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B001-9899

10		AN ACT concerning
	20	Local HIV Prevention Initiative

FOR the purpose of authorizing1 with certain exceptions, counties to
establish an AIDS prevention sterile needle and syringe exchange program;
specifying the goals and objectives of a needle exchange program;
specifying the duties and responsibilities of the director of the needle
exchange program under this Act; providing for the appointment of a
certain advisory committee; specifying membership, duties, and
responsibilities of an advisory committee; providing certain immunities
for certain persons; restricting the disclosure or release of certain
program information; and generally relating to the authorization for the
establishment of a local needle exchange program in each county.

BY adding to
Article - Health - Genera]
Section 24-901 through 24-909 to be under the new subtitle
"Subtitle 9. Statewide Local Needle Exchange program;"
Annotated Code of Maryland
(1996 Replacement Volume and 1997 Supplement)


SECTION 1. BE IT ENACTED BY THE MARYLAND STUDENT LEGISLATURE,
That the Laws of Maryland read as follows

	190	Article - Health - General

200	SUBTITLE 9. STATEWIDE LOCAL NEEDLE EXCHANGE PROGRAM

210	2~9Ol

(A)	IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED.

(B)	"CHIEF EXECUTIVE OFFICER" MEANS THE CHIEF EXECUTIVE OFFICER OF A
COUNTY OR, 'F THE COUNTY DOES NOT ELECT A
CHIEF EXECUTIVE OFFICEW THE PRESIDING OFFICER OF THE LOCAL GOVERNING BODY.


(C)	"HIV" MEANS THE HUIAN IMIUNODEFICIENCY VIRUS THAT CAUSES ACQUIRED
IMMUNE DEFICIENCY SYNDROME (AIDS)
   


	300	(D)	"PARTICIPANT" MEANS AN INDIVIDUAL WHO HAS
REGISTERED
	310		WITH THE PROGRAM

(E)	"PROGRAM" MEANS THE AIDS PREVENTION STERILE NEEDLE AND SYRINGE
EXCHANGE PROGRAM.

(F)	"RESIDUE" MEANS THE DRIED REMAINS OF A CONTROLLED DANGEROUS
SUBSTANCE ATTACHED TO OR CONTAINED WITHIN A
HYPODERMIC NEEDLE OR SYRINGE

	370	2~9O2

 (A)	(1)  A COUNTY MAY ESTABLISH AN AIDS PREVENTION STERILE NEEDLE AND
SYRINGE EXCHANGE PROGRAM, SUBJECT TO THE PROVISIONS OF THIS SUBTITLE

410		(2)	BALTIMORE CITY IS EXEMPT FROM THE PROVISIONS OF
THIS
420			SUB TITLE:
	430	(B)  THE PROGRAM SHALL

(1)	PROVIDE FOR THE ONE-FOR-ONE EXCHANGE BY
PARTICIPANTS OF USED HYPODERMIC NEEDLES AND SYRINGES FOR STERILE
HYPODERMIC NEEDLES AND SYRINGES, AND

(2)	OPERATE IN ACCORDANCE WITH THE PROCEDURES APPROVED, WITH THE
APPROVAL OF THE ADVISORY
	COMMITTEE. BY THE COUNTY HEALTH OFFICER.

	510	2~9O3
	520	THE PROGRAM SHALL

(1)	BE DESIGNED AND MAINTAINED TO PROVIDE MAXMUM SECURITY OF EXCHANGE
LOCATIONS AND EQUIPMENT, INCLUDING SECURITY MEASURES THAT MAY BE REQUIRED
TO CONTROL THE USE AND DISPERSAL OF HYPODERMIC NEEDLES AND SYRINGES AND
SECURITY MEASURES THAT ALLOW FOR A FULL ACCOUNTING OF THE NUMBER OF
HYPODERMIC NEEDLES AND SYRINGES IN CIRCUL~ON AND THE NUMBER OF HYPODERMIC
NEEDLES AND SYRINGES IN STORAGE
   

	620	(2)	BE OPERATED TO ALLOW PARTICIPANTS TO EXCHANGE
	630		USED HYPODERMIC NEEDLES AND SYRINGES AT ANY
	640		EXCHANGE LOCATION, IF MORE THAN ONE LOCATION IS
	650		AVAILABLE.

 (3)	INCLUDE APPROPRIATE LEVELS OF STAFF EXPERTISE IN WORKING WITH
INJECTING DRUG USERS AND ADEQUATE
STAFF TRAINING IN PROVIDING COMMUNITY REFERRALS, COUNSELING, AND
PREVENTIVE EDUCATION,

 (4)	PROVIDE FOR THE DISSEMINATION OF OTHER PREVENTIVE MEANS FOR
CURTAILING THE SPREAD OF THE HIV INFECTION,

 (5)	PROVIDE REFERRALS TO DRUG COUNSELING AND TREATMENT SERVICES

 (6)	EDUCATE INJECTING DRUG USERS ON THE DANGERS OF CONTRACTING THE HIV
INFECTION OR THE HEPAT~S B VIRUS THROUGH NEEDLE-SHARING PRACTICES AND
UNSAFE SEXUAL BEHAVIORS,


(7)	INCLUDE POLICIES AND PROCEDURES FOR THE SCREENING OF APPLICANTS TO
THE PROGRAM IN ORDER TO PRECLUDE NONINJECTING DRUG USERS FROM
PARTICIPATING IN THE PROGRAM,


(8)	ESTABLISH PROCEDURES FOR IDENTIFYING PROGRAM PARTICIPANTS THAT ARE
CONSISTENT WITH THE CONFIDENTIALITY PROVISIONS OF THIS SUBTITLE, AND


(9)	ESTABLISH A METHOD OF IDENTIFICATION AND AUTHORIZATION FOR PROGRAM
STAPF MEMBERS WHO HAVE ACCESS TO HYPODERMIC NEEDLES, SYRINGES, OR PROGRAM
RECORDS.

890  24-904


(A)	THE CHIEF EXECUTIVE OFFICER OR THE CHIEF EXECUTIVE OFFICER'S
DESIGNEE SHALL APPOINT AN ADVISORY COMMITTEE FOR THE PROGRAM.

930  (B)	THE ADVISORY COMMITTEE SHALL CONSIST OF:
   

950	NOMINATED BY THE SECRETARY OF THE DEPARTMENT OF
960	PUBLIC SAFETY AND CORRECTIONAL SERVICES;


(2)	ONE REPRESENTATIVE FROM THE LOCAL LAW ENFORCEMENT AGENCY.


(3)	ONE REPRESENTATIVE FROM THE DEPARTMENT OF HEALTH AND MENTAL HYGWNE
NOMINATED BY THE SECRETARY OF HEALTH AND MENTAL HYGIENE,

	1020	(4)	ONE REPRESENTATIVE OF AN AIDS ADVOCACY GROUP;
	1030	(5)	ONE DRUG ABUSE TREATMENT COUNSELOR, AND
	1040	(6)	ONE RECOVERING INJECTING DRUG USER.
	1050 (C)  IN ADDITION THE ADVISORY COMMITTEE MAY CONSIST OF:
	1060	(1)	TWO REPRESENTATIVES FROM ACADEMIA WHO SPECIALIZE
	1070		IN PUBLIC HEALTH ISSUES;
	1080	(2)	ONE REPRESENTATIVE OF A COUNTY CO~~NITY GROUP,
	1090		AND
	1100	(3)	OTHER INDIVIDUALS WHOM THE CHIEF EXECUTIVE
	1110		OFFICER OR THE CHIEF EXECUTIVE OFFICER'S DESIGNEE
	1120		DETERMINES TO BE APPROPRIATE FOR APPOINTMENT TO
THE
	1130		ADVISORY COMMITTEE.

1140 (1))  THE ADVISORY COMMITTEE SHALL


(1)	PROVIDE ADVICE TO THE COUNTY HEALTH OFFICER AND THE PROGRAM
DIRECTOR ON DEVELOPING:


(I)	PROGRAM OPERATING PROCEDURES FOR THE FURNISHING, IDENTIFYING, AND
ONE-FOR-ONE EXCHANGE OF HYPODERMIC NEEDLES AND SYRINGES TO INJECTING DRUG
USERS;

	1210	(II)	A PLAN FOR COMMITY OU'REACH AND EDUCATION;

1220	(III) A PROTOCOL FOR REFERRING PROGRAM
1230	PARTICIPANTS TO SUBSTANCE ABUSE TREATMENT AND
1240	REHABILIT~ON; AND
   

1250	(IV) A PLAN FOR EVALUATING THE PROGRAM,

1260
1270
1280
(2)	BEFORE THE PROGRAM BEGINS OPERATING, REVIEW AND MAAE A
RECOMMENDATION TO THE COUNTY HEALTH
OFFICER FOR THE APPROVAL OR DISAPPROVAL OF:


(I)	THE PROGRAM OPERATING PROCEDURES FOR THE FURNISHING AND
ONE-FOR-ONE EXCHANGE OF HYPODERMIC NEEDLES AND SYRINGES TO INJECTING DRUG
USERS;

1330
(II)  THE COMMUNITY OUTREACH AND EDUCATION PLAN;

(III) THE PROTOCOL FOR REFERRING PROGRAM PARTICIPANTS TO SUBSTANCE ABUSE
TREATMENT AND
REIIABILITATION; AND

1370
(IV) THE PLAN FOR EVALUATING THE PROGRAM; AND

(3)	MAKE RECOMMENDATIONS TO THE PROGRAM DIRECTOR OR THE COUNTY HEALTH
OFFICER REGARDING ANY ASPECT OF PROGRAM PROCEDURES, OPERATION, OR
EVALUATION



THE COUNTY HEALTH OFFICER SHALL APPOINT A DIRECTOR FOR THE PROGRAM

WITH THE ADVICE OF THE ADVISORY COMMITTEE, THE DIRECTOR SHALL DEVELOP:
	1410	24-905

1420 (A)
1430
	1440	(B)
1450
	1460	(1)	PROGRAM OPERATING PROCEDURES FOR THE FURNISHING
	1470		AND ONE-FOR-ONE EXCHANGE OF HYPODERMIC NEEDLES
	1480		AND SYRINGES TO INJECTING DRUG USERS,

1490
(2)	A COMMUI~TY OURREACH AND EDUCATION PROGRAM, AND

1500
1510
(3)	A PROTOCOL FOR REFERRING PROGRAM PARTICIPANTS TO SUBSTANCE ABUSE
TREATMENT AND REHABILITATION

THE DIRECTOR SHALL SUBMIT THE OPERATING PROCEDURES, THE
PLAN FOR A COMMIINITY OUTREACH AND EDUCATION PROGRAM,
AND THE SUBSTANCE ABUSE TREATMENT REFERRAL PROTOCOL TO
THE COUNTY HEALTH OFFICER FOR APPROVAL PRIOR TO
IMPLEMENTATION
1520 (C)


  	1570	2~9O6
	1580	(A)
1590
1600
 THE COUNTY HEALTH OFFICER SHALL INCLUDE IN THE PROGRAM
OPERATING PROCEDURES MEASURES TO COLLECT THE FOLLOWING
DATA:
  
	1610	(1)	THE NUMBER OF PARTICIPANTS SERVED BY THE PROGRAM,
	1620	(2)	THE LENGTH OF TIME A PARTICIPANT IS SERVED BY THE
	1630		PROGRAM,
	1640	(3)	DEMOGRAPHIC PROFILES OF PARTICIPANTS SERVED BY THE
	1650		PROGRAM THAT INCLUDE:
	1660	(I)  AGE;
	1670	(II)  SEX;
	1680	(III) RACE;
	1690	(IV) OCCUPATION;
	1700	(V) ZIP CODE OF RESIDENCE;
	1710	(VI) TYPES OF DRUGS USED;
	1720	(VII) LENGTH OF DRUG USE, AND
	1730	(VIII) FREQUENCY OF INJECTION;

1740
1750
(4)	THE NUMBER OF HYPODERMIC NEEDLES AND SYRINGES EXCHANGED, AND

1760
1770
(5)	THE NUMBER OF PARTICIPANTS ENTERING DRUG COUNSELING AND TREATMENT

1780
1790
1800
1810
1820
~)  WITH THE ADVICE OF THE ADVISORY COMMITTEE, THE COUNTY HEALTH OFFICER
SHALL DEVELOP AND IMPLEMENT
A PLAN FOR PROGRAM EVALU~ON AS APPROPRIATE BASED
ON THE PREVAILING KNOWLEDGE AT THE TIME. THE PLAN
MAY INCLUDE

	1830	(1)	REPORTED CHANGES IN THE LEVEL OF DRUG USE
	1840		AMONG PROGRAM PARTICIPANTS;
 	1850	(2)	REPORTED CHANGES IN THE LEVEL OF
	1860		NEEDLE-SHARING AMONG PROGRAM PARTICIPANTS'.
	1890	(3)	REPORTED CHANGES IN THE USE OF CONDOMS AMONG
	1900		PROGRAM PARTICIPANTS, AND
	1910	(4)	THE ADVISABILITY OF CONTINUING THE PROGRAM
1920  2~9O7

1930
1940
(A)	(1)  EACH PROGRAM PARTICIPANT SHALL BE ISSUED AN IDENTIFICATION
CARD WITH AN IDENTIFICATION NUMBER

	1950	(2)	THE IDENTIFICATION NUMBER SHALL BE CROSS-INDEXED
	1960		TO A CONFIDENTIAL RECORD CONTAINING PERTINENT DATA
	1970		ON THE PARTICIPANT

1980	SUBJECT TO THE PROVISIONS OF SUBSECTION (C) OF THIS
1990	SECTION, ANY INFORMATION OBTAINED BY THE PROGRAM THAT
2000	WOULD IDENTIFY PROGRAM PARTICIPANTS, INCLUDING PROGRAM
2010	RECORDS, IS
	2020	(1)	CONFIDENTIAL,
	2030	(2)	NOT OPEN TO PUBLIC INSPECTION OR DISCLOSURE; AND

2040
2050
(3)	NOT DISCOVERABLE IN ANY CRIMINAL OR CIVIL PROCEEDING.

(1)	UPON THE WRITTEN CONSENT OF A PROGRAM PARTICIPANT, INFORMATION
OBTAINED BY THE PROGRAM
THAT IDENTIFIES THE PROGRAM PARTICIPANT MAY BE
RELEASED OR DISCLOSED TO A PERSON OR AGENCY
PARTICIPATING IN THE PROGRAM
	2060	(C)
	2070
	2080
	2090
2100
	2110	(2)	IN ADDITION TO THE PROVISIONS OF PARAGRAPH (1)
	2120		OF THIS SUBSE~ON, IF A PROGRAM PARTICIPANT RAISES
	2130		THE ISSUE OF PARTICIPATION IN THE PROGRAM EITHER
AS A
	2140		SUBJECT MATTER OR LEGAL DEFENSE IN AN
	2150		ADMINISTRATIVE, CIVIL, OR CRIMINAL PROCEEDING, THE
	2160		PROGRAM PARTICIPANT WMVES THE CONFIDENTIALITY AS
	2170		TO IDENTITY PROVIDED UNDER SUBSECTION ~)(1) OF
THIS
	2180		SECTION.
 	
 2190	24-908
	2200	(A)

SUBJECT TO THE PROVISIONS OF SUBSE~ON (13) OF THIS
SECTION, A PROGRAM STAFF MEMBER OR PROGRAM PARTICIPANT
MAY NOT BE FOUND GUILTY OF VIOLATING ARTICLE 27, ¤ 287, ¤
287A, OR ~ 288 OF THE CODE FOR POSSESSING OR DISTRIBUTING
CONTROLLED PARAPHERNALIA OR DRUG PARAPHERNALIA
WHENEVER THE POSSESSION OR DISTRIBUTION OF THE
CONTROLLED PARAPHERNALIA OR DRUG PARAPHERNALIA IS A
DIRECT RESULT OF THE EMPLOYEE'S OR PARTICIPANT'S ACTIVITIES
IN CONNECTION WITH THE WORK OF THE PROGRAM AUTHORIEED
UNDER THIS SUBTITLE

A PROGRAM STAFF MEMBER OR PROGRAM PARTICIPANT IS NOT IMME FROM CRMIINAL
PROSEC~ON FOR:
	2320	(1)	THE REDISTRIBUTION OF HYPODERMIC NEEDLES OR
	2330		SYRINGES IN ANY FORM,

2340
2350
(2)	ANY ~VITIES NOT AUTHORIZED OR APPROVED BY THE PROGRAM; OR

2360
2370
2380
(3)	THE POSSESSION OR DISTRIBUTION OF CONTROLLED
PARAPHERNALIA OR DRUG PARAPHERNALIA OR ANY OTHER
UNLAWFUL ACTIVITY OUTSIDE OF THE COUNTY LIMITS

2390  24-909

EXCEPT FOR VIOLATIONS OF ANY LAWS THAT COULD ARISE FROM
RESIDUE ATTACHED TO OR CONTAINED WITHIN HYPODERMIC NEEDLES,
SYRINGES BEING RETURNED OR ALREADY RETURNED TO THE PROGRAM,
NOTHING IN THIS SUBTIThE MAY BE CONSTRUED TO PROVIDE IMMNITY
TO A PROGRAM STAFF MEMBER OR PROGRAM P~CIPANT FROM
C~NAL PROSECUTION FOR A VIOLATION OF ANY LAW PROHIBITING OR
REGULATING THE USE, POSSESSION, DISPENSING, DISTRIB~ON, OR
PROM~ON OF CONTROLLED DANGEROUS SUBSTANCES, DANGEROUS
DRUGS, DETRIMENTAL DRUGS, OR HARMFUL DRUGS OR ANY CONSPIRACY
OR ATTEMPT TO COMMIT ANY OF THOSE OFFENSES.

2500
2510
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect on
October 1, 1998


Sponsor: UMBC DELEGATION
http://sta.umbc.edu/~msl/