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Public comment SIGN-IN SHEET FOR PUBLIC HEARING ON 0 V06 \rukiy‘c -e l' ,-I Lewis County Courthouse, 351 N.W. North Street, Chehalis, Wash. Meeting date: 3 it'l I v621/44 NAME PHONE REPRESENTING CITY/TOWN OF RESIDENCE 1 _izk IL 1 6619L3 -3,0"70__ __Leac,-ea4 gOlcr'ed/ C- I 2 ff,m _,5,,,, 9)p , its_fiA2c_ e �- 31 5 - ' _ R 7 r--tfo-(0 t frrtveis 62.„4.4--t 4_-41-0-1±45 - -- 4__110111. -fintwi m- Fall--110'1 Ciathir I_ dedatis 5____? -e=d_ca____Rg.keir (.3(q()__YoZ_ -L.76).-2 6-6-44L-Q-K _ 1 69--,14--1-- '--- _1 71 ! (00'i -_`a -- --- - 73 i-- 8 ebecra S+ kr 1 305 _ cog-69 1 adraitt . 9 M or 1 o P i 'sic.-- ��e c� _ re h 3�.—_�S 2 �Z.S_ pe s-io 1Ci t-40 lrMD -- io LIi _ I c.,4N___CALI:mats._ i Ro- Vtoci- 7 BM Cirsivit..Ds• PI) . (..6-11144-‘04 11 ; 6;14-0,,,.. r-ba.,A s .503- Z s-i- I s.h1- ieAA"-e� Cd&v.A\e"Lo=k_ 02A, 3C;o--%0 - gt___d_ e_t r ____.t.Led IP!Lag, g.„„e- iCa . -;i6-v. 0 e eiti'4Vi. 14 ,\ 'IS S-03 0• 65 IA-- - - Notice: The information provided on this document may be subject to public disclosure per RCW 42.56.070. ---.11111111111111111 SIGN-IN SHEET FOR PUBLIC HEARING ON N4c - ) 3 SL�OP--CIA Lewis County Courthouse, 351 N.W. North Street, Chehalis, Wash. Meeting date: NAME PHONE REPRESENTING CITY/TOWN OF RESIDENCE 1 MA,/L MC L ; �--1. {'-�./V firkwyCcoe, S. C .��.-F-a.l;� V -- f_ 2 _ ram^ 4 3T- --/--- /, I /.6 �/164A- `17-5 z ic� 3 .�G�'1�lrL�it� Zi'G lit L 1 ifct ' missionaries or 4 Liza,/dueithpyfoil .5°3 5 ' 6 ' II . 8 9 10 11 � i - - -- , 1 i � 13 � 14 , Notice:The information provided on this document may be subject to public disclosure per RCW 42.56.070. Chapter 8.80: Sterile Needle and Syringe Exchange Comparison of version proposed 1, as proposed by Swope, Revised 3/27/24 AND Pollock proposal—Revised 3/29/24 -- 4L<-ags.1) Under 8.80.020 DEFINITIONS: • Pollock eliminates the definition of a "child" • Pollock eliminate the definition of "drug offense" • Pollock eliminates the definition of"drug paraphernalia" • Pollock eliminates the definition of"Program Staff" Under 8.80.030 REGISTRATION • Pollock eliminates "locations of where the needle and hypodermic syringe exchange will operate" • Pollock eliminates "all staff, volunteers, and any other individuals working for or with the sterile needle and syringe exchange program" Pollock eliminates in its entirety Swope's section "Program Staff" Under 8.80.040 (was 8.80.050 Swope) QUANTITY OF STERILE NEEDLE AND SYRINGE EXCHANGE • Pollock adds: "The program operator may offer first time participants of the needle and syringe exchange program that are not in possession of any used needles or syringes a package of up to ten needles and syringes." • RED FLAG: This opens the program up to criticism as it engages in illegal activity— supplying drug paraphernalia to those who may or may not currently be addicted (addiction being the underlying qualification for disability status) Pollock adds a new section 8.80.050 SAFER INJECTION KITS "The program operator may offer participants of the sterile needle and syringe program a safer injection kit. A safer injection kit may include a sterile needle and syringe, alcohol swabs, filters, tourniquet, cooker, and sterile water ampules." RED FLAG: supplying drug paraphernalia which is, in my opinion, illegal Under 8.80.100 LOCATION OF STERILE NEEDLE AND SYRINGE EXCHANGE • Pollock eliminates age restrictions in its entirety Pollock eliminates LOCATION OF STERILE NEEDLE AND SYRINGE EXCHANGE in its entirety Pollock eliminates SITE SECURITY in its entirety Under 8.80.110 (was Swope 8.80.130) DATA AND REPORTING REQUIREMENTS Pollock eliminates "number of known participants that are referred to or enroll in a substance use disorder treatment program, drug abuse prevention, education, or those tested for HIV, AIDS, viral hepatitis, or other blood-borne diseases and referred for medical treatment." Instead Pollock proposes the "watered down" statement: "the demographic profiles of the participants served." RED FLAG: If this policy, as purported, is to address public health issues, this eliminates the responsibility of the provider to be proactively responsible. Under 8.80.130 (was Swope 8.80.160) PENALTIES Section (1): Pollock eliminates "whether or not the violation took place in the citing authority's presence" Pollock eliminates in its entirety Swopes section (3): "A third violation, and all subsequent violations, of this Chapter shall be a misdemeanor, punishable as prescribed in LCC 1.20.020. A committed finding on a prior infraction for violating this Chapter shall e sufficient to show the prior violation and notice to the accused, but shall not be necessary for proof of the misdemeanor. It shall suffice if it is proven beyond a reasonable doubt within the misdemeanor prosecution that (a) the prior violation occurred; (b) the accused was lawfully served with written notice of the prior violations before the third or subsequent violation; and (c) the third and subsequent violation occurred. RED FLAG: by eliminating any consequences for illegal behavior, one condones that illegal behavior. ttLed1 v hi) March 29,2023 3oard of County Commissioners L2utia Crumb,wnshinaton Lewis County Board of Commissioners At'K 0 2 2024 Lewis County Courthouse 351 NW.North St Chehalis,WA,98532 Dear Commissioners Pollock, Swope,and Brummer, I am writing in opposition to ordinance#1354. I object to the following. 8.80.030—This is more in the form of a question. Do not all programs of this nature have to meet state requirements already. I suppose the providers would already post information listed here. 8.80.040—Who is going to monitor this and exactly how? Who's budget is going to be increased to monitor this? Since there are only a certain amount of dollars,whose budget is going to be decreased to monitor this? 8.80.50-If you truly believe that your efforts are for all the citizens of Lewis County,then your efforts with this clause does not demonstrate that.If you truly believe in less harm programs,this ordinance does not demonstrate that. By tying the needle program to a"brick and motor"facilities you eliminate less harm programs to the majority of those citizens in need that you were elected to represent.From Packwood to Centralia is nearly 75 miles and 1%hours away. I agree,like all adult activities for which there are already ordinances,such as bars,adult video stores,etc. needle exchange programs should not be located near locations frequently visited by children. Line#4 has no place in this ordinance. It should be one of its own. According to your statement of purpose this ordinance is about needle exchange. No mention is given to supervised injection sites in your purpose statement. 8.80.06-According to the testimony of the staff that currently runs an exchange program this is the current practice. So I guess there really isn't anything wrong in repeating it. Except for the Paraphernalia line. My reading has enlightened me on injected drug use. I tell you I have learned quite a bit. It's amazing how much you learn if you don't isolate yourself to the sources that agree with you.It is my understanding that the ordinance as written would equate to handing out the syringe vessel but not the plunger. The items distributed are items that can also pass along infectious diseases if clean ones are not supplied. These items are explicitly exempt from the drug paraphernalia law if they are distributed by a harm reduction program.In addition,according to your definition of paraphernalia,every public restaurant or place of food service is going to have to count their spoons if they don't want to be arrested for the distribution of drug paraphernalia. Convenience stores can't sell lighters either. 8.80.090 and 8.80.090—Yes....These are practices already done by the present provider and are in the state protocols for needle exchange programs. But I suppose it would be okay to codify them on a county level since they don't disagree with state and federal law. 8.80.110 and 8.80.110—Again these are,as you quoted state laws,by which our local provider program abides. But if you feel the need to codify,I suppose it's okay. Perhaps a waste of paper. 8.80.120—8.80.130-You're kidding aren't you! I don't think there are codes this strict for drug stores and they are actually drugs there. Here you are really grandstanding. You are aiming to make things so difficult----so restrictive that providers will throw their hands in the air and quit. This segment of the ordinance really reveals the real intent of this ordinance. Finally.....the nail you hope will go in coffin. Pun intended considering the needle exchange programs save lives. 8.80.160-Let's make the"rules"so restrictive,with so many barriers that it is nearly impossible to run a program without breaking the"rules".Let's create a program for vulnerable and a clientele that doesn't trust law enforcement or government and have them parading through at any time. Then let's punish the good people who are trying in good faith to help the"least of these"with fines or worse. Again,this segment of the ordinance really reveals the real intent of this ordinance. I would also would like to address the statistics that have been thrown around in the hearings without clarification or sources.The purpose of including such statements as far as I am concerned was only for the purpose of instilling horror and fear.I accept that we have had a major increase in overdoses. The dead don't lie.I have read several articles with quotes concerning the increase and it is definitely a sad state of affairs. But what has not been clarified is how many of these were caused by intravenous use and your statistics contribute little to the subject.Almost,no I will say it stronger,every resource I researched (especially CDC,NCDAS-National Center for Drug Abuse Statistics and others)report an increase in fentanyl deaths.They have also stated that the preferred avenue of ingestion is smoking not needles. I have no authoritative resource for this but an article by Crosscut Cascade (https://crosscut.com/news/2023/11/was-new-drug-law-could-help-needle-exchanges-or-restrict-them)cited two needle exchange programs in Washington counties have seen an increase in drug over doses primarily fentanyl but a decrease in the number of needles exchanged at their facilities. Logic would lead us to believe we have a fentanyl problem.A deadly fentanyl problem. But this ordinance does not address that. I am also at a loss as to the reason for this ordinance to begin with. It seems to be more of a question of philosophies like naturopath vs.pill pushers.(Not the best analogy,but you get my drift.) I don't see how this is the business of the county commissioners,unless your goal is not health and safety at all but turf wars and political capital.If this was a true health issue I believe it's origin would have been within the County Health Department not the commissioners office. The last thing this county needs is another lawsuit. But when one commissioner insists on throwing out religious sermons in the middle of an open hearing it does draw the attention of some organizations who just love to sue.I believe this proposed ordinance is just flawed enough to bring them out of woodwork. While we are on the topic of religion,let us remember Matt.25:40."Whatever you did for one of the least of these brothers and sisters of mine,you did for me". Needle exchange programs will not solve the drug problem. They are not intended to. They are meant to save lives so those lives will be long enough to hopefully seek help. I am firmly opposed to Ordinance 1315 in its present form. It needs radical reforming. Thank you, Commissioner Pollock,for proposing a cooling-off period when hopefully clearer thinking heads will succeed.I will forward a copy of this via mail so that you are sure to receive a copy. Thank you. Sandra Sund 459 SW Pacific Ave Chehalis,WA Kathryn Chatterton From: Ray Chapman-Wilson <rleroyw@gmail.com> Sent: Wednesday, April 10, 2024 8:05 PM To: BOCC; Ray Chapman-Wilson Subject: vote no on ordinance 1354 and fully fund law enforcement to fight the fentanyl crisis Attachments: BOCC 2024-04-09 Fentanyl .pdf You don't often get email from rleroyw@gmail.corn Learn why this is important Hello, this is what I spoke about at the last County Commissioners meeting.Would you please forward to Commissioners and can I get it entered into the record opposing ordinance 1354 on medical freedom and privacy rights? Also, can I get receipt of this email for any future litigation and reference?Thank you very much, Ray Chapman-Wilson 503-381-7444 rlero_yw@gmail.com External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before o•enin• it. i April 9, 2024 Ray Chapman-Wilson, Centralia We're here with Families of Faith for Health and Safety. We want to address Ordinance 1354, and the current fentanyl crisis. First off, we're a poor county, with millions and billions of our infrastructure tax dollars finally coming back to us right now. If we use some of this money to improve this poverty issue, lots of these problems will go away. After going to the front lines and sifting through health information provided by Lewis County, It is clear drug overdoses and deaths related to fentanyl are far out-pacing anything else. Right now, the fentanyl crisis needs to be the front line of action in Lewis County. Lewis County numbers are right up there with King County. Why is it so bad here in Lewis County? Is it because, unlike every other County along the 1-5 corridor; and we mean every county, Commissioner Swope and other public servants in Lewis County have encouraged and perpetrated false public health and safety narratives like "masks don't work, vaccines are bad, among other bad information and falsehoods based on deeply held inaccurate beliefs, not on good , factual health information"? No other county is doing this to their constituents. Lewis County stands alone in that fact. There is one saving grace here in Lewis County; Gather Church provides important life-saving services for those struggling to get a foothold. This includes pro-life neighbor-to-neighbor community outreach, wound care, a meds first clinic, care coordination and health education, among many other community services. These programs are so successful, and so many lives of neighbors and loved ones have been helped and saved and stabilized, that Gather is internationally recognized as a shining example for the help they provide. The value of all these combined ministries is unlimited. Pastor Cole at Gather has invited you to collaborate in this mission, and we encourage you to do so. Make it your mission to be protective of our flock. Stand against the lions. Stop exploiting the healthcare workers who are treading water in this mess you've created. Finally, Law Enforcement. We ask you to please fully fund and train and give them the resources they need to stop the flow of fentanyl flooding into our community. We're requesting that ordinance 1354 get completely discarded. Start over with a correct focus on fentanyl and law enforcement and public health and safety campaigns that are factually correct. For the common, good, we thank you Opioid and drug use data: https://doh.wa.gov/data-and-statistical-reports/washington-tracking-network-wtn/opioids/overdos e-dashboard Washington per capita income: https://en.wikipedia.org/wiki/List_of_Washington Jocations by per capita income County health rankings: https://www.countyhealthrankings.org/sites/default/files/media/document/CHR2021 WA.pdf Poverty and addiction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247994/ Homeless sweeps harm the whole community: https://jamanetwork.com/journals/jama/fullarticle/2803839 Kathryn Chatterton From: mitchel.townsend@localaccess.com Sent: Wednesday,April 10, 2024 6:41 PM To: BOCC Subject: Ordinance# 1354 Amendments Consideration Importance: High You don't often get email from mitchel.townsend@localaccess.com.Learn why this is important Hon. Scott Brummer, Lewis County, WA Lewis County Commissioner 3rd District (Commissioners Swope and Pollack) Commissioner Brummer, (Commissioners Swope and Pollack) As a resident of your district, I am personally and philosophically against any needle exchange in Lewis County. Yet also recognize its peer reviewed efficacy in helping to reduce the transmission of HIV and Hepatitis. I support the adoption of Ordinance#1347 as originally written without the additional amendments proposed by Commissioner Pollack and subsequently rejected by the Lewis County Health Advisory Board on April 4th. The objections that ALCU identified regarding potential criminalizing parts of the program are seemingly valid as cited yet a compromise upon this identified conflict would simply be to remove any criminalization language in Ordinance#1347. We need additional regulation and accountability requirements with regards to the administration of this controversial program. The rapidly increasing problem of drug abuse and its increasingly deadly consequences require data and results- based policy creation and adoption. Respectfully, Mitchel N. Townsend 360-219-5423 External Email - Remember to think before you click! 1 This message may contain links with malware, viruses, etc. Please ensure the message is legitimate before opening it. 2 Kathryn Chatterton From: contact@lewiscountywa.gov Sent: Friday, March 29, 2024 8:34 AM To: Tammy Martin; Rieva Lester; BOCC Subject: Email from Commissioners Contact Form Name: Sandra Sund Email: slsund@gmail.com Message: Lewis County Board of Commissioners Lewis County Courthouse 351 NW. North St Chehalis, WA, 98532 Dear Commissioners Pollock, Swope, and Brummer, I am writing in opposition to ordinance #1354. I object to the following. 8.80.030-This is more in the form of a question. Do not all programs of this nature have to meet state requirements already. I suppose the providers would already post information listed here. 8.80.040-Who is going to monitor this and exactly how?Who's budget is going to be increased to monitor this?Since there are only a certain amount of dollars, whose budget is going to be decreased to monitor this? 8.80.50- If you truly believe that your efforts are for all the citizens of Lewis County, then your efforts with this clause does not demonstrate that. If you truly believe in less harm programs,this ordinance does not demonstrate that. By tying the needle program to a "brick and motor"facilities you eliminate less harm programs to the majority of those citizens in need that you were elected to represent. From Packwood to Centralia is nearly 75 miles and 1' hours away. I agree, like all adult activities for which there are already ordinances, such as bars, adult video stores, etc. needle exchange programs should not be located near locations frequently visited by children. Line#4 has no place in this ordinance. It should be one of its own.According to your statement of purpose this ordinance is about needle exchange. No mention is given to supervised injection sites in your purpose statement. 8.80.06-According to the testimony of the staff that currently runs an exchange program this is the current practice. So I guess there really isn't anything wrong in repeating it. Except for the Paraphernalia line. My reading has enlightened me on injected drug use. I tell you I have learned quite a bit. It's amazing how much you learn if you don't isolate yourself to the sources that agree with you. It is my understanding that the ordinance as written would equate to handing out the syringe vessel but not the plunger.The items distributed are items that can also pass along infectious diseases if clean ones are not supplied.These items are explicitly exempt from the drug paraphernalia law if they are distributed by a harm reduction program. In addition, according to your definition of paraphernalia, every public restaurant or place of food service is going to have to count their spoons if they don't want to be arrested for the distribution of drug paraphernalia. Convenience stores can't sell lighters either. 8.80.090 and 8.80.090-Yes.... These are practices already done by the present provider and are in the state protocols for needle exchange programs. But I suppose it would be okay to codify them on a county level since they don't disagree with state and federal law. 8.80.110 and 8.80.110-Again these are, as you quoted state laws, by which our local provider program abides. But if you feel the need to codify, I suppose it's okay. Perhaps a waste of paper. 8.80.120-8.80.130-You're kidding aren't you! I don't think there are codes this strict for drug stores and they are actually drugs there. Here you are really grandstanding. You are aiming to make things so difficult---- so restrictive that providers will throw their hands in the air and quit. This segment of the ordinance really reveals the real intent of this ordinance. Finally the nail you hope will go in coffin. Pun intended considering the needle exchange programs save lives. 8 80.160 - Let's make the "rules" so restrictive, with so many barriers that it is nearly impossible to run a program without breaking the "rules". Let's create a program for vulnerable and a clientele that doesn't trust law enforcement or government and have them parading through at any time. Then let's punish the good people who are trying in good faith to help the "least of these"with fines or worse. Again, this segment of 1 the ordinance really reveals the real intent of this ordinance. I would also would like to address the statistics that have been thrown around in the hearings without clarification or sources. I accept that we have had a major increase in overdoses. The dead don't lie. I have read several articles with quotes concerning the increase. But what has not been clarified is how many of these were caused by intravenous use. Almost, no I will say it stronger, every resource I researched (especially CDC, NCDAS- National Center for Drug Abuse Statistics and others) report an increase in fentanyl deaths.They have also stated that the preferred avenue of ingestion is smoking not needles. I have no authoritative resource for this but an article by Crosscut Cascade (https://crosscut._com/news/2023/11/was-new- drug-law-could-help-needle-exchanges-or-restrict-them) cited two needle exchange programs in Washington counties have seen an increase in drug over doses primarily fentanyl but a decrease in the number of needles exchanged at their facilities. Logic would lead us to believe we have a fentanyl problem. This ordinance does not address that. I am also at a loss as to the reason for this ordinance to begin with. It seems to be more of a question of philosophies like naturopath vs. pill pushers. (Not the best analogy, but you get my drift.) I don't see how this is the business of the county commissioners, unless your goal is not health and safety at all but turf wars and political capital. If this was a true health issue I believe it's origin would have been within the County Health Department not the commissioners office.The last thing this county needs is another lawsuit. But when one commissioner insists on throwing out religious sermons in the middle of an open hearing it does draw the attention of some organizations who just love to sue. I believe this proposed ordinance is just flawed enough to bring them out of woodwork. While we are on the topic of religion, let us remember Matt. 25:40. "Whatever you did for one of the least of these brothers and sisters of mine, you did for me". Needle exchange programs will not solve the drug problem.They are not intended to. They are meant to save lives so those lives will be long enough to hopefully seek help. I am firmly opposed to Ordinance 1315 in its present form. It needs radical reforming. Thank you, Commissioner Pollock, for proposing a cooling-off period when hopefully clearer thinking heads will succeed. Thank you. Sandra Sund 459 SW Pacific Ave Chehalis, WA PS I will forward a copy of this via mail so that you are sure to receive a copy. 2 Kathryn Chatterton From: Les Doyle <lesdoyle@pm.me> Sent: Tuesday, March 26, 2024 9:41 AM To: BOCC Subject: Ordinance 1354 You don't often get email from lesdoyle@pm.me. Learn why this is important Greetings Board of County Commissioners, My name is Les Doyle. The US Army brought me to Washington in 1995, and after 25 years of service, I retired and remained in this state where my two children went on to graduate from the UW and remain with their families to this day. I have been a citizen of Lewis County (Winlock) since 2014. My wife and I visited this county when we lived up in Pierce County and decided that this would be a great place to live. We have not regretted our decision to relocate. Before I retired in 2016, I was the Director of the New Life Program at the Tacoma Rescue Mission, a year-long residential drug treatment program. I have experience with the needle exchange programs located in Pierce County. Additionally, I refuse to consider the disease model that so many attach to the addiction that pervades our local communities and beyond. This is plainly an idolatry issue, and we must have approaches in dealing with addiction that go beyond simple behavioral modification. I am currently a founding member and on the Board of Directors for Christ the King Academy (a classical Christian school located in Centralia) and an Elder at Christ Covenant Church in Centralia. I echo what you have already heard from my Pastor, Aaron Ventura: Every Sunday, our church prays for each of you by name. This is because we believe that you have a God given responsibility to promote virtue and discourage vice in obedience to God's law (Romans 13:1-10). It is very troubling to myself and our church that the state of Washington has become a place where drugs, crime, and all kinds of perversity are tolerated and go unpunished. We are failing to truly love our neighbors when we vote for, pay for, and subsidize drug use, and do so under the lying banner of "Harm Reduction." If we truly want to reduce harm in Lewis County, then we ought to do whatever it takes to make access to drugs and the actual doing of drugs more difficult. These are destructive substances that no responsible parent would want for their children. It is no act of love or compassion to enable someone to do a destructive thing with "greater cleanliness." I join with Pastor Ventura in pleading with each of you to do all that is within your power to serve our community by passing Ordinance 1354 without any amendments that might weaken its authority to regulate needle exchange programs. As a resident, parent, grandparent, elder, and Christian, I desire Lewis County to be a place that is safe for my grandchildren to walk down the street. I desire our downtown areas to be places of beauty and joy, rather than ugliness and sorrow. This ordinance would be a good start towards cleaning up our county. And I pray that God gives you fortitude and courage to do what is righteous in His eyes, regardless of what the crowds may shout. May God bless you in your work and may we all seek God in ending this scourge that robs people, families, and communities of life. Thank you for your service to our community. Les Les Doyle Christ Covenant Church, Centralia < https://lewiscountv.church/> Christ the King Academy, Centralia < https://www.christthekinq.academv> lesdoyle@pm.me i 253-208-8909 "There is not a square inch in the whole domain of our human existence over which Christ, who is Sovereign over all, does not cry, Mine!'" --Abraham Kuyper External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before o•enin• it. 2 Kathryn Chatterton From: Sherri Murphy <justsmurffie577@gmail.com> Sent: Tuesday, March 26, 2024 9:44 AM To: BOCC Subject: Ordinance 1347 You don't often get email from justsmurffie577@gmail.com. Learn why this is important Commissioners: Greetings. My name is Sherri Murphy, and I'm a Lewis County resident. I am opposed to the needle exchange in its entirety. I acknowledge I have no background in medicine, nor have I served on any public health boards or matters. I come to you today not to disparage The Gather Church, nor argue it's"ministry", but to offer a different perspective that has yet to be discussed.That perspective is the liability to the taxpayers. As commissioners, one of your duties is to mitigate circumstances that could be viewed as negligence on behalf of the county as well as limiting or removing liability.At no time should Lewis County engage in activities that facilitate the use of illegal substances,whether by providing funding, providing paraphernalia or by turning a blind eye as another entity does so. Imagine if you will, a situation where a person uses a needle to inject an illegal substance, gets behind the wheel of a vehicle and kills an innocent person or family, and that needle came from a program you allowed. Imagine a situation where a person injects an illegal substance from a needle exchange program, and kills an innocent store clerk etc.There is no end to the possibilities of what can go wrong.Just like any other statistical data, we can see the trend with victims,victim's families and even suspects utilizing attorneys for a cash payout.That payout NEVER comes from the suspect! The attorney follows the money,which in this situation leads right back to Lewis County.We cannot afford the liability in providing drug paraphernalia! Additionally, I do not support a mobile needle exchange for the same reasons. I ask you to consider passing the proposed ordinance 1347 on behalf of the citizens of Lewis County. Sherri Murphy Chehalis, WA External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before o•enin. it. 1 Kathryn Chatterton From: gustafam <gustafam@protonmail.com> Sent: Thursday, March 28, 2024 7:05 AM To: BOCC Subject: Ordinance 1354 You don't often get email from gustafam@protonmail.com. Learn why this is important Hello my name is Dane Gustafson and I worship in Lewis County. I would like the Board of County Commissioners to know that I support ordinance 1354 being considered on 3/26/24 in full and would like it to be passed without amendments that would in any way weaken the county's authority to regulate needle exchange programs in full. I would also like to remind the members of the BOCC that governments exist and have been granted authority by God whether at the federal, state, and local level local so that they will "reward the righteous and be a terror to those who do wickedness (Rom 13:3-4)." Please consider this truth when deciding how best to let the citizens of Lewis County and Western Washington know that we are a community where righteousness is rewarded and degeneracy is punished. VR Dane Gustafson Sent with Proton Mail secure email. External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before o•enin• it. 1 Kathryn Chatterton From: Aaron Ventura <aaron@christcovenantcentralia.com> Sent: Monday, March 25, 2024 3:52 PM To: BOCC Subject: Support For Ordinance 1354 [You don't often get email from aaron@christcovenantcentralia.com. Learn why this is important at https://aka.ms/LearnAboutSenderldentification ] Greetings Board of County Commissioners, I am the pastor of Christ Covenant Church in Centralia, and every single Sunday, our church prays for each of you by name.This is because we believe that you have a God given responsibility to promote virtue and discourage vice in obedience to God's law(Romans 13:1-10). It is very troubling to myself and our church that the state of Washington has become a place where drugs,crime, and all kinds of perversity are tolerated and go unpunished. We are failing to truly love our neighbors when we vote for, pay for, and subsidize drug use, and do so under the lying banner of"Harm Reduction." If we truly want to reduce harm in Lewis County,then we ought to do whatever it takes to make access to drugs and the actual doing of drugs more difficult.These are destructive substances that no responsible parent would want for their children. It is no act of love or compassion to enable someone to do a destructive thing with "greater cleanliness." Therefore, I plead with each of you to do all that is within your power to serve our community by passing Ordinance 1354 without any amendments that might weaken its authority to regulate needle exchange programs. As a resident, parent, pastor, and Christian, I desire Lewis County to be a place that is safe for my children to walk down the street. I desire our downtown areas to be places of beauty and joy, rather than ugliness and sorrow.This ordinance would be a good start towards cleaning up our county. And I pray that God gives you fortitude and courage to do what is righteous in His eyes, regardless of what the crowds may shout. May God bless you in your work.And I thank you for your service to our community. Sincerely, Aaron Ventura External Email - Remember to think before you click! This message may contain links with malware,viruses, etc. Please ensure the message is legitimate before opening it. 1 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! LY'v LI) 3oisra of County Commissioners Lewis County Washington MAR 19 2024 • Kathryn Chatterton From: David Sinkman <sinkman@kaplangrady.com> Sent: Tuesday, March 19, 2024 7:28 AM To: BOCC; Lindsey Pollock; Scott Brummer; Sean Swope Subject: Ordinance 1354 and federal civil rights litigation Attachments: Ordinance 1354 letter.pdf IYou don't often get email from sinkman@kaplangrady.com. Learn why this is important Dear Clerk Lester and Lewis County Commissioners: I write regarding Ordinance 1354 which proposes adding Chapter 8.80 to the Lewis County Code. I am a former federal prosecutor where I worked for years on addressing discriminatory barriers to medical treatment for people with substance use disorder for the United States Department of Justice. I currently help direct Kaplan &Grady's Access to Medications for Opioid Use Disorder practice. Chapter 8.80, as written, likely violates federal civil rights laws. If implemented, it will likely lead to a costly federal civil rights lawsuit for violations of the Americans with Disabilities Act, the Rehabilitation Act, and the Equal Protection Clause of the United States Constitution. I respectfully suggest Lewis County reconsider Ordinance 1354, particularly Chapter 8.80.50, which directly targets the Gather Church, and Chapters 8.80.040 and 8.80.160. Attached please find a letter explaining why. Thank you. Sincerely, David Howard Sinkman External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before openin• it. 1 1<1 A P L AN David Howard Sinkman sinkman@kaplangrady.com 3128522184 March 18, 2024 Via Email Rieva Lester, Clerk Lewis County 351 NW North Street Chehalis, WA 98532 Re: Ordinance 1354 I write regarding Ordinance 1354 which proposes adding Chapter 8.80 to the Lewis County Code. I am a former federal prosecutor where I worked for years on addressing discriminatory barriers to medical treatment for people with substance use disorder for the United States Department of Justice.I currently help direct Kaplan&Grady's Access to Medications for Opioid Use Disorder practice. Chapter 8.80, as written, likely violates federal civil rights laws. If implemented, it will likely lead to a federal civil rights lawsuit for violations of the Americans with Disabilities Act ("ADA"), the Rehabilitation Act ("RA"), and the Equal Protection Clause of the United States Constitution. I respectfully suggest Lewis County reconsider Ordinance 1354, particularly Chapter 8.80.50, which directly targets the Gather Church, and Chapters 8.80.040 and 8.80.160. Civil rights protections Title II of the ADA prohibits disability discrimination by public entities, including state and local governments.' Likewise, Section 504 of the Rehabilitation Act of 1973 prohibits recipients of federal financial assistance from discriminating on the basis of disability in their programs and activities.2 Lewis County receives federal funding. The ADA and RA only protect people with qualifying disabilities.Establishing a disability requires showing a physical or mental impairment that substantially limits a major life activity, a record of such impairment,or being regarded as having such an impairment.3 In enacting the ADA 42 U.S.C. §§ 12131 32 ("no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services,programs,or activities of a public entity,or be subjected to discrimination by any such entity."). 2 29 U.S.C.§794("No otherwise qualified individual with a disability...shall,solely by reason of her or his disability,be excluded from the participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal financial assistance."). 3 28 C.F.R.§35.108(ax1). Kaplan &Grady LLC 2071 N. Southport Ave.,Suite 205 Chicago, IL 60614 www.kaplangrady.com Rieva Lester,Clerk March 18,2024 Page 2 of 7 Amendments Act in 2008, Congress made clear that ADA jurisprudence should focus less on establishment of disability and more on whether entities were taking steps to avoid discrimination.4 To ensure this breadth of coverage, additional major life activities, including operation of major bodily functions,were added to the ADA's coverage.5 According to the appendix to Title II of the ADA,"[a]ddiction is a disability,"6 and courts have regularly ruled as such. While the ADA and RA do not protect individuals currently engaged in the illegal use of drugs, there is a notable exception to this caveat that covers the Gather Church and its patients.? Public entities, such as Lewis County, cannot deny health services, such as those related to substance use disorder ("SUD"), because of the illegal use of drugs if the person is otherwise entitled to such health programs or services.8 In the recent Department of Justice Guidance entitled "Americans with Disabilities Act and the Opioid Crisis: Combating Discrimination Against People in Treatment or Recovery,"the Department gave the following example illustrating how the health services exception protects people with SUD who are currently using illegal drugs: Example F: A hospital emergency room routinely turns away people experiencing drug overdoses, but admits all other patients who are experiencing emergency health issues. The hospital would be in violation of the ADA for denying health services to those individuals because of their current illegal drug use, since those individuals would otherwise be entitled to emergency services.9 Of course, there is a"direct threat" limitation to the health services exception. If a person using illegal drugs"poses a direct threat to the health or safety of others,"then the health services exception does not apply.10 In practice, this means that a person with SUD who recently used illegal drugs, but is otherwise entitled to health services, is protected by the ADA and RA unless 4 28 C.F.R. §35.101(b). 5 28 C.F.R. §35.108(cX1Xii). 6 28 C.F.R.app.B§35.131. 28 C.F.R. §35.131(a)(1). 8 28 C.F.R. §35.131(b)(1)("a public entity shall not deny health services,or services provided in connection with drug rehabilitation,to an individual on the basis of that individual's current illegal use of drugs,if the individual is otherwise entitled to such services");29 U.S.C.A. §705(20)(C)(iii)("Notwithstanding clause(i),for purposes of programs and activities providing health services and services provided under subchapters I,II,and III,an individual shall not be excluded from the benefits of such programs or activities on the basis of his or her current illegal use of drugs if he or she is otherwise entitled to such services."). 9 DOJ,'The Americans with Disabilities Act and the Opioid Crisis:Combatting Discrimination Against People in Treatment or Recovery',available at https://archive.ada.gov/opioid_guidance.pdf. 10 28 C.F.R. §36.208(a)(emphasis added). 2 Rieva Lester,Clerk March 18,2024 Page 3 of 7 there is a particularized showing based on "objective evidence" that he or she is an actual and direct threat to others." Courts are clear that the "direct threat" exception cannot "be based on generalizations or stereotypes about the effects of a particular disability."12 This is especially so when local governments pass ordinances that categorically impact the medical needs of people with SUD. As the United States Court of Appeals for the Ninth Circuit warned in a decision involving a zoning ordinance restricting methadone clinics because of purported concerns that the clinics would increase crime and drug use,13 "[flew aspects of a handicap give rise to the same level of public fear and misapprehension, as the challenges facing recovering drug addicts."" Because syringe service programs in general, and the Gather Church in particular, are health services providers delivering essential medical treatment to at-risk populations facing elevated risks of overdose death and transmission of infectious diseases(including HIV),they are covered by the ADA and RA. This means that unless there is objective evidence that Gather Church and its patients pose an actual risk of a direct harm to others (not themselves),15 then the ADA and the RA protect them from the proposed ordinance. Court decisions striking down similar ordinances. Recent court decisions involving local restrictions targeting SUD treatment facilities illustrate how Ordinance 1354,which clearly targets the mobile operations of the Gather Church, violates the ADA and RA. I bring this to your attention and the attention of Lewis County Commissioners voting on Ordinance 1354 in the hopes that you reconsider the proposed ordinance. In Bay Area Addiction Research & Treatment, Inc. v. City of Antioch, the United States Court of Appeals for the Ninth Circuit(the federal appellate court that presides over federal cases brought in Washington) held that the ADA and the RA apply to zoning restrictions targeting substance use treatment facilities because"zoning is a normal function of a government entity."16 The Ninth Circuit then struck down an emergency moratorium prohibiting the operation of " 28 C.F.R. §35.131(b)(1);28 C.F.R. §36.208(a)-(b)("In determining whether an individual poses a direct threat to the health or safety of others, a public accommodation must make an individualized assessment, based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence,to ascertain); 28 C.F.R. §36.209(b)(1). 12 Bay Area Addiction Research&Treatment,Inc. v. City of Antioch 179 F.3d 725,735(9th Cir. 1999). 13 Id.at 729.("Specifically,the city council found that the methadone clinic would attract drug dealers and lead to an increase in crime in the area surrounding the clinic"). 14 Id at 736(citing School Bd of Nassau Cnty. v.Arline,480 U.S.273,285(1987)). 15 28 C.F.R. §35.131(b)(1);28 C.F.R.§36.208(a)-(b);28 C.F.R. §36.209(b)(1). 16 Bay Area Addiction Research& Treatment,Inc., 179 F.3d at 735. 3 Rieva Lester,Clerk March 18,2024 Page 4 of 7 methadone clinics within 500 feet of residential areas in the City of Antioch for being facially discriminatory on the basis of the plaintiff's disability— drug addiction." The Ninth Circuit noted that Antioch might defend the ordinance under the "significant risk" test by showing (1) the methadone clinic "poses a direct threat to the health or safety of others" and (2) that Antioch is addressing this evident risk through a reasonable zoning modification.'s The court stressed, however, that to satisfy the "significant risk"or"direct threat test" there must be evidence of a real and significant risk and that any such zoning restrictions "may not be based on generalizations or stereotypes about the effects of a particular disability."19 Other federal appellate courts have joined the Ninth Circuit's reasoning. Three years after the Bay Area decision, the Sixth Circuit in MX Grp., Inc. v. City of Covington invalidated a city ordinance limiting the number of SUD treatment clinics to one facility for every 20,000 persons in the city. The Sixth Circuit held that"the blanket prohibition of all methadone clinics from the entire city was discriminatory on its face"and thus violated the ADA and RA.20 The Sixth Circuit emphasized that the evidence demonstrated that the zoning ordinance was motivated by prejudice because it was based on fears and stereotypes,not concrete evidence of a direct threat to others?' Similarly, the Third Circuit struck down a Pennsylvania statute imposing a ban on the establishment of SUD treatment clinics within 500 feet of schools, churches, and residential housing developments because the law "facially singles out methadone clinics, and thereby methadone patients, for different treatment,thereby rendering the statute facially discriminatory," in violation of the ADA and RA.22 The Third Circuit in New Directions Treatment Servs. v. City of Reading emphasized that the standard for determining whether a methadone clinic poses such a risk to justify closure is an "objective" one: "we cannot base our decision on the subjective judgments of the people purportedly at risk. . .but must look to objective evidence in the record of any dangers posed by methadone clinics and patients."23 Turning to the evidence offered,the Third Circuit held that the city failed to satisfy the"direct threat"test,providing no objective evidence that methadone clinics increase criminal activity.24 17 Id. 18 Id. 19 Id. 20 MX Grp.,Inc. v. City of Covington,293 F.3d 326,345(6th Cir.2002). 21 Id. at 342(citing Ross v. Campbell Soup Co.,237 F.3d 701,706(6th Cir.2001)). 22 New Directions Treatment Servs. v. City of Reading,490 F.3d 202,304(3d Cir.2007). 23 Id.at 306. 24 Id. ("the record demonstrates no link between methadone clinics and increased crime," "no evidence to support its contrary assertion that there is a`frequent association' between methadone clinics and criminal activity," 4 Rieva Lester,Clerk March 18,2024 Page 5 of 7 The Second Circuit long ago reached the same conclusion. In 1997, it affirmed a trial court's injunction requiring a city in New York to allow a drug treatment facility to open.The city had initially denied the facility permission to open on the grounds that there was no physician"on premises."The federal district court had rejected that reasoning because there were"other entities offering services similar to [the facility's] proposed use in the same zoning district," and because of "the considerable animus towards drug and alcohol-dependent people expressed by certain members of the community and their attorneys during the pendency of these proceedings,"among other factors 25 The Second Circuit affirmed the district court's injunction, in part,because"there is little evidence in the record to support the [the board]'s decision on any ground other than the need to alleviate the intense political pressure from the surrounding community brought on by the prospect of drug-and alcohol-addicted neighbors. The public hearings and submitted letters were replete with discriminatory comments about drug- and alcohol-dependent persons based on stereotypes and general, unsupported fears."26 Like the above cases, Ordinance 1354 is not supported by any report,testimony,photo,or other evidence documenting any public safety danger caused by the operations of the one mobile syringe service exchange in Lewis County. Rather, it appears driven by animus against syringe service exchanges and the people they serve and by unfounded fears of increased drug use,crime, and the number of unhoused in the county. We expect any legal challenge to be met with the same scrutiny as the cases cited above. Costs and expenses. In defending discriminatory zoning provisions eventually struck down as facially discriminatory, government entities have incurred substantial financial and resource burdens. For example, in RHJ Med. Ctr., Inc. v. City of DuBois, a federal district court struck down a zoning ordinance that specifically excluded treatment facilities. The court ultimately ordered the City of DuBois to pay$132,801.64 in damages and over$270,000 in attorneys' fees and costs.27 To avoid the risk of protracted and expensive litigation and possibly a federal investigation, Lewis County should not enact Ordinance 1354 as written. and even if such connections existed,we are skeptical that they would qualify as the substantial harms contemplated by the Arline and Bragdon Courts"). 25 Innovative Health Sys., Inc. v. City of White Plains, 931 F. Supp. 222, 244 (S.D.N.Y. 1996),affd in part, 117 F.3d 37(2d Cir. 1997). 26 Id, 117 F.3d at 49. 27 RHJMed Ctr., Inc. v. City of Dubois,No.CIV.A.3:09-131,2014 WL 3892100,at*1 (W.D. Pa. Aug. 8, 2014). 5 Rieva Lester,Clerk March 18,2024 Page 6 of 7 Syringe service programs, including exchanges, are proven to reduce overdose deaths and the spread of infection diseases. When considering Ordinance 1354 and the applicability of the ADA and RA,it is important to keep in mind that nearly thirty years of medical research have documented that syringe service programs ("SSP"), including exchanges, are essential health service providers, necessary for an effective public health response to the opioid and HIV crises 28 According to the Centers for Disease Control and Prevention,for example,"[w]e can prevent and treat infections and overdose deaths through SSPs. Together, we have an unprecedented opportunity to combat the nation's opioid crisis while continuing to strengthen infectious disease prevention and treatment for communities everywhere."29 Leading medical organizations have repeatedly called for expanded SSP access and highlighted the harmful impact that restrictions and bans,such as those proposed in Lewis County, pose to this proven, effective, and safe medial response to the opioid and HIV crises. I highlight a few for your reference. For example: • According to the National Institute on Drug Abuse: o SSPs are "especially critical for preventing the community spread of HIV and addressing the intertwined public health crises of HIV and opioid use."30 o SSPs "result in better substance use outcomes for people who inject drugs and can improve the overall health of communities in which programs operate."31 o "NIDA,the Centers for Disease Control and Prevention,and others have conducted and supported research on these programs for nearly 30 years. Researchers have found that syringe services programs are safe, effective, and cost-saving tools to prevent HIV and high-risk injection behaviors that can impact the spread of other infectious diseases among people who inject drugs."32 28 https://nida.nih.gov/research-topics/syringe-services-programs#what-are-syringe (last visited March 17, 2024)(concluding that SSPSs are"especially critical for preventing the community spread of HIV and addressing the intertwined public health crises of HIV and opioid use"):https://www.cdc.gov/ssp/index.html(last visited March 17, 2024). 29 https://www.cdc.gov/ssp/index.html(last visited March 17,2024). 30 https://nida.nih.gov/research-topics/syringe-services-programs#how-do-syringe (last visited March 17, 2024). 31 https://nida.nih.gov/research-topics/syringe-services-programs#do-syringe-services (last visited March 17, 2024) 32 https://nida.nih.gov/research-topics/syringe-services-programs#what-are-syringe (last visited March 17, 2024) 6 Rieva Lester,Clerk March 18,2024 Page 7 of 7 • According to the Centers for Disease Control and Prevention: o "Nearly thirty years of research shows that comprehensive SSPs are safe,effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis,HIV and other infections."33 o "We can prevent and treat infections and overdose deaths through SSPs. Together, we have an unprecedented opportunity to combat the nation's opioid crisis while continuing to strengthen infectious disease prevention and treatment for communities everywhere."34 o "Comprehensive SSPs have been shown to dramatically reduce HIV risk and can serve as an entry point for a range of services to help stop drug use,overdose deaths, and infectious diseases."35 • According to the American Medical Association: o "Syringe services programs provide comprehensive services to reduce harms, save lives."36 o "Increasing access to syringe services programs is essential to limiting the spread of blood-borne infectious disease."37 o "Public health officials, colleges, universities, and other educational settings can reduce harms and help control infectious disease spread through supporting comprehensive needle and syringe exchange services, as well as supporting widespread, community-level distribution of naloxone and fentanyl test strips."38 Please let me know if you have any questions about how Ordinance 1354 invokes federal civil rights laws and protections. Sincerely, /s/David Howard Sinkman 33 https://www.cdc.gov/ssp/index.html(last visited March 17,2024). 34 Id. 35 https://www.cdc.gov/hiv/effective-interventions/prevent/index.html(last visited March 17,2024). 36 https://end-overdose-epidemic.org/wp-content/uploads/2022/09/AMA-Advocacy-2022-Overdose-Epidemic- Report 090622.pdf(last visited March 17,2024). 37 Id. 38 https://end-overdose-epidemic.org/wp-content/uploads/2022/09/AMA-Advocacy-2022-Overdose-Epidemic- Report 090[622.pdf. (last visited March 17,2024). 7 ['] 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 livinq 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 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 Kathryn Chatterton 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 Flag Status: Flagged You don't often get email from christina.riley85@yahoo.com.Learn why this is important 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 External Email - Remember to think before you click! This message may contain links with malware, viruses, etc. Please ensure the message is le•itimate before openin. it. 2