Hawaii 2025 Regular Session

Hawaii House Bill HB1114 Compare Versions

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11 HOUSE OF REPRESENTATIVES H.B. NO. 1114 THIRTY-THIRD LEGISLATURE, 2025 STATE OF HAWAII A BILL FOR AN ACT RELATING TO HARM REDUCTION. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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33 HOUSE OF REPRESENTATIVES H.B. NO. 1114
44 THIRTY-THIRD LEGISLATURE, 2025
55 STATE OF HAWAII
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77 HOUSE OF REPRESENTATIVES
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99 H.B. NO.
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1313 THIRTY-THIRD LEGISLATURE, 2025
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1717 STATE OF HAWAII
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3131 A BILL FOR AN ACT
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3737 RELATING TO HARM REDUCTION.
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4343 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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4646
4747 SECTION 1. The legislature finds that sharing injection equipment among individuals who use drugs is a major contribution to the spread of human immunodeficiency viruses, hepatitis B, hepatitis C, and other serious bloodborne infections. Act 152, Session Laws of Hawaii 1992, authorized the establishment of the first state-funded sterile needle and syringe exchange program in the United States. The program has aimed to prevent the transmission of bloodborne pathogens and to provide individuals who inject drugs with services such as referrals to appropriate health and social services, thereby reducing overall disease burden in 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 healthcare 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, lower 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, 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. "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" means any controlled substance, as the term is 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 month 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 these exceptions apply to any needles, syringes, or authorized objects delivered between syringe exchange participants, between a syringe exchange participant and an individual who is neither a syringe exchange participant nor program staff, between individuals who are neither syringe exchange participants nor program staff, or between such an individual and 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 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. INTRODUCED BY: _____________________________ BY REQUEST
4848
4949 SECTION 1. The legislature finds that sharing injection equipment among individuals who use drugs is a major contribution to the spread of human immunodeficiency viruses, hepatitis B, hepatitis C, and other serious bloodborne infections. Act 152, Session Laws of Hawaii 1992, authorized the establishment of the first state-funded sterile needle and syringe exchange program in the United States. The program has aimed to prevent the transmission of bloodborne pathogens and to provide individuals who inject drugs with services such as referrals to appropriate health and social services, thereby reducing overall disease burden in Hawaii.
5050
5151 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 healthcare 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."
5252
5353 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, lower 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.
5454
5555 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.
5656
5757 The Model Syringe Services Program Act, 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.
5858
5959 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.
6060
6161 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.
6262
6363 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.
6464
6565 SECTION 2. Section 325-111, Hawaii Revised Statutes, is amended as follows:
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6767 1. By adding five new definitions to be appropriately inserted and to read as follows:
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6969 ""Authorized objects" means objects authorized by the department, by rule, for dissemination to syringe exchange participants for the purpose of reducing infection or injury. "Authorized objects" may include, but are not limited to, cookers, cottons, or ties.
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7171 "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.
7272
7373 "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.
7474
7575 "Residue" means any controlled substance, as the term is defined in section 329-1, in an amount less than 0.05 milliliter.
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7777 "Syringe exchange participant" means an injection drug user who receives a sterile needle and syringe pursuant to the program."
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7979 2. By repealing the definition of "participant".
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8181 [""Participant" means an injection drug user who exchanges a sterile needle and syringe unit pursuant to the program."]
8282
8383 SECTION 3. Section 325-113, Hawaii Revised Statutes, is amended to read as follows:
8484
8585 "[[]§325-113[]] Operation of the program. (a) The program shall be operated for the purpose of:
8686
8787 (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
8888
8989 (2) Providing [injection] drug users with referrals to appropriate health and social services.
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9191 (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.
9292
9393 (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.
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9595 (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.
9696
9797 (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.
9898
9999 (f) The program shall include services to:
100100
101101 (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
102102
103103 (2) Offer substance [abuse] use disorder treatment referral and counseling services to all non-injection drug users and syringe exchange participants.
104104
105105 (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."
106106
107107 SECTION 4. Section 325-114, Hawaii Revised Statutes, is amended to read as follows:
108108
109109 "[[]§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.
110110
111111 (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.
112112
113113 (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 month 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.
114114
115115 (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 these exceptions apply to any needles, syringes, or authorized objects delivered between syringe exchange participants, between a syringe exchange participant and an individual who is neither a syringe exchange participant nor program staff, between individuals who are neither syringe exchange participants nor program staff, or between such an individual and program staff.
116116
117117 (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.
118118
119119 [(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."
120120
121121 SECTION 5. Section 325-116, Hawaii Revised Statutes, is amended to read as follows:
122122
123123 "[[]§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:
124124
125125 (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;
126126
127127 (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;
128128
129129 (3) Impact of the program on needle and syringe sharing and other high risk behavior;
130130
131131 (4) Data on syringe exchange participants regarding HIV testing, counseling, drug treatment, and other social services, including referrals for HIV testing and counseling and for [drug abuse] substance use disorder treatment;
132132
133133 (5) Impact on the transmission of HIV infection among injection drug users;
134134
135135 (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;
136136
137137 (7) An assessment of the cost-effectiveness of the program versus direct and indirect costs of HIV infection; and
138138
139139 (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.
140140
141141 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."
142142
143143 SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
144144
145145 SECTION 7. This Act shall take effect upon its approval.
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147147
148148
149149 INTRODUCED BY: _____________________________
150150 BY REQUEST
151151
152152 INTRODUCED BY:
153153
154154 _____________________________
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157157
158158
159159
160160 BY REQUEST
161161
162162 Report Title: Department of Health; Sterile Needle and Syringe Exchange Program; Needs-Based Distribution; Non-Injection Drug User Participation; Liability Description: Repeals the one-to-one syringe limit for the needle exchange program. Authorizes the Sterile Needle and Syringe Exchange Program to provide needs-based distribution. Authorizes non-injection drug user participation in the Program. Modifies liability for exchange program participants, staff, and law enforcement officers. The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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170170 Report Title:
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172172 Department of Health; Sterile Needle and Syringe Exchange Program; Needs-Based Distribution; Non-Injection Drug User Participation; Liability
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174174
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176176 Description:
177177
178178 Repeals the one-to-one syringe limit for the needle exchange program. Authorizes the Sterile Needle and Syringe Exchange Program to provide needs-based distribution. Authorizes non-injection drug user participation in the Program. Modifies liability for exchange program participants, staff, and law enforcement officers.
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186186 The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.