Information for Organizations Operating a Syringe Service Program

Legal Authorities and Requirements

SSPs are allowable in New Hampshire based on the passage of SB 234 (Laws of 2017, Chapter 117) on June 16, 2017. The bill:

• Exempts residual amounts of controlled substances in hypodermic syringes and needles from the provision of the controlled drug act (RSA 318-B:1)
• Authorizes persons other than pharmacists to dispense hypodermic syringes and needles and allows them to be sold in retail establishments other than pharmacies; and, (RSA 318-B:17-a)
• Authorizes the operation of syringe service programs in New Hampshire. (RSA 318-B:43-a)

Agencies that may operate syringe service programs are: (RSA 318-B:43-a, I)

• Federally Qualified Health Centers (FQHC)
• Community Health Centers (CHC)
• Public Health Networks (PHN)
• AIDS Service Organizations (ASO)
• Substance misuse support or treatment organizations
• Community Based Organizations (CBO)

NH DHHS requests any entity operating a syringe service program in New Hampshire to: (RSA 318-B:43-a, II)

• Provide referral and linkage to HIV, viral hepatitis, and substance use disorder prevention, care, and treatment services, as appropriate.
• Coordinate and collaborate with other local agencies, organizations, and providers involved in comprehensive prevention programs for people who inject drugs to minimize duplication of effort.
• Be a part of a comprehensive service program that may include, as appropriate:
• Providing sterile needles, syringes, and other drug preparation equipment and disposal services.
• Educating and counseling to reduce sexual, injection, and overdose risks.
• Providing condoms to reduce risk of sexual transmission of viral hepatitis, HIV, or other STIs.
• Screening for HIV, viral hepatitis, STIs, and tuberculosis.
• Providing naloxone to reverse opioid overdoses.
• Providing referral and linkage to HIV, viral hepatitis, STI and tuberculosis prevention, treatment, and care services, including antiretroviral therapy for hepatitis C virus (HCV) and HIV, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), prevention of mother-to-child transmission, and partner services.
• Providing referral and linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination.
• Providing referral and linkage to and provision of substance use disorder treatment including medication assisted treatment for opioid use disorder which combines drug therapy such as methadone, buprenorphine, or naltrexone with counseling and behavioral therapy.
• Providing referral to medical care, mental health services, and other support services.
• Post its address, phone number, program contact information, if appropriate, hours of operation, and services offered on its Internet website.
• Register with the New Hampshire Department of Health and Human Services and confirm registration annually on or before November 1st of each subsequent year. The NH Syringe Service Program Registration should be used to submit your registration.
• Provide quarterly data reports in a format directed by and to the Division of Public Health Services.

Funding

No mechanism to fund SSP activities was included in NH’s new SSP law. Organizations that decide to operate an SSP need to identify a funding source for these activities.

The federal Consolidated Appropriations Act of 2016 includes language that gives states and local communities, under limited circumstances, the opportunity to use federal funds to support certain components of SSPs. State, local, tribal, and territorial health departments must request permission to use federal funds to support SSPs by consulting with the Centers for Disease Control and Prevention (CDC) and providing evidence that their jurisdiction is (1) experiencing, or (2) at risk for significant increases in hepatitis infections or an HIV outbreak due to injection drug use.

NH DPHS submitted a Determination of Need request to CDC on October 5, 2017 and on October 26, 2017, CDC issued a letter of concurrence that NH is at substantially increased risk of viral hepatitis or an HIV outbreak due to injection drug use. This letter of concurrence does not mean that NH will receive any new funding for SSP operations. Eligible HHS-funded recipients in NH may apply to direct federal funds to support certain aspects of SSPs. Recipients interested in directing funds should contact the specific HHS funding agency to submit such a request.