SENATE BUDGET AND APPROPRIATIONS COMMITTEE
SENATE, No. 494
STATE OF NEW JERSEY
DATED: †OCTOBER 12, 2006
††††† The Senate Budget and Appropriations Committee reports Senate Bill No. 494 (1R) without recommendation.
††††† Senate Bill No. 494 (1R), which is designated the "Bloodborne Disease Harm Reduction Act," provides for a Statewide demonstration program to permit the operation in certain municipalities of sterile syringe access programs to prevent the spread of HIV/AIDS, hepatitis C and other bloodborne diseases.
††††† Specifically, the bill provides as follows:
∑ The Commissioner of Health and Senior Services is to establish a demonstration program to permit up to six municipalities to operate a sterile syringe access program in accordance with the provisions of the bill.† The commissioner is directed to prescribe by regulation requirements for a municipality to establish, or otherwise authorize the operation within that municipality of, a sterile syringe access program to provide for the exchange of hypodermic syringes and needles.
∑ The commissioner is to:
†††† (1) request an application, to be submitted on a form and in a manner to be prescribed by the commissioner, from any municipality that seeks to establish a sterile syringe access program, or from other entities authorized to operate a sterile syringe access program within that municipality, as provided in the bill;
†††† (2) approve those applications that meet the requirements established by regulation of the commissioner and contract with the municipalities or entities whose applications are approved to establish a sterile syringe access program;
†††† (3) support and facilitate, to the maximum extent practicable, the linkage of sterile syringe access programs to such health care facilities and programs as may provide appropriate health care services, including mental health and substance abuse treatment, and to housing assistance, career employment-related counseling, and education counseling to consumers participating in any such program;
†††† (4) provide for the adoption of a uniform identification card or other uniform Statewide means of identification for consumers, staff and volunteers of a sterile syringe access program; and
†††† (5) maintain a record of the data reported to the commissioner by sterile syringe access programs pursuant to the bill.
∑ The commissioner is authorized to accept such funding as may be made available from the private sector to effectuate the purposes of the bill.
∑ A municipality may establish or authorize establishment of a sterile syringe access program that is approved by the commissioner to provide for the exchange of hypodermic syringes and needles.
†††† (1) A municipality may operate the program directly or contract with one or more of the following entities to operate the program:† a hospital or other licensed health care facility, a federally qualified health center, a public health agency, a substance abuse treatment program, an AIDS service organization, or another nonprofit entity designated by the municipality.† These entities will also be authorized to contract directly with the commissioner in any municipality in which the governing body has authorized, by ordinance, the operation of sterile syringe access program.† The municipality or entity under contract is to implement the sterile syringe access program in consultation with a federally qualified health center and the New Jersey Office on Minority and Multicultural Health, and in a culturally competent manner.
†††† (2) A municipality whose governing body has authorized the operation of a sterile syringe access program may require within the authorizing ordinance that an entity obtain approval from the municipality to operate a sterile syringe access program prior to obtaining approval from the commissioner to operate the program, or may permit the entity to obtain approval to operate the program by application directly to the commissioner without obtaining prior approval from the municipality.
†††† (3) Two or more municipalities may jointly establish or authorize establishment of a sterile syringe access program that operates within those municipalities pursuant to adoption of an ordinance by each participating municipality.
∑ A sterile syringe access program must comply with the following requirements.† The program is to:
†††† (1) Provide sterile syringes and needles at no cost to consumers 18 years of age and older;
†††† (2) Train and regularly supervise program staff in:† harm reduction; substance abuse, medical and social service referrals; and infection control procedures, including universal precautions and needle stick injury protocol; and programs are to maintain records of staff and volunteer training and of hepatitis C and tuberculosis screening provided to volunteers and staff;
†††† (3) Offer information about HIV, hepatitis C and other bloodborne pathogens, and prevention materials, at no cost to consumers, and seek to educate all consumers about safe and proper disposal of needles and syringes;
†††† (4) Provide information and referrals to consumers, including HIV testing options, access to drug abuse treatment programs, and available health and social service options relevant to the consumer's needs, encourage consumers to receive an HIV test, and, when appropriate, develop an individualized drug abuse treatment plan for each participating consumer;
†††† (5) Screen out consumers under 18 years of age from access to syringes and needles, and refer them to drug abuse treatment and other appropriate programs for youth;
†††† (6) Develop a plan for the handling and disposal of used syringes and needles in accordance with requirements set forth at N.J.A.C.7:26-3A.1 et seq. for regulated medical waste disposal pursuant to the "Comprehensive Regulated Medical Waste Management Act," and also develop and maintain protocols for post-exposure treatment;
†††† (7) Maintain the confidentiality of consumers by the use of confidential identifiers, which are to consist of the first two letters of the first name of the consumer's mother and the two-digit day of birth and two-digit year of birth of the consumer, or by the use of such other uniform Statewide mechanism as may be approved by the commissioner for this purpose;
†††† (8) Provide a uniform identification card that has been approved by the commissioner to consumers and to staff and volunteers involved in transporting, exchanging or possessing syringes and needles, or provide for such other uniform Statewide means of identification as may be approved by the commissioner for this purpose;
†††† (9) Provide consumers at the time of enrollment with a schedule of program operation hours and locations, in addition to information about prevention and harm reduction and drug abuse treatment services; and
†††† (10) Establish and implement accurate data collection methods and procedures as required by the commissioner for the purpose of evaluating the programs, including the monitoring and evaluation on a quarterly basis of:
†††† (a) sterile syringe access program participation rates, including the number of consumers who enter drug abuse treatment programs and the status of their treatment;
†††† (b) the effectiveness of the programs in meeting their objectives, including, but not limited to, return rates of syringes and needles distributed to consumers and the impact of the sterile syringe access programs on intravenous drug use; and
†††† (c) the number and type of referrals provided by the programs and the specific actions taken by the programs on behalf of each consumer.
∑ A municipality may terminate a sterile syringe access program operating within that municipality if its governing body approves such an action by ordinance, in which case the municipality is to notify the commissioner of its action in a manner prescribed by regulation of the commissioner.
∑ The commissioner is directed to report to the Governor and the Legislature, no later than one year after the effective date of the bill and biennially (every two years) thereafter, on the status of sterile syringe access programs established pursuant to the bill, and is to include in that report the data provided to the commissioner by each sterile syringe access program.
For the purpose of each biennial report, the commissioner is to:
†††† (1) consult with local law enforcement authorities regarding the impact of the sterile syringe access programs on the rate and volume of crime in the affected municipalities and include that information in the report; and
†††† (2) seek to obtain data from public safety and emergency medical services providers Statewide regarding the incidence and location of needle stick injuries to their personnel and include that information in the report.
∑ The commissioner is further directed to report to the Governor and the Legislature no later than six months after the date that the initial sterile syringe access program commences its operations, and is to include in that report:
†††† (1) an assessment of whether an adequate number of drug abuse treatment program slots is available to meet the treatment needs of persons who have been referred by sterile syringe access programs pursuant to the bill; and
†††† (2) a recommendation for such appropriation as the commissioner determines necessary to ensure the provision of an adequate number of drug abuse treatment program slots for those persons.
∑ The commissioner is to contract with an entity that is independent of the Department of Health and Senior Services to prepare a detailed analysis of the sterile syringe access programs, and to report on the results of that analysis to the Governor, the Governor's Advisory Council on HIV/AIDS and Related Blood-Borne Pathogens, and the Legislature no later than 24 months after the adoption of regulations required pursuant to the bill and annually thereafter.† The analysis is to include, but not be limited to:
† †††(1) any increase or decrease in the spread of HIV, hepatitis C and other blood-borne pathogens that may be transmitted by the use of contaminated syringes and needles;
†††† (2) the number of exchanged syringes and needles and an evaluation of the disposal of syringes and needles that are not returned by consumers;
†††† (3) the number of consumers participating in the sterile syringe access programs and an assessment of their reasons for participating in the programs;
†††† (4) the number of consumers in the sterile syringe access programs who participated in drug abuse treatment programs; and
†††† (5) the number of consumers in the sterile syringe access programs who benefited from counseling and referrals to programs and entities that are relevant to their health, housing, social service, employment and other needs.
∑ Within 90 days after receipt of the third report from the independent entity, the commissioner is to submit to the Governor and the Legislature, on a day when both Houses of the Legislature are meeting in the course of a regular or special session, the commissionerís recommendations regarding whether or not to continue the demonstration program established pursuant to the bill.† The commissionerís recommendations will be effective unless the Legislature passes a concurrent resolution overriding the commissionerís recommendations no later than the 45th day after its receipt of those recommendations.
∑ The Commissioner of Human Services is directed to develop a plan for establishing and funding regional substance abuse treatment facilities.† The plan is to include a strategy for soliciting proposals from nonprofit agencies and organizations in the State, including State-licensed health care facilities, with experience in the provision of long-term care or outpatient substance abuse treatment services to meet the post-acute health, social, and educational needs of persons living with HIV/AIDS.† The commissioner is to submit the plan to the Governor and the Legislature no later than the 120th day after the effective date of the bill, and to report biannually thereafter to the Governor and the Legislature on the implementation of the plan.
∑ The possession of a hypodermic syringe or needle by a consumer who participates in, or an employee or volunteer of, a sterile syringe access program established pursuant to the bill will not constitute an offense pursuant to N.J.S.A.2C:36-1 et seq. (drug paraphernalia).† This provision extends to a hypodermic syringe or needle that contains a residual amount of a controlled dangerous substance or controlled substance analog.
∑ Each county freeholder board and the New Jersey Meadowlands Commission, in accordance with standards adopted by regulation of the Commissioner of Environmental Protection in consultation with the Commissioner of Health and Senior Services, is to prepare and adopt a sharps disposal component as an amendment to the district solid waste management plan required pursuant to the "Solid Waste Management Act" to provide for the proper and safe disposal of medical waste generated at home within the district.
∑ The bill directs the Commissioners of Health and Senior Services and Environmental Protection to adopt rules and regulations, pursuant to the "Administrative Procedure Act," to effectuate the purposes of the bill.
∑ The bill appropriates $10,000,000 from the General Fund to the Division of Addiction Services in the Department of Human Services for inpatient and outpatient drug abuse treatment program slots and outreach.
††††† The bill establishes standards by which up to six municipalities may implement sterile syringe access programs.† Because the programs are implemented at the option of the municipalities and because levels of staffing and services may vary by municipality, no estimates of municipal program costs can be made at this time.
††††† The bill appropriates $10,000,000 from the General Fund to the Division of Addiction Services in the Department of Human Services for inpatient or outpatient residential substance abuse treatment program slots and outreach. The bill also requires the Commissioner of Human Services to make a recommendation for such appropriation as the commissioner determines necessary to ensure the provision of an adequate number of substance abuse treatment program slots for the treatments needs of persons referred by sterile syringe access programs within six months after the first program commences operations.
††††† No information is currently available to determine the State or municipal costs, if any, of a program's providing a uniform identification card that has been approved by the commissioner to consumers and to staff and volunteers involved in transporting, exchanging or possessing syringes and needles, or whether existing uniform Statewide means of identification, such as the identification cards issued by the Motor Vehicle Commission, may be approved by the commissioner for this purpose.
††††† No information is available to determine the county costs, if any, of implementing the sharps disposal component of the district solid waste management plan.††
††††† No information is available to determine the expenses associated with the Department of Human Services contract with an entity that is independent of the department to prepare a detailed analysis of the sterile syringe access programs.