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A BILL TO BE ENTITLED
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AN ACT
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relating to programs established to eliminate injection-associated |
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infectious diseases; providing certain civil and criminal |
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immunity. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. This Act shall be known as the Texas |
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Injection-Associated Infectious Disease Elimination (IDEA) Act. |
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SECTION 2. (a) In this section, "HIV" means human |
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immunodeficiency virus. |
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(b) The legislature finds that: |
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(1) persons of all ages who do not misuse, abuse, or |
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inject heroin, opioids, or other drugs may nevertheless be exposed |
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to and contract injection-associated infectious diseases, |
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including HIV and the hepatitis C virus; |
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(2) heroin drug use is at a 20-year high and in the |
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last 10 years its use has more than doubled in young adults aged 18 |
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to 25; |
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(3) prescription opioid misuse and abuse has led to |
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increased numbers of people who inject drugs, increasing the risk |
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of HIV to new populations; |
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(4) rural and nonurban areas with limited HIV and |
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hepatitis C virus prevention and treatment services and substance |
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use disorder treatment services, traditionally areas at low risk |
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for HIV and hepatitis C virus, have been disproportionately |
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affected; |
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(5) Texas had 4,364 newly diagnosed cases of HIV in |
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2017, bringing the total living with HIV in Texas to 90,700; |
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infection from injection drug use accounts for 8.5 percent of all |
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cases of HIV in Texas; |
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(6) cases of acute hepatitis C virus in Texas |
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increased by 100 percent in the period from 2009 to 2013, and 60 |
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percent of those cases were attributable to injection drug use; |
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(7) drug overdose deaths in Texas increased by 274 |
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percent from 1999 to 2017, with a likelihood that many deaths were |
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underreported due to a lack of training and resources in rural and |
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nonurban areas; |
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(8) the lifetime treatment cost of an HIV patient is |
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conservatively estimated at $380,000; |
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(9) the current cost to effectively treat hepatitis C |
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virus is up to $95,000; and |
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(10) injection-associated infectious diseases such as |
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HIV and the hepatitis C virus can also be contracted accidentally by |
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health care providers, law enforcement officers, first responders, |
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other emergency personnel, and members of the general public |
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through a needlestick or other sharps injury or exposure to blood or |
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bodily fluids. |
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SECTION 3. Chapter 81, Health and Safety Code, is amended by |
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adding Subchapter K to read as follows: |
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SUBCHAPTER K. ELIMINATION OF INJECTION-ASSOCIATED DISEASES |
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Sec. 81.501. DEFINITIONS. In this subchapter: |
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(1) "Controlled substance" has the meaning assigned by |
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Section 481.002. |
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(2) "HIV" means human immunodeficiency virus. |
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(3) "Individual who injects drugs" means an individual |
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who uses a syringe or hypodermic needle to inject a controlled |
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substance into the individual's own body. |
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(4) "Infectious disease" means disease that may be |
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spread by intentional or unintentional needlesticks, including HIV |
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and the hepatitis C virus. |
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(5) "Local health unit" has the meaning assigned by |
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Section 121.004. |
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(6) "Program" means an injection-associated |
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infectious disease elimination program established under this |
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subchapter. |
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Sec. 81.502. INJECTION-ASSOCIATED INFECTIOUS DISEASE |
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PROGRAMS. (a) The department or a local health unit, in |
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conjunction with an organization that promotes scientifically |
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proven ways of mitigating risks associated with the use of |
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controlled substances, may establish and operate an |
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injection-associated infectious disease elimination program. |
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(b) The mission of a program is to: |
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(1) reduce the spread of HIV, the hepatitis C virus, |
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and other injection-associated infectious diseases; |
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(2) reduce needlestick injuries to health care |
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providers, law enforcement officers, first responders, other |
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emergency personnel, and the general public; and |
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(3) encourage individuals who inject drugs to enroll |
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in evidence-based treatment for substance use disorder. |
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(c) A program established under this subchapter must do the |
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following: |
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(1) safely dispose of used needles, hypodermic |
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syringes, and other injection supplies; |
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(2) provide needles, hypodermic syringes, and other |
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injection supplies at no cost and in quantities sufficient to |
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discourage the sharing or use of needles, hypodermic syringes, or |
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other injection supplies; |
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(3) provide educational materials on the following |
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subjects: |
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(A) overdose prevention and response; |
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(B) prevention of infectious diseases; |
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(C) drug abuse prevention; and |
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(D) treatment for mental illness or substance |
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abuse, including providing treatment referrals; |
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(4) provide access to kits that contain naloxone |
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hydrochloride, or a chemical equivalent that is approved by the |
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federal Food and Drug Administration, for the treatment of a drug |
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overdose or provide referrals to programs that provide access to |
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such medications; |
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(5) provide personal consultations for individuals |
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seeking assistance by a program employee or volunteer concerning |
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mental health or substance use disorder treatment, as appropriate; |
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(6) encourage each individual who injects drugs to |
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seek appropriate medical, mental health, or social services; |
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(7) use a record keeping system that ensures that the |
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identity of each individual who injects drugs remains anonymous; |
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(8) notify appropriate local law enforcement agencies |
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about the program, including information on the limited immunity |
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from criminal liability granted by Section 81.504; |
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(9) provide an identification card to each individual |
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served by the program identifying them as a participant of the |
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program, which shall serve as proof of the limited immunity from |
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criminal liability granted under Section 81.504; |
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(10) provide emergency medical care or referrals to |
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program participants in need of immediate medical attention; and |
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(11) comply with applicable state and federal rules |
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and regulations governing participant confidentiality. |
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Sec. 81.503. NOTIFICATION OF PROGRAM. (a) Before a |
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program may be established, notification must be provided to the |
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following interested parties in the area to be served by the |
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program: |
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(1) local law enforcement agencies; |
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(2) local prosecutors; |
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(3) representatives of substance use disorder |
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treatment facilities certified by the department; |
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(4) individuals who inject drugs and individuals in |
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recovery from substance use disorder; |
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(5) nonprofit organizations whose primary purpose is |
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education on or mitigation of HIV, the hepatitis C virus, substance |
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use disorder, or mental health; and |
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(6) residents of the geographical area to be served by |
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the program. |
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(b) When consulting with interested parties, the program is |
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encouraged to consider: |
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(1) the population to be served; |
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(2) the concerns of local law enforcement agencies and |
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prosecutors; and |
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(3) the day-to-day administration of the program, |
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including the need for security of program sites, equipment, |
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personnel, and volunteers. |
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Sec. 81.504. LIMITED IMMUNITY. (a) An individual who |
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injects drugs and who is an active participant in a program is |
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granted limited immunity from and shall not be subject to criminal |
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liability under Subchapter D, Chapter 481. The limited immunity |
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provided in this section applies to an individual who injects drugs |
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and who is an active program participant only if: |
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(1) the individual claiming immunity possesses the |
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program identification card provided in accordance with Section |
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81.502(c)(9); or |
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(2) program personnel can otherwise confirm an |
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individual's participant status in response to charges related to |
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or resulting from their participation in the program. |
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(b) The limited immunity in Subsection (a) shall apply to a |
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needle, hypodermic syringe, or other injection supply obtained |
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from, or to a used needle or hypodermic syringe containing residual |
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amounts of a controlled substance being returned for disposal to, a |
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program established under this subchapter. |
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(c) In addition to any other applicable immunity from civil |
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liability, a law enforcement officer who arrests or charges a |
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person who is later determined to be entitled to immunity from |
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prosecution under Subsection (a) is not subject to civil liability |
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for the arrest or filing of charges against the person. |
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(d) Any person or entity contributing funds or providing |
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assistance, consultations, emergency care, referrals, needles, |
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hypodermic syringes, or other injection supplies, or any other |
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materials or service, including providing educational materials or |
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naloxone kits, for the benefit of the program shall be immune from |
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civil and criminal liability as a result of such participation with |
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or contributions to the program. |
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(e) The limited immunity, including limited vicarious |
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liability, provided in this section shall also extend to the |
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members of any local health unit establishing, sponsoring, |
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operating, or administering a program. Immunity under this section |
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shall be provided to and for any employees, officers, agents of the |
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state, persons, and entities described in this subchapter for |
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personal injury, damage to or loss of property, or other civil |
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liability caused by or arising out of, or relating to, an actual or |
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alleged act, error, or omission that occurred, or that the |
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employee, officer, agent of the state, person, or entity had a |
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reasonable basis for believing occurred, in relation to or in |
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conjunction with the program. |
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(f) Nothing in this section shall impair or otherwise limit |
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any other immunity of any person or entity under constitutional, |
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statutory, or common law. |
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Sec. 81.505. REPORT. Not later than December 1 of each year |
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that a program exists, each local health unit sponsoring, |
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operating, or administering a program shall report the following to |
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the department: |
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(1) the number of individuals served by the program; |
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(2) the number of needles, hypodermic syringes, and |
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other injection supplies dispensed by and returned to the program; |
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(3) the number of naloxone kits distributed by the |
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program; |
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(4) the number of service referrals provided to |
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individuals served by the program, by type of treatment, including |
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a separate report on the number of individuals referred to programs |
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that provide access to naloxone hydrochloride, or a chemical |
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equivalent that is approved by the federal Food and Drug |
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Administration, for the treatment of an overdose; and |
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(5) the number and type of medical, mental health, and |
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social services referrals provided to individuals served by the |
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program. |
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SECTION 4. This Act takes effect September 1, 2019. |