litter and does nothing for the HIV crisis or the overdose crisis of our city. SOAR over the next few days is going to be working with city council members to float an alternative ordinance that will actually help everybody, that will help syringe litter and help us get a handle on the HIV crisis. We’ve taken a draft written by the American Medical Association and we’ve added sections that address needle litter. For example, it invites the city to set up 10 to 15 syringe disposal boxes across the city over the next year.
On a recent soggy Wednesday evening, dozens of West Virginians packed a conference room inside the Charleston Coliseum and Convention Center to discuss the need for a “just transition” for coal-impacted communities.
As the nation grapples with climate change, the need for a fair transition for workers and communities that depend upon coal jobs and revenue has also gained traction. Nearly every 2020 Democratic presidential hopeful has touted some version of the idea, ranging from the expansive “Green New Deal” championed by Vermont Sen. Bernie Sanders to former Vice President Joe Biden’s more modest mix of worker training and direct assistance for coal country.
In West Virginia, discussions are starting to get attention in the state’s capital despite strong political support for the coal industry.
“When you’re hearing a call for a just transition for coal-reliant communities, folks are saying ‘look, starting now and into the future, we’re going to decarbonize the economy,’” said Ann Eisenberg, a law professor at the University of South Carolina. “There will be disproportionate losses imposed on coal-reliant communities. And that’s unfair. So we’re going to offset the losses. And that is where I think this is a good thing. And it’s also tricky.”
Eisenberg was one of a handful of experts who spoke at the event hosted by West Virginia University’s Center for Energy and Sustainable Development, the nonprofit West Virginia Center on Climate Change (an offshoot of conservation group Friends of Blackwater), and the left-leaning West Virginia Center on Budget and Policy.
The speakers facilitated a conversation about what constitutes a “just transition” as well as how West Virginia and other regions that depend on coal could actually get there.
Credit Brittany Patterson / WVPB
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WVPB
Three groups hosted a just transition discussion on Feb. 5, 2020 in Charleston, WV.
Adele Morris with the Brookings Institution said the first step is to acknowledge the clear data about coal. Even without a comprehensive climate policy, the fuel is already losing ground in the region and across the country. Low natural gas prices and the falling cost of renewable energy have priced many coal plants out of the market.
Federal data show since 2009, mining employment and coal production has fallen by about 50 percent in the Ohio Valley. The energy shift is already underway, Morris said, but without the part that would help communities make the transition.
“We’re in it. We’re in the transition,” said Morris, who is a senior fellow and policy director at the nonpartisan think tank. “And it’s going to get worse before it gets better. But it’s not fair. And that’s what I think should be urgently at the top of the agenda of the policymakers from coal country, and they’re not, in my opinion.”
Legislative Attempt
One lawmaker is making a pitch in West Virginia. State Del. Evan Hansen, a Democrat representing the north-central county of Monongalia, has introduced a bipartisan bill that would create a state Just Transition Office, and a community-led advisory committee that would focus on helping West Virginia communities affected by the decline of coal.
“The primary goal here is to write a just transition plan for the state of West Virginia that would look at ways to funnel funding into these communities and other types of resources into these communities in a manner that’s led by what people in those communities think is best,” Hansen said.
Still, he believes the appetite is growing among the state’s lawmakers to address coal’s decline.
“I would say privately many legislators of both parties acknowledge that there is a transition going on and that this is one of the most important issues that we need to deal with as a Legislature,” Hansen said.
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
Not everyone is a fan of the bill, including the West Virginia Coal Association.
“Sounds to me like that they think that it would be much better if it were something other than the coal miners,” said the group’s president Bill Raney. “And that bothers me a whole lot because we got the best coal miners in the world.”
Raney’s group is pushing a bill this legislative session that would require West Virginia coal plants to burn the same amount of coal they did in 2019 in the years ahead, regardless of what makes most economic sense.
Of major note during the discussion was how to pay for a “just transition.”
Today most economic transition work in the region comes from federal programs including the Appalachian Regional Commission and Abandoned Mine Land program funding, which offer grants to coal-affected communities in the millions of dollars range.
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
Morris has estimated the region will require tens of billions of dollars over the next decade and would require some kind of regulatory leadership from Washington, D.C., preferably a carbon tax. Democratic candidates who have supported the idea have differing ways to fund it, although most rely heavily on investing in clean energy and decarbonizing the economy through a “Green New Deal.”
Some in the region have encouraged lawmakers and candidates looking at these climate policies to engage with residents directly.
That includes Cecil Roberts, head of the United Mine Workers of America. In September, he spoke at the National Press Club in Washington, D.C. He expressed concern the type of sweeping change Democratic presidential candidates are promising may be too big of a lift for Congress given its past track record in helping coal country.
“We want our health care saved, and if you can’t do that, and it’s been 10 years, how do you think we’re going to believe that you’re going to be able to give us a just transition from the coal industry to some other employment?” he said.
Kentucky Conversations
Chuck Fluharty, President and CEO of the Rural Policy Research Institute, helped to organize a community-centered, just transition model in eastern Kentucky called Shaping Our Appalachian Region, or SOAR. He said SOAR has shown this type of work is possible, especially if a community-centric approach is embraced. However, it’s not easy.
Credit Sydney Boles / Ohio Valley ReSource
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Ohio Valley ReSource
Kentucky entrepreneurs show their products at the 2019 SOAR Summit.
SOAR’s premise is built upon a collective impact investing model that engaged the public, private and philanthropic sectors.
“The real proof of the pudding is in how broad collective commitment is, and is it there for the money or is it there for the future?” he said. “How much it is about investing and not simply dropping dollars on the table.”
Some politicians hope to engage coalfield communities directly about how to balance implementing climate legislation while protecting workers and investing in communities. Kentucky Democratic state senator and U.S. Senate candidate Charles Booker recently launched a series of town meetings on the subject in the heart of eastern Kentucky coal country.
Even among those who support a just transition, questions remain about how best to do it. Morris said there is little data on what has worked in economic transitions in the past. Her team has looked at the impact of military base closures, for example, but said the analogy isn’t perfect. Worker retraining efforts often have mixed results.
“There’s this policy design challenge of how do you get from the wholesale dollars of the federal government into well designed retail level grants and assistance and so on,” she said. “I’m still struggling with exactly how you do that in a way that gets those resources out, but does it in a way that that gives people comfort that it’s responsibly allocated.”
In a report published last July, Morris and colleagues at the Center on Global Energy Policy at Columbia University quantified just how much of a coal-producing county’s budget came from coal, and how big a hole their budgets might face without coal revenue.
Then the authors turned to the various policy proposals to limit greenhouse gas emissions, which would set a price on each ton of carbon dioxide released to the atmosphere.
Morris said that the revenue generated by such policies could be steered into the type of investments needed and at a scale that would make a just transition more likely.
For example, a carbon tax of $25 per ton would likely raise a trillion dollars in revenue over 10 years, she said.
“And that kind of revenue allows for a very generous support for coal-reliant areas,” Morris said.
