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.