The Madison County commissioners voted unanimously Tuesday to approve a contract with Aspire Indiana to manage the program for two years.

Marion County Public Health Department director Dr. Virginia A. Caine declared a public health epidemic and proposed a syringe exchange program Thursday morning, citing a 1,000 percent increase in the number of hepatitis C cases from 2013 to 2017 and the potential for an HIV outbreak.

The Wayne County commissioners voted unanimously Wednesday to continue the program.

Clark County's needle exchange had been open each Thursday, for six hours, since it began operations in Jeffersonville in January 2017.

A nonprofit group is negotiating to take over the Madison County program, which was stopped last summer.

The Clark County Health Department is waiting on final numbers but said tests so far show 60 drug-related deaths in 2017. That compares to 90 in 2016.

The county plans to also operate a mobile exchange on weekends in addition to the stationary location, as a means of reaching a still-rising number of patients.

Scott County opened the state's first syringe exchange program in 2015 after then-Governor Mike Pence declared a public health emergency.

The state's syringe exchange law is mentioned in a report from the National Center on Addiction and Substance Abuse as a best practice for reducing opioid deaths.

Government funding was cut off this summer when the County Council voted to prohibit county funds or donations from supporting the program.