Flickr: Staxnet

D.C. needle exchange providers are breathing a collective sigh of relief after news broke yesterday that the impending temporary budget bill wouldn’t cut their funding after all.

But the possible loss of such funding spurred us to ask: how do needle exchanges work, anyway and who would be most affected if such a cut went through?

A few organizations in the District run needle exchange programs, including Helping Individual Prostitutes Service (HIPS), which works with commercial and informal sex workers in the District. Executive director Cyndee Clay says her group works with about 1,000 people a year, exchanged 8,000 syringes in March and about 65,000 in 2010.

Different providers handle needle exchange differently. For HIPS, clients register and then can exchange dirty needles for an equal number of sterile ones. In addition to the exchange, HIPS workers often take the opportunity to provide health counseling and other drug intervention services.

The majority of clients are African Americans and they are about evenly divided among women, men and transgender men and women, says Clay.

“These populations often never go through the door of a social agency, so those people would effectively be cut off from any services except for law enforcement” if needle exchanges ceased, Clay says.

All of this is of particular concern in the District, which has the country’s highest HIV-infection rate. Public health advocates have long boasted that needle exchanges are among the most effective ways to reduce infections, says William McColl, political director for AIDS United.

“Once you’ve prevented one case of HIV, you’ve prevented all other future cases from them,” McColl says.

Public funding for needle exchanges in the District is relatively new: the federal ban on funding was only lifted in 2007. But now needle exchange programs have a bigger burden to bear after PreventionWorks!, long the needle exchange program in town, had to close this year for lack of money.

HIPS receives about $125,000 from the District for its syringe access program, constituting 80 percent of its needle exchange funding. So the prospect of such a cut made Clay “just livid.”

“It’s just infuriating. This is our budget. Especially syringe exchanges, this has the support of our local government and our local health department,” Clay says.

Flickr: Andrew Magill

Reading city budgets are boring undertakings, but boy are they important documents. D.C. Mayor Vincent Gray’s proposed fiscal 2012 budget has been out for a few days now, and it includes $187 million in cuts, 60 percent of which come from social services. Ouch. If you haven’t had time to comb through the pages and pages of proposed cuts, here are a few that would affect the District’s most vulnerable residents:

• $4,373,927 cut from Child and Family Services

• $30,655,447 cut from the Department of Health

• $8,802,107 cut from the Department of Mental Health

• $18,628,455 cut from the Disability Compensation Fund

Wealthy D.C. residents are being tasked with bearing the burden of the city’s financial woes, too — a tax hike for households bringing in $200,000 or more a year is on the table.

It should be noted that some of those proposed cuts are in response to loss of federal funds, such as $12,518,000 of federal grant money gone from the Department of Health’s budget. Also, some of these cuts represent large chunks of an agency’s relatively small budget (a $1,625,000 cut from the Children and Youth Investment Collaborative represents a 35 percent cut).

In response to some of these proposed cuts, D.C. Behavioral Health Association executive director told Washington City Paper:

“D.C. already under-spends on children’s mental health treatment: we spent $13 million on our children’s mental health program while Vermont, which has a similar population size, spent $72 million.  Now Mayor Gray’s proposed FY2012 further reduces the mental health services that keep children out of hospitals and out of the juvenile delinquency system.  It reduces the treatment funds that help parents improve their parenting skills.  Perversely, while cutting these effective programs, Mayor Gray proposes spending significantly more on the expensive interventions that don’t have the proven track record of efficacy.”