No. 42177 (Amendment): Rule R386-900. Special Measures for the Operation of Syringe Exchange Programs

(Amendment)

DAR File No.: 42177
Filed: 10/02/2017 09:00:37 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The reason for the change is to provide clarification on syringe exchange programs and requirements.

Summary of the rule or change:

This change clarifies the purpose of the syringe exchange program and provides additional clarification on operating requirements for entities operating syringe exchange programs.

Statutory or constitutional authorization for this rule:

• Section 26-7-8

This rule or change incorporates by reference the following material:

• Adds Syringe Services Program (SSP) Development and Implementation Guidelines for State and Local Health Departments, published by National Alliance of State & Territorial AIDS Directors, 2012
• Adds Guide to Developing and Managing Syringe Access Programs, published by Harm Reduction Coalition, 2010

Anticipated cost or savings to:

the state budget:

These revisions provide clarification only and do not add additional requirements that impact the state budget. The Department of Health (Department) is utilizing 1.0 FTE in federal funds to monitor, analyze, and report on syringe exchange programs throughout the state = $54,329.60 (personnel and fringe).

local governments:

These revisions provide clarification only and do not add additional requirements to impact local governments. Anticipated costs if a local health department chooses to operate a syringe exchange program include, but are not limited to: personnel costs, educational materials, syringes, and sharps disposals.

small businesses:

These revisions provide clarification only and do not add additional requirements to impact small businesses. Anticipated costs if a small business chooses to operate a syringe exchange program include, but are not limited to: personnel costs, educational materials, syringes, and sharps disposals.

persons other than small businesses, businesses, or local governmental entities:

These revisions provide clarification only and do not add additional requirements to impact businesses. Anticipated costs if a business chooses to operate a syringe exchange program include, but are not limited to: personnel costs, educational materials, syringes, and sharps disposals.

Compliance costs for affected persons:

These revisions provide clarification only and do not add additional requirements that impact affected persons. Minimal personnel costs for entities operating a syringe exchange program for completing mandatory reporting forms and faxing/emailing forms to the Department.

Comments by the department head on the fiscal impact the rule may have on businesses:

The proposed amendment clarifies a syringe exchange program includes not only the syringe but also other materials such as cotton filters, cookers, tourniquets, alcohol swabs, and condoms. The amendment clarifies operating requirements of a syringe exchange program. It also incorporates by reference a "Guide to Developing and Managing Syringe Access Programs", and the "Syringe Services Program, (SSP) Development and Implementation Guidelines for State and Local Health Departments" published by the National Alliance of State and Territorial AIDS Directors, 2012. The revisions are clarifications with no additional requirements so there will be no fiscal impact on any business choosing to operate a syringe exchange program.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Disease Control and Prevention, Epidemiology
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Erin Fratto at the above address, by phone at 801-538-6701, by FAX at , or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/14/2017

This rule may become effective on:

11/21/2017

Authorized by:

Joseph Miner, Executive Director

RULE TEXT

R386. Health, Disease Control and Prevention, Epidemiology.

R386-900. Special Measures for the Operation of Syringe Exchange Programs.

R386-900-1. Authority.

This rule is authorized under Utah Code 26-7-8.

 

R386-900-2. Purpose.

This rule establishes operating and reporting requirements required of an entity operating a syringe exchange pursuant to 26-7-8.

 

R386-900-3. Definitions.

The following definitions apply to this rule:

(1) "Department" means the Utah Department of Health Bureau of Epidemiology Prevention, Treatment and Care Program.

(2) "Syringe exchange" [is defined in 26-7-8.]is a community-based program that provides access to sterile syringes and and other clean and new prevention materials, including, but not limited to, cotton filters, cookers, tourniquets, alcohol swabs, and/or condoms, collects and properly disposes of used syringes, and provides information and referrals and other services as identified by population and community needs to reduce the harms associated with injection drug use; consistent with;

(a) the "Department of Health and Human Services Implementation Guidance to Support Certain Components of Syringe Services Programs, 2016" HHS 3/29/2016

(b) the CDC Syringe Services Programs standards and definitions.

(3) "Operating entity" is defined in 26-7-8.

(4) "HIV" means human immunodeficiency virus.

(5) "HCV" means hepatitis C virus.

(6) "HBV" means hepatitis B virus.

(7) "Opiate antagonist" is defined by Chapter 55, Opiate Overdose Response Act.

 

R386-900-4. Operating Requirements.

(1) An operating entity intending to begin syringe exchange programming within a local community shall meet with local stakeholders, which should include: public health, mental health, substance abuse, law enforcement, local governing body, community councils, etc. This meeting should provide education on the purpose and goals of a syringe exchange program, syringe exchange protocols, awareness of operating entity's plans and community partnerships and will assess community readiness, norms, needs and parameters for implementing syringe exchange in that area. The operating entity shall provide UDOH meeting summary(s) which should include: participants, what was discussed, outcomes and plans for implementation. This documentation must be submitted for each major area where exchange will be conducted upon enrollment and submitted 30 days prior to the initiation of syringe exchange program operation in a new area.

[(1)](2) An operating entity shall utilize the department's enrollment form to provide written notice of intent to conduct syringe exchange activities to the department 15 days prior to conducting syringe exchange activities. If an operating entity discontinues syringe exchange activities, written notice shall also be submitted utilizing the department's report form within 15 days of termination of activities to the department.

[(2)](3) An operating entity must submit a safety protocol to the department for the prevention of needlestick and sharps injury before initiating syringe exchange activities.

[(3)](4) An operating entity shall submit a sharps disposal plan to the department. Sharps disposal is the financial responsibility of the entity operating and responsible for the syringe exchange program.

[(4)](5) An operating entity shall facilitate the exchange of an individuals used syringes by providing a disposable, medical grade sharps container for the disposal of used syringes.

[(5)](6) [The operating entity shall exchange one or more new syringes in sealed sterile packages to the individual free of charge.]The operating entity shall exchange one or more new syringes in sealed sterile packages and may provide other clean and new prevention materials to the individual free of charge.

[(6)](7) As available, the department will provide syringes, education materials, and other resources to entities operating a syringe exchange program.

[(7)](8) An operating entity must provide and make available to all recipients of new syringe(s) verbal and written instruction on:

(a) Methods for preventing the transmission of blood borne pathogens, including HIV, HBV and HCV;

(b) Information and referral to drug and alcohol treatment;

(c) Information and referral for HIV and HCV testing; and

(d) How and where to obtain an opiate antagonist.

(9) The Department incorporates by reference the "Guide to Developing and Managing Syringe Access Programs", Harm Reduction Coalition, 2010.

(10) The Department incorporates by reference the " Syringe Services Program (SSP) Development and Implementation Guidelines for State and Local Health Departments" National Alliance of State & Territorial AIDS Directors, 2012.

 

R386-900-5. Reporting Requirements.

(1) All entities operating a syringe exchange program shall report aggregate data elements in accordance to 26-7-8 to the department on a quarterly basis, utilizing the format provided by the department which is to include:

(a) Number of individuals who have exchanged syringes,

(b) A self-reported or approximated number of used syringes exchanged for new syringes,

(c) Number of new syringes provided in exchange for used syringes,

(d) Educational materials distributed; and

(e) Number of referrals provided.

 

R386-900-6. Penalty.

(1) Any person who violates any provision of R386-900 may be assessed a penalty as provided in section 26-23-6.

 

R386-900-7. Official References.

(1) Centers for Disease Control and Prevention (CDC), 2016, Program Guidance for Implementing Certain Components of Syringe Services Programs.

(2) Federal Register, Health and Human Services Department, 2011, Determination That a Demonstration Needle Exchange Program Would be Effective in Reducing Drug Abuse and the Risk of Acquired Immune Deficiency Syndrome Infection Among Intravenous Drug Users.

(3) Harm Reduction Coalition, 2006, Syringe Exchange Programs and Hepatitis C.

(4) Harm Reduction Coalition, 2006, Syringe Exchange Programs: Reducing the Risks of Needlestick Injuries.

(5) Substance Abuse and Mental Health Services Administration (SAMHSA), Summary of Syringe Exchange Program Studies.

(6) United States Department of Health and Human Services (HHS), 2016, Implementation Guidance to Support Certain Components of Syringe Services Programs.

(7) World Health Organization (WHO), 2004, Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users.

 

KEY: syringe exchange programs, needles, syringes

Date of Enactment or Last Substantive Amendment: [November 7, 2016]2017

Authorizing, and Implemented or Interpreted Law: 26-7-8

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