As the county faces multiple threats of potential litigation, the Lewis County Health and Advisory Board largely voted against recommending a series of amendments to a proposal restricting needle exchange programs suggested by Commissioner Lindsey Pollock.
Thursday's votes were not binding, though the recommendation comes as county commissioners consider becoming the first county in the state to adopt stricter regulations on Syringe Services Programs (SSPs).
The measure was put forward by Lewis County Commissioner Sean Swope.
A public hearing for the ordinance has spanned two business meetings, and the alternative proposal comes after Pollock submitted “a list of proposed amendments,” which amounted to “significant changes” to the proposal, changes that were not completed before the board’s March 26 meeting.
A public hearing on the ordinance is set to continue on April 16.
“The charge that we have before us on this particular subject came from one of our commissioners, and asked that we offer thoughts on the proposal that Commissioner Pollock has come to propose as an alternative to Commissioner Swope,” said Advisory Board Chair Jami Lund.
Gather Church operates the only mobile needle exchange program in Lewis County.
“We’ve always complied with State Department of Health guidelines, procedures, and processes,” said Patty Howard, associate pastor of Gather Church and the lead on the needle exchange program. "When Department of Health staff have done site visits, they have remarked that we are exemplary.”
As drafted, the ordinance would ban mobile needle exchange programs, require program operators to offer “on-site counseling or referrals for an approved substance use disorder (SUD) treatment program,” and ban needle exchange programs from use as a “safe or supervised injection site,” among other requirements.
The advisory board recommended retaining the potential for a criminal penalty in the ordinance. As written, three or more violations of “any portion” of Swope’s ordinance could result in a misdemeanor charge for needle exchange operators in Lewis County, a charge that could result in a penalty of up to 90 days in jail and a monetary fine.
“I get really concerned when we’re talking about the criminalization of health care after the debacle that we’ve been through in the past four years,” Pollock said at the board’s March 27 business meeting.
“The most egregious part of this ordinance is the criminalization of these activities, which oversteps state law, which has been pointed out by three law firms in letters to the county,” Howard said Thursday.
According to the ACLU of Washington, the potential criminal charge places the ordinance “in direct conflict with the Uniformed Controlled Substance Act as the lawfulness of needle exchange programs are expressly authorized” under Washington law.
“The ACLU of Washington trusts that the Lewis County Commissioners will develop alternative methods to ensure the safe implementation of harm reduction services that do not run afoul of state law,” the ACLU of Washington previously wrote in a letter to the Lewis County Commissioners. “Moreover, it is our hope that the commissioners consider reasonable alternative measures for the greater good of the county and all its constituents.”
The board did, however, recommend removing language stating a violation didn't need to be witnessed by an “enforcement entity.”
The ordinance would require the needle exchange to operate as a one-for-one — meaning to get a new needle, a participant would have to turn in a used one — and would forbid “other drug paraphernalia” from being “issued or distributed in any manner.”
The advisory board voted in support of an amendment to allow providing first-time participants with up to 10 needles without exchange. The advisory board voted against recommending Pollock’s amendment to allow the distribution of swabs, filters, tourniquets, cookers, sterile water and ampoules.
“Somebody who has drugs will find a way to use them,” Howard said. “Instead of a sterile receptacle for liquifying the substance, they will use the bottom of the soda can or a piece of aluminum foil, wherever they can find it. Instead of clean cotton, they will use a cigarette butt, old gauze, or anything that they consider a filter. Instead of sterile water, they will use toilet water or water from a puddle. The lack of these supplies does not keep someone from using drugs.”
The board also voted to keep stricter registration requirements, a requirement to refer patients to counseling, prohibiting those under 18 years old from accessing the program, site security requirements and banning county money from funding needle exchange programs.
According to Howard, Gather receives funding from the program through the Washington state Department of Health for supplies, while Gather covers the cost of staff time, disposal, fuel and other associated costs.
The advisory board voted to recommend forbidding those who have accessed SUD treatment in the last 24 months from volunteering at the clinic, a timeframe Howard said is not supported by research.
“Recovery is an individual journey, and 24 months is not policy anywhere I know,” Howard said. “It might be a ballpark figure that somebody would draw out of a conversation, but it is not policy, to my knowledge. In our experience, some people are ready after three months, and others aren’t ready even after 24.”
According to Howard, Gather Church has a “robust policy” to ensure volunteers are prepared to work at the needle exchange program.
The Board of County Commissioners previously passed an amendment proposed by Swope to allow Gather to operate its mobile unit exclusively at their clinic on Tower Avenue in Centralia through Dec. 31, 2025. On Thursday, the advisory board voted against recommending an amendment that would have removed the timeline altogether, and allowed syringe exchange programs to operate “at one or more fixed locations or through mobile health units.”
According to Pollock, an explicit ban on mobile units could prevent Gather or other organizations from expanding the use of mobile units.
The advisory board voted Thursday to recommend Pollock’s amendment removing certain reporting requirements from the ordinance. The advisory board also recommended an additional amendment “explicitly” protecting personally identifiable information from “any disclosure.”
