The New York State Department of Health AIDS Institute contracts with 25 community-based organizations designated as Syringe Exchange Programs in New York State to provide additional drug user health services.

Syringe Exchange Programs were established in 1992 to address the HIV/AIDS epidemic in injection drug users, provide comprehensive harm reduction prevention services. To become a Syringe Exchange Program, an organization must complete a lengthy process to be authorized by the New York State Department of Health Commissioner in order to distribute syringes to, and collect from, those who inject drugs. These new contracts expanded Syringe Exchange Program/Drug User Health Hub coverage areas and services provided, including adding mental health, medications for opioid use disorder and reproductive health care education/counseling, to the array of services being provided.

Death by drug overdose remains a statewide crisis, and more resources are needed to support priority populations that are especially vulnerable to overdose and who have been historically marginalized and stigmatized by systems of care. The goal of this initiative is to expand comprehensive harm reduction services/supplies and culturally competent medical and social services for people who use drugs with a focus on priority populations who experience persistent inequities including but not limited to drug use, overdose, and other negative health outcomes. The priority populations include Black, Indigenous, Persons of Color, Criminal Legal/Justice Involved, Houseless, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex +, Older Adults, and Pregnant/Parenting People. Each funded agency will:

• increase harm reduction services and supplies through non-stigmatizing care
• advance health equity, and address social determinants of health that contribute to perpetuating an individual's vulnerability to repeated overdose, such as lack of stable housing, poverty, stigma, and racism
• address the intersectionality of drug user health with other specialty care like sexually transmitted infections, HIV, and hepatitis C
• increase engagement of people who use drugs
• evaluate and report on activities, trends, and innovations

Agencies are expected to work collaboratively with the Syringe Exchange Programs, Drug User Health Hub, Opioid Overdose Prevention programs, and other relevant partners in their region to provide meaningful, non-coercive, client-driven services to reduce overdose and other negative outcomes of substance use. Examples of activities may include increased access to low-threshold buprenorphine, providing naloxone and training on its use, distributing fentanyl test strips and other harm reduction supplies, as well as targeted interventions for those who have previously experienced an overdose.

The New York State Department of Health AIDS Institute Office of Drug User Health's Drug Overdose Report Submission Reimbursement Program was developed to help support counties, and specifically, coroner and medical examiner offices, as they play an important role in providing data and reports on fatal drug overdoses occurring throughout the state while facing increasing costs.

Due to the increasing volume and complexity of drug overdose cases, it is imperative that accurate, timely, data and reports must be completed and submitted to our Drug Overdose Surveillance and Epidemiology Unit to develop an evidence-based state and local-level response to the drug overdose epidemic.

The State Unintentional Drug Overdose Reporting System, a program that collects data on all fatal overdoses occurring in the state, contacts coroner and medical examiner offices throughout the year to request autopsy, forensic, and toxicology reports. Reimbursement will be provided based on the number of reports received.

The New York State Department of Health AIDS Institute contracts with University Emergency Medical Services to expand the New York section of a secure patient data exchange system, known as Medication for Addiction Treatment & Electronic Referrals.

NY MATTERS is a collection of resources to initiate care and quickly link patients to appropriate treatment. It utilizes an electronic platform hosted by New York State Department of Health to efficiently refer patients with opioid use disorder to community-based clinics. New York State Department of Health has recognized a need to enhance existing mechanisms to meet the expanding needs of New York State residents who are battling opioid addiction. The system is intended to develop efficient linkage of patients to care, provide access to integrated telemedicine evaluations, allow for medication/ transportation vouchers to be issued to patients in need, provide a mechanism to continuously engage patients, coordinate harm reduction supplies, provide social determinants of health support and evaluate ongoing retention in treatment.

Funding supports expansion of the NY MATTERS network to regions throughout the state that do not have a robust service infrastructure, including rural communities, counties with low health rankings, high opioid burden counties and communities of color. This funding allows the NY MATTERS team to integrate more comprehensive follow-up services for those being referred through the platform.

Through this contract with Emergent Devices, Inc., the New York State Department of Health AIDS Institute purchases Narcan®, a 4mg intranasal formulation of naloxone. This medication reverses potentially fatal opioid overdoses and has been successfully deployed in the community among more than 700,000 non-medical persons. These "citizen responders" are trained by more than 1,200 New York State Department of Health registered Opioid Overdose Prevention Programs to recognize overdoses and to respond to them by calling emergency medical services and administering Narcan. Naloxone is central to the State's response to the opioid overdose crisis.

The New York State Department of Health AIDS Institute funds a five-year (5) contract with Foundation for AIDS Research to support the expansion of Syringe Exchange Programs, Technology Enhanced Access to Syringes program and the vending machine pilot program. This expansion provides increased access to supportive and health-related services for people who use drugs who live in remote or rural areas. These programs provide individuals with syringe/harm reduction supplies, naloxone, fentanyl test strips and safer sex supplies.

This funding will support a new telemedicine program for two (2) years aimed at increasing access to medications for addiction treatment or medications for opioid use disorder.

The contractor will provide low-threshold harm reduction services via telemedicine to persons with opioid use disorder and for those at risk of overdose. With the steady increase of drug overdoses, it is imperative that New York State expand its current funding of drug user health services into regions that do not currently have any harm reduction services coverage. The funding will enable the contractor to provide medical and social services to clients, including low-threshold access to buprenorphine and naloxone, mental health services, trauma-informed care, primary care, and sexual and reproductive health services.

A Request for Applications was issued in August 2023 for Development of a Comprehensive Coroner Training Program. No applications were received in response to this request. The New York State Department of Health anticipates reissuing a revised Request for Applications (RFA) in July 2024.