A bill to replicate Miami’s needle exchange program statewide is inching closer to passing the Florida Legislature. It cleared its first committee hurdle Tuesday in the House.
The measure takes Miami’s model for a one-for-one needle exchange program, which has since expanded to include other health services, and looks to copy what supporters point to as statistical success.
Tyler Bartholomew is a PhD student at Miami’s Miller School of Medicine, and one of students who helped develop the three-year-old program. During a trip to the Capitol in February to support the legislation, he outlined some of the additional screening and safeguards against HIV offered by the original exchange.
“We have money to test everybody for HIV and hepatitis C. If they do come back reactive, we’ll do a second rapid test, a confidential rapid test because our program is completely anonymous, and they get linked to the Ryan White clinic at Jackson, right away, on the same day,” Bartholomew said. “And if they’re not already in care, we get them into care the same day.”
Then, Bartholomew says, the exchange can start administering medication.
“From there, their medication comes to the exchange, we give out a five-day supply for those participants, and then they come back in every five days to receive their medication,” Bartholomew said.
Kasha Bornstein is also a University of Miami medical student who is pushing for the legislation to pass. Before medical school, Bornstein was a paramedic for nine years.
“You have to survive to recover from all of the effects of addiction. And if you’re overdosing, and you’re getting so sick that you don’t have the opportunity, then you’re too far gone. So what we’ve found is that, by creating this preventive intervention, we’re able to reach people before it’s too late,” Bornstein said.
Bornstein adds the data shows more communities than Miami-Dade can benefit from introducing an exchange.
During Tuesday's House Quality Subcommittee meeting, Democratic Representative Carlos Guillermo Smith asked the House bill’s sponsor and fellow Democrat, Representative Shevrin Jones, about HIV statistics in South Florida.
Smith: “Where does Miami rank currently on the HIV epidemic nationwide, as far as number of new transmissions?”
Jones: “Number one.”
Jones highlighted data related to the distribution of Naloxone, the drug used to reverse opioid overdoses, which Miami’s exchange is equipped to do.
“1,195 was the number of overdose reversals that happened last year,” Jones said.
A strike-all amendment in Jones’ House bill has been adopted to make it more similar to the Senate version, with two exceptions.
“The strike-all retains the current requirement for a one-to-one exchange, and makes no exceptions,” Jones said. “The second – the bill retains the current prohibition on the use of state, county, or municipal funds to be used to operate exchange programs.”
The House bill states exchange programs, which county commissions must opt into, would be funded through grants and donations ‘from private resources and funds.’ They could be housed in permanent facilities or mobile health units.
Representative Smith says he hopes the state would eventually consider putting money behind the program, should it pass. The Orlando Democrat believes it could eventually pay for itself in healthcare savings.
“I know that one of the themes this session is how do we reduce our healthcare costs? Based on some of the facts sheets I’ve been given, the costs for one of these programs – to replace a needle with a clean needle, to stop the spread of infectious diseases – is nine cents. Nine cents, compared with the cost of over $400,000 in medications to mitigate someone who is living with HIV,” Smith said.
The Senate’s version of the bill will be heard in its appropriations committee this week. That’s its final committee stop.
