Florida Senate - 2019                              CS for SB 366
       By the Committee on Health Policy; and Senators Braynon, Pizzo,
       and Book
       588-02477-19                                           2019366c1
    1                        A bill to be entitled                      
    2         An act relating to infectious disease elimination
    3         programs; providing a short title; amending s.
    4         381.0038, F.S.; providing that a county commission may
    5         authorize a sterile needle and syringe exchange
    6         program; defining the term “exchange program”;
    7         prohibiting the establishment of an exchange program
    8         under certain conditions; providing requirements for
    9         establishing an exchange program; specifying entities
   10         that may operate an exchange program; requiring the
   11         development of an oversight and accountability system
   12         for certain purposes; specifying requirements for
   13         exchange programs; requiring the collection of data
   14         and submission of reports; authorizing the Department
   15         of Health to adopt certain rules; providing for
   16         immunity from civil liability under certain
   17         circumstances; authorizing sources of funding for
   18         exchange programs; authorizing the continuation of a
   19         specified pilot project under certain circumstances;
   20         providing severability; providing an effective date.
   22  Be It Enacted by the Legislature of the State of Florida:
   24         Section 1. This act may be cited as the “Infectious Disease
   25  Elimination Act (IDEA).”
   26         Section 2. Subsection (4) of section 381.0038, Florida
   27  Statutes, is amended to read:
   28         381.0038 Education; sterile needle and syringe exchange
   29  programs pilot program.—The Department of Health shall establish
   30  a program to educate the public about the threat of acquired
   31  immune deficiency syndrome.
   32         (4) A county commission The University of Miami and its
   33  affiliates may authorize establish a single sterile needle and
   34  syringe exchange pilot program to operate within its county
   35  boundaries in Miami-Dade County. The pilot program may operate
   36  at one or more fixed locations a fixed location or through a
   37  mobile health units unit. The pilot program shall offer the free
   38  exchange of clean, unused needles and hypodermic syringes for
   39  used needles and hypodermic syringes as a means to prevent the
   40  transmission of HIV, AIDS, viral hepatitis, or other blood-borne
   41  diseases among intravenous drug users and their sexual partners
   42  and offspring. Prevention of disease transmission must be the
   43  goal of the program. For the purposes of this subsection, the
   44  term “exchange program” means a sterile needle and syringe
   45  exchange program established by a county commission under this
   46  subsection. A sterile needle and syringe exchange program may
   47  not operate unless it is authorized and approved by a county
   48  commission in accordance with this subsection.
   49         (a) Before an exchange program may be established, a county
   50  commission must:
   51         1. Authorize the program under the provisions of a county
   52  ordinance;
   53         2. Enter into a letter of agreement with the department in
   54  which the county commission agrees that any exchange program
   55  authorized by the county commission will operate in accordance
   56  with this subsection;
   57         3. Enlist the local county health department to provide
   58  ongoing advice, consultation, and recommendations for the
   59  operation of the program;
   60         4. Contract with one of the following entities to operate
   61  the program:
   62         a. A hospital licensed under chapter 395.
   63         b. A health care clinic licensed under part X of chapter
   64  400.
   65         c. An accredited medical school associated with a
   66  university in this state.
   67         d.A licensed addictions receiving facility as defined in
   68  s. 397.311.
   69         e. A 501(c)(3) HIV/AIDS service organization.
   70         (b)(a)An exchange The pilot program must:
   71         1. Develop an oversight and accountability system to ensure
   72  the program’s compliance with statutory and contractual
   73  requirements. The system must include measurable objectives for
   74  meeting the goal of the program and must track the progress in
   75  achieving those objectives. The system must require the program
   76  operator to routinely report its progress in achieving the
   77  objectives and the goal of the program. The system must also
   78  incorporate mechanisms to track the program operator’s
   79  compliance or noncompliance with contractual obligations and to
   80  apply consequences for noncompliance. The program must receive
   81  the county commission’s approval of the oversight and
   82  accountability system before commencing operations.
   83         2.1. Provide for maximum security of exchange sites where
   84  needles and syringes are exchanged and of any equipment used
   85  under the program, including, at a minimum, an accounting of the
   86  number of needles and syringes in use, the number of needles and
   87  syringes in storage, safe disposal of returned needles, and any
   88  other measure that may be required to control the use and
   89  dispersal of sterile needles and syringes.
   90         32. Operate a one-to-one exchange, whereby a the
   91  participant shall receive one sterile needle and syringe unit in
   92  exchange for each used one. The county commission is authorized
   93  to grant a waiver of this requirement under its contract with
   94  the program operator if the terms of such a waiver require the
   95  operator to maintain the one-to-one ratio except for exigent
   96  circumstances delineated in the waiver.
   97         43. Make available educational materials and referrals to
   98  education regarding the transmission of HIV, viral hepatitis,
   99  and other blood-borne diseases. The program operator must offer
  100  such materials to program participants whenever needles or
  101  syringes are exchanged; provide referrals for drug abuse
  102  prevention and treatment; and provide or refer for HIV and viral
  103  hepatitis screening.
  104         5. Provide onsite counseling or referrals for drug abuse
  105  prevention, education, and treatment, and provide onsite HIV and
  106  viral hepatitis screening or referrals for such screening. If
  107  such services are offered solely by referral, they must be made
  108  available to participants within 72 hours. The county commission
  109  in a rural county may, under its contract with the program
  110  operator, adjust the 72-hour requirement if the commission finds
  111  that the availability of providers warrants an extended
  112  timeframe.
  113         6. Provide kits containing an emergency opioid antagonist,
  114  as defined in s. 381.887, or provide referrals to a program that
  115  can provide such kits.
  116         7. Collect data for annual reporting purposes. The data
  117  must include the number of participants served; the number of
  118  used needles and syringes received and the number of clean,
  119  unused needles and syringes distributed through exchange with
  120  participants; the demographic profiles of the participants
  121  served; the number of participants entering drug counseling or
  122  treatment; the number of participants receiving testing for HIV,
  123  AIDS, viral hepatitis, or other blood-borne diseases; and other
  124  data that may be required under department rule. However, a
  125  participant’s personal identifying information may not be
  126  collected for any purpose. Each exchange program must submit a
  127  report to its county commission and to the department by August
  128  1 annually. The department must submit a compilation report
  129  encompassing data from all exchange programs annually by October
  130  1 to the Governor, the President of the Senate, and the Speaker
  131  of the House of Representatives. The department may adopt rules
  132  to implement this subparagraph.
  133         (c)(b) The possession, distribution, or exchange of needles
  134  or syringes as part of an exchange the pilot program established
  135  under this subsection is not a violation of any part of chapter
  136  893 or any other law.
  137         (d)(c)An exchange A pilot program staff member, volunteer,
  138  or participant is not immune from criminal prosecution for:
  139         1. The possession of needles or syringes that are not a
  140  part of the exchange pilot program; or
  141         2. The redistribution of needles or syringes in any form,
  142  if acting outside the exchange pilot program.
  143         (d) The pilot program must collect data for quarterly,
  144  annual, and final reporting purposes. The annual report must
  145  include information on the number of participants served, the
  146  number of needles and syringes exchanged and distributed, the
  147  demographic profiles of the participants served, the number of
  148  participants entering drug counseling and treatment; the number
  149  of participants receiving testing for HIV, AIDS, viral
  150  hepatitis, or other blood-borne diseases; and other data
  151  necessary for the pilot program. However, personal identifying
  152  information may not be collected from a participant for any
  153  purpose. Quarterly reports must be submitted to the Department
  154  of Health in Miami-Dade County by October 15, January 15, April
  155  15, and July 15 of each year. An annual report must be submitted
  156  to the Department of Health by August 1 every year until the
  157  program expires. A final report is due on August 1, 2021, to the
  158  Department of Health and must describe the performance and
  159  outcomes of the pilot program and include a summary of the
  160  information in the annual reports for all pilot program years.
  161         (e) A law enforcement officer acting in good faith who
  162  arrests or charges a person who is thereafter determined to be
  163  immune from prosecution under this section shall be immune from
  164  civil liability that might otherwise be incurred or imposed by
  165  reason of the officer’s actions.
  166         (f)(e) State, county, or municipal funds may not be used to
  167  operate an exchange the pilot program. Exchange programs may The
  168  pilot program shall be funded fully or partially through county
  169  commission expenditures or through grants and donations from
  170  private resources and funds.
  171         (f) The pilot program shall expire July 1, 2021.
  172         Section 3. Notwithstanding s. 381.0038(4), Florida
  173  Statutes, as amended by this act, the pilot program established
  174  in Miami-Dade County under chapter 2016-68, Laws of Florida, may
  175  continue to operate under that chapter until the Miami-Dade
  176  County Board of County Commissioners establishes an exchange
  177  program as defined under this act or until July 1, 2021,
  178  whichever occurs first.
  179         Section 4. If any provision of this act or its application
  180  to any person or circumstance is held invalid, the invalidity
  181  does not affect other provisions or applications of the act
  182  which can be given effect without the invalid provision or
  183  application, and to this end the provisions of this act are
  184  severable.
  185         Section 5. This act shall take effect July 1, 2019.