MORGANTOWN – Over the worries of some physicians and public health officials, and some committee members, Senate Health approved on Tuesday a tweaked version of the bill to license needle exchange programs across the state.
The committee began work on SB 344 last Thursday. Bill lead sponsor Eric Tarr, R-Putnam, told the committee the intent is to curb the needle litter problem that poses a danger to the communities hosting the programs.
It began last year as a bill to eliminate the programs altogether, committee chair Mike Maroney, R-Marshall, told members, but he worked with Tarr to turn it into a regulatory measure.
SB 334 would require any needle exchange program to be licensed by Office for Health Facility Licensure and Certification (OHFLAC). An applicant would have to supply specific descriptions of services and plans for referrals to the varieties of care intravenous drug users require.
Over the weekend, Maroney said, he worked to tone down some of the measures that most worried oppoenents. A needle needle tracking mandate was eliminated and a requirement of a one-for-one exchange of needles distributed and returned was changed to a goal.
Also eliminated was a requirement to obtain letters of recommendation from the local health officer and sheriff that allowed for unilateral abolition of a program.
On Thursday, a long string of physicians testified that the problem is not as prevalent as Tarr believes and the bill would only serve to harm or even shut down exchange programs and worsen the spread of HIV and hepatitis the programs seek to limit.
No more witnesses appeared Tuesday. The two-part split meeting was devoted to briefing members on the updates, discussion and voting.
Another update in the bill – to adress worries about pop-up exchange sites that would lack resources to refer clients to various kinds of assistance – was a requirement that mobile exchanges be operated by providers with either a fixed or an independent license.
The tweaked bill also prohibits providers from supplying needles to clients to pass to third parties – termed secondary exchange.
Sen. Robert Plymale, D-Wayne, represents Huntington, which has what most consider one of the two best exchange programs in the state (the other being Monongalia County’s).
He appreciated the efforts to fix the bill, he said. “I still think what you’re doing is essentially shutting down some of the very successful programs.” He later clarified he meant hinder them, not close them.
Cabell and Kanawha counties have severe HIV and hepatitis outbreaks, he said, and the bill will put too many shackles on programs seeking to curb the outbreaks.
Plymale said he’ll be considering amendments for when the bill reaches second reading on the floor. He mentioned three areas of concern. The 1-to-1 goal is still too burdensome; secondary exchange is important because some lack access to the sites and clean needles, and the license renewal process is onerous, particularly for programs that have run well.
Sen. Ron Stollings, D-Boone and a physician, agreed that open access and secondary exchange are needed to get the local outbreaks under control. He noted the Charleston program required a 1-to-1 exchange and failed.
“We are hamstringing these programs,” he said. “We’re going to have a bump in HIV.” The same for hepatitis. “We’re going to be responsible for it.”
The bill contradicts CDC recommendations, Stollings said. “I took a Hippocratic oath to do no harm. I cannot vote for this bill because it will do harm to the people of West Virginia.”
Sen. Tom Takubo, R-Kanawha and a physician, said he’s always been a proponent of needle exchange when it’s done appropriately, as Huntington’s is.
People are wrongly focusing on needle litter, he said, but the vast majority of needles are getting returned, which means people are getting steered to help they need. And if there weren’t good programs, there would be more litter, as evident in some counties without them.
However, he said, legislators do have to balance the interests of those who have fears and concerns about needle litter. The bill creates some balance and provides some structure.
Maroney, also a physician, agreed that these programs prevent disease, reduce harm and provide clients access to counseling and other services. But they have to deal with negative perceptions and make sure the program do what they’re supposed to do.
SB 334 passed in a 7-3 show of hands and goes to the Senate floor.
Tweet David Beard@dbeardtdp Email dbeard@dominionpost.com
