Federal Funding for Syringe Services Programs

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The Consolidated Appropriations Act of 2018 permits use of funds from the Department of Health and Human Services (HHS), under certain circumstances, to support SSPs, with the exception that funds may not be used to purchase needles or syringes.

HHS released guidance pdf icon[PDF – 367 KB, 22 pages] for state, local, tribal, and territorial health departments that will allow them to request permission to use federal funds to support SSPs. The guidance states that eligible state, local, tribal, and territorial health departments must consult with CDC and provide evidence that their jurisdiction is (1) experiencing, or (2) at risk for significant increases in hepatitis infections or an HIV outbreak due to injection drug use.

Each federal agency (e.g., CDC, HRSA, SAMHSA) developed its own guidance for its funding recipients regarding which specific programs may apply and its application process.

The CDC Program Guidance for Implementing Certain Components of Syringe Services Programs, 2016 pdf icon[PDF – 340 KB, 8 pages] provides specific procedures for CDC-funded grantees. The CDC guidance details which SSP activities can be supported with CDC funds, which relevant CDC cooperative agreements can be used to support SSPs, and the process by which CDC-funded programs may request to direct resources to implement new or expand existing SSPs for PWID. More information about federal funding for syringe services programs is available below.

FAQS Regarding Funding for SSPs
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FAQs Regarding CDC Program Guidance for Implementing SSPs
  • What is the purpose of the CDC Program Guidance for Implementing SSPs?
  • What is the process for requesting use of CDC funds for SSPs?
    • After obtaining CDC notification that the jurisdiction has sufficiently demonstrated need to use federal funding for SSP activities, CDC directly-funded state and/or local health departments, or other eligible entities, should discuss plans to direct funds to SSP activities with their CDC project officer. Local health departments, who are not directly funded by CDC, must work with CDC directly-funded state and/or local health departments to request program funding to support SSPs.
    • In accordance with CDC Office of Grant Services (OGS) guidelines pdf icon[PDF – 340 KB, 8 pages], jurisdictions must then prepare a proposal that identifies the SSP activities that will be supported by CDC funds. The proposal should include: 1) a proposed program plan and 2) a revised budget. For all grantees, the proposal, including the proposed program plan and revised budget, must be submitted to OGS with a courtesy copy to the CDC project officer. Once approved by both the OGS Grants Management Specialist and the CDC Project Officer, the requestor will receive a revised Notice of Award signed by the OGS Grants Management Officer. Grantees must obtain this approval before using their awarded funding to implement any SSP activities.
    • CDC will then approve or disapprove requests to direct funding to support SSPs activities within 30 business days upon receipt of all requested information. After request approval, CDC will work in partnership with grantees to determine the appropriate process measures to capture for SSPs.
  • What needs to be included in requests to use CDC funds to support SSPs?
    • CDC grantees cannot request that funds be directed to support SSP activities unless the jurisdictional health department has first demonstrated the need for SSPs, in consultation with CDC, and received a notice of approval from the CDC SSP Review Panel. During the processes of requesting either: 1) determination of need or 2) directing CDC funds to support SSPs, grantees should contact their project officers to discuss specific capacity building and technical assistance needs and, if needed, submit a request(s) for additional technical assistance or training. All proposals to request the use of CDC funds to support SSPs pdf icon[PDF – 340 KB, 8 pages] should include the following elements, unless otherwise noted:
      • CDC’s notice of approval that the jurisdiction has sufficiently demonstrated need to use federal funding for SSP activities;
      • Description of proposed new or expanded SSP related activities;
      • Timeline for implementation;
      • Impact on current activities funded under the respective funding opportunity announcement (FOA);
      • Copy of existing protocols and guidelines for SSP related activities, if available;
      • Budget and budget justification, proposed activities and measures;
      • Description of current training and technical assistance needs related to planning, implementing, and evaluating SSPs, as appropriate; and
      • Location of SSP-related activities to be supported with federal funds.
    • If a jurisdiction (county, city, state, etc.) wants to discuss the potential need for and benefits of SSPs, who is the primary point of contact in the state’s department of health?
    • Entities seeking information about the potential needs for and benefits of SSPs in their jurisdiction should contact their state HIV and viral hepatitis coordinator(s). For jurisdictions where CDC has been consulted and concurred that need exists, the point of contacts can be found at Syringe Service Program.
  • How do we know if injection drug use (IDU) is on the rise and that the risk of hepatitis B, hepatitis C, or HIV infection among persons who inject drugs (PWID) is increasing in our state or municipality?
    • To best assess if unsafe injection drug use is occurring in your jurisdiction, examine all national and local data sources available to you that are either known or may reasonably be associated with unsafe (non-sterile) illegal injection of drugs. Such data sources include, but are not limited to, the following:
      • Drug overdose deaths (especially opioid-related)
      • Access to prescription opioids (e.g., production, sales, prescriptions)
      • Access to care related to illegal injection of drugs (e.g., data on the use of care and treatment services for drug overdose or intoxication related to injectable drugs)
      • Demand for medication-assisted therapy (e.g., methadone, buprenorphine, naltrexone)
      • The six variables used in CDC’s national analysis (Percent White, Non-Hispanic Population; Drug Overdose Deaths per 100K Persons; Per Capita Income; Percent Unemployed Population; Prescription Opioid Sales per 10K; Buprenorphine Prescribing Potential by Waiver per 10K Persons)
      • EMS calls for drug overdose;
      • Arrests for drug possession or sales
      • Arrests for possession of needles, syringes, or other drug paraphernalia;
      • Population surveys assessing prevalence of IDU;
      • State prescription drug monitoring plan data to identify for hot spots of prescribed opioids;
      • Rates of endocarditis or skin and soft tissue infections; and
      • Medical examiner and toxicology records.
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Page last reviewed: May 23, 2019
Content source: National Center for HIV, Viral Hepatitis, STD, and TB Prevention