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THE SENATE |
S.B. NO. |
1433 |
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THIRTY-THIRD LEGISLATURE, 2025 |
S.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO HARM REDUCTION.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
Over the past thirty years, extensive scientific research has confirmed that syringe exchange programs nationwide effectively reduce disease transmission, increase access to addiction treatment, improve public safety, lower health care costs, and do not lead to an increase in drug use or crime. Research has also helped identify the most effective approaches in what are now commonly referred to as "syringe services programs".
A 2020 report
by the Centers for Disease Control and Prevention, United States Department of Health
and Human Services, concluded that syringe programs that restrict syringe distribution
to one-to-one exchange are less effective than needs-based distribution programs
that provide sterile needles and syringes to syringe exchange participants in
quantities sufficient to reduce the likelihood of needles and syringes being
shared or reused. The Centers for Disease
Control and Prevention supports needs-based approaches to syringe distribution based
on evidence that it is the best practice for reducing new HIV and viral hepatitis
infections. The Centers for Disease Control
and Prevention concludes that, compared to one-to-one exchanges, needs-based syringe
distribution results in less syringe sharing and reuse, lowers risk of infection,
and is not associated with increased unsafe syringe disposal. Research shows that syringe distribution programs
are safe, effective, cost-saving, do not increase drug use or crime, and do not
cause people to begin injecting drugs. However,
Hawaii and Florida remain the only states that impose a strict one-to-one sterile
needle and syringe exchange limit. This Act
will authorize the State's syringe exchange program to transition from a one-to-one exchange
model to a needs-based distribution system.
Syringes and needles are not the only injection equipment that contribute to the spread of infection. Any materials used in the preparation or administration of drugs may potentially transmit pathogens or cause injury when shared or reused.
The Model Syringe Services Program Act, a model legislation released by the White House Office of National Drug Control Policy in December 2021, recommends extending protection from criminal liability under drug paraphernalia statutes to syringe program staff, volunteers, and participants while implementing or accessing program services intended to reduce transmission of bloodborne infections. This Act makes amendments consistent with those recommendations.
In alignment with recommendations for improving effectiveness, the State's sterile needle and syringe exchange program also facilitates access to critical health services necessary for participants. These include educating participants about the dangers of contracting human immunodeficiency virus through sharing drug injection equipment and offering counseling services and referrals for treatment of substance use disorders. Furthermore, individuals who do not inject drugs but are marginalized often seek harm reduction information, supplies, and referrals to other services through the program. This Act will remove the requirement that the program exclude non-injection drug users, ensuring the program can assist individuals in need when resources are available.
Syringe services programs also play a crucial role in collecting and safely disposing of used injection equipment. Safe disposal occurs most effectively if program participants batch all used injection equipment for safe disposal by syringe services programs. However, participants may be reluctant to batch used injection equipment for safe disposal if they risk criminal penalties for drug residue found on used equipment. Extending protection to program participants from arrest and prosecution for possession of drug residue on used syringes and needles will increase the likelihood of proper disposal, thereby reducing public health risk. Program staff regularly encourage participants to batch and return all used injection equipment to the syringe exchange program, not only for the safety of the community, but also to assist in ensuring the program's continuity. For these reasons, the Model Syringe Services Program Act recommends providing immunity from criminal penalties for possession of a controlled substance or other illicit drug due to the presence of residue in a hypodermic needle or syringe or other supplies.
The purpose
of this Act is to improve the safety, effectiveness, and cost savings of the State's sterile needle and syringe exchange program by amending it based
on current recommendations from the Centers for Disease
Control and Prevention and the White House Office of National Drug Control Policy's model legislation.
SECTION
2. Section
325-111, Hawaii Revised Statutes, is amended as follows:
1. By adding five new definitions to be
appropriately inserted and to read as follows:
""Authorized
objects" means objects authorized by the department, by rule, for dissemination
to syringe exchange participants for the purpose of reducing infection or
injury; provided that the objects are incidental to syringe exchange. "Authorized objects" may include,
but are not limited to, cookers, cottons, or ties.
"Needs-based distribution" means
a syringe distribution
practice that provides sterile needles and syringes to syringe exchange participants
in quantities sufficient to reduce the likelihood of needles and syringes being
shared or reused.
"Program staff" means an employee
of the department or its designee who is specifically tasked with procuring, handling,
transporting, and providing sterile needles, syringes, and authorized objects and
services to syringe exchange participants.
"Residue"
has the same meaning as "controlled substance" as defined in section
329-1, in an amount less than 0.05 milliliter.
"Syringe
exchange participant" means an injection drug user who receives a sterile needle
and syringe pursuant to the program."
2. By repealing the definition of
"participant".
[""Participant" means
an injection drug user who exchanges a sterile needle and syringe unit pursuant
to the program."]
SECTION 3. Section 325-113, Hawaii Revised Statutes, is amended to read as follows:
"[[]§325-113[]] Operation of the program. (a) The
program shall be operated for the purpose of:
(1) Preventing the transmission of the human
immunodeficiency virus, the hepatitis B virus, the hepatitis C virus, and
other [blood borne diseases;] bloodborne infections; and
(2) Providing [injection] drug users
with referrals to appropriate health and social services.
(b) The program shall provide for maximum security
of exchange sites and equipment, including a full accounting of the number of needles
and syringes [in use,] distributed, the number in storage, the
number of used needles and syringes collected, and any other measure that may
be required to control the use and dispersal of sterile needles and syringes; provided
that a syringe exchange participant may exchange used needles and syringes
at any exchange site if more than one site is available.
(c) The program
shall provide [for a one-to-one exchange, whereby the participant shall receive
one sterile needle and syringe unit in exchange for each used one.] needs-based
distribution of sterile needles and syringes.
(d) The program [shall provide procedures for the
screening of participants to prevent non-injection drug users from participating
in the programs.] may provide screening procedures to allow
non-injection drug users to safely and effectively receive services, exclusive
of syringes and needles, from the program.
(e) The department and its designees shall
keep records to identify and authorize [persons employed by the department or
its designees] program staff to have access to needles, syringes, or
authorized objects, and the program's records.
(f) The program shall include services to:
(1) Educate the syringe exchange participant
about the dangers of contracting [HIV infection] bloodborne pathogens
through [needle-sharing] needle- and other materials-sharing practices;
and
(2) Offer substance [abuse] use
disorder treatment referral and counseling services to all non-injection
drug users and syringe exchange participants.
(g) The program shall compile research data on behavioral
changes, enrollment in [drug abuse] substance use disorder treatment,
counseling, and education programs, service provision, disease transmission,
and other information that may be relevant and useful to assist in the planning
and evaluation of efforts to combat the spread
of [blood borne diseases.] bloodborne infections."
SECTION 4. Section 325-114, Hawaii Revised Statutes, is amended to read as follows:
"[[]§325-114[] Criminal
liability.] Liability. (a) [Exchanges under
the sterile needle and syringe exchange program] Possession or delivery of
needles or syringes shall not constitute an offense under section 329-43.5 for
[the participant or for the employees of the department or its designees.]
program staff acting in the course and scope of official duties; provided that
delivery is limited to other program staff or to syringe exchange participants pursuant
to this part. Possession of needles or syringes
shall not constitute an offense under section 329-43.5 for syringe exchange participants
participating in a program visit.
(b) Possession or delivery of authorized objects shall
not constitute an offense under section 329-43.5 for program staff acting in the
course and scope of official duties; provided that delivery is limited to other
program staff or to syringe exchange participants pursuant to this part. Possession of authorized objects shall not constitute
an offense under section 329-43.5 for syringe exchange participants participating
in a program visit. The department shall
establish, by rule, a specific list of authorized objects, which may be updated
from time to time as needed.
(c) Possession or delivery of used needles or syringes
containing residue shall not constitute a drug possession offense under section
712-1242(1)(c), 712-1243, 712-1245(1)(c), 712-1246.5, 712-1248(d), or 712-1249,
for syringe exchange participants within six months after their last participation in a program visit; and
shall not constitute such an offense for program staff acting in the course and
scope of official duties; provided that any delivery, whether by syringe exchange
participants or by program staff, shall be made only to program staff pursuant to
this part.
(d) Subsections (a), (b), and (c) shall only apply
to needles, syringes, or authorized objects possessed by syringe exchange participants
or program staff; or to needles, syringes, or authorized objects delivered between
program staff, or between a syringe exchange participant and program staff. Subsection (a), (b), or (c) shall not apply to
any needles, syringes, or authorized objects possessed by anyone other than syringe
exchange participants or program staff, nor shall subsection (a), (b), or (c) apply
to any needles, syringes, or authorized objects delivered between:
(1) Syringe exchange participants;
(2) A syringe exchange participant and
an individual who is neither a syringe exchange participant nor program staff;
(3) Individuals who are neither syringe
exchange participants nor program staff; or
(4) An individual who is neither a
syringe exchange participant nor program staff.
(e) A law enforcement officer who, acting in good
faith, arrests or charges a person who is thereafter determined to be exempt from
an offense pursuant to this section shall not be subject to civil liability for
the mere arrest or filing of charges.
[(b)
Nothing] (f) Except as specifically
provided in this section, nothing in this part provides immunity from prosecution
to any person for violation of any law prohibiting or regulating the use, possession,
dispensing, distribution, or promotion of controlled substances, dangerous drugs,
detrimental drugs, or harmful drugs. [Nothing]
Except as specifically provided in this section, nothing in this part provides
immunity from prosecution to any person for violation of [sections] section
329-41, 329-42, or 712-1241 through [712-1249.6.] 712-1249.7."
SECTION 5. Section 325-116, Hawaii Revised Statutes, is amended to read as follows:
"[[]§325-116[]] Reports.
The department, on or before January 1 of each year, shall submit a report
to the oversight committee. The report shall
include:
(1) Information
as to the number of syringe exchange participants served [and],
the number of needles and syringes distributed[;], and the number of used
needles and syringes collected;
(2) A demographic
profile of the syringe exchange participants served, including but not limited
to: age, sex, ethnicity, area of residence,
occupation, types of drugs used, length of drug use, and frequency of injection;
(3) Impact of the program on needle and syringe sharing
and other high risk behavior;
(4) Data on syringe exchange participants regarding
[HIV] human immunodeficiency virus (HIV) testing,
counseling, drug treatment, and other social services, including referrals for HIV
testing and counseling and for [drug abuse] substance use disorder
treatment;
(5) Impact on the transmission
of HIV infection among injection drug users;
(6) Impact on behaviors that caused syringe
exchange participants to be at risk for HIV transmission such
as frequency of drug use and needle sharing;
(7) An assessment of the cost-effectiveness of the
program versus direct and indirect costs of HIV infection; and
(8) Information
on the percentage of persons served through treatment programs for injection drug
users funded through the department that were attributed to needle exchange referrals.
The report shall address the strengths and weaknesses of the program, the advisability of its continuation, amendments to the law, if appropriate, and other matters that may be helpful to the oversight committee in evaluating the program's efficacy."
SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 7. This Act shall take effect upon its approval.
Report Title:
Department of Health; Sterile Needle and Syringe Exchange Program; Needs-Based Distribution; Non-Injection Drug User Participation; Liability
Description:
Amends the distribution system of sterile needles and syringes under the Sterile Needle and Syringe Exchange Program from a one-to-one exchange system to a needs-based distribution system. Authorizes non-injection drug user participation in the Program. Modifies liability for Program participants, staff, and law enforcement officers. (SD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.