Prison Needle Exchange Program
Date: May 4, 2020
Classification: Unclassified
Branch/Agency: CSC
Issue:
Media is reporting that a lawsuit brought by a former federal inmate was dismissed by an Ontario Superior court. The legal challenge had argued that denying inmates access to sterile needles in prison violates their constitutional rights since it is essential health care.
Proposed Response:
- The Correctional Service of Canada is carefully considering the court’s decision.
- Like much of Canadian society, the Correctional Service of Canada is experiencing the effect of Canada’s opioid crisis as a health issue.
- The Prison Needle Exchange Program provides an opportunity for inmates to access clean needles, taking into account offenders’ confidentiality and health, while ensuring the safety and security of other inmates and staff.
- The Correctional Service of Canada approaches the issue from a health care and harm reduction perspective and uses a variety of measures to ensure everyone’s health and safety.
- As of today, the Prison Needle Exchange Program has been implemented at eleven institutions including most recently Warkworth and Bowden. There have been no reported injuries involving staff or inmates.
Background:
This application commenced in 2012 and alleged inmates’ sections 7 and 15 Charter rights are breached by the Correctional Service Canada’s (CSC) classification of sterile injection equipment as prohibited contraband. The applicants, Steven Simons (a former federal inmate) and several public interest groups, asserted that this prohibition increases the inmates’ risk of contracting HIV/HCV.
In June 2018, CSC began the implementation of a Prison Needled Exchange Program (PNEP) at two institutions, with a commitment to complete the national roll out to all institutions by August 2020. The PNEP provides access to, and possession of, sterile injection equipment (SIE) subject to a Threat Risk Assessment (TRA). In September 2018, the Court adjourned the matter to allow CSC to deliver additional evidence regarding the workings and efficacy of the PNEP.
The applicants challenged the PNEP on the basis that the model adopted by CSC is not Charter compliant. They asserted that the model is not sufficiently confidential, will not be utilized and therefore exposes inmates to the risk of contracting HIV/HCV. The Applicants further alleged that the government failed to provide effective access to SIE in accordance with professionally accepted standards for inmates using drugs in prisons, which violates their equality rights under s. 15 of the Charter. The Court heard the application on March 6, 2020.
The main goals of the PNEP are to reduce the sharing of needles among people who inject drugs, help prevent fatal and non-fatal overdoses, and to facilitate referral to health care services.
CSC began implementation of the PNEP in its institutions in June 2018. To date, the PNEP has been implemented at eleven institutions with the most recent at Warkworth Institution and Bowden Institution. There have been no safety incidents involving staff or other inmates. Implementation will continue along with ongoing consultation with partners. PNEP is currently still ongoing in our institutions where it is implemented. Full implementation is not expected until 2021.
Prior to introducing the PNEP, “sharps” were in institutions for injecting insulin and as Epipens and there are effective protocols in place to safely manage those. CSC completes a Threat Risk Assessment to evaluate security concerns before an inmate is approved to participate in the PNEP. Appropriate safeguards have also been established to ensure that PNEP kits are safely stored and accounted for at all times.
PNEP Evaluation
A social epidemiologist and Research Scientist in the School of Epidemiology and Public Health at the University of Ottawa is evaluating the program and her evaluation will be completed in two phases. An interim report exploring the acceptance, attitude and beliefs of staff and inmates will be completed in spring 2020. The final report which will include a qualitative and quantitative evaluation will be completed in early fall 2020.
PNEP Consultations with Bargaining Agents
CSC has been engaging with all three bargaining agents, the Union of Safety and Justice Employees, the Professional Institute of the Public Service of Canada and the Union of Canadian Correctional Officers/Syndicat des Agents Correctionnels du Canada/Confédération des Syndicats Nationaux, and partners, on the implementation of the PNEP at the local, regional and national levels. At the institutions where the PNEP has been implemented, the implementation pathway involved engagement with institutional staff including the three bargaining agents, distribution of written information to staff and inmates and information sessions with staff, management, Citizen Advisory Committees, inmate committees, Workplace Health and Safety Committees and others. The same approach will continue as CSC continues its roll out of the PNEP at other institutions across the country.
Given the current COVID-19 situation, CSC has paused the consultation process temporarily for new implementation of PNEP because it requires extensive consultation and face-to-face meetings. This is line with guidelines from the Public Health Agency of Canada about social distancing.
Staff Safety
CSC has gained experience managing inmates using needles in a safe and secure manner with its existing programs for EpiPens and insulin use for diabetes. A Threat Risk Assessment model similar to the one currently in effect for EpiPens and insulin needles will be used to determine which offenders can participate. Health and security factors, such as an inmate’s past involvement in security-related incidents are reviewed. The institutional head or deputy warden will confirm if there are security concerns that would prevent the offender from participating in the program. Staff training and ongoing engagement with bargaining agents and other partners will help ensure safe and successful implementation. Since the program was implemented, there have been no reported assaults involving needles at any of the approved sites.
Once enrolled in the PNEP, an inmate can exchange the entire PNEP kit for a new one as needed. Appropriate safeguards will be established in every institution to ensure that PNEP kits are safely stored and accounted for. Each site will establish a procedure, whereby PNEP kits are verified by staff on a daily basis. The kit and its contents will be visually inspected and will be seized if it appears to be altered, have unaccounted contents, or the contents are observed outside of the kit. This could also result in the inmate being reassessed for participation in the PNEP program, as well as institutional charges or disciplinary measures.
Contacts:
Prepared by: Stephan Dietz, Officer Parliamentary Relations, 613-355-1224
Approved by: Kirstan Gagnon, Assistant Commissioner, Communications & Engagement, 613-995-6867
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