A new state law requires Indiana syringe services programs to adhere to a one-to-one needle exchange. (Aprile Rickert / LPM)For the past month-and-a-half, the Clark County Health Department has been operating its syringe services program at a new location and with shortened hours, in response to re quirements in state legislation passed this year.One of the changes is that programs need permission to be within 1,000 feet of buildings such as schools or places of worship to distribute or exchange syringes.The law also requires programs to adhere to a strict one-to-one exchange and to check clients’ IDs.In Clark County, health representatives sought permission from two nearby churches to be able to continue to operate the syringe program at the health department. One said no, but health leaders are talking with the church with the hope of providing more information on what the program does.Health officials say moving syringe services to a mobile unit about a mile away has made it harder to provide the full spectrum of care they did before, and that participation in the program is down.“It was a one-stop-shop,” Clark County Health Officer Dr. Eric Yazel said earlier this month. He said the syringe program attracts people that health staff might not otherwise encounter, providing things such as education, harm reduction and wraparound services. “And with this move, it's a little more challenging to provide those.”Response to state changesSyringe services programs provide clean needles and take back used ones from people who inject drugs. They also offer other services, including disease testing and access to recovery or housing options.Indiana lawmakers first approved the programs in 2015, in response to a major HIV outbreak in Scott County. Clark County’s program, one of a handful in Indiana, opened in early 2017.The measure Indiana lawmakers passed this year extends state approval five years, while adding new rules, including the 1,000-foot buffer, ID requirement and one-to-one exchange.Some proponents have said some of the changes may be a way to address concerns with the programs and provide more accountability.But they could present some challenges to services.Doug Bentfield, administrator at the Clark County Health Department, said new clients or people who have relapsed may not have syringes to return, so they can’t get clean ones. He said the ID requirement can be a bigger issue for unhoused participants.When the health department reached out to the two local churches this year that fell within the 1,000-foot range, one declined to give permission and one didn’t respond, so they relocated, health officials said.For now, they’re providing syringe services out of a mobile unit parked at West Maple Baptist Church in Jeffersonville, about a mile away from the health department. It’s at the site where Paul Stensrud operates homeless outreach Jesus Cares at Exit 0. He said he didn’t hesitate when health department staff reached out.He said he told them, “I already know what you guys do. It's successful, and it's something that we've always, always backed.’”He said this partnership has helped connect some new folks to his outreach, and they’ve been able to connect more to the syringe program, “and that’s the way it should be.”A drop in numbers Overall, participation in the syringe program has taken a significant drop in recent months.Information provided by the health department shows the number of visits at the start of the year was similar to that period in 2025, with 120 visits last January and 114 this January. But since then, the gap has widened.April’s 54 visits were a little less than half the same time last year. In May, people visited the syringe services program just 21 times, compared with just over 100 times in May 2025. Bentfield said there were 13 visits in June as of Tuesday.He said he thinks the drop is mainly due to the relocation and that the other requirements, while a challenge, are not destabilizing to the program.At the mobile unit, staff can do general intakes and provide syringes, HIV, Hepatitis C and STI testing. If these patients were visiting the health department, they may be able to get more help, including wound care, immunizations and other social services, Bentfield said. They could also get immediate treatment if they tested positive for HIV, for example.He said it takes a lot of courage for people to go to the program or seek resources.“We need to make sure we’re able to take full advantage of their willingness to accept help,” Bentfield said.Along with the shift to the mobile unit, syringe services hours are much more limited: six hours a week instead of 40. Bentfield said the setup also reduces privacy, because the patient is walking up to a mobile unit specifically for syringe services, compared with going into the health department, which offers other kinds of help, too.Yazel said he’s concerned that if fewer people are participating in the program, there could be an uptick in abscesses or other complications from drug use without sterile products, which he said he saw a lot as an emergency physician before the Clark County program opened.“I worry that…we'll start to see those again as utilization goes down,” he said.Along with the state renewal earlier this year, the Clark County Health Department also received the required local approval to continue the program last month.Bentfield said he is hopeful discussions with community partners will lead to reestablishing syringe services at the health department.If the program does move back, Bentfield hopes to maintain a presence once a week at Exit 0, to help connect unhoused people to the syringe services and the showers and laundry services there.Yazel said the department is creative in looking for ways to lower barriers and make things work. He said while the health department site offered more comprehensive care, he hopes that if they end up using the mobile site long term, that consistency and the possibility for building more services around it could improve participation.“I think it's a mixed bag,” he said, of the mobile unit. “I don't think it'll ever be what it was when it was housed at the health department, but I think it won't always be as grim as what it looks right now.”He said earlier this year the state renewal was a win and that while he recognized some concessions had to be made, they could present challenges.The statewide extension became law earlier this year without Indiana Gov. Mike Braun’s signature. He said in March he felt the programs were “treating a symptom. And we need to get at the underlying issue of what it was done for in the first place, to where you don't use that as a crutch going forward.”The recent changes aren’t the first challenge the health department has faced within the past year with syringe services. Last year, it stopped giving out certain federally funded harm reduction supplies to comply with a federal executive order.Coverage of Southern Indiana is funded, in part, by Samtec Inc., the Hazel Walter T. Bales Foundation, and the Caesars Foundation of Floyd County. ...read more read less