Single Source Procurement: Syringe Exchange Program - Youth Intravenous Drug Users

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

HIV and AIDS in New York State cannot be addressed without focusing on injection drug users (IDUs) and syringe exchange programs. The Syringe Exchange Programs (SEP) initiative was established in 1992 to address the HIV epidemic in injection drug users. Syringe exchange is the one intervention which could be described as the gold standard of HIV prevention for injecting drug users. The data shows that syringe exchange is one of the most successful HIV prevention initiatives of the NYS DOH, AIDS Institute, based on the numbers of lives and health care dollars saved. In 1992, 52 percent of newly diagnosed AIDS cases were among IDUs. In 2012, IDU risk accounted for only 3 percent of new HIV diagnoses.

The SEP was initially approved through procurement DOH01-0000393-3450000 for the period of 7/1/13–6/30/18. An amendment to that procurement was subsequently approved which contained program expansions for reaching young intravenous drug users - component 2 of DOH01-0000748-3450000 for a period of 7/1/14-6/30/16. The amendment was to fund 18 of the SEP providers for 2 years as part of an overall strategy to end the AIDS epidemic. This expansion was to pilot new services to hire staff and/or peers; use social media platforms accessed regularly by young people; or provide other related services to assist in reaching and engaging young IDUs.

These services for young IDUs were established in response to the increasing rates of Hepatitis C and Opioid Overdoses throughout New York State - especially in upstate. The implementation of the ISTOP prescription drug program drastically reduced the number of illegal opioid pills available for purchase on the street. Young people who previously were taking and addicted to these pills containing opioids (e.g. Oxycontin) started using heroin as a less expensive and more readily available option. The new users, having less experience or history with injection drug use, may have shared syringes and injection equipment making them vulnerable to acquisition of HIV/AIDS and Hepatitis C as well as Opioid Overdoses. This initiative targets these young users and provides education on safer injection practices and sexual risk reduction as well as behavioral intervention counseling and referrals for substance use treatment, if requested. Findings have shown that the demographics of these new young users differ from those typically found in syringe exchange programs. A larger percentage of these young users are Caucasian and from middle income or more affluent areas not impoverished communities.

The findings from the 1/15/15 – 12/31/15 funding show the following successes achieved by the funded programs:

  • The aggregate number of new clients under age 30 for all funded agencies increased 19% between 2014 to 2015 (from 1814 to 2,160);
  • The aggregate number of clients served under age 30 for all funded agencies increased by 11% between 2014 to 2015 (from 3,813 to 4,244);
  • All funded agencies are registered Opioid Overdose Prevention (OOP) Providers and train young IDUs on the use of naloxone and provide OOP kits when they are enrolled in the program;
  • All funded agencies have active linkages with substance use treatment programs that will accept young IDUs and a subset offer on-site Buprenorphine induction or are considering adding this service under a new AI multi-Bureau initiative;
  • Have developed, implemented or expanded innovative programming to reach young IDUs.

Contractors were awarded contract(s) as a result of the competitive procurement process. This is a two year extension of the contract(s) under the same terms, conditions, and pricing authorized under the existing contract(s). The single source extension period will allow for the continuation of critical services pending outcome of a new competitive procurement to obtain these services.

Procurement / Program Name Syringe Exchange Program - Youth Intravenous Drug Users
Contractor Name(s) Multiple – Please See Attached.
Contract Period 7/1/2016-6/30/2018
Contract Number(s) C028470-C028489, C029038, C029594 & C030209