Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 366
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Health Policy (Braynon) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. This act may be cited as the “Infectious Disease
    6  Elimination Act (IDEA).”
    7         Section 2. Subsection (4) of section 381.0038, Florida
    8  Statutes, is amended to read:
    9         381.0038 Education; sterile needle and syringe exchange
   10  programs pilot program.—The Department of Health shall establish
   11  a program to educate the public about the threat of acquired
   12  immune deficiency syndrome.
   13         (4) A county commission The University of Miami and its
   14  affiliates may authorize establish a single sterile needle and
   15  syringe exchange pilot program to operate within its county
   16  boundaries in Miami-Dade County. The pilot program may operate
   17  at one or more fixed locations a fixed location or through a
   18  mobile health units unit. The pilot program shall offer the free
   19  exchange of clean, unused needles and hypodermic syringes for
   20  used needles and hypodermic syringes as a means to prevent the
   21  transmission of HIV, AIDS, viral hepatitis, or other blood-borne
   22  diseases among intravenous drug users and their sexual partners
   23  and offspring. Prevention of disease transmission must be the
   24  goal of the program. For the purposes of this subsection, the
   25  term “exchange program” means a sterile needle and syringe
   26  exchange program established by a county commission under this
   27  subsection. A sterile needle and syringe exchange program may
   28  not operate unless it is authorized and approved by a county
   29  commission in accordance with this subsection.
   30         (a) Before an exchange program may be established, a county
   31  commission must:
   32         1. Authorize the program under the provisions of a county
   33  ordinance;
   34         2. Enter into a letter of agreement with the department in
   35  which the county commission agrees that any exchange program
   36  authorized by the county commission will operate in accordance
   37  with this subsection;
   38         3. Enlist the local county health department to provide
   39  ongoing advice, consultation, and recommendations for the
   40  operation of the program;
   41         4. Contract with one of the following entities to operate
   42  the program:
   43         a. A hospital licensed under chapter 395.
   44         b. A health care clinic licensed under part X of chapter
   45  400.
   46         c. An accredited medical school associated with a
   47  university in this state.
   48         d.A licensed addictions receiving facility as defined in
   49  s. 397.311.
   50         e. A 501(c)(3) HIV/AIDS service organization.
   51         (b)(a)An exchange The pilot program must:
   52         1. Develop an oversight and accountability system to ensure
   53  the program’s compliance with statutory and contractual
   54  requirements. The system must include measurable objectives for
   55  meeting the goal of the program and must track the progress in
   56  achieving those objectives. The system must require the program
   57  operator to routinely report its progress in achieving the
   58  objectives and the goal of the program. The system must also
   59  incorporate mechanisms to track the program operator’s
   60  compliance or noncompliance with contractual obligations and to
   61  apply consequences for noncompliance. The program must receive
   62  the county commission’s approval of the oversight and
   63  accountability system before commencing operations.
   64         2.1. Provide for maximum security of exchange sites where
   65  needles and syringes are exchanged and of any equipment used
   66  under the program, including, at a minimum, an accounting of the
   67  number of needles and syringes in use, the number of needles and
   68  syringes in storage, safe disposal of returned needles, and any
   69  other measure that may be required to control the use and
   70  dispersal of sterile needles and syringes.
   71         32. Operate a one-to-one exchange, whereby a the
   72  participant shall receive one sterile needle and syringe unit in
   73  exchange for each used one. The county commission is authorized
   74  to grant a waiver of this requirement under its contract with
   75  the program operator if the terms of such a waiver require the
   76  operator to maintain the one-to-one ratio except for exigent
   77  circumstances delineated in the waiver.
   78         43. Make available educational materials and referrals to
   79  education regarding the transmission of HIV, viral hepatitis,
   80  and other blood-borne diseases. The program operator must offer
   81  such materials to program participants whenever needles or
   82  syringes are exchanged; provide referrals for drug abuse
   83  prevention and treatment; and provide or refer for HIV and viral
   84  hepatitis screening.
   85         5. Provide onsite counseling or referrals for drug abuse
   86  prevention, education, and treatment, and provide onsite HIV and
   87  viral hepatitis screening or referrals for such screening. If
   88  such services are offered solely by referral, they must be made
   89  available to participants within 72 hours. The county commission
   90  in a rural county may, under its contract with the program
   91  operator, adjust the 72-hour requirement if the commission finds
   92  that the availability of providers warrants an extended
   93  timeframe.
   94         6. Provide kits containing an emergency opioid antagonist,
   95  as defined in s. 381.887, or provide referrals to a program that
   96  can provide such kits.
   97         7. Collect data for annual reporting purposes. The data
   98  must include the number of participants served; the number of
   99  used needles and syringes received and the number of clean,
  100  unused needles and syringes distributed through exchange with
  101  participants; the demographic profiles of the participants
  102  served; the number of participants entering drug counseling or
  103  treatment; the number of participants receiving testing for HIV,
  104  AIDS, viral hepatitis, or other blood-borne diseases; and other
  105  data that may be required under department rule. However, a
  106  participant’s personal identifying information may not be
  107  collected for any purpose. Each exchange program must submit a
  108  report to its county commission and to the department by August
  109  1 annually. The department must submit a compilation report
  110  encompassing data from all exchange programs annually by October
  111  1 to the Governor, the President of the Senate, and the Speaker
  112  of the House of Representatives. The department may adopt rules
  113  to implement this subparagraph.
  114         (c)(b) The possession, distribution, or exchange of needles
  115  or syringes as part of an exchange the pilot program established
  116  under this subsection is not a violation of any part of chapter
  117  893 or any other law.
  118         (d)(c)An exchange A pilot program staff member, volunteer,
  119  or participant is not immune from criminal prosecution for:
  120         1. The possession of needles or syringes that are not a
  121  part of the exchange pilot program; or
  122         2. The redistribution of needles or syringes in any form,
  123  if acting outside the exchange pilot program.
  124         (d) The pilot program must collect data for quarterly,
  125  annual, and final reporting purposes. The annual report must
  126  include information on the number of participants served, the
  127  number of needles and syringes exchanged and distributed, the
  128  demographic profiles of the participants served, the number of
  129  participants entering drug counseling and treatment; the number
  130  of participants receiving testing for HIV, AIDS, viral
  131  hepatitis, or other blood-borne diseases; and other data
  132  necessary for the pilot program. However, personal identifying
  133  information may not be collected from a participant for any
  134  purpose. Quarterly reports must be submitted to the Department
  135  of Health in Miami-Dade County by October 15, January 15, April
  136  15, and July 15 of each year. An annual report must be submitted
  137  to the Department of Health by August 1 every year until the
  138  program expires. A final report is due on August 1, 2021, to the
  139  Department of Health and must describe the performance and
  140  outcomes of the pilot program and include a summary of the
  141  information in the annual reports for all pilot program years.
  142         (e) A law enforcement officer acting in good faith who
  143  arrests or charges a person who is thereafter determined to be
  144  immune from prosecution under this section shall be immune from
  145  civil liability that might otherwise be incurred or imposed by
  146  reason of the officer’s actions.
  147         (f)(e) State, county, or municipal funds may not be used to
  148  operate an exchange the pilot program. Exchange programs may The
  149  pilot program shall be funded fully or partially through county
  150  commission expenditures or through grants and donations from
  151  private resources and funds.
  152         (f) The pilot program shall expire July 1, 2021.
  153         Section 3. Notwithstanding s. 381.0038(4), Florida
  154  Statutes, as amended by this act, the pilot program established
  155  in Miami-Dade County under chapter 2016-68, Laws of Florida, may
  156  continue to operate under that chapter until the Miami-Dade
  157  County Board of County Commissioners establishes an exchange
  158  program as defined under this act or until July 1, 2021,
  159  whichever occurs first.
  160         Section 4. If any provision of this act or its application
  161  to any person or circumstance is held invalid, the invalidity
  162  does not affect other provisions or applications of the act
  163  which can be given effect without the invalid provision or
  164  application, and to this end the provisions of this act are
  165  severable.
  166         Section 5. This act shall take effect July 1, 2019.
  168  ================= T I T L E  A M E N D M E N T ================
  169  And the title is amended as follows:
  170         Delete everything before the enacting clause
  171  and insert:
  172                        A bill to be entitled                      
  173         An act relating to infectious disease elimination
  174         programs; providing a short title; amending s.
  175         381.0038, F.S.; providing that a county commission may
  176         authorize a sterile needle and syringe exchange
  177         program; defining the term “exchange program”;
  178         prohibiting the establishment of an exchange program
  179         under certain conditions; providing requirements for
  180         establishing an exchange program; specifying entities
  181         that may operate an exchange program; requiring the
  182         development of an oversight and accountability system
  183         for certain purposes; specifying requirements for
  184         exchange programs; requiring the collection of data
  185         and submission of reports; authorizing the Department
  186         of Health to adopt certain rules; providing for
  187         immunity from civil liability under certain
  188         circumstances; authorizing sources of funding for
  189         exchange programs; authorizing the continuation of a
  190         specified pilot project under certain circumstances;
  191         providing severability; providing an effective date.