CLARK COUNTY — Nearly six months after Clark County's health commissioner declared an HIV epidemic resulting from intravenous drug use, an application to set up a needle exchange program in the county is still underway.

Clark County Health Commissioner Kevin Burke submitted a roughly 50-page request to the Indiana State Department of Health on Dec. 15, four months after county commissioners formally adopted Burke's declaration. The state responded by asking Burke to nail down contracts with partners who would help fund and staff the needle exchange. Those partners include the AIDS Healthcare Foundation and Marian University.

"Those [contracts] were finally drafted in the final form this week and we're going to send those in to the AIDS Healthcare Foundation," Burke said, adding that he expected the state might requests to see final contracts before being able to approve his request.

"So they did what I suspected they might and they asked to see the contracts, which that's their prerogative. They're going to give permission to do this and they want specific types of information so I think it's reasonable."

Burke added that he expects the request to be approved quickly once the contracts are finalized and sent back to the state. The state then has 10 days to respond. A spokesperson for the state health department said it would not be appropriate to comment on the status of Clark County's operation, but did confirm that the state asked Burke for additional materials.

In addition to the contracts, Burke said the state asked him to reword his official declaration of an HIV epidemic to better form to statutory requirements and language.

STABLE, BUT URGENT

When Burke declared an epidemic last year, he noted that Clark County has an estimated 5,000 IV drug users. With 11 people per 100,000 diagnosed with HIV in 2014, Clark County's rate of new HIV cases was about 37 percent higher than the state average. The county's rate of hepatitis C — 97 per 100,000 people in 2014 — was about 40 percent higher than the state average.

A needle exchange would provide clean needles in exchange for dirty ones and connect drug users with treatment resources.

Burke said since last August, the rate of drug use and disease appears to be unchanged. He attributed increased awareness to community efforts, like the week of events hosted by Clark County CARES — an acronym for community addiction resource, education and support — in January.

"My impression is that it is it relatively stable," he said. "The Clark County CARES ... they have increased public awareness and they're going to continue to have periodic presentations and meetings to inform people and encourage those that have a problem to seek assistance. So hopefully with their added community effort — and I'm a member as well — we'll see some improvement in the numbers of people that are getting help and hopefully a decrease in IV drug use and eventually see a lower level of Hep C and HIV."

Clark County Commissioner Rick Stephenson said commissioners haven't been briefed on the status of the needle exchange, but that he takes that as a sign that things are going smoothly. Still, he acknowledged that the need for help is urgent.

"I think that obviously with the epidemic that's going on in Scott County and with that being neighboring, and also with the residual effects of being so close to Louisville, that it's imperative that we initiate this this just so we can curtail any of the spreading of the drugs and disease," Stephenson said.

Burke said he expects to send in the contracts and comply with the state's requests by the end of the month.

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