I convened a Harm Reduction training with 50 local stakeholders which included information on principles and current policies, as well as a historical background of the development of syringe exchange programs in the United States.

After completing the research phase and collecting initial input from local stakeholders, the pilot program was designed to:

1. • reach the target population including any individual using syringes, with a priority on substance abusers and low income diabetics, approximately 1,000 participants in the first year;
   

2. • focus on target locations on the West and East sides of San Antonio;
   

3. • operate Monday thru Friday;
   

4. • identify specific locations for mobile street sites with a minimum two hour stay at each site;
   

5. • determine a stationary site using the community health and safety pantry concept;
   

6. • acquire and/or develop bilingual/bicultural prevention materials;
   

7. • develop community awareness campaign;
   

8. • create program evaluations;
   

9. • establish an advisory committee; and
   

10. • report on the programs progress to the Legislature.
    

In September 2007, while we were moving forward with the program planning and design, Bexar County District Attorney Susan Reed filed a request with the Texas Attorney General’s office seeking an official position on the legality of the pilot program.

On May 5, 2008 Attorney General Greg Abbott issued his official opinion concerning the implementation of the anonymous needle and syringe exchange portion of the pilot program in Bexar County. The opinion stated that the pilot program could proceed without the needle and syringe exchange component, however if the County proceeded with that part of the program participants “would appear to be subject to prosecution.”

Due to this ruling, the syringe exchange component of the pilot program will not be implemented until the legislature revisits the issue and passes a law allowing for such programs. Instead the program is focusing on harm reduction and community health, wellness and prevention education. The program is disseminating bilingual/bicultural materials and resources to community stakeholders, organizations and agencies, as well as continuing harm reduction training events.

Since the inception of the project the following have been accomplished:

Efficiency Measures

# of Baseline Committee Meetings Held                                                          5

# of Persons on Harm Reduction Data Base (community contacts)                 84

# of site visits to NEPS                                                                                  3

# of presentation at conferences/community meetings                                   4

# of organizations/agencies contacted                                                           8

# of program resources and material disseminated -   

                 Condoms                                                                             8,500

                 Lubricant                                                                             8,250

                 Sharps containers                                                                 1,800

                 Literature/Pamphlets, condom cards                                        600

                 Wound care kits                                                                        85

                 Hygiene kits – female                                                              100

                 Hygiene kits – male                                                                 100                                                                                       

Bexar County Harm Reduction Program

Charlene Doria-Ortiz

Community Health Program Manager

Aurora M. Sanchez

Executive Director

Department of Community Investment

So Close and Yet So Far

By Charlene Doria-Ortiz

Community Health Program Manager

Department of Community Investment

Division of Community Health

In May 2007, the Texas Legislature passed Senate Bill (SB) 10 which included authorization to establish a pilot program to prevent the spread of certain diseases and the anonymous exchange of needles and syringes in Bexar County.

In August 2007, the Bexar County Commissioners Court authorized initial funding to provide for a staff position and the planning and design of the pilot program in the Department of Community Investment. A Harm Reduction Coordinator position was created and I was hired to support the program efforts.

Brochures being distributed by the Bexar County Harm Reduction Program

To plan the design of the program I organized meetings with community stakeholders to gather their input and support for the program and to form working committees.  I also traveled to California to visit successful syringe exchange programs run by city and county governments, and conducted extensive research on other successful programs in the United States.

Two nationally recognized experts on syringe exchange programs in the United States visited San Antonio and their visit resulted in the expansion of the program to include the concept of harm reduction. The main objective of harm reduction is to mitigate the potential dangers and health risks associated with the risky behaviors themselves.

In Bexar County there are an estimated 10,000 injection drug users. However, under current Texas law there is a lack of access to a community mechanism for the safe disposal and collection of used syringes.