Live saving policy well within reach

The Texas Legislature adjourned Monday evening without passing SB 188, which would have allowed local options for setting up disease prevention programs including syringe exchange. While the final hurdle was not passed, many legislators let us know they believe it would have had the votes to pass the House floor if it had been called up for a debate and vote.

Senate Bill 188 made Texas History this year by:

• making it farther through the legislative process than any similar piece of legislation filed since 1993;

• inspiring the largest bi-partisan coalition of House and Senate bill authors and supporters ever for this issue; and

• bringing together an unprecedented and diverse coalition of supporting organizations from around the state.

So what now?

The Texas Legislature will not meet again for a regular session until January, 2011. However, over the summer House Speaker Joe Straus will be considering the issues he will direct House Committees to study during the interim. In order for House members and the public to have an even better understanding of the need for allowing syringe exchange programs to operate throughout Texas, it would be wonderful to see Speaker Straus direct the Public Health Committee to investigate the issue further and to provide a space for regional feedback on the issue from the public.

The committee could review the effectiveness of current efforts in Texas to curb the spread of HIV and hepatitis B & C among Texas' injection drug using population, and provide recommendations for how these efforts could be improved in order to save lives and reduce indigent health care costs to the state. Committee members might even be directed to travel to a state such as Maryland to visit longstanding successful syringe exchange programs where they can witness firsthand the measurable benefits of allowing such programs.

What are your thoughts for next steps to educate Texans about the importance of allowing syringe exchange programs in Texas? We would appreciate hearing your feedback. Feel free to leave a public comment or email your thoughts to noelle@texasaccessproject.org.

SB 188 waiting on General Calendar

The Texas House of Representatives is delaying the debate and vote on Senate Bill 188 for reasons unrelated to the bill, and we are waiting every day to see if the bill will be heard before the Tuesday deadline.

Click here to see the bi-partisan list of authors and sponsors, and to learn more about what the legislation would allow if passed.

Click here to read the House Research Organization's updated bill analysis for SB 188.

HIV exploding in rural Texas but SB188 will not offer local options for rural areas

The Abeline Reporter News reported this week that the city has seen a drastic rise in HIV cases, which is partially due to an increase in injection of methamphetamine. According to Kevin Owens, director of medical services at AIDS Resources of Rural Texas:

"Intravenous methamphetamine abuse in rural areas, which exploded 10 to 12 years ago, can account for new cases, Owens said.

"'A lot of people are now coming in with HIV and hepatitis C,' he said, saying that in his earlier career in rural health in Ballinger he was surprised by the prevalence of such drugs in rural communities."

These increases in cases cost tax payers as well as private health insurance pools. Mr. Owens discussed the cost of these services to taxpayers:

"The gains that have come do come at a cost, he said, with treatments costing a minimum of $1,400 a month.

"But the majority of patients ARRT sees get their medications through the state- and federally-funded Texas HIV Medication Program, paying only a $5 co-pay."

The current version of SB188 only allows local options for disease prevention in Texas counties with over 300,000 residents. Abeline is in Taylor County, a county with 126,555 residents, so the bill will not allow Abeline to choose to prevent these diseases using proven syringe exchange programs.

In its current form, SB188 will only allow the local option in 12 Texas counties: Bexar, Cameron, Collin, Dallas, Denton, El Paso, Fort Bend, Harris, Hidalgo, Nueces, Tarrant and Travis.

Learn more about HIV in rural Texas here and here.

SB188 set on House Calendar for tomorrow

SB188, the bill that allows local options to set up publicly or privately-funded disease prevention programs including syringe exchange, has been set on the House Calendar for tomorrow, Thursday, May 21. If the House is unable to reach the bill tomorrow, they are likely to reach the bill on Friday.

SB188 doesn't mandate or fund any program - it simply gives local urban areas another option for life-saving disease prevention. The bill will save millions of state and local tax dollars, save first responders and other innocent victims' lives, and save lives within the main affected community. According to the Texas Department of State Health Services, the programs do not increase drug use but do increase the use of drug treatment.

SB188 will:

• allow local entities to authorize a privately-funded or local tax-funded program in their area,
• offer education and a path to treatment and recovery to every client of the program,
  
• require programs to exchange a dirty syringe for every safe and clean one they provide,
• require monitoring and reporting of each program so we know they are effective, and
  
• only apply to counties with over 300,000 residents.

Please be sure that your friends who are interested in this legislation are aware that the Texas House may debate the issue tomorrow. You can always find more information on this blog and this website. Thank you and stay tuned!

More legislators and organizations support SB188 as it moves to House Calendars Committee

With two weeks left in session, SB188 is on its way to the Calendars Committee. The new bill language, fiscal note and bill analysis is available here. The list of bill authors, sponsors and cosponsors has grown and now includes:

• Sponsor County Affairs Chair Garnet Coleman;
• Joint Sponsors Rules and Resolutions Chair Ruth Jones McClendon,
• Representative Solomon Ortiz, Jr.,
• Appropriations Health & Human Services Subcommittee Chair (and Doctor) John Zerwas,
• SB188 Public Health Subcommittee Chair Susan King; and
• Cosponsors Public Health Vice-Chair Elliott Naishtat, and
• Technology, Economic Development and Workforce Chair Mark Strama.

These House members join a strong list of authors in the Senate:

• Primary Authors Health & Human Services Vice-Chair and Senate Republican Caucus Chair (and Doctor) Robert "Bob" Deuell,
• Veterans Affairs & Military Installations Chair and Senate Democratic Caucus Chair Leticia Van de Putte; and
• Coauthors Finance Vice-Chair Juan "Chuy" Hinojosa,
• Jurisprudence Chair Jeff Wenworth,
• Intergovernmental Relations Chair Royce West, and
• Higher Education Chair Judith Zaffarini.

The official witness list for the House Public Health Committee hearing is available here. Organizations testifying or registering in favor of SB188 include:

• Texas Medical Association
• Texas Hospital Association
• Texas Nurses Association
• Texas Pediatric Society
• Texas Academy of Family Physicians
• Coalition for Nurses in Advanced Practice
• Scott & White Center for Healthcare Policy
• Harris County Healthcare Alliance
• Houston Area Immunization Partnership
• CHRISTUS Santa Rosa Health Care
• Legacy Community Health Services
• Bexar Area Harm Reduction Coalition
• South Texas Substance Abuse Recovery Services (STSARS)
• County Judges & Commissioners Association of Texas
• Bexar County Commissioners Court
• Trinity County
• League of Women Voters
• Texas IMPACT
• James A. Baker Institute for Public Policy, Rice University
• Texas Advocacy Project
• Retired Bexar County Constable
  
• St. Mark's Episcopal Church

Organizations that could not attend the hearing but submitted letters and resolutions in support include:

• Combined Law Enforcement Associations of Texas (CLEAT)
• Austin Police Chief
• Nueces County Sheriff
• Cameron County Sheriff
• Nueces County Constable Precinct 1
• Nueces County Constable Precinct 2
• Community Health Outreach Work to Prevent AIDS
• AIDS Services of Austin, Inc.
• American Civil Liberties Union of Texas
• Hepatitis C Advocate Network
• Latino HIV Task Force
• San Antonio AIDS Foundation
• Texas Academy of Internal Medicine

We will update you when the House Calendars Committee has acted. In the meantime, don't miss the excellent Grits for Breakfast coverage after the House hearing. Stay tuned!

Powerful coalition endorses federal syringe exchange legislation

Federal law authorizes syringe exchange programs - many organizations would like to see the federal government fund the programs also. In a letter to President Obama, the Hepatitis C Appropriations Partnership (HCAP) requested federal support for syringe exchange programs.

This impressive coalition of organizations all agree with the Texas Department of State Health Services that there is overwhelming scientific evidence that the transmission of HIV through injection drug use can be decreased significantly by needle exchange programs, and that they do not increase drug use. At this time, the group includes:

ACT UP Philadelphia
Agape Center, Woonsocket, RI
AIDS Action Baltimore
AIDS Action Committee of Massachusetts
AIDS Action Council, Washington, DC
AIDS Alabama, Birmingham, AL
AIDS Community Research Consortium (ACRC), Redwood City, CA
AIDS Community Research Initiative of America, New York, NY
The AIDS Institute, Washington, DC
AIDS Foundation of Chicago
AIDS Support Network, San Luis Obispo, CA
AIDS Treatment Data Network, New York, NY
Alert Health, Inc., North Miami, FL
Alliance for Saving Lives, San Francisco, CA
American Liver Foundation
Arizona Hepatitis C Coalition
Asian Health Coalition of Illinois
Asian Liver Center at Stanford University
Association of Asian Pacific Community Health Organizations
Bangor STD Clinic, Bangor, ME
CAB Health & Recovery Services, Lynn, MA
California Hepatitis Alliance (CalHEP)
Caring Ambassadors Program, Inc., Vancouver, WA
Cascade AIDS Project, Portland, OR
Chicago Recovery Alliance
Community Health Action of Staten Island
Community HIV/AIDS Mobilization Project
Discovery House: Bangor
Division of Gastroenterology and Hepatology, Weill Cornell Medical Center, NY
Drug Abuse Alternatives Center, Santa Rosa, CA
Florida Association of Public Health Nurses (FAPHN), Inc. Foundation for Healthy Living , Latham, NY
Georgia Doty Health Education Fund, IL
Greenview Hepatitis C Fund, Ann Arbor, MI
Harlem United Community AIDS Center
Harm Reduction Center of Southern Oregon
Harm Reduction Coalition
Hepatitis Support Network of Hawai’i
hepCmeditations project, Seattle, WA
Hep C Advocate Network, Inc. (HEPCAN), Longview, TX
HCV & HBV Support Group / O'Connor Hospital, Delhi, NY
H.E.A.L.S of the South, Hepatitis Education Awareness and Liver Support, Tallahassee, FL
Hep C Connection, Denver, CO
Hepatitis B Foundation
Hepatitis C Association, Scotch Plains, NJ
Hepatitis C Support Group – NYU Medical Center
Hepatitis C Support Project/HCV Advocate, San Francisco, CA
Hepatitis Education Project, Seattle, WA
Hepatitis Foundation International
Hepatitis Outbreaks’ National Organization for Reform (HONOReform)
HIV/AIDS Services for African Americans in Alaska, Anchorage, AK
HIVictorious, Inc., Madison, WI
HIV Alliance, Eugene, OR
Immunization Action Coalition
Latino Organization for Liver Awareness ( L.O.L.A.), New York, NY
Liver Health Today, Houston, TX
LiverHope, Minnetonka, MN
Los Angeles Gay & Lesbian Center
Lower East Side Harm Reduction Center, New York, NY
Maryland Hepatitis C Action, Annapolis, MD
Maryland Viral Hepatitis Task Force, Baltimore, MD
Maui AIDS Foundation
Mission Neighborhood Resource Center, San Francisco, CA
Mo Hepatitis C Alliance
National Alliance of State and Territorial AIDS Directors
National Association of People With AIDS (NAPWA)
National Coalition of STD Directors
National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans
National Viral Hepatitis Roundtable
New York Harm Reduction Educators Inc.
New Mexico Hepatitis C Alliance
North Shore Health Project, Gloucester, MA
NYC AIDS Housing Network (NYCAHN)
Ohio Asian American Health Coalition
OraSure Technologies, Inc.
Piedmont HIV Health Care Consortium, Durham, NC
Point of Change, Inc., Detroit, MI
Positive Health Project, Inc., New York, NY
Project Inform, San Francisco, CA
PROYECTO SOL, Philadelphia, PA
San Mateo County AIDS Community Board, San Mateo, CA
Southern AIDS Coalition
St. Ann’s Corner of Harm Reduction, Bronx, NY
Status C Unknown, Inc., Medford, NY
Test Positive Aware Network (TPAN), Chicago, IL
Title II Community AIDS National Network, Washington, DC
Treatment Access Expansion Project
Treatment Action Group, New York, NY
The Virology Treatment Center, Maine Medical Center, Portland, ME
Upstate New York Hepatitis Awareness Project, Delancey, NY
Utah Department of Corrections
Vertex Pharmaceuticals Incorporated
Virginia Hepatitis Education and Training Center, Springfield, VA
Visionary Health Concepts
VOCAL-NY Users Union
Wabanaki Mental Health, Bangor, ME
Weill Cornell Medical Center
Western Maine Community Action Health Services, Lewiston, ME
Wilson Resource Center, Arnolds Park, IA
Wings for Life

SB188 headed to House floor with strong support

The Texas House Public Health Committee voted SB188 favorably out of committee this afternoon. The bill will be considered for the House floor schedule by the House Calendars Committee.

In the House committee process, the Senate bill and three similar House bills became one agreed piece of legislation with several strengthening amendments. During the formal meeting today, Chair Kolkhorst added language that strengthens the bill's monitoring and reporting requirements and Representative John Davis amended the preamble to clarify the legislation's purpose.

Voting in favor of the legislation were: Chairman Garnet Coleman, Representative John E. Davis, Chair Veronica Gonzales, Chair Susan King, Vice Chair Elliott Naishtat, Chair Vicki Truitt, and Chair (and Doctor) John Zerwas.

We will post updates regarding the witness list from Tuesday's hearing, the language of the committee substitute, and possible timing of a House floor decision as soon as we obtain these pieces of information.

House committee testimony overwhelmingly in favor of local control over disease prevention

The House Public Health Committee received testimony yesterday from several members of the clergy, the Texas Medical Association, a Senior Fellow for Religion and Public Policy, the Texas Department of State Health Services (resource witness), law enforcement, health providers and others - overwhelmingly in favor of giving local authorities the option to allow syringe exchange disease prevention programs. In addition, the Committee received letters and words of support from elected officials and organizations that could not attend the hearing including a Police Chief, Sheriffs, Constables, County Commissioners, the Combined Law Enforcement Associations of Texas and Scott & White hospital. We will post the letters and witness lists as they become available.

The hearing is available online for your viewing pleasure. It took place in three segments: morning can be seen here (forward to 1:00:45); lunch can be seen here; and the night time can be viewed here.

In addition, Grits for Breakfast covered the issue masterfully before and after the hearing. In the first piece, Grits provides links to all prior coverage which gives a rich history of the issue, and correctly points out:

"A majority of Public Health Committee members already voted for needle exchange once. The House had a vote in 2007 on an amendment by Rep. McLendon to allow a needle exchange pilot in Bexar County that tells us a lot about the bill's likely reception on committee. Here's how the committee members voted on that 2007 amendment:

Ayes: Naishtat; Coleman; Gonzales; Hopson; McReynolds, King, S;

Nays: Laubenberg, Truitt

Absent: Kolkhorst; Davis, J;

Present not voting: Zerwas"

In the second piece published after the morning hearing, Grits observed:

"Rep. Susan King, who chaired the subcommittee, was an especially knowledgeable and enthusiastic proponent for the legislation; I hope she'll repeat the performance when it comes up on the House floor because she did a great job arguing the merits of the program.

"Reacting to urging from the chair and committee member Dr. John Zerwas, King said the subcommittee added a strong counseling component to the bill, requiring syringe exchange programs to be "one stop shopping" information centers for helping drug addicts access treatment and medical services.

"The witnesses began with ministers from St. Mark's in San Antonio and another minister from Austin who gave a faith-based argument for the program. A minister from St. Mark's said Christ ate and sat with sinners, not to condone them but to redeem them. The Austin minister said healing was a central activity of Jesus' own ministry - 72% of Jesus' miraculous activity relates to healing those with physical or mental illness, he said."

Things are happening quickly now. Please stay tuned for more information about this life-saving legislation as it becomes available.

The evening portion of the hearing is beginning

Watch the live video feed here.

First videos of the House Public Health Committee hearings are posted

The House Public Health Committee began its hearing on SB188 at 9:15am today and continued until the House convened at 10am - watch the video here (forward to 1:00:45). The Committee continued the hearing during the lunch break - watch the video here.

The Committee heard testimony from experts and faith leaders from various Christian denominations. We'll discuss the hearing in later posts but there is no substitute for watching the videos yourself!

The Committee will continue to receive testimony on SB188 after the House adjourns today. As of this moment, they are still going strong on the House floor so we don't know what time that will be. Once they begin, you can watch this evening's hearing live here. ... Stay tuned.

Faith based panel will resume at the lunch break

The faith-based panel was not able to complete it's testimony this morning, so it will continue at the House lunch break. The remainder of the hearing on SB188 will continue after the House adjourns.

SB188 hearing schedule

Chair Kolkhorst announced the schedule for SB188 this morning. Testimony from the first panel will be received at 9am. The Committee will break to go to the House floor by 10am, and the remainder of the SB188 hearing will take place this afternoon a few minutes after the House adjourns for the day.

Watch the hearing live online here.

Bexar County Judge Nelson W. Wolff and Commissioners Court Support SB188

Bexar County Commissioners Court presiding officer Judge Nelson W. Wolff, who will be in a work session in San Antonio while the House Public Health Committee considers SB188 in Austin, sent the Commissioners Court's written support for SB188 for the legislature's consideration.

SB188 is a local options bill - it does not mandate any program. The legislation simply allows local governments to fund a local program, or authorize a privately-funded charity program, or simply do nothing. The Committee Substitute is expected to permit this disease prevention option in any Texas county with over 300,000 residents.

Soon after the Texas legislature authorized a pilot program in Bexar County in 2007, Judge Wolff (who has served the City of San Antonio as a city council member and as it's mayor and has served Bexar County as a member of the Texas House, the Texas Senate, and now serves as the head of Bexar County government) and his Commissioners Court unanimously authorized county funds to support the program. In his letter of support, he states:

"[W]e believe that a Sterile Needle Exchange program will stop the spread of blood borne diseases like HIV and various kinds of Hepititis. The cost of treatment to the taxpayers of Bexar County often runs into the hundreds of thousands of dollars for each infected person.

"Further, the history and experience of Sterile Needle Exchange programs in every other state in the nation has demonstrated that these programs promote access to drug treatment."

The hearing is expected to begin Tuesday, May 5, at 8:00 AM in Texas Capitol room E2.012. Watch the hearing live online here.

House Public Health Committee set to hear syringe access bill next week

Senator Deuell's syringe access bill, SB 188, is scheduled for a hearing in the House Public Health Committee on Tuesday, May 5, 2009, at 8:00 AM in E2.012 in the Texas Capitol. Click here to see the full text of the bill, as well as its fiscal note and analysis. Find names and contact information for the Representatives who sit on the committee here.

If a majority of the committee members vote to approve the bill on Tuesday, it can then move on for consideration by the House Calendars Committee.

Texas agency concludes syringe exchange programs do not increase drug use and do increase the use of drug treatment

The Texas Department of State Health Services posted their official conclusions about disease prevention through syringe exchange. They conclude:

Numerous studies indicate that SEPs do not increase drug use or crime, but do increase the use of substance abuse treatment services.

It's funny how sometimes things that seem obvious turn out to be false. It seems obvious to many that exchanging a clean syringe for a dirty one from a drug addict would encourage drug use ... but it turns out the opposite is true.

Syringe exchange programs often become an injection drug user's only window into the functioning world. As they exchange their syringes, they are kindly offered a path to recovery at the same time. These studies show that many users choose to enter recovery, and many successfully recover, by accepting the invitation to treatment which they were only offered in one place time after time - their syringe exchange program.

As syringe exchange programs have increased, researchers' access to hard data has increased and it all seems to be pointing to the same conclusion. Our Texas agency now joins the National Institute of Health, the Journal of Substance Abuse Treatment, the U.S. Department of Health and Human Services, the Johns Hopkins and New York Academy of Medicine, the Chicago Recovery Alliance Outreach Program, the New Haven Connecticut Syringe Exchange Program, the Tacoma and Seattle Washington Syringe Exchange Programs, and others who have concluded that syringe exchange programs increase drug users' use of drug treatment and recovery services.

Make sure you are receiving your email updates about this issue in Texas by signing up here.

Why do some people oppose disease prevention?

Syringe exchange programs are accepted throughout the United States as part of a comprehensive approach to prevent infections like HIV, Hep B and Hep C among drug users and the innocent victims they expose to these deadly diseases. They are also the number one proven way that these addicts enter recovery.

So why do some people oppose them? While most people have benevolent intentions, some people claim that they oppose syringe exchange programs because they want injection drug users to die. This cruel sentiment has been expressed from time to time throughout the history of HIV prevention programs, as well as in recent cyberspace and blogosphere postings in conversations about the Texas legislation.

When discussing the Texas legislation, some people have advocated poisoning the drug user's needles with cyanide. Others have suggested ending their lives in other ways.

It's difficult to know what to say when a fellow Texan takes such a harsh position, condescending to the point that they claim human life is disposable. One approach is to decline to engage in this line of conversation.

Thankfully most Texans on both sides of the issue are interested in saving lives and preventing deadly diseases and the exposure of innocent victims. Most Texans believe in the ability of a person to change. In other words, fortunately the rest of Texas is having a respectful and interesting conversation about the issue this session.

House subcommittee hosts Senator Deuell to speak about bills

Subcommittee Chair Susan King led a fast-paced and productive meeting on Thursday morning to consider giving locals more options for HIV and Hep B and C prevention. She and subcommittee members J. Davis, Naishtat, Coleman and Zerwas heard from Senator Deuell, Chairman of the Senate Republican Caucus, as well as House bill authors Chair McClendon and Representative Ortiz.

The authors agreed to sign on to Senators Deuell, Van de Putte, Wentworth, Hinojosa, West and Zaffarini's bill SB188. Chair King and the subcommittee members agreed that Chairman Coleman would lead, and that they would move quickly to draft three changes to the bill to strengthen it.

The Christian thing to do

Sunday's Houston Chronicle featured an opinion piece on why allowing local options for setting up syringe exchange programs is the Christian thing to do. Author Dr. William Martin addresses the shift toward ministering to people with HIV/AIDS that has taken place within conservative Christian churches in recent years:

Then, in 2002, Franklin Graham hosted Prescription for Hope, a global conference attended by more than 800 Christians from many countries and denominations. PBS Frontline pointed to that gathering as the moment at which Christians got involved in confronting HIV/AIDS. Soon afterward, Rick (author of The Purpose Driven Life) and Kay Warren launched a major HIV/AIDS initiative. Today, many other churches, large and small, minister to people stricken with this disease. These ministries do not screen the people they serve to make sure they were infected through no fault of their own. They meet them at the point of their need and offer what help they can.

Then at the end of the piece Dr. Martin poses a compelling question:

How can we justify saying it is permissible, even laudable, to help people after they have contracted HIV/AIDS, but wrong to approve of measures that significantly reduce their chances of contracting that disease? Jesus had nothing to say about needles, but we do know how he treated social outcasts and sinners, and he had a great deal to say about people who let prim concern with their own righteousness interfere with offering needed assistance to those in peril.

In other news, last week the San Antonio Express-News editorial board again called on the Texas Legislature to "finally give Bexar County and other municipalities the ability to invest in a proven life-saving and cost-saving effort." The editorial also addresses common misconceptions about syringe exchange programs:

The great myth about needle exchange is that it subsidizes and encourages illegal drug use. In fact, the drug use is already taking place. Studies of needle-exchange programs around the nation demonstrate they do not increase illegal drug use.

Deuell's bill does not require communities to create needle-exchange programs. It simply gives them the option to do so.

Click here to read all four of the local option bills filed this session.

Needle-exchange program curbing disease: Sask. study

Our friends to the north released a study in February concerning needle exchange programs with positive results.

"A study released Tuesday suggests a provincially funded needle-exchange program is making a difference in Saskatchewan by sharply curbing disease.

The review, for the provincial Health Ministry, found that seven health regions have a needle-exchange program and an estimated four million needles are provided to Saskatchewan's 5,000 intravenous drug users each year.

The report concludes that the programs are meeting the goal of reducing the spread of disease.

It estimates that infections such as HIV and hepatitis C, which are expensive to treat, have been reduced in numbers by up to one-third among drug users, saving an estimated $4 million in health-care costs per year.

Despite the positive findings, the review notes there is room for improvement, especially in the area of needle returns and cleaning up discarded needles.

More

This supports much of what we said here a few weeks ago

Local options for HIV prevention

Did you know that a privately-funded charity worker who is trying to save lives can be arrested and incarcerated in Texas if their program includes exchanging clean syringes for dirty ones that might carry HIV or Hep C? 73-year old Chaplain Bill Day currently faces a year behind bars for his volunteer work in a program funded in part by his church.

Did you know that a county government or hospital district employee can be sent to jail in Texas if they carry out an HIV prevention program that has been proven to save lives and tax dollars, and is currently legal in every state except Texas?

Today our local governments and private charities have no options due to a state mandate that criminalizes the exchange of clean syringes for dirty ones.

Local options would be allowed by the HIV prevention bills authored by Senators Deuell, Van de Putte, Wentworth, West, Zaffirini and Hinojosa; and Representatives McClendon, Crabb, Ortiz, McCall, Rodriguez, Coleman, Naishtat, and Farrar. The bills would allow each local government in Texas to choose whether or not to allow these disease prevention programs in the local area, and to choose whether or not to use tax funds to pay for the programs. Several national charities would like to fund the programs privately without any tax dollars - but right now state law says "no."

When the United States government funds HIV prevention through syringe access, which President Obama has promised that it will do ... wouldn't it be tragic if Texas medical providers and charities were threatened with criminal prosecution by state government if they choose to utilize the funds to save lives?

Chairwoman Kolkhorst, Chair of the Texas House Public Health Committee (pictured above), will decide tomorrow whether or not to set these local options bills for a hearing next week.

Texas prosecutor supports disease prevention, "I'm all for making this country and world a better place to live."

Williamson County District Attorney John Bradley isn't the EF Hutton of Texas criminal justice that he used to be. When he talks ... fewer and fewer people listen. When Mr. Bradley tried to rally opposition to HIV prevention through syringe exchange this month on the computer forum where he communicates with fellow prosecutors across the state, he was met with the sound of crickets. (He goes by "JB" on the forum.) It's been over a week and there is no indication that any of his colleagues read his post.

The last time Mr. Bradley tried to stir up the same hornet's nest, in 2007, no one stuck out their neck to agree with him and one Texas prosecutor respectfully but firmly disagreed. Here is their conversation:

quote:

---

Originally posted by JB:
And next up are free cab rides for drunks at bars because of the high accident rate of drunks.

Is there a principle here for drawing a line and simply enforcing the law that is being broken?

---

I think the principal at work here is some realization that the war on drugs has not been very successful and that, in an effort to mitigate the high social costs of certain kinds of drug abuse, lawmakers are being realistic about the existence of the problem.

Social issues like disease and death via needle sharing, transmission of deadly disease to absolutely innocent third parties who contract via sex (or in the past, blood transfusions), the high costs to our public medical system that are basically bankrupting it and the spectre of addiction are being addressed with this approach.

I don't think anyone would argue that those not already inclined to engage in this activity would be lured into it by a program of this nature.

Instead, it is an effort to mitigate the above-listed problems, amongst others, and to extend some degree of humanity to those addicted persons currently behaving as outlaws.

If the program extended to supplying them whatever it was they needed drugwise, similar to the methadone program, I would think we could reduce drug related crimes massively, since the incentive to steal, rob, etc would be removed.

I'm all for making this country and world a better place to live. If this is what it takes to get these folks and their drug seeking crime off of the streets, not spread disease to innocents, and ease the burden on our public health care sector, then it seems like a good deal.

Bear in mind, JB, we're talking about a specific area here with problems that are directly and affirmatively linked to IV drug abuse. No one is proposing that crackheads be given free crack to smoke or a safe harbor to do it. (emphasis added.)

The Texas prosecutor association is on the record at the legislature as neutral on this HIV prevention legislation and testified that their members will have no problem if the legislature decides to grant local governments the option to use this disease prevention tool.

DA will not prosecute 73-year old Chaplain if HIV and Hep C prevention program passes

As reported by USA Today, the LA Times and others, Bexar County (San Antonio) District Attorney Susan Reed is prosecuting 73-year-old San Antonio chaplain Bill Day for preventing the spread of HIV by removing deadly dirty needles from the community and exchanging them for clean ones. Chaplain Day currently faces one year of incarceration and thousands of dollars in fines.

Last week, Texas Senator Jeff Wentworth announced on the Senate floor that Susan Reed will dismiss the case if the Texas legislature approves the Chaplain's HIV prevention program:

"Susan Reed is the criminal District Attorney for Bexar County and she did have some difficulty with this but her office has advised my office that if this bill passes, she will not prosecute."

You can watch the video by clicking here and forwarding to 2:07:10.

SB 188 heads to the House, Chairman Coleman's HB 3707 referred to Public Health

This morning Senator Deuell's disease control bill, SB 188, was considered on third reading and passed out of the Senate with 23 yeas and 6 nays. Now the bill will head to the House to join its companion bills in the Public Health Committee.

Before it passed out of the Senate, SB 188 picked up two more co-authors, Senators Hinojosa and West. Thank you Senators!

Last week Representative Garnet Coleman, Chair of the House Committee on County Affairs, filed HB 3707 relating to county-regulated disease control programs to reduce the risk of certain communicable diseases for certain counties. Thank you Chairman Coleman! Earlier today HB 3707 received its first reading in the house and was then referred to the Public Health Committee. Representative Ortiz, author of HB 272, is a joint author of the bill.

HB 3707 is very similar to the other disease control bills filed this session (SB 188, HB 142, & HB 272), with the main difference being that it would limit the counties that are eligible to establish programs to those with a population of more than 730,000. The legislation allows the county commissioner's courts in the six largest counties in Texas to approve the establishment of a syringe exchange program, and provides for a defense to prosecution for individuals participating in the programs.

To learn more about the benefits of syringe exchange programs please visit www.texasaccessproject.org.

Senate votes for allowing disease prevention programs

Earlier this afternoon the committee substitute for Senate Bill 188 was taken up for consideration on the Senate floor and passed to engrossment by a vote of 23 yeas and 7 nays. This was the second reading of the bill, and a final vote should occur on Thursday.

Voting with the yeas were Senators Averitt, Carona, Davis, Deuell, Duncan, Ellis, Eltife, Gallegos, Harris, Hegar, Hinojosa, Lucio, Nelson, Nichols, Seliger, Shapleigh, Uresti, Van de Putte, Watson, Wentworth, West, Whitmire and Zaffirini.

Senators voting nay included Estes, Fraser, Huffman, Ogden, Patrick, Shapiro, and Williams. Senator Jackson was absent.

While laying out the bill Senator Deuell said that if this legislation becomes law it will save the state money without costing the state any money, and that countless studies have shown syringe exchange programs do not increase drug use.

Senator Wentworth pointed out that Bexar County District Attorney Susan Reed, who blocked full implementation of the pilot syringe exchange program that passed last session, has advised his office that if this bill passes she will not prosecute people participating in the programs.

To watch the Senate consideration and vote on CSSB 188 visit the Senate RealMedia Video Archives page, scroll down and click on the March 18 Senate Session, and skip ahead to 2:07:20 into the video.

The Access Project would also like to take this opportunity to thank Senators Wentworth and Zaffirini, who each represent a portion of Bexar County, for signing on as co-authors of SB 188. Thank you!

Abilene Reporter News op-ed: It's time to consider needle exchange program

Sunday's edition of the Abilene Reporter News featured an opinion piece on the benefits of allowing syringe/needle exchange programs in Texas. The author of the op-ed, Dr. William Martin, is a Senior Fellow at the James A. Baker III Institute for Public Policy at Rice University and an expert on the issue.

At the end of the piece, Dr. Martin addresses why he believes Texas has not already implemented such programs:

Given the overwhelming evidence, why have policymakers resisted establishment of such proven lifesaving programs? Why have politicians and platforms of both major parties repeatedly vowed, "Not a dime for needle exchange programs!"? The real reason may be fear that any sign of being "soft on drugs" will hurt their standing among people who have not looked at the issue. But the rationale most commonly, often honestly, offered is, "It sends the wrong message."

Before we accept that rationale, we need to think about the message we send to IDUs: "We know a way to dramatically cut your chances of contracting a deadly disease, then spreading it to others, including your unborn children. It would also dramatically cut the amount of money society will have to spend on you and those you infect. But because we believe what you are doing is illegal, immoral and sinful, we are not going to do what we know works. As upright, moral, sincerely religious people, we prefer that you and others in your social orbit die."

The Texas Legislature is considering a bill to permit needle exchange programs. No responsible person wants to encourage drug abuse. No fiscally prudent person wants to waste money simply to satisfy a sense of righteous indignation. No compassionate person wants to consign people unnecessarily to death or a living hell. Fortunately, providing injecting drugs users with access to sterile syringes allows us to be responsible, prudent and compassionate -- admirable criteria for good public policy.

To read more of Dr. Martins work on this subject visit http://www.bakerinstitute.org/programs/drug-policy

Senate Bill 188 vote correction and movement update

Last week we let you know that the committee substitute for Senate Bill 188 was voted out of the Health and Human Services Committee on a vote of 5 to 1 with three senators absent. Now that the committee report is available we have learned that the three senators we listed as being absent actually submitted their votes by proxy, updating the final vote count to 7 to 2. Senators West and Zaffirini voted aye, and Senator Patrick voted nay.

Senate Bill 188 has been placed on the Senate Intent Calendar and could be voted on by the full Senate as early as next week.

Houston Chronicle and Associated Press focus the public on syringe access bill

The Houston Chronicle published an Associated Press description of the syringe access issue and the Texas bill, "Senate panel OKs shield for needle exchange." Constable Jimmy Willburn, pictured here, traveled to Austin to testify in favor of saving the lives of our public servants. Here is an excerpt:

In written and vocal support on Tuesday, law enforcement and health practitioners said the proposed legislation would prevent the spread of disease among drug users and prevent spread to the families of drug users, children who find dirty needles and others who are stuck by dirty needles.

Also, retired Bexar County Constable Jimmy Wilborn told the committee on Tuesday that the legislation would lower the chances of police officers contracting disease from contaminated syringes.

“My partners were stuck with needles when we were executing search warrants. As a constable in Precinct 2, two of my people were stuck with needles,” he said. “The fact of the matter is, if these people are distributing these needles, it’s going to be better for the police officers because of one reason — because they are going to be exchanging these things.”

The Texas Department of State Health Services has predicted that 100 new cases of HIV could be prevented in the first year of implementing a needle-exchange program.

Texas is the only state that doesn’t allow syringe exchange programs of any kind.

Check it out, share it, digg it, spread it, email it to friends!

Syringe exchange bill approved and headed to the Senate floor

The Senate Committee on Health and Human Services held a public hearing today and reported the committee substitute for Senate Bill 188 favorably from the committee on a vote of five ayes, one nay, with three senators absent. Voting in favor of CSSB 188 were Senator Nelson, Chair of the Committee, and Senators Deuell, Nichols, Shapleigh, and Uresti. Senator Huffman voted against and Senators Patrick, West and Zaffirini were absent.

Senator Deuell explained that his substitute language simply changes the exception to prosecution to a defense to prosecution and the substitute language exactly matches the bill the Senate passed in 2007.

Testifying in favor of the bill on behalf of the Texas Medical Association was Dr. Janet Realini, a family physician from San Antonio. Dr. Realini spoke about the medical evidence supporting the effectiveness of syringe exchange programs, and shared a moving story about having to tell one of her patients, a young mother of two she described as an innocent victim, that she tested positive for HIV. Dr. Realini implored the committee members to get the bill passed to help get injection drug users into treatment and keep them from infecting their families.

Next to testify was retired Bexar County Constable Jimmy Willborn, also a retired San Antonio police officer and former narcotics officer and supervisor. Constable Willborn said that while working in law enforcement some of his partners and employees, and EMS workers who he knew, were stuck with needles when they were executing search warrants and searching or helping individuals. He emphasized that syringe exchange programs will make it better for police officers because the programs will help decrease the chance of a disease being passed on to an officer.

Groups who registered in favor of SB 188 but did not testify include:
Texas Impact
ACLU of Texas
Texas Pediatric Society
Legacy Community Health Services
Scott & White Center for Healthcare Policy

To watch the hearing visit the Senate RealMedia Video Archives page on the Texas Senate website, and click on part two of the hearing on March 3. The fiscal note and bill analysis are available on Texas Legislature Online, but the Committee Substitute has not been posted as of this time.

Those who testified and registered in favor of CSSB 188, and of course those senators who voted in favor, have helped Texas move toward a sensible solution. When the federal government begins to fund syringe exchange programs, Texas should not be left out.

Learn more about the issue here.

Harris County Officials Discuss Syringe Access Legislation

Officials representing the Harris County Commissioners' Court, Houston City Council, Houston Police Department, Harris County Hospital District, Harris County criminal courts, HIV service providers, and state level elected officials attended a luncheon yesterday at the United Way of Greater Houston to learn and share the latest information about syringe access programs and the pending Texas legislation.

Dr. William Martin, Senior Fellow for Drug Policy at the Baker Institute for Public Policy at Rice University, and Randall Ellis, Senior Director for Government Relations at Legacy Community Health Services, each made excellent presentations. Attendees were able to ask questions and share the latest information and insights from their perspective.

Dr. Martin had some in tears as he gave us a metaphor for the current syringe access situation in Texas (it is currently a crime punishable by incarceration to give a drug user a clean syringe in Texas) through a story of two neighbors who met in Heaven:

One neighbor in Heaven said to the other: "You mean you knew about Him the whole time we lived next to one another but you never mentioned Him to me?"

Imagine yourself working in a health care facility, he said, and you are approached by an injection drug user who has contracted AIDS by using a dirty needle. The dying person looks into your eyes and says, "You mean you knew a simple way to prevent the spread of this disease that is killing me, and you never mentioned it to me?"

Distributing a clean needle to an injection drug user and offering her a bridge to recovery costs about 7 cents. Learn more here.

Senate Committee Could Vote on Syringe Access Bill Next Week

Senator Deuell and Senator Van de Putte's syringe access bill, SB 188, is set to be heard by the Senate Health & Human Services Committee on Tuesday, March 3, 2009, at 9:00 AM in the Texas capitol in the Senate Chamber. You can see the full text of the bill and its fiscal note here. Last session, this committee approved the bill by a vote of 7 to 1. If a majority of the committee members vote to approve the bill on Tuesday, it can be considered by the full Senate. Find names and contact information for the Senators who sit on the committee here.

Find legislative history and background information about syringe access in Texas here.

House Bills 142 & 272 gain new bi-partisan support

Last week the Access Project let you know that Representative Joe Crabb signed on as a joint author of House Bill 272, by Representative Solomon Ortiz, Jr. Well today Representative Crabb demonstrated his support for disease prevention again by signing on as a joint author of House Bill 142, by Representative Ruth Jones McClendon. Thanks again Representative Crabb!

Disease prevention and outreach programs gained even more bi-partisan support today when Republican Representative Brian McCall, Chair of the House Committee on Calendars, signed on as a joint author of House Bill 272. Thanks so much Chairman McCall!

House Bill 272 is referred to committee & receives a new Joint Author

Today House Bill 272, by Representative Solomon Ortiz, Jr., received its first reading and was then referred to the Committee on Public Health. I am also happy to report that last week Republican Representative Joe Crabb, Vice Chair of the Committee on Rules & Resolutions, signed on as a joint author of HB 272. Many thanks to Representative Crabb!

House Bill 142 referred to committee

House Bill 142, by Representative Ruth Jones McClendon, received its first reading and was then referred to the Committee on Public Health.

President Obama Makes U.S. Support for Needle Exchange Official

As reported by PRI The World, "In a significant break from both Mr. Bush and Bill Clinton before him, Barack Obama is making his support for needle exchange programs official."

The United States now officially acknowledges that our priority is to save lives and give our fellow human beings an opportunity to recover from addiction. This week the United States gave its negotiators at the United Nations summit new guidelines: "The US will endorse and support needle exchange programs."

The next logical step for the Obama administration will be to lift the federal ban on funding needle exchange programs, as promised during his campaign. This will allow all health institutions who receive federal funds to offer safe and clean needles to people so they can stop spreading deadly infections.

There is no better way to offer an opportunity to recover from addiction to an injection-drug user than when we have a chance to interact with them and show them how to care for their own health. Needle exchange programs are the number one path to recovery for these Texans.

Today, it is a crime in Texas to distribute clean needles - in fact, the Bexar County DA is currently trying to put an elder clergy member into jail as punishment. But the Texas legislature can change the law this session, bringing Texas into line with the rest of the world when it comes to compassion and saving human life. Get the latest updates on this blog and this site.

Senate Bill 188 referred to committee

Senate Bill 188, by Senators Deuell and Van de Putte, received its first reading and was then referred to the Committee on Health and Human Services.

Dallas Morning News: Public Health Officials Must Take Steps to Curb HIV

Thank you Dallas Morning News Editorial Columnist James Ragland for highlighting the harrowing statistics on HIV in Dallas. The disease is spinning out of control:

"Dallas County had the state's highest HIV rate in 2006 and 2007. More than 13,500 folks are living with HIV/AIDS in Dallas, a 35 percent increase in the last five years, according to a report by the county's Health and Human Services Department.

"The black community is really feeling the brunt of careless lifestyle choices: Black residents make up just 20 percent of the county's population, but they represented a whopping 46 percent of new HIV/AIDS diagnoses in 2007.

"Worse still, the infection rate among 13- to 24-year-olds nearly tripled over the last five years. That's a group we can least afford to have succumbing to a virulent disease, particularly when you consider the mounting costs of HIV care. We're talking hundreds of millions of dollars a year, most of which is coming out of the federal till."

He points out that, whatever our value system, public health officials must take advantage of simple prevention tools to stop the spread of the deadly infectious disease - especially when saving lives costs pennies:

"Make no mistake, my conservative religious cohorts are right on the mark when they argue that our fundamental challenge still is in overhauling the value systems of those who willingly or unwittingly put themselves in harm's way by sleeping around or sharing needles.

"But changing deep-rooted behaviors – an ongoing, epic battle whose end is nowhere in sight – is only part of the solution to this health crisis.

"It's also vitally incumbent upon public-health officials to do everything they can to control and curb a disease that poses a very tangible threat"

Visit this site for the latest, and sign up for free email updates, on what the Texas legislature is doing to prevent the spread of infectious disease.

Bush-era envoys to the UN blocking global promotion of syringe exchange

An article in the Washington Independent last week examines how envoys to the United Nations who were appointed by the last administration are blocking global efforts to promote HIV/AIDS prevention programs. The article goes on to question the envoys actions considering the fact that President Obama has clearly stated his support for syringe exchange programs in the Civil Rights section of his Agenda.

According to the article several members of Congress are now getting involved.

The episode has attracted the attention of some congressional Democrats. In a Jan. 28 letter to U.S. Ambassador to the United Nations Susan Rice, Reps. Henry Waxman (D-Calif.), Barbara Lee (D-Calif.) and Jose Serrano (D-N.Y.) cite “an apparent disconnect in U.S. policy” as it pertains to efforts to promote needle exchange to fight HIV/AIDS.

“We understand that the U.S. delegation in Vienna has been actively blocking the efforts of some of our closest allies — including the European Union — to incorporate in the declaration reference to harm reduction measures, such as needle exchange,” the Democrats wrote. They’re urging that the delegation “should immediately be given new instructions from the highest levels of the new Administration.”

If you want to let President Obama know how you feel about this situation you can visit the Contact Us page on WhiteHouse.gov.

Syringe exchange opponent lobbies in Texas from Florida

Last Friday a staffer from a Texas House members office emailed me a fax and other materials the office received from the executive director of Florida based Save Our Society From Drugs, Calvina Fay. In the fax Ms. Fay states her strong opposition to syringe exchange programs and then lists several reasons for her opposition.

I decided to pass along Ms. Fay's fax and other materials to Dr. William Martin, an expert on syringe exchange programs, to see what he thought of her claims. Before the weekend was out Dr. Martin emailed me back with his response to Ms. Fay's fax, his response notably full of documentation where hers was lacking.

About her fax and other materials Dr. Martin said "As an advocate for NEPs, I am not surprised that Ms. Fay could not martial better arguments to support her opposition to these programs, since the evidence against her position is simply too strong. I am, however, somewhat surprised that she apparently assumed no one would examine her assertions and claims."

Well examine them he did! Check out Dr. Martins response to Calvina Fay and a copy of Ms. Fay's fax to decide for yourself who is being honest in there examination of this important public health option.

Videos from seminar on syringe exchange now online

On December 9, 2008 the Bexar Area Harm Reduction Coalition hosted a seminar on syringe exchange programs in San Antonio. The seminar featured presentations by Dr. William Martin, Senior Fellow for Drug Policy at the Baker Institute, and Neel Lane, volunteer attorney for the Bexar Area Harm Reduction Coalition. The Access Project attended the seminar and filmed both presentations which are now available to view on our website.

Following is an interview with Charlene Doria-Ortiz, Community Health Program Manager for the Bexar County Department of Community Investment, filmed after the seminar ended. In the interview Charlene shares her perspective as the harm reduction coordinator for the pilot syringe exchange program in Bexar County.

New NEP Papers on the Baker Institute Website

Dr. William Martin, Senior Fellow at the James A. Baker III Institute for Public Policy at Rice University, is an expert on needle exchange programs (NEP's). In a new paper posted on the Baker Institute website, Needle Exchange Programs: Sending the Right Message, Dr. Martin sites extensive research to outline why he believes NEP's are a proven method of reducing the spread of blood-borne diseases such as HIV/AIDS and Hepatitis C without increasing drug use. As part of a set of policy recommendations the Baker Institute fellows prepared for President Obama, Dr. Martin has also prepared a paper addressing the removal of the ban on using federal funds for NEP's. To read the papers visit the Drug Policy link on the Baker Institute website, then scroll down to "Publications, 2009".