Ordinance 1354 Before 3/19/2024 Tammy Martin
From: Leah Vann <thenewmedec24@gmail.com>
Sent: Friday, March 15, 2024 10:46 AM
To: BOCC
Subject: Public comment
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This is a public comment for the meeting on.Tuesday 3/19
regarding the sterile needle and syringe exchange ordinance 8.80
Please confirm that you have received this e mail.
Sean Swope,
You are ignorant in so many ways. It's "heartbreaking". I noticed you like to use that word.You think
shutting down the harm reduction program is going to stop people from using and clean up our city?you
are so wrong. If an addict wants to use a needle they will and without the needle exchange it will more
than likely be a used dirty needle. So you shut down that program and not only do you have a sick addict
but also an addict without connection or resources. I was a dirty needle user and because of my choices
I got hep c.You know who was there for me when I got clean and wanted to treat my hep c?Gather
Church.The harm reduction program and all of their services. If you think shutting down this program or
Gather Church,who provides this program is going to cure addiction or make things better in our
community you are so wrong it's not just about providing clean needles it's a bigger picture. It's providing
services and helping make those connections with addicts so they can get help so they feel comfortable
and not judged asking for help. If you take all that away you think the addicts on our streets will just
disappear?You will see more deaths as well as more sick people. You will only see the addiction crisis
rise. As you said you have never been an addict. I have been. I know from firsthand experience what
helps and what doesn't.
You also mentioned in your meeting"graduation a few months ago for drug court happened here and that
person passed away".What does my brother's death have to do with what you are fighting against what
does it have to do with the harm reduction program what does it have to do with Gather Church? It has
nothing to do with that! SO HOW DARE YOU BRING UP HIS DEATH! You want to "protect those in active
recovery". What about the people who are in active addiction?those people need protected and helped
as well!
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Tammy Martin
From: Patty Howard <pattyh@gatherchurch.com>
Sent: Friday, March 15, 2024 10:54 AM
To: BOCC
Subject: Written comment for Tuesday, March 19 hearing
Attachments: Healthcare comment on ordinance.pdf
Follow Up Flag: Follow up
Flag Status: Completed
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Good morning,
Attached is a letter from Dr. Lily Lo regarding proposed ordinance 1354, which she would like to have
read during the hearing on Tuesday, March 19. Please let me know if you have any questions or there is
an issue with having it read.
Thank you,
Patty Howard
Patty Howard
Gather Church
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March 14, 2024
To the Lewis County Commissioners:
I would like to comment as a healthcare professional on the proposed Ordinance Chapter 8.80
STERILE NEEDLE AND SYRINGE EXCHANGE. I am a volunteer physician at Gather
MedsFirst, a low-barrier clinic for medication assisted treatment of Opioid Use Disorder. I am
also Medical Director at Northwest Pediatric Center,which cares for over 15,000 children in our
county and oversees the medical care at both Lewis and Thurston County Juvenile Detention
Centers. I have over 24 years of experience providing healthcare in this community.
I believe strongly that this proposed ordinance creates multiple, inexplicable barriers to
providing healthcare to people suffering from substance use disorders. Substance use disorders
are classified as mental health disorders which affect a person's brain and behavior, leading to
their inability to control their use of substances like tobacco, alcohol, opioids, or stimulants.
These disorders are multifactorial in origin and require multifaceted approaches to treatment; like
most medical conditions,there is no one-size-fits-all cure. Harm reduction strategies are one
facet of treatment.
Harm reduction refers to a range of public health policies intentionally designed to lessen the
negative physical and social consequences associated with various human behaviors, both legal
and illegal. As of 2020, some 86 countries had one or more programs using a harm reduction
approach to substance use,primarily aimed at reducing blood-borne infections resulting from use
of contaminated injecting equipment. Harm reduction recognizes that people with substance use
disorder(SUD)can still make positive change to protect themselves and others, even if their
disorder prevents them from stopping their use of substances that harm themselves.
This proposed Lewis County ordinance would be devastating for our community from a public
health standpoint, as it not only interferes with proven harm reduction strategies already in place
that target substance use disorder,but goes even further as to criminalize them. Imposing
criminal penalties on measures that improve public health outcomes is nonsensical and
dangerous, depriving a protected class of individuals from accessing the services they need to
keep themselves and the community around them safe.
The proposed ordinance is also not based upon current evidence and best practices in public
health policy. For instance, Section 8.80.040 mandates that all staff and volunteers who work for
or with a sterile needle and syringe exchange program be persons who have not benefited from
this intervention in the past 24 months. However, research has repeatedly shown that people
with lived experience are the ones most likely to convince their peers to seek help in treating
their SUD. Peers with recently lived experience are extremely effective in spreading the
message of harm reduction because stereotyping and stigmatization has led to distrust of the
conventional healthcare system. This distrust keeps people from seeking help and is also the
reason that mobile harm reduction services are sorely needed in order to reach those who need
care the most.
The Centers for Disease Control and Prevention state: "a comprehensive, multi-
component, prevention program is the most effective approach for preventing the
transmission and acquisition of HIV and other blood-borne infections among drug-
using populations. SSPs [syringe services programs] are an important component
of this approach and are particularly key in establishing contact with otherwise
hard-to-reach populations to deliver health services, including HIV, sexually
transmitted diseases, and viral hepatitis counseling (including for risk reduction)
and testing, overdose prevention,and substance use disorder treatment referrals."
Section 8.80.050 of the proposed ordinance prohibits the use of mobile SSPs. This removes one
of the main avenues through which people with SUD can access much needed harm reduction
services, as many people suffering from SUD are unhoused, lack adequate transportation, and
distrust conventional healthcare facilities because of how they have been treated there.
Section 8.80.020 defines cookers, cotton balls, syringes, and sterile water as"drug
paraphernalia," similar to language found in RCW 69.50.4121, but neglects to mention that the
state code does not prohibit"the distribution or use of public health supplies including,but not
limited to, syringe equipment, smoking equipment, or drug testing equipment,through public
health programs, community-based HIV prevention programs, outreach, shelter,and housing
programs, and pharmacies."
Cookers are one of the most commonly shared items used in drug injections;they are more
commonly shared than needles. They may be shared directly,as when several users draw up their
injections from the same cooker, or indirectly/accidentally, for example when a user finds a
discarded spoon that they do not know has been previously used as a cooker. Shared cookers,
like shared needles and other equipment used with injections, have been shown to transmit
serious blood-borne infections such as hepatitis B, hepatitis C,and HIV between users.Any non-
sterile cooker,even if it is not shared, may be contaminated by bacteria,which can lead to life-
threatening bacterial infections, including abscesses, cellulitis,bone and joint infections,or heart
infections.
SSPs that provide sterile needles and injection supplies help protect communities by preventing
infectious disease outbreaks and facilitating safe disposal of used syringes. Needle exchange
programs alone have reduced HIV incidence by 70%in New York City. Numerous research
studies have shown that these programs are not associated with increased drug use, crime, or
syringe litter in communities.
Lewis County has the distinction of having one of the highest rates of chronic hepatitis C
infection(75-158 cases/100,000 population) in the state. Our own Public Health Advisory Board
has unanimously agreed that SSPs are best practice and beneficial for our community's overall
health. Providing safe supplies to people who inject drugs creates a way to engage hard-to-reach
and underserviced populations in healthcare and social services and, as numerous studies have
shown,does not make people more likely to engage in harmful drug use. On the contrary,people
who engage with SSPs are provided access to peers whom they trust with lived experience in
recovery, information on risk reduction, counseling,and referrals for other services that can help
them break the cycle of addiction and reduce the spread of preventable infectious diseases to
others. Criminalizing outreach program volunteers and staff for providing this public service
will only hinder the provision of much needed healthcare services to an already disenfranchised
and protected class of citizens.
For all of these reasons, I oppose the proposed ordinance prohibiting mobile SSPs and the
distribution of public health supplies aimed at reducing harm from substance use disorders.
Respectfully yours,
Lily L. Lo,MD, FAAP
Supervising Physician, Gather MedsFirst Clinic
Medical Director,Northwest Pediatric Center
Tammy Martin
From: Ray Chapman-Wilson <rleroyw@gmail.com>
Sent: Saturday, March 16, 2024 9:54 AM
To: BOCC; Ray Chapman-Wilson
Subject: public record
Attachments: BOCC letter 2024-03-12 support women - Google Docs.pdf
Follow Up Flag: Follow up
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Hello, This Is what I spoke about at a recent BOCC meeting, and is intended for public record and to be
used in case of litigation or any other legal action.
Can this please be forwarded the commissioners and may I also get confirmation of receipt of this
email?
Best regards,
Ray Chapman-Wilson
503-381-7444
rleroywCCgmail.com
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March 12, 2024
Lewis County Commissioners
Ray Chapman-Wilson, Centralia
We're with the group, Grandparents Supporting Trans Kids
Did you all see that letter published March first in The Chronicle titled "Sean Swope
commentary: Rejecting a misguided celebration of International Women's Day at college"
Grandparents Supporting Trans Kids reject the harmful opinions and views included
Commissioner Swopes letter.
Commissioner Swope criticizes the women's group who organized International Women's Day,
because apparently, they did not organize their event the way Commissioner Swope would have
done. I am not kidding. We still don't know why he didn't just organize his own event instead of
tearing down someone else's.
Regardless, more concerning is the way The Commissioner, especially in relation to people
that organized the event, uses buzzwords like "undermine, abuse, erase, defy, relentless, insult,
disrespect, oppress, discriminate, succumbing, radical, ideologies, slap, violence, overshadow,
external, distorted, diminish". Along with phrases like "succumbing to radical ideologies" "we
cannot allow", "refuse to compromise", "resist external pressures" That language, those specific
words are pampered throughout his letter in an effort to create division, fear and distrust.
These patterns of "moral and truth narratives" are used by several other hypocritical behavior
control groups like Alliance Defending Freedom and Westboro Baptist Church. The same type
of speech used by Moms for Liberty Oklahoma School Board members, prior to the beating
and subsequent death of a child, Nex Benedict, targeted in a similar fashion. Our speech has
the potential to promote unity. As we've seen, our speech has the potential to "green light"
violence against others.
It's important to note that free speech is not absolute and that certain speech can create liability
and can be legally actionable. Remember, the KKK in large part was taken down not because of
the violent crimes they committed but largely because of the speech that tied the organization
to those hate crimes.
Commissioner Swope says that the views he expresses may be contentious, and I agree.
However, a letter supporting women instead of tearing them down would not be contentious.
Very basic stuff. Call other people names, contentious. Support women, not contentious.
Commissioner Swope, there is no right way to do the wrong thing. Grandparents Supporting
Trans Klds asks you to consider not tearing others down, but lifting us all up.
Peace be with you friends,
Citations:
Nex Benedict: preventable beating and death
https://www.edweek.org/leadership/district-under-federal-investigation-following-death-of-nonbin
ary-student-nex-benedict/2024/03
The KKK loses
https://magazine.columbia.edu/article/klans-last-stand
Deceptive language of the holocaust
https://www.vadvashem.org/blog/deceptive-definitions.html
Westboro Baptist Church blames Nex Benedict for his own death
https://www.msn.com/en-us/news/us/westboro-baptist-church-blames-nex-benedict-for-his-own-
death-will-protest-his-school/ar-BB1jjhO0
Tammy Martin
From: Christina Riley <christina.riley85@yahoo.com>
Sent: Monday, March 18, 2024 8:55 AM
To: BOCC
Subject: Ordinance 1354
Follow Up Flag: Follow up
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Board of Lewis County Commissioners
Thank you, County Commissioners, for the opportunity to comment on this topic.
Open injection sites, while well-intentioned, are not the best option for small communities. There are several
potential drawbacks to consider:
1. Increased crime: While open injection sites aim to reduce the harm associated with drug use, they also
attract criminal activity to the surrounding area. This can make residents feel unsafe and deter businesses from
opening in the area, as well as shifting the burden to these small businesses.
2. Negative impact on property values: The presence of an open injection site may lower property values in the
surrounding area, making it more difficult for homeowners to sell their homes or attract new buyers.
3. Strain on Medical Providers: Open injection sites require significant resources to operate, including trained
staff, medical supplies, and security measures. This can strain local budgets and divert resources away from
other important community needs, especially in small communities with limited resources. Moreover, our local
medical providers are already experiencing a need for more medical professionals. Therefore, the operation of
these sites requires a larger number of medical staff to be present on-site, adding further pressure on the
already stretched resources.
4. Lack of community support: The establishment of an open injection site can be controversial, and some
community members may not support the idea. This can lead to social tensions and divisions within the
community.
5. Reduced Stigma on drug use: When you look up Pro's to a safe injection site, reduced stigma on drug use is
often number one. That should not be considered a pro. We are seeing record numbers of drug usage and
overdoses all across our country. What we know is that Fentanyl is killing kids, and to continue to reduce the
stigma around drug use is a disservice to our youth and to our families. We need to be focusing on the
opposite. We must educate our community members on the harmful effects of all drugs and break the cycle of
drug use.
It is important to consider the potential drawbacks carefully before implementing or sustaining such a program
in a small community. Taking a holistic approach to rehabilitation, mental health support, education, and
training services can provide hope for a better future for vulnerable populations. Additionally, Lewis County
may have other opportunities to assist this population. Narrowing the use of these sites and creating more
regulations for utilization will improve much-needed safety measures in our county.
For our families and especially our youth, please regulate sterile needle and syringe exchanges.
i
Thank you,
Christina Riley
Winlock, Wash
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Tammy Martin
From: Rieva Lester
Sent: Monday, March 18, 2024 2:40 PM
To: BOCC
Subject: FW:OPPOSE Ordinance 1354
Attachments: OPPOSE proposed Lewis County ordinance 1354.docx
Follow Up Flag: Follow up
Flag Status: Completed
Rieva Lester
Clerk of the Board
Lewis County Board of County Commissioners
351 N.W. North St.
Chehalis,WA 98532
360-740-1419 I Rieva.Lester@lewiscountywa.gov
From:Amy Lieberman <ALieberman@networkforphl.org>
Sent: Monday, March 18, 2024 2:36 PM
To: Rieva Lester<Rieva.Lester@lewiscountywa.gov>
Subject:OPPOSE Ordinance 1354
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Attached please find our letter opposing the adoption of Ordinance 1354.
Thank you for your time.
Amy Lieberman
Senior Attorney, Harm Reduction Legal Project
Network for Public Health Law
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[\ The Network The Network—Harm Reduction Legal Project
for Public Health Law 7101 York Avenue South,Suite 270
Edina,Minnesota 55435
Tel(952)452-9706
Ideas. www.networkforphl.org
Experience.
Practical Answers.
Rieva Lester
rieva.lester@lewiscountywa.gov
BOCC
Ordinance 1354
Room 210
351 NW North Street
Chehalis, WA 98532
RE: Ordinance 1354
March 18, 2024
Dear Ms. Lester:
On behalf of the Harm Reduction Legal Project, I appreciate the opportunity to submit brief comments
regarding proposed Lewis County ordinance 1354. The Harm Reduction Legal Project is an initiative of
the Network for Public Health Law, and provides actionable information, guidance, and support to
policymakers, health agencies, providers, and advocates working to create more just, equitable, and
health-focused drug policy in the Unites States.
We believe that this ordinance will create unnecessary barriers to those who wish to reduce drug-related
harm to both themselves and the community accessing harm reduction supplies and services, which will
result in preventable harm and expense to the people of Lewis County. We urge you to support
evidence-based harm reduction policies and reject the proposed Chapter 8.80 addition to the Lewis
County Code.
According to data from the Centers for Disease Control and Prevention (CDC), more than 109,000
Americans died from a drug overdose in 2022. These deaths are overwhelmingly caused the presence of
illicit fentanyl in the illegal opioid supply. Participants in syringe services programs (SSPs)are more likely
to stop using drugs—new users of SSPs are five times more likely to enter drug treatment than those
who do not use an SSP. Those who do not stop using drugs but participate in an SSP are three times
more likely to reduce their injection frequency. SSPs also greatly reduce the transmission of disease and
save health care costs, all while reducing the presence of needle litter and causing no increase in illegal
drug use or crime.
Washington state law recognizes the importance of SSPs and of public health supplies like injection
equipment, smoking equipment, and drug testing equipment and provides for wide distribution and use of
such supplies by public health programs, community-based HIV prevention programs, outreach, shelter,
and housing programs, and pharmacies. Wash. Rev. Code Ann. § 69.50.4121(3). The restrictions
proposed in Ordinance 1354 are not backed by science and impose new requirements for SSPs that
threaten the continued operation of existing programs and would make it extremely difficult if not
impossible for new programs to begin operations.
If the ordinance is enacted, the result would likely be that syringe litter and communicable disease will
increase, and connection to treatment will decrease. The lack of safer drug use supplies will lead to an
increase in community costs due to the increase in preventable disease and overdose. Further, the
scientific literature is clear that syringe services programs reduce syringe litter in areas where they are
implemented. Syringe services programs are also a key element in connecting those who are ready to
stop using drugs to treatment. Eliminating SSPs does not stop people from using drugs.
Even if SSPs are able to continue operating in the County after the passage of Ordinance 1354, the
restrictions the ordinance would impose will reduce their effectiveness. Perhaps most importantly, the 1:1
requirement has long been found to be insufficient and counterproductive -SSP effectiveness increases
when providing syringes on an as-needed basis. The CDC supports a needs-based approach, as it is the
best practice for public health for a new syringe to be used for every injection.
Banning mobile services will also cripple the abilities of SSPs to best serve the community. Beyond the
fact that it can be extremely costly to acquire a permanent space, being able to meet people where
they're at, both mentally and physically, is an important factor in harm reduction. Due to distance, lack of
transportation, or illness, it may be impossible for some people to show up at a brick-and-mortar
locations, reducing the amount of people that SSPs can help to reduce their chance of disease and link to
care. Mobile harm reduction units can also provide medications for opioid use disorder to people who
may not be able to access it otherwise.
Limiting the SSP to distribution of syringes only is another counterproductive provision of the ordinance.
A new syringe can still be high risk if people reuse cottons, use dirty water, or use cookers that have been
used previously for drugs of unknown potency. Further, choosing to smoke drugs instead of injecting
them can often be a way to avoid overdose, as many people who use drugs feel they can better control
their high by smoking. The distribution of injection supplies, smoking supplies, and any other supplies
needed to maintain the basic health of people who use drugs should not be restricted, and should be fully
endorsed and funded by the county, rather than forbidding any county funding to be used for SSPs
whatsoever—another troublesome aspect of the ordinance.
Finally, the ordinance restricts staff at SSPs to those who have not been participants in an SSP or been
involved in a drug crime in the last two years—essentially, meaning anyone with recent lived experience
is banned from working at an SSP. The rejection of staff with recent lived experience is shortsighted at
best. Often, these are the people who know how best to reach out to the drug-using community, who
know what the most recent issues in the community are, and who are most trusted by the exact people
that SSPs want to reach. Without staff with lived and living experience, the reach of the SSP will be
hampered.
SSPs are an evidence-based public health and medical intervention. Their operation should not be
restricted by politicians with no training in either field. Decreasing the effectiveness of SSPs does not stop
drug use, it simply makes it more dangerous. The consequences of re-using or sharing injection
equipment are incurable disease and death at incredible cost to the public, both financially and in the
emotional toll on the community that comes with preventable morbidity and mortality. If the BOCC is truly
Di]
concerned about syringe litter or the lives of those people who use drugs, we strongly suggest that they
fully fund and work in conjunction with their local SSPs to make them even more effective.
Sincerely,
Amy Lieberman
Senior Attorney, Harm Reduction Legal Project
Network for Public Health Law
Tammy Martin
From: Mark Obtinario <mobtinario@yahoo.com>
Sent: Monday, March 18, 2024 3:36 PM
To: Sean Swope; Scott Brummer; Lindsey Pollock
Subject: Needle exchange
Hello,
I have never been a fan of needle exchanges. In my estimation it is a tacit government approval of aberrant behavior.
As the needle exchange program has expanded it now seems to me it has morphed into a way in which government is
actually promoting the use of illegal and illicit drugs.
I would be in favor of shutting down completely the needle exchange program but as I understand it the ability to do that
has been taken away from local control and the only control is over how the program is being administered.
If the government is going to continue facilitating the use of illegal and illicit drugs then the government shouldn't make
it easy. Taking the clean needles to the drug addicts is not a good idea. Making the drug users come to a central location
and not handing out any other stuff to make using illegal and illicit drugs easy would be my preference. I would also limit
the number of clean needles exchanged per person per day. I would hate to think someone was getting a lot of free
needles and then selling the clean needles to people who don't want to exchange them in person.
I see government's job is to reduce the use of illegal and illicit drugs. Handing out free needles is not my idea of how to
reduce the use of illegal and illicit drugs.
Mark Obtinario
Winlock, Washington
360-431-7759
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