A bill for an ordinance authorizing a supervised use site pilot program contingent upon the state General Assembly passing legislation authorizing the operation of supervised use sites in the state of Colorado. The Committee approved filing this item at its meeting on 11-7-18.
No, no, it's three names. Council Resolution 1300 has been abducted. All right. That brings us to 1292. Madam Secretary, if you could put that up on our screens. And Councilman Cashman, will you please? What? Counsel Bill 1292 on the floor. Yes, I moved the council bill 18, Dash 1290 to be ordered published. Thank you, Councilman Cashman. It has been moved and seconded questions or comments by members of Council Councilman Flynn. You called this one up? Yes, Mr. President, I did. In the three years that I've been sitting up here and indeed looking back on the probably 30 years I used to sit over there, I can't recall an issue on which I have struggled. As much as I struggled trying to come to terms with this one, because this is literally life and death. And I recognize that and I respect that. There are just so many moving parts. To the issue of supervised use facilities. And I haven't been able to settle yet on whether I believe I truly believe that this approach will be effective. Or the best way to proceed, as opposed to some other methods I've seen elsewhere. And as I did more research, I came to believe that it would be really good for this city to provide. To its citizens, not just to its first responders, but to family members and to citizens and to volunteers. Naloxone kits or Narcan kits. And to have them volunteer or even in their own family, to go out into the community where we are finding. Overdose deaths. I had one right around the corner from my office in the Bear Valley Shopping Center. A woman in it was found in a car after three weeks in an abandoned car. So this is this hits real close to home to me. I've also had a heroin bust of a dealer right outside my office in Bear Valley. This hits real close to me as well. And while I was considering whether this other approach might be more effective as I'm watching television last night after the news, 60 Minutes came on and detailed the this very program in Salt Lake City , this program of distributing naloxone kits to the general population and the effect it's having on saving lives there, as opposed to establishing a single site here where the government will then sponsor you in in safely injecting your opioids or your meth or whatever substance. And so I'm still so unsettled, not just on the matters of law, the state law, which still doesn't allow that may change in the next session. And I understand that this bill is contingent on that passing, but also the issue of federal federal law and whether this runs afoul of federal law. We know that the Justice Department believes that it does. And so, Mr. President, at this point, I know that there are votes here to pass this, but I intend to be probably the sole no vote on this, because I'm not convinced that this is the best approach for this city. The deciding factor for me was a recent article in Vancouver where they've run a site like this for 15 years, and in the year 2017, Vancouver set a record for overdose deaths after 15 years of having such a facility. The problem in Vancouver was I think it was 48% more deaths in 2017 than in 2016. And this is after 15 years of this approach. So I'm not persuaded that a government sanctioned injection facility is a better approach than having a community full of volunteers who go where the problem is, who go to the Cherry Creek bike path or the central library. In the Central Library, they've had. 21. Overdoses reversed by the security teams down there since about the last year and a half. And I think that would be a much better approach than to set up a facility like this. Thank you, Mr. President. Thank you, Councilman Flynn. Councilwoman Sussman. Thank you, Mr. President. I am in support of this bill, and I just think that it's really important for us to take a real realized reality. People are going to be doing this and people are going to be doing this on our streets. If we pretend that it's not happening, it's not going to go away. And we we are known. In Denver for doing some very bold. Things. And even though it I don't really want to compare them, we win against federal government for marijuana. Again, sort of looking at reality. What is the reality here? And I think with the safe injections, we can at least prevent some deaths. I actually want to sort of like Councilman Flynn was talking about. I'd like to also think about the deaths that that we might prevent that aren't about public injection, but the deaths of people inside their homes, the sort of the invisible addicts, the ones that are taking the pills. And certainly the 60 Minutes article last night talked a great deal about that. Here I am already. We haven't passed this one and I'm piling on. What can we what can we do next to to understand the reality of the situation? We have to be grown up about this and what can we do? And I feel like this is a really important step. If it doesn't work, I suppose we'll learn how to make it work. And we wouldn't never learn how to make it work if we didn't try this this particular path to helping folks who are struggling with this disease. This is a disease. Thank you very much, Mr. President. Thank you, Councilwoman Sussman. Councilman Brooks. Yeah, thank you, Mr. President. And thank you, everybody, that's here. And thank you for being a part of this journey and teaching this entire city what's going on in the dark. Councilman Flynn mentioned some issues. This is a hard decision for him. If this is an easy decision for you and you are supportive of this, please stand up. Thank you. All of these individuals here are in our community and they have personally witnessed the hard stuff that we've been thinking about for the last. Well, that I've been thinking of for the last year and a half, but that we've been contemplating for the last four weeks. And this is a public health crisis that we're in and we're bringing it to the light. And I am supportive of this. I do feel like we've waited long enough and it's time that we address this issue. Councilman Flynn, let me just address two things that you said that are a little bit inaccurate. One, the government is not sponsoring this. This actually is going to be privately run. A nonprofit will run this. That's in the bill. Number two, Vancouver is one, but 60 cities internationally that have data in context. And so to just look at that and not look at the other cities like a Barcelona, which I've mentioned this many times, the day one that they've opened up a supervised use site. Dramatically. They saw a drop in deaths and they're continuing to see a drop in deaths. And so it's important that you look at the data per the context that you're in. Last thing I'll say is we have no good American data. That's why we're asking for this pilot. And here tonight, we do have a state senator who will help us take this to the next level. And I'd love. Mr.. Mr. President, if you indulge me for about 3 minutes, to have State Senator elect Brittany Patterson come and just share a little bit, because I believe she's for the title for this bill at the state. And I think we need to hear about that at the city. Is that okay, Mr. President? Yup. Go ahead. Hello, everybody. It's great to be here. I've never actually testified, so I apologize if I didn't go. Don't actually do the right rules and I call you by the right title. I am currently state representative. I was just elected to enter the state senate. I have pulled a bill and I just wanted to come here to thank you for taking this initiative because Denver, actually showing that they want to move forward with a pilot program is going to be an essential step in us actually taking action at the state level. I feel very confident with the change in leadership that will actually get a fair hearing this time and that this will be a bipartisan bill. I know that this is an uncomfortable issue to talk about. It is something that we don't want to recognize is happening. But I can tell you that whether or not we pass this pilot program and whether or not we pass this at the state level, people are going to continue to use and inject drugs and they are going to continue to die. In fact, we saw the highest overdose rates last year in the highest death toll that we've had here in Colorado. And we expect it to continue to rise here and nationally. We've been told by experts that it's going to get worse before it gets better. And to Councilman Flynn, what happened in Vancouver is actually because it wasn't because of the safe you cite, it was because right now they're actually having a surge of fentanyl. And so we've met with with professionals. I had the opportunity to visit Vancouver and the the police officers that we were in contact with said that heroin doesn't even exist there anymore because they get such a a greater high from fentanyl. So that's actually where the skyrocket of deaths is happening. So what we have the opportunity to do right now is to make history in making sure that we are treating people with an addiction, with the care that they need, that we're bringing them out of the shadows for people that are injecting drugs. This has been a long journey. You don't just start using heroin. I know my mom was overprescribed. Opioids, like so many people here in Colorado and across the United States, she was a soccer mom. We were in the middle class. She is an amazing person. This is this affects everybody. I mean, I'm telling her story because the greatest barrier that I have found to actually getting people the help that they need is the stigma that exists. And when we talk about even this site, it is it is uncomfortable for people to talk about. So I want to tell you about my mom. She was overprescribed opioids. Like so many people, she had a back problem. We've seen a system that has incentivized overprescribing. That's why right now we are facing a public health crisis. We are facing the greatest public health crisis of our time. And you happened to be elected during this time. And it is incumbent upon all of us to act. And this is one measure in ensuring that we're actually keeping people alive that have gone down the path. 80% of people who use and inject drugs started off with prescription opioids like my mom. So when you think about that journey that has led them to the point where they became wildly addicted, like my mom, so many people are getting cut off of their prescription without access to treatment because right now we're trying to ramp up actually getting them the help that they need. But we need to make sure that we're keeping them alive today. I when you are injecting drug injecting drugs, it's very isolating. So a lot of these people, the point of having a pilot program to have these super supervised sites is actually bring them out of the shadows in front of health professionals that are not only going to ensure that when they're using drugs, they're not overdosing, but also building those relationships, having a room where they can sit, get they're making sure that we are testing them for hepatitis C, for HIV, making sure that when they're ready to get help, that we actually give them the prescription that they need for medication assisted treatment. And then ultimately, when they're ready to move towards our. Recovery, that they have those relationships intact and that we're actually building capacity there to get them the treatment that they need. So my mom has been addicted to drugs for 30 years. She was cut off when her doctor recognized she had a problem. And she, like so many people, was just trying to stay well. It wasn't about getting high. It was about making sure that she was not going through withdrawal. People who are addicted say that withdrawal is they fear withdrawal more than death. So when you think about the physical pain that that must be that you fear going through that more than death. So they will do anything to stay well. And that's why so so many people have moved to injecting drugs, to buying cheap heroin on the street. And we've seen an increase in fentanyl here as well. So you have an incredible opportunity to move forward to show Colorado that we are not going to increase the amount of crime in this area. In fact, it's been proven to do the opposite, that we are going to save lives and that we are going to actually get people to help that they need. This is going to really change. Be an example for Colorado. And I just want to thank thank you for the opportunity to speak to you. Thank you for taking this up. This is this is critical for the United States and for Colorado. Thank you. Councilman Brooks, was that all you. Had a follow up at the end? Okay. Thank you very much, Councilman Cashman. Thank you, Mr. President. I agree with Councilman Flynn on a couple of areas. I'd like to see Naloxone much more readily available in the community. I think that makes great sense. And I also agree that I don't know that this is the right solution for Denver. What I do know is that we have no drug treatment beds available in the Denver area. I know that we don't have a functioning mental health system in the Denver area outside our jail system. We have like 98 or 90 beds at Denver Health for both mental health and drug treatment. For a city of 700,000 and a metro area, somewhere around 3 million are allowing people to die in restaurant bathrooms and in our parks and on the street has not slowed the the opioid epidemic. And as Mr. Patterson said, you know, the landscape changes continually. Now it's fentanyl. Who knows what else is going to be appearing for me? And I totally understand the difficulty that many people are have having wrapping their minds around providing a facility for people to inject. Illegal drugs. I get that it's difficult for me to wrap my mind around it, but we need to try something to stem the tide. As as my friend Lisa Revell says all the time, we can't get someone into treatment when they're dead. You know. While while the country is getting off its lazy behind to take care of the mentally ill and to take care of people suffering from the disease of addiction, we owe it to to our community to do something to keep keep things going until we can give them the care that they need. So I'll be voting to move this forward. Thank you. Thank you. Councilman Cashman. Councilman Espinosa. I watched I watched the 60 minute piece and what was happening there were an 80 $80 drug was being put to market at $4,000 is appalling. And I hope that companies commitment to bringing that drug price back down is fall through. And I hope that people maybe all of you will write in Visio and make sure that that drug, which there's their mechanism for delivery, is far simpler than anything else on the market and could be readily administered by people, the layperson. There's no reason why in America that isn't the standard protocol for how we deliver this drug. That said, the life saving ability of naloxone is proven. And I can tell you, if one life is saved in the supervised use facility, the facility is paid for. And so that as tangible as that is, the only reason I mean, that isn't the only reason I supported supervised use facilities. From the moment Councilman Brooks approached me on this and I've never wavered on that is because it's not just the life saved in the facility. When you're present and able to address that, it's the other aspects that are tangible from this side of the dais in delivering services to this community is you will get fewer overdose deaths because those lives are saved, you will get fewer ambulance calls for overdoses. When I went on my one ride along with with the FDA and I'm sort of maybe violating hip rules, we went on one of those calls. I've never experienced that. And it was it was eye opening. And and that's midday on a on a on a Friday. That's not the hot spot for when those things are. But it happens on a routine basis in this city. The decrease in transmitted diseases that are transmitted by by dirty needles and things like that, all of those have major consequences to our our ability as a city to deliver services to populations that need them. And so this is actually the step in the right direction. And and so thank you, Councilman Brooks. Thank you all for supporting council in in doing what is is is a bit a bit too progressive for some, but it's the right thing for this city. And and I'm happy to be supporting it. Thank you. Thank you. Councilman Espinosa. Councilman Lopez. Thank you, Mr. President. I am a yes vote. This is this is very easy to me when the question was asked me about it. And this was absolute. Yes. And for a couple of reasons. And one is in this country, we are absolutely backwards. We are backwards when it comes to drug treatment. We are backwards when it comes to medicine. We are backwards when it comes to health care. We are an industrialized nation and we are an incredibly powerful nation and a wealthy nation. Yet we do not. You have more access to illicit and pharmaceutical drugs than you do to medicine to treat it. And when it comes to when it comes to treating it, we create all these barriers. We don't we don't believe it's a function of government to treat it. We don't believe I mean, we believe it's a it's a privilege and not a right. Collectively, there is something wrong with that. And so we are in we of course, we're going to be afraid of it. Of course we're going to be fearful and nervous about it if we haven't been exposed to how to actually treated. And in order to do that, you have to leave stateside and go across the world to see how they're treating it. And we have to learn from other countries. We have to learn from other, you know, other governments that are doing this right. I do believe this is absolutely worth it. I don't want to see somebody overdose pass away anywhere in a park or in a bathroom, anywhere or even in a facility. And this you know, this is an opportunity to go in that right direction. It's more than just a test. We know that this is proven. And when when we put our our resources and we behind it, and we do believe it is our function. Right. And so finally, I think I would imagine that. If you are in one of these sites, you have access to not just sterile, sterile needles and people there who are supervising you and know what to do just in case, but also because you have someone to talk to. And that person, that interaction could be that interaction that gets them on that right path. So you know what? Maybe I shouldn't do this. You think I should do this? It's up to you. It's a survival rate. I mean, you have those conversations. Think about those conversations. And how those in and of themselves are life saving. And that's what we want. Access to care. Access. That is so easy. Yes. On this one. Thank you, Mr. President. Thank you, Councilman. Thank you. Guzman-Lopez Councilwoman Black. Thank you, Mr. President. I wasn't going to say anything tonight because this is just first reading and it will be back up next week. But since everybody is talking, I thought I should put in my $0.02 worth. I agree with all of the things that have been said for the reasons why we should have this and it is a crisis and there are no solutions. And so for those reasons, I am in favor of it. However, I do agree with Councilman Flynn's concerns. So there are two things that are really important to me. One is that there is treatment available and that it will connect people to treatment. And I said that in committee, someone Cashman said it tonight, we don't have enough treatment, so we've got to work on that. The other thing is the fact that it's a pilot and we need data and we need real data. And I think it will be hard to collect because it's a changing landscape if there's more fentanyl coming in. I don't know how you collect that data, but we need to have real data so that we can look back and see how successful it was or it wasn't. So without those two features, I would not be supporting it. But as of now I am in support of it. And thank you for your work, Councilman Brooks, and everyone, for being here tonight. Thank you, Councilwoman Black, Councilwoman Cannick. Thank you. I, too, want to thank Councilman Brooks for his not just sponsorship, but leadership on this issue and to the community. That also is leading example of code governing, where you work together to challenge and take on a challenge. I guess for me, I just was thinking about the comments about this being a disease and I think about what if it was kidney disease and people were trying to treat themselves with their own dialysis and they were dying in the alley because they'd done it wrong? Or what if it was cancer and they were, you know, self administering in no other disease model do we leave folks to fend for themselves. And so the difference between this and the other diseases is the stigma, right? That's the stigma and the misunderstanding that the point at which addiction occurs, it becomes medical. It's it's a physical dependency. It's not a weak moral character. And in this particular set it well in some of the drugs, not all the introduction drugs, but in the case of heroin, what we know is that people actually need medicine in many cases because they can die from quitting or they can die from the process of trying to wean themselves off in their tolerance changing. And so I agree, we need more treatment. We also need, you know, medically assisted treatment in the form of replacement methadone or the other the other types of replacements that are available to make this a safer transition, because in this case, the transition off can be can be dangerous as well. So thank you to my colleague for pointing out the medical nature of this situation. And I think the second thing that resonates with me is Councilman Espinoza's point about one life. And so I think that there's, you know, several ways to think about data. And I think that a simple comparison of whether or not deaths are dropping or not is not an accurate scientific model. The way that you have to do this is you have to ask the question of bending the curve so it's not did fewer or more people die since supervised injection, but did fewer people die than would have died without it? And so you will know that from from the the potential reversals or from the community that's being served compared to a control group, for example, that's not being served. So there's a couple of different ways that I believe good, good professors and good researchers could could structure this, but it will never be a more or less situation because, again, it's one site. We can't put the expectation of eliminating addiction in a community on one site. So we have to have realistic evaluation methods. And so if we have those, I think we'll have a really informed discussion. So so with that, I feel like this is the right next step. I appreciate having our state leaders here and I imagine this will be an ongoing dialog with them. The one other thing I will say is the federal government, the appointees who serve in the federal government are not always right in the law. That has been proven numerous times, including cases that this very city has been engaged in regarding their interpretations of federal law where cities have prevailed. So while it's important for us to consider the federal legal landscape, it is not beyond this administration to overread or under read the law. And they have been corrected on numerous occasions. And so I think that it's important for us to do what is right to legally research and evaluate it and then to be bold enough to understand that we won't be threatened by our beds. Beds are not legal opinions from judges. They are the opinions of one individual in a newspaper. And so it's important that we be strong, thoughtful and not shy away from a good, important debate, even if it involves some legal questions down the road. So with that, I will strongly be supporting this tonight, and I wish our community luck with the process of considering this. Should we have the legislation we need at the state to move forward? Thank you. Thank you. Councilwoman, can each. Councilwoman Ortega. Thank you, Mr. President. I, too, will be. This tonight is, as you all heard, once the state takes action. Then our Board of Environmental Health will engage in this process to figure out, you know, are we looking at one or are we looking at more than one? What are the criteria? All of that stuff that would need to be put into place. And I know that will be a public that will include a very public process. So I'm very comfortable with with that sort of next step phase of where it goes. The one thing I do want to mention, having received a letter from an adjacent property owner to the existing site, there have been concerns expressed about some of the issues around the current site that are related to just safety is one of the things that is being expressed. They have an apartment building that has the highest vacancy rate because of its close proximity to this site. Now, he does mention that there is a homeless shelter close by as well and is indicating that it's just I don't know if it's the individuals that are hanging out outside of the facility and in this alley that they're concerned about. But how we do the operations at any location that is selected is going to be really important to being a good neighbor to the adjacent community, because with any of our operations, whether it's a liquor store or a marijuana facility, these are issues our neighborhoods scream at all of us about and want to make sure that we're helping ensure that we have a safe community for everybody. So we want it safe for the people who are utilizing the facility, for sure. But we also want to make sure it's a safe facility for the adjacent community, and that will all be part of that environmental health process when after the state legislature takes action and we are able to then move forward with the first ever safe injection site in the city of Denver. So I will be supporting this. Thank you. Thank you. Councilwoman Ortega, Councilman Gilmore. Thank you, President Clark. You know, the stigma that's associated with addiction treatment and recovery is really is very real. And by us taking a first step to start normalizing the conversation, I think is very important. And we need to make sure that we're protecting the safety of those who are struggling with addiction, their families, and also residents and business owners. And so my ask is, if this does pass tonight, that we have a plan in place to have a robust community engagement, education and dialog with our constituents and with the Denver community. So we make sure that any rulemaking that is undertaken by the Board of Public Health and Environment is informed by the community as well. And so that's my main ask, but also thank you to Councilman Brooks for including in the bill, language distribution of fentanyl testing strips as well. The only other piece that is a little concerning to me, but but I think we can get beyond it is that there won't be any report back or evaluation until after the 24 months that period. And I would ask that if the state legislature does act and pass into law some version that would allow this that we come back because we probably will then need to have bend amend this bill language that we include something that would update it that would have at least an annual report back to City Council Committee just so that we can continue the conversation so that it's not a one and done, but that where are we going and where are those additional treatment options that we're going to need in the city to address this? And I know that this is. It's a difficult barrier, honestly, for some community residents to get beyond. But when I look out at all of you and I look at my community, we're talking about sons, daughters, mothers, fathers, grandparents. We're we're talking about our Denver community. And so right now, we need to make that our first priority, their safety and reducing the harm that they're doing. And so with that, I will be supportive of this, wanting to make sure that we have a robust community engagement and education going forward. Thank you, President Clark. Thank you, Councilwoman Gilmore. Councilman Brooks, you want to. Say, you know what, Mr. President, I just wanted to just wrap up. I want to thank everybody for their comments. And clearly, you know, their engagement. I think a lot of the council members have been emailing me, emailing Lisa Revelle, emailing the administer the administration, Kirsten, who's helped us draft this. And I just really appreciate that you guys have gotten in there and you've educated yourself on this issue. Let me just bring up one more point that no one really talked about. And we 100% agree with the opioid plan that the mayor proposed. It talks about prevention, treatment and harm reduction. This is a clear piece that needs to be a part of it, of harm reduction. There are many people who don't understand the full scope of what we're talking about, so they would just focus on this small portion of a pilot. We believe in the entire scope of what we need to do in the city of Denver prevention, treatment and harm reduction. There are tremendous problems in treatment. There are tremendous barriers that we need to remove. But if when we're talking about this, please talk about it in the totality of the vision of what we're trying to accomplish in our city. The other thing, and I know Lisa Ravel from Harm Reduction will love that I'm mentioning this, that their organization received a Good Neighbor Award from the chair neighborhood. So I know that Councilman. Councilwoman Ortega. You heard that. But, John, neighborhood does not give those things out lightly. And so these folks with Lisa's group have been in the community connecting with neighbors, picking up needles, really a great neighborhood partner. And so I just want to give you that little shout out with that. Mr. President, this is the first reading. We're going to come back next week for the second reading. But it sounds like we have a good super majority of our council folks support. And I'll also say I have added all of your suggestions into the bill, added the mayors suggestions into the Bears. So we will be receiving his support and signing this bill. And so if there are other conversations that you guys need to have, please let me know this week. Thank you. Thank you. Councilman Brooks, thank you for taking the lead on this. Madam Secretary. Raquel. Flynn now. Black guy. CLARKE I'm sorry. BROOKS Hell, yeah. Aspirin. Espinosa. I. Gilmore. I Herndon. I Cashman. I can h. Lopez All right. Ortega Hi. Assessment. Hi. Mr. President. Hi. I'm secretary. Please close voting. Announce the results. Of a nice one day. 11 I as one nay council 1292 has passed. Just to clarify, has been ordered published next week will be passage. I do have a big favor to ask. There are a lot of you in here. If you all stand up right now and go for the exit and start talking to each other, we're not going be able to get to recess. We have about 2 minutes worth of possibly very boring things to do, but just 2 minutes if possible. If you could just hang tight and then at recess I'll get up and go. If you absolutely have to go, please hold your conversations. Even when you're in the hall, we can hear you and we just need to get through a few more things before we can get to recess so that we can get set up for the public hearings and the folks who are here for that today.