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Second Regular Session

Sixty-first General Assembly

LLS NO. 98­0374.01 JAP SENATE BILL 98­099

STATE OF COLORADO

BY SENATOR Wham;

also REPRESENTATIVES Tool and Entz .

ENGROSSED

JUDICIARY

A BILL FOR AN ACT

CONCERNING AUTHORIZATION OF LOCALLY ADMINISTERED HARM­REDUCTION PROGRAMS TO REDUCE THE TRANSMISSION OF BLOOD­BORNE COMMUNICABLE DISEASES, AND, IN CONNECTION THEREWITH, AUTHORIZING LOCAL NEEDLE EXCHANGE PROGRAMS THAT INCLUDE INTERVENTION AND EDUCATION STRATEGIES.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.)

Recognizes the dangers of blood­borne diseases communicated through injection drug use.

Allows any not­for­profit organization or local health department to submit a program implementation plan for operation of a needle exchange program to the state department of public health and environment. Requires the department to review and either deny or approve the plan within 60 days, based on whether the plan meets the statutory and regulatory requirements for needle exchange program implementation plans.

Following department approval of a program implementation plan, allows the entity seeking to operate the program to submit the plan to the governing body of the county, city and county, or municipality in which the program would operate. Authorizes the governing body of the local government to impose requirements on the implementation plan in addition to the statutory and regulatory requirements. Following any necessary revisions of the plan, provides that the governing body may approve the plan by resolution. Allows the governing body to rescind the authorization at any time.

On receipt of an approved program implementation plan, requires the governing body of a county or city and county to transmit a copy of the program implementation plan to the county board of health or other designated regulatory body for review and recommendations. Requires the governing body to hold a public hearing for comment on the program implementation plan prior to taking final action to authorize or deny the program. If the governing body does not adopt a resolution authorizing the program, prohibits the not­for­profit organization or local health department from submitting another plan for at least 6 months.

Specifies the minimum requirements for a program implementation plan. Instructs the state board of health to adopt guidelines for program implementation plans and the form and type of information that each operating needle exchange program shall submit.

Requires each operating needle exchange program to submit an operating report to the department of public health and environment. Instructs the department to prepare a summary report for the general assembly. Requires each needle exchange program to submit an annual operating report to the governing body of the jurisdiction in which the program operates. Instructs the governing body to allow for public comment on the report. Repeals the authorization of needle exchange programs, effective July 1, 2001.

Adds needle exchange program identification cards to the list of instruments the false creation of which constitutes forgery.

Exempts participants in and volunteers and employees of a needle exchange program from the criminal provisions prohibiting possession and transfer of drug paraphernalia.

Makes a conforming amendment.

Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.  Article 4 of title 25, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW PART to read:

PART 19

NEEDLE EXCHANGE PROGRAMS

25­4­1901.  Legislative declaration. (1)  THE GENERAL ASSEMBLY HEREBY FINDS THAT:

(a)  INJECTION DRUG USERS WHO SHARE NEEDLES ARE AT INCREASED RISK OF CONTRACTING HIV, HEPATITIS B AND C, AND OTHER DEVASTATING BLOOD­BORNE COMMUNICABLE DISEASES THAT ARE OFTEN TRANSMITTED TO SEXUAL PARTNERS AND UNBORN CHILDREN;

(b)  INJECTION DRUG USE IS RESPONSIBLE FOR THE GREATEST NUMBER OF NEW HIV AND HEPATITIS B AND C INFECTIONS IN THE HETEROSEXUAL POPULATION;

(c)  RESEARCH HAS DEMONSTRATED THAT NEEDLE EXCHANGE PROGRAMS THAT INCLUDE EDUCATION AND COUNSELING CAN REDUCE THE TRANSMISSION OF HIV, HEPATITIS B AND C, AND OTHER BLOOD­BORNE DISEASES AMONG DRUG USERS AND THE PREPONDERANCE OF EVIDENCE INDICATES THAT SUCH PROGRAMS DO NOT RESULT IN INCREASED LEVELS OF INJECTION DRUG USE IN AREAS WHERE SUCH PROGRAMS EXIST;

(d)  NEEDLE EXCHANGE PROGRAMS CAN OFFER A BRIDGE TO DRUG TREATMENT, HIV PREVENTION INFORMATION, AND MEDICAL SUPPORT SERVICES FOR HARD­TO­REACH POPULATIONS WHO MIGHT NOT OTHERWISE RECEIVE SUCH SERVICES;

(e)  IMPLEMENTATION OF NEEDLE EXCHANGE PROGRAMS IS A MATTER OF MIXED STATEWIDE AND LOCAL CONCERN AND THAT LOCAL GOVERNMENTS AND HEALTH AGENCIES ARE IN THE BEST POSITION TO OVERSEE SUCH PROGRAMS IN COOPERATION WITH THE STATE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT AND THE STATE BOARD OF HEALTH.

25­4­1902.  Definitions. AS USED IN THIS PART 19, UNLESS THE CONTEXT OTHERWISE REQUIRES:

(1)  "DEPARTMENT" MEANS THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT CREATED IN SECTION 25­1­102.

(2)  "GOVERNING BODY OF A LOCAL GOVERNMENT" FOR A COUNTY MEANS THE BOARD OF COUNTY COMMISSIONERS AND FOR A CITY AND COUNTY OR A MUNICIPALITY MEANS THE CITY COUNCIL.

(3)  "IDENTIFICATION CARD" MEANS A CARD ISSUED BY A NEEDLE EXCHANGE PROGRAM PURSUANT TO SECTION 25­4­1906 TO IDENTIFY PERSONS WHO ARE LEGITIMATELY PARTICIPATING IN, VOLUNTEERING WITH, OR EMPLOYED BY THE NEEDLE EXCHANGE PROGRAM.

(4)  "LOCAL GOVERNMENT" MEANS A COUNTY, A CITY AND COUNTY, OR A MUNICIPALITY.

(5)  "LOCAL HEALTH DEPARTMENT" MEANS A COUNTY OR DISTRICT HEALTH DEPARTMENT ESTABLISHED PURSUANT TO SECTION 25­1­501.

(6)  "NEEDLE EXCHANGE PROGRAM" MEANS A PROGRAM APPROVED BY THE DEPARTMENT PURSUANT TO SECTION 25­4­1903, AUTHORIZED BY A LOCAL GOVERNMENT PURSUANT TO SECTION 25­4­1904, AND OPERATED BY A NOT­FOR­PROFIT ORGANIZATION OR A LOCAL HEALTH DEPARTMENT THAT IS TARGETED AT INJECTION DRUG USERS AND:

(a)  ENCOURAGES INJECTION DRUG USERS TO SEEK TREATMENT FOR SUBSTANCE ABUSE;

(b)  PROVIDES REFERRALS FOR SUBSTANCE ABUSE TREATMENT AND OTHER PREVENTIVE HEALTH CARE SERVICES FOR PARTICIPANTS IN THE PROGRAM; AND

(c)  PROVIDES FOR THE ONE­FOR­ONE EXCHANGE OF USED SYRINGES FOR STERILE SYRINGES.

(7)  "STATE BOARD" MEANS THE STATE BOARD OF HEALTH CREATED IN SECTION 25­1­103.

25­4­1903.  Needle exchange program ­ state approval. (1)  ANY NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT MAY APPLY TO PROVIDE A NEEDLE EXCHANGE PROGRAM IN ANY JURISDICTION BY SUBMITTING TO THE DEPARTMENT A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN THAT COMPLIES WITH THE REQUIREMENTS SPECIFIED IN SECTION 25­4­1905 AND THE GUIDELINES ADOPTED BY THE STATE BOARD PURSUANT TO SECTION 25­4­1905.

(2)  ON RECEIPT OF A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN, THE DEPARTMENT SHALL REVIEW THE PLAN. IF THE DEPARTMENT DETERMINES THAT THE PROGRAM IMPLEMENTATION PLAN MEETS THE REQUIREMENTS SPECIFIED IN SECTION 25­4­1905 AND THE GUIDELINES ADOPTED BY THE STATE BOARD PURSUANT TO SECTION 25­4­1905, THE DEPARTMENT SHALL APPROVE THE PLAN AND RETURN IT TO THE SUBMITTING ENTITY. THE DEPARTMENT SHALL EITHER DENY OR APPROVE AND RETURN THE PROGRAM IMPLEMENTATION PLAN WITHIN SIXTY DAYS AFTER THE PLAN IS SUBMITTED.

25­4­1904.  Needle exchange program ­ local government authorization ­ public hearing. (1) (a)  AFTER A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN IS APPROVED BY THE DEPARTMENT PURSUANT TO SECTION 25­4­1903, THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT PROPOSING TO PROVIDE THE NEEDLE EXCHANGE PROGRAM SHALL SUBMIT THE PLAN TO THE GOVERNING BODY OF THE LOCAL GOVERNMENT FOR THE JURISDICTION IN WHICH THE PROGRAM WOULD OPERATE. THE GOVERNING BODY, ACTING COLLECTIVELY OR THROUGH A DESIGNEE, MAY IMPOSE RESTRICTIONS ON AND REQUIREMENTS FOR OPERATION OF THE NEEDLE EXCHANGE PROGRAM IN ADDITION TO THOSE IMPOSED PURSUANT TO SECTION 25­4­1905, SO LONG AS SAID RESTRICTIONS AND REQUIREMENTS DO NOT CONFLICT WITH ANY REQUIREMENTS IMPOSED PURSUANT TO SECTION 25­4­1905 OR THE GUIDELINES ADOPTED BY THE STATE BOARD PURSUANT TO SAID SECTION.

(b)  FOLLOWING ANY NECESSARY REVISION OF A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN RECEIVED PURSUANT TO PARAGRAPH (a) OF THIS SUBSECTION (1), THE GOVERNING BODY OF THE LOCAL GOVERNMENT MAY TAKE FINAL ACTION TO AUTHORIZE OPERATION OF THE NEEDLE EXCHANGE PROGRAM WITHIN ITS JURISDICTION BY ADOPTING A RESOLUTION TO THAT EFFECT. THE GOVERNING BODY MAY REPEAL THE AUTHORIZATION FOR THE NEEDLE EXCHANGE PROGRAM AT ANY TIME.

(2)  ON RECEIPT OF A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN PURSUANT TO SUBSECTION (1) OF THIS SECTION, THE GOVERNING BODY OF THE LOCAL GOVERNMENT OR ITS DESIGNEE SHALL TRANSMIT A COPY OF THE PLAN TO THE COUNTY BOARD OF HEALTH OR OTHER REGULATORY BODY DESIGNATED BY THE GOVERNING BODY TO GOVERN HEALTH ISSUES; EXCEPT THAT, IF THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT SUBMITS THE PLAN TO THE GOVERNING BODY OF A MUNICIPALITY, THE GOVERNING BODY NEED NOT TRANSMIT A COPY OF THE PLAN TO ANY REGULATORY BODY. THE COUNTY BOARD OF HEALTH OR OTHER REGULATORY BODY SHALL SUBMIT RECOMMENDATIONS TO THE GOVERNING BODY OR ITS DESIGNEE REGARDING AUTHORIZATION OR DENIAL OF THE PROGRAM IMPLEMENTATION PLAN.

(3)  PRIOR TO TAKING FINAL ACTION TO AUTHORIZE OR DENY A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN, THE GOVERNING BODY OF THE LOCAL GOVERNMENT SHALL HOLD A PUBLIC HEARING, AFTER NOTICE, TO PROVIDE AN OPPORTUNITY FOR PUBLIC COMMENT ON THE PLAN.

(4)  IF THE GOVERNING BODY OF THE LOCAL GOVERNMENT DOES NOT EITHER ADOPT A RESOLUTION AUTHORIZING THE NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN OR DENY THE PLAN WITHIN ONE HUNDRED EIGHTY DAYS AFTER THE PLAN IS SUBMITTED TO THE GOVERNING BODY, THE PLAN SHALL BE DEEMED DENIED, UNLESS THE GOVERNING BODY AND THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT THAT SUBMITTED THE PLAN HAVE MUTUALLY AGREED TO EXTEND THE PERIOD FOR CONSIDERATION. THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT MAY NOT SUBMIT A REVISED PLAN TO THE GOVERNING BODY FOR AT LEAST SIX MONTHS AFTER DENIAL OF THE PREVIOUS PLAN.

(5)  IN DEVELOPING A NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN, A NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT SHALL CONSULT WITH THE LOCAL LAW ENFORCEMENT AGENCIES LOCATED WITHIN THE JURISDICTION TO WHICH THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT SUBMITS AN APPLICATION. IN ADDITION, THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT IS ENCOURAGED TO CONSULT WITH OTHER APPROPRIATE LOCAL ENTITIES AND PARTICIPANTS, INCLUDING BUT NOT LIMITED TO THE COUNTY BOARD OF HEALTH, THE LOCAL HEALTH DEPARTMENT, THE LOCAL GOVERNMENT, AND SUBSTANCE ABUSE AND HIV HEALTH SERVICES PROVIDERS LOCATED WITHIN THE JURISDICTION OF THE LOCAL GOVERNMENT TO WHICH THE NOT­FOR­PROFIT ORGANIZATION OR LOCAL HEALTH DEPARTMENT SUBMITS AN APPLICATION.

(6)  ANY PERSON PARTICIPATING IN, VOLUNTEERING WITH, OR EMPLOYED BY A NEEDLE EXCHANGE PROGRAM WHO HOLDS A VALID IDENTIFICATION CARD ISSUED PURSUANT TO SECTION 25­4­1906 SHALL BE EXEMPT FROM THE PROVISIONS OF SECTIONS 18­18­428 AND 18­18­429, C.R.S., AS PROVIDED IN SECTION 18­18­430.5, C.R.S.

25­4­1905.  Program implementation plans ­ minimum requirements ­ guidelines. (1)  EACH NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLAN SUBMITTED TO THE DEPARTMENT PURSUANT TO SECTION 25­4­1903 AND TO THE GOVERNING BODY OF A LOCAL GOVERNMENT PURSUANT TO SECTION 25­4­1904 SHALL INCLUDE, BUT SHALL NOT BE LIMITED TO, THE LOCATION OF THE PROGRAM, THE GEOGRAPHIC AREA TO BE SERVED, AND THE METHOD OF PROGRAM OPERATION. IN ADDITION, THE PROGRAM IMPLEMENTATION PLAN SHALL INCLUDE THE INFORMATION REQUIRED UNDER GUIDELINES ADOPTED BY THE STATE BOARD PURSUANT TO SUBSECTION (2) OF THIS SECTION.

(2)  ON OR BEFORE OCTOBER 1, 1998, THE STATE BOARD SHALL ADOPT GUIDELINES FOR NEEDLE EXCHANGE PROGRAM IMPLEMENTATION PLANS. AT A MINIMUM, THE GUIDELINES SHALL ADDRESS:

(a)  THE DESIGN AND PROTOCOLS OF A NEEDLE EXCHANGE PROGRAM;

(b)  THE PROPER SAFEGUARDING, HANDLING, AND DISPOSAL OF HYPODERMIC SYRINGES AND NEEDLES;

(c)  THE PROVISION TO NEEDLE EXCHANGE PROGRAM PARTICIPANTS OF EDUCATION AND COUNSELING, INCLUDING REFERRALS FOR HEPATITIS AND HIV TRANSMISSION PREVENTION AND HARM REDUCTION, SUBSTANCE ABUSE TREATMENT, HEPATITIS AND HIV TESTING AND TREATMENT, AND OTHER PREVENTATIVE HEALTH SERVICES;

(d)  REASONABLE, STANDARDIZED REPORTING CRITERIA FOR NEEDLE EXCHANGE PROGRAMS;

(e)  PROCEDURES FOR MAINTAINING THE CONFIDENTIALITY OF NEEDLE EXCHANGE PROGRAM PARTICIPANTS;

(f)  A STANDARDIZED IDENTIFICATION CARD FORMAT TO BE USED FOR NEEDLE EXCHANGE PROGRAM PARTICIPANTS AND VOLUNTEER WORKERS FOR AND EMPLOYEES OF NEEDLE EXCHANGE PROGRAMS;

(g)  CRITERIA FOR EVALUATING THE SERVICES AND GOALS OF NEEDLE EXCHANGE PROGRAMS.

(3)  ON OR BEFORE OCTOBER 1, 1998, THE STATE BOARD SHALL ADOPT GUIDELINES ESTABLISHING STANDARD REPORTING CRITERIA AND SPECIFYING THE INFORMATION TO BE REPORTED BY EACH NEEDLE EXCHANGE PROGRAM PURSUANT TO SECTION 25­4­1907.

25­4­1906.  Needle exchange program participants, volunteers, and employees ­ identification card. EACH NEEDLE EXCHANGE PROGRAM AUTHORIZED AND OPERATING PURSUANT TO THIS PART 19 SHALL ISSUE AN IDENTIFICATION CARD, IN THE FORM ESTABLISHED THROUGH GUIDELINES ADOPTED BY THE STATE BOARD, TO EACH PARTICIPANT IN THE PROGRAM AND TO EACH PERSON WORKING AS A VOLUNTEER OR AS AN EMPLOYEE WITH THE PROGRAM. ANY NEEDLE EXCHANGE PROGRAM PARTICIPANT, VOLUNTEER, OR EMPLOYEE MAY PRESENT HIS OR HER IDENTIFICATION CARD TO ANY LAW ENFORCEMENT OFFICER TO VERIFY THAT HE OR SHE IS A LEGITIMATE PARTICIPANT IN OR VOLUNTEER OR EMPLOYEE WITH THE PROGRAM AND THEREFORE EXEMPT FROM THE PROVISIONS OF SECTIONS 18­18­428 AND 18­18­429, C.R.S., AS PROVIDED IN SECTION 18­18­430.5, C.R.S.

25­4­1907.  Report ­ operations. (1)  ON OR BEFORE DECEMBER 31, 2000, EACH NEEDLE EXCHANGE PROGRAM AUTHORIZED AND OPERATING PURSUANT TO THIS PART 19 SHALL SUBMIT TO THE DEPARTMENT A REPORT REGARDING THE OPERATIONS OF THE PROGRAM. THE DEPARTMENT SHALL COMPILE THE REPORTS AND SUBMIT A SUMMARY OF THE NEEDLE EXCHANGE PROGRAM REPORTS TO THE GENERAL ASSEMBLY ON OR BEFORE JANUARY 31, 2001.

(2)  ON OR BEFORE OCTOBER 1, 1999, AND EACH OCTOBER 1 THEREAFTER, EACH NEEDLE EXCHANGE PROGRAM SHALL SUBMIT A REPORT OF THE OPERATIONS OF THE PROGRAM TO THE GOVERNING BODY OF THE LOCAL GOVERNMENT IN WHICH THE PROGRAM IS AUTHORIZED AND TO THE COUNTY BOARD OF HEALTH OR OTHER REGULATORY BODY DESIGNATED BY THE GOVERNING BODY. THE GOVERNING BODY SHALL ANNUALLY PROVIDE AN OPPORTUNITY FOR PUBLIC COMMENT ON THE OPERATIONS OF THE NEEDLE EXCHANGE PROGRAM. THE GOVERNING BODY IS ENCOURAGED TO SOLICIT COMMENT FROM THE COUNTY BOARD OF HEALTH, THE LOCAL HEALTH DEPARTMENT, THE LOCAL GOVERNMENT, LOCAL LAW ENFORCEMENT AGENCIES, AND SUBSTANCE ABUSE AND HIV HEALTH SERVICES PROVIDERS IN THE JURISDICTION OF THE LOCAL GOVERNMENT IN WHICH THE NEEDLE EXCHANGE PROGRAM IS OPERATING.

25­4­1908.  Repeal of part. THIS PART 19 IS REPEALED, EFFECTIVE JULY 1, 2001.

SECTION 2.  The introductory portion to 18­5­102 (1), Colorado Revised Statutes, is amended, and the said 18­5­102 (1) is further amended BY THE ADDITION OF A NEW PARAGRAPH, to read:

18­5­102.  Forgery. (1)  A person commits forgery, if, with intent to defraud, such person falsely makes, completes, alters, or utters a written instrument which THAT is or purports to be, or which THAT is calculated to become or to represent if completed:

(h)  A NEEDLE EXCHANGE PROGRAM IDENTIFICATION CARD ISSUED PURSUANT TO SECTION 25­4­1906, C.R.S.

SECTION 3.  Part 4 of article 18 of title 18, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW SECTION to read:

18­18­430.5.  Drug paraphernalia ­ exemptions ­ repeal. (1)  IT SHALL CONSTITUTE AN EXCEPTION TO THE PROVISIONS OF SECTIONS 18­18­428 AND 18­18­429 IF:

(a)  A PERSON WHO IS IN POSSESSION OF A HYPODERMIC SYRINGE OR NEEDLE FOR THE PURPOSE OF INJECTING A CONTROLLED SUBSTANCE OBTAINED THE SYRINGE OR NEEDLE THROUGH A NEEDLE EXCHANGE PROGRAM AUTHORIZED AND OPERATING PURSUANT TO PART 19 OF ARTICLE 4 OF TITLE 25, C.R.S., AND THE PERSON IS LEGITIMATELY PARTICIPATING IN THE NEEDLE EXCHANGE PROGRAM AS EVIDENCED BY POSSESSION OF AN IDENTIFICATION CARD ISSUED TO THE PERSON PURSUANT TO SECTION 25­4­1906, C.R.S.; OR

(b)  A PERSON WHO IS IN POSSESSION OF A HYPODERMIC SYRINGE OR NEEDLE OR DELIVERS A HYPODERMIC SYRINGE OR NEEDLE TO ANOTHER PERSON FOR THE PURPOSE OF INJECTING A CONTROLLED SUBSTANCE IS VOLUNTEERING FOR OR EMPLOYED BY A NEEDLE EXCHANGE PROGRAM AUTHORIZED AND OPERATING PURSUANT TO PART 19 OF ARTICLE 4 OF TITLE 25, C.R.S., AND THE PERSON POSSESSES AN IDENTIFICATION CARD ISSUED TO HIM OR HER PURSUANT TO SECTION 25­4­1906, C.R.S., EVIDENCING SUCH VOLUNTEER OR EMPLOYEE STATUS.

(2)  THIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2001.

SECTION 4.  The introductory portion to 18­18­426, Colorado Revised Statutes, is amended to read:

18­18­426.  Drug paraphernalia ­ definitions. As used in sections 18­18­425 to 18­18­430 TO 18­18­430.5, unless the context otherwise requires:

SECTION 5.  Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.