The Community Health Care Van — a local clinic initiated by the Yale AIDS program more than two decades ago — is poised to assume the responsibilities of the New Haven Health Department’s Syringe Exchange Program. At the end of 2016, the city relinquished authority over the program, which allows users of drugs and steroids to exchange used needles for clean ones. However, the CHCV’s contract with the Connecticut Department of Public Health has yet to be approved.
Created in 1993 by Yale School of Medicine professor Frederick Altice, the CHCV is a 40-foot mobile clinic equipped with facilities for its disease assessment, prevention and treatment services. The health care van’s outreach and intervention activities include on-site addiction treatment, HIV and hepatitis testing and, more recently, overdose prevention, in light of the city’s current opioid crisis.
Altice said he was approached in mid-December by both the Connecticut and the New Haven health departments to discuss the future of the New Haven Syringe Exchange Program, given the city’s staff reduction plans. He said that in the meeting, state officials expressed concerns that the services provided by the city were insufficient, especially compared to those of Bridgeport and Hartford.
As a result, the Connecticut Department of Public Health is hoping that Yale will be able to implement a more effective model, Altice said.
“The idea is that we just need to figure out how to revitalize the program and make it work with different models,” Altice said. “To figure out what is needed, we are going to have to have a rapid assessment of the community and figure out what is going on out there.”
New Haven was one of the first sites of syringe exchange, opening the first U.S. syringe exchange program during the AIDS epidemic of the 1980s, according to the Public Broadcasting Service. Dean of the Yale School of Public Health Paul Cleary noted that the city’s success led to the worldwide expansion of syringe exchange programs as a preventative measure.
However, in recent years New Haven was the only place in Connecticut still using a municipality or health department for syringe exchange, according to Altice. All other programs in the state are now run by community-based organizations like the CHCV.
“If [syringe exchange] services are included in a revitalized program, our local exchange could once again serve as a national and international model,” Cleary said. “This kind of service is especially important, given that the opioid overdose epidemic has claimed the lives of twice as many Connecticut residents as traffic crashes in 2016.”
Altice added that he plans to create advisory boards that will allow community members to provide guidance throughout the transition process. The ultimate goal is to figure out how to reach more people and increase the volume of needles exchanged, he said.
At the time of its discontinuation, the city’s SEP had three workers, all of whom belong to Local 3144 and were laid off at the end of 2016. Local 3144 is a local union that represents over 460 city employees. In a letter to the New Haven Board of Public Health Commissioners and Board of Alders, Local 3144 president Cherlyn Poindexter asked the city to reinstate the program. She cited worker concerns over the city’s ability to adequately serve the community without the SEP. As of Wednesday, Poindexter said she had received no response.
One of the workers, Mamie Smith, said that the city’s Syringe Exchange Program operated out of the health department’s outreach unit -— a vehicle that visited “high-crime, high-risk areas” such as the Hill, Newhallville and Fair Haven neighborhoods. George Bucheli, another of the workers, said that the Syringe Exchange Program also included a home delivery option, which offered food and clothing donations to those who needed it as well. He added that until recently, clients had the option to exchange needles at the health department’s offices, too.
Bucheli and Smith both expressed concern about Yale’s ability to establish a trusting relationship with clients. Many of the Syringe Exchange Program’s employees were former users themselves, so they brought firsthand experience and more insight into helping clients, Smith said.
“We were meeting [our clients] where they were at because of who we were,” Smith said. “I’m not saying [the transition to Yale] is a bad thing, but it’s still going to be different for the clients — more clinical. It’s like going to the hospital and talking to a doctor that you don’t know rather than going to your primary doctor that you’ve had for years.”
Bucheli also expressed concern over the inefficient transition, noting that the CHCV sometimes provides the wrong type of syringes, and the New Haven Health Department still has many syringes in storage that have yet to be transferred to Yale.
City spokesperson Laurence Grotheer had not responded to request for comment by Wednesday night.