MORGANTOWN – The state Senate approved Tuesday a bill to regulate needle exchange programs across the state. The bill faced strong opposition from physicians and public health officials during committee deliberations but passed overwhelmingly on the Senate floor, along mostly party lines.
SB 334 would require any needle exchange program to be licensed by the Office for Health Facility Licensure and Certification. An applicant would have to supply specific descriptions of services and plans for referrals to the varieties of care intravenous drug users require.
Programs must set a goal of a one-for-one exchange of needles distributed and returned. A provision eliminated in committee was restored on the floor. It requires a county sheriff to write a letter of recommendation for a program. That recommendation can later be withdrawn, giving a sheriff unilateral power to close a program.
Sen. Eric Tarr, R-Putnam and lead sponsor, offered an amendment to the bill adding more restrictions, explaining again that he introduced the bill to curb the needle litter problem that poses a danger to the communities hosting the programs.
Tarr’s amendment brought back the sheriff’s endorsement. It also requires exchange clients to have a valid West Virginia ID. Tarr said this it to prevent drug dealers from using clients as intermediaries to obtain clean needles they can load with heroin or meth and sell for a profit.
A third element of the amendment requires any program that does not offer a full array of harm reduction services required by the bill – referrals to counseling and medical help among them – six months before the bill’s final passage must cease functioning and would have until Jan. 1, 2022, to come into compliance.
The amendment was heavily debated. Sen. Richard Lindsay, D-Kanawha, said no sheriff ever offered testimony they wanted program veto power. Tarr responded, “There’s a criminal component that comes with needle exchange,” and authorization by the majority of members of a county commission doesn’t provide sufficient accountability.
Sen. Ron Stollings, D-Boone and a physician, said needle exchange in border towns serve people from across state lines. And the amendment doesn’t take into account the program goals of controlling HIV and hepatitis, or Tarr’s litter concerns. “We’re taking a very restrictive – I would call it an anti-harm reduction bill – and making it even more restrictive.”
The amendment was adopted in a voice vote. Stollings offered one that would have replaced the entire bill with an opioid reduction program that included many of the regulatory aspects of the original. It failed in an 11-22 head count.
A proposed Lindsay amendment also failed.
During bill debate, Sen. Stephen Baldwin, D-Greenbrier, called the bill, with additional regulations accompanied by no extra money for county health departments an unfunded mandate. Health chair Mike Maroney, R-Marshall, agreed.
Stollings argued that the regulations will be the most restrictive in the nation and may force the 16 or so certified programs in the state to close. “Public health has a mandate to prevent and control the spread of communicable diseases; they will not be able to do that with this bill passing. … We’re pouring gasoline on a fire with this bill right here.”
Sen. Bill Ihlenfeld, D-Ohio, said he fears the costs to the public of caring for hepatitis patients – $500,000 over one person’s lifetime – will fall on the public because of this bill.
Sen. Mike Woelfel, D-Cabell, said he was on the fence regarding his vote. “I’ve never even seen a damn needle in Huntington and my office is right downtown. I kind of resent it when people just casually throw comments about my hometown that needles are everywhere, because that’s a lie.”
Maroney recounted that the bill began last year as a plan to eliminate all exchanges but he worked with Tarr to tone it down. He doesn’t like all of it – such as the sheriff’s veto power. But the bill aims to maximize the good in the programs and eliminate any negativity.
“There’s a few bad actors that are ruining this for everybody as far as these programs,” he said. “There are some places where they’re a disaster … there’s other places where they’re awesome.”
The bill passed 22-11. Woelfel was the only Democrat to vote yes. Two Republicans voted no. All local senators voted with their party.
The Dominion Post contacted Dr. Lee Smith, Monongalia County Health Department executive director and county health officer for his comments on the bill.
He said in an email exchange, “This is a terrible bill for several reasons. First it is an unfunded mandate with no funding to assist people with substance use issues. However, public health will be faced with dealing with the very predictable results which is increased hepatitis and HIV.
“One-to-one needle exchange is not a best practice nor state of the art. Limiting the number of clean syringes and needles to a person who may inject three to four or more times per day will not keep them from using whatever is available. It is not too difficult to see what this one-for-one exchange has brought Kanawha county, which is experiencing a large number of HIV and Hepatitis cases.
“This is basic preventative medicine where the costs of clean needles are weighed against the cost of caring for a single person with HIV whose lifetime medical expenses are over $400,000. The fear of increasing needle exchanges does not increase IV drug use or signify that by preventing blood-borne disease leads to increased numbers of heroin users.
“This bill will not achieve any purpose other than to decrease the number of syringe exchange programs which will not save lives, diminish disease or get more people into treatment,” Smith concluded.
In other Senate news, President Craig Blair, R-Berkeley, announced that Sen. Eric Karnes, R-Randolph, had resigned all his committee posts. A letter from Karnes released by Blair’s office says a large project his company is undertaking will impair his ability to participate in committee meetings. He will notify Blair when he is able to return to his assignments.
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