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Changing Policy to Change Lives
- 1. Changing Policy to Change Lives University of North Carolina at Chapel Hill HBEH 730: Theoretical Foundations of Behavioral & Social Science, Fall 2015 Shauna Ayres, Bridget Hochwalt, Tom Joseph, & Elizabeth Orlan
- 2. West Virginia experienced a increase in Hepatitis C rates between 2006-2012
- 3. 73% 27% Primary Risk Factors Injection Drug Use Other
- 5. The Road to Addiction and Disease 1996 2000 INTRODUCTION Policy Campaign Program Timeline Summary
- 6. INTRODUCTION Policy Campaign Program Timeline Summary
- 7. Rates of Acute Hep. C per 100,000 residents 2007 2014 INTRODUCTION Policy Campaign Program Timeline Summary
- 8. HARM REDUCTION POLICY West Virginia Legislature PROGRAM Injection Drug Users DualApproach Introduction POLICY Campaign Program Timeline Summary
- 9. Proposed Bill for West Virginia •County mandated & appropriated Needle Exchange Programs • Surveillance for Hepatitis C • Needle disposal • Addiction treatment • Naloxone & Suboxone • Good Samaritan Law • Evidence-based education added to school curriculum Introduction POLICY Campaign Program Timeline Summary BILL SPONSOR, Delegate Dr. Chris Stansbury of Kanawha County
- 10. NEPs by State • Kentucky SB 192 is a comprehensive harm reduction package Prevention • Good Samaritan • NEP • Education Treatment • Naloxone • Suboxone • Counseling 32 STATES + District of Columbia & Puerto Rico Introduction POLICY Campaign Program Timeline Summary
- 11. Evidence Introduction POLICY Campaign Program Timeline Summary
- 12. Cost $0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000 $140,000 $160,000 1 HCV Tx 1 NEP Introduction POLICY Campaign Program Timeline Summary
- 13. Cabell County NEP Pilot Program SUCCESSES Community acceptance 8 other counties are interested Started September 2015 Free needle exchange program with educational components, counseling, & testing Serving 305 individuals, 21-35 years old, 60% males Goal: 1-1 exchange LIMITATIONS Budget Meeting demand Transportation Introduction POLICY Campaign Program Timeline Summary
- 14. Passing HB 1001 Federal Gov. Legislature State & Local Gov. Civil Society Media Constituents StakeholderMapping Introduction POLICY Campaign Program Timeline Summary
- 15. Crushing the Competition Allies Coalition Opponents Introduction POLICY Campaign Program Timeline Summary BILL SPONSOR, Del. Chris Stansbury House Speaker Tim Armstead Rep. Hal Rogers (R-KY) Patrick Morrissey- AG Sen. Joe Manchin (D-WV) Gov. Earl Ray Tomblin Sen. Shelley Capito (R-WV)
- 16. Diffusion of Innovations ConfirmationImplementationDecisionPersuasionAwareness Introduction Policy CAMPAIGN Program Timeline Summary
- 17. Media Advocacy Local PegInjustice Introduction Policy CAMPAIGN Program Timeline Summary
- 18. “…It is literally touching every community around this state… If you don’t think it’s your problem now, it soon will be.” --Delegate Dr. Chris Stansbury of Kanawha County & BILL SPONSOR Introduction Policy CAMPAIGN Program Timeline Summary
- 19. Driving the Conversation Introduction Policy CAMPAIGN Program Timeline Summary
- 20. Access to Accurate Information Introduction Policy CAMPAIGN Program Timeline Summary
- 21. Fact Sheet Introduction Policy CAMPAIGN Program Timeline Summary
- 22. HARM REDUCTION POLICY West Virginia Legislature PROGRAM Injection Drug Users DualApproach Introduction Policy Campaign PROGRAM Timeline Summary
- 23. Program Summary • County-Wide • Individualized Service Delivery • Suite of Services • Needle disposal • Addiction treatment • Infectious disease testing • Harm reduction education • Naloxone & Suboxone Introduction Policy Campaign PROGRAM Timeline Summary
- 24. Social Networks Homophily Centrality Reciprocity Introduction Policy Campaign PROGRAM Timeline Summary
- 25. Word of Mouth Most Cabell County’s NEP patrons are referred by word of mouth. Introduction Policy Campaign PROGRAM Timeline Summary
- 26. Mobile AppHomophily Centrality Reciprocity MobileApp Homophily Centrality Reciprocity Introduction Policy Campaign PROGRAM Timeline Summary
- 27. Outcome Evaluation Introduction Policy Campaign PROGRAM Timeline Summary NEP State Policy NEP ↓Use of dirty needles among IDUs ↓Use of dirty needles among IDUs’ peers ↓Hep C & other infectious diseases HARM REDUCTION Educational Material & Resources Testing & Treatment
- 28. Timeline Introduction Policy Campaign Program TIMELINE Summary NEEDLE EXCHANGE PROGRAM
- 29. Take Home Points • Hepatitis C is an immediate & growing public health threat Lack of funding from government • Strong evidence that NEPs are a solution • Clear cost-benefit • Widespread community support Introduction Policy Campaign Program Timeline SUMMARY NEEDLE EXCHANGE PROGRAMS SAVE LIVES
- 30. Dr. Donna Evon Dr. Kurt Ribisl Claire Brennan Dirk Davis Tim Hazelett, Cabell County Health Administrator Dr. Michael Kilkenny, Cabell County Health Director Philip McDaniel, GIS Librarian, UNC-CH Daniel Raymond, Policy Director, Harm Reduction Coalition, NYC Looking Glass Café Thank You! “We hope to put ourselves out of business in the Harm Reduction Program.” -Tim Hazelett, Cabell County Health Administrator