Wednesday, May 30, 2007

Bexar County Judge Elated at Opportunity to Pioneer Texas Needle Exchange

Finally, with the passage of SB 10 with an amendment by San Antonio state Rep. Ruth Jones McLendon, Texas will no longer be the only state in the nation without a single, legal needle exchange. We'll now have one.

After SB 308 by Deuell allowing local governments to decide the question passed the Texas Senate, that bill died in committee but was resurrected as a single-county pilot project in Bexar County (San Antonio). I just received this press release from Rep. McLendon which quotes Bexar County Judge Nelson Wolff enthusiastically embracing the idea:
(San Antonio) -- State Representative Ruth Jones McClendon (House District 120, D-San Antonio) announced today that a legislative proposal has passed which would allow a pilot program so that public health care providers in Bexar county can evaluate the effects of a safe needle-exchange program as one means of combating the spread of hepatitis, HIV, and other infectious diseases. Her proposal was presented as an amendment to Senate Bill 10, a lengthy bill authored by Senator Jane Nelson (State Senate District 12, R-Lewisville), which addressees various aspects of examining state and local Medicaid and uncompensated health care costs in Texas. After signature by the Governor, it will take effect on September 1.

This Session, Senator (and physician) Robert Deuell (Senate District 2, Greenville) and Representative McClendon and filed companion bills (S.B.308 and H.B.856) to help prevent the spread of infectious diseases such as hepatitis and HIV, and reduce the drain on local health authorities for the enormous costs of treatment. Nelson Wolff, Judge of the Bexar County Commissioners Court, said enthusiastically, "Last year Bexar County spent more than $4 million on HIV/AIDS services. A needle exchange program will not only save lives but also taxpayers' dollars. We appreciate Rep. McClendon's courageous leadership, which could mean the difference between life and death for hundreds of Bexar County citizens." Studies show that the life expectancy of a person with HIV has risen to 24.2 years, and lifetime treatment costs are at least $385,000.

Representative McClendon said, "The public health and safety of Texas requires that we offer public health programs that prevent the spread of infectious diseases. Fiscal responsibility also requires that preventive programs be made available, and this is just one way that we can begin curbing the spread of hepatitis and HIV in geometric proportions." This development would permit Bexar County health authorities and their contracting agencies to establish and administer a safe-distribution and exchange programs for syringes and needles. Such programs have proved highly successful across the nation, including Hawaii, New York, Connecticut, and have helped cut the spread of HIV infections dramatically.

Texas has long awaited authorization for this type of disease-prevention program: Texas Monthly reported in its April, 2007 issue that Texas was the only state that did not allow this type of measure to help prevent the spread of infectious diseases. Opponents object to needle exchange programs (sometimes called NEP's or SEP's), on the basis that they allow users of intravenous drugs to continue an addictive habit; however, those who favor the programs emphasize that when a person can exchange dirty needles for clean ones, this helps keep uninfected persons stay that way. Also, NEP's offer the program sponsors with recurring opportunities to make rehabilitation and recovery available to the needle user; this has also has proved highly successful. As Representative McClendon emphasized, "This is not about increasing the number of intravenous drug users or helping them perpetuate an unfortunate addiction; it is about helping people stay free from infection. The Texas Medical Association, the Texas Hospital Association, the Texas Pharmacy Association, and many local officials and health care providers who treat infectious diseases supported this legislative concept."
This legislation has failed in Texas every year since the early '90s, so this was an enormous "get"- especially since McLendon convinced Rep. Dianne Delisi (R-Temple), who'd stalled the bill in the Public Health commitee, to agree to the pilot program. If needle exchange can show success in preventing disease and reducing costs in San Antonio, there's a good chance Texas will expand legal needle exchange programs to other cities in the future.

Among legislators, Rep. McLendon, Rep. Coleman, Rep. Delisi, Sen. Deuell, Sen. Nelson, Sen. Janek, Sen. West, and many others stepped up to make this happen. Others whose involvement was critical were Deuell's staffer Scot Kibbe, McLendon's staffer Janis Reinken, activist Tracey Hays (Austin Harm Reduction Coalition and ACLUTX), and Bill Martin, Texas Monthly's religion writer who wrote an editorial in that publication this spring supporting needle exchange. I should also mention that Glen Maxey carried this legislation doggedly for years, pushing it when nobody thought it had a prayer. It wouldn't this year without his pioneering work in years past.

I was proud of the Senate and the House when they both approved needle exchange for the first time ever on record votes (23-8 in the Senate, and 71-60 in the House). The quite-conservative Dr. Deuell has done such a good job re-framing the issue and defusing opposition, I wouldn't expect this to turn into an election issue for needle exchange supporters, or if it happens I think such ill-informed arguments can be easily beaten back. If that's accurate, and Bexar's outcomes follow patterns in the other 49 states at preventing disease and getting addicts into treatment, one assumes that would make it easier for advocates to come back to the 81st Texas Legislature in 18 months to take another bite at the apple.

See prior Grits coverage:


Anonymous said...

"Fiscal responsibility also requires that preventive programs be made available, and this is just one way that we can begin curbing the spread of hepatitis and HIV in geometric proportions."

That's a politicians line if I ever heard one. What does prudence & the Public health have to do with each other ? Nothing. Some things the government just needs to spend money on to protect the public. Period.

Anonymous said...

Nice, there is a Bexar County Judge who will speak out! Good for you Nelson Wolff! Now go rattle the cages of the criminal judges.

Anonymous said...

Thank you fro bringing such nice posts. Your blog is always fascinating to read.

Anonymous said...

Scot Kibbe. He spells his name with one "t" for some unknown reason.

Gritsforbreakfast said...

Thanks, 12:43, I corrected it in the text.

David Smith said...

I just want to confirm my understanding -- in San Antonio these programs can now operate legally and in public view.

Programs in other Texas cities have to continue their practice of operating "under the radar" and depend on the willingness of the local police to look the other way in declining to enforce the law.

Gritsforbreakfast said...

David, that's right - starting Sept. 1.