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Friday, April 24, 2015

Ind. Gov't. - The news is full of Indiana's HIV health care crisis

The Louisville Courier-Journall has posted in full the long testimony of "Dr. Shane Avery of Scottsburg, Ind., [who] recently testified before the Indiana General Assembly about the HIV outbreak in Southern Indiana and the benefits of a needle exchange."

Governing today has a story by Chris Kardish titled "Indiana Up Against Clock and Governor on Needle Exchanges." It begins:

The Indiana legislature is close to passing a bill that would expand needle-exchange programs following an HIV outbreak along the state’s southeastern border. Two hurdles remain: the end of the state’s legislative session and a potential veto from Gov. Mike Pence.

The measure would allow Indiana counties with the highest transmissions of hepatitis C, an infectious disease commonly spread through intravenous drug use, to run their own needle exchange programs, which are currently only allowed by an emergency decree of the governor. Supporters call needle exchanges a critical, if limited, tool to head off future public health emergencies because hepatitis C is far more easily spread and can presage an HIV outbreak.

Pence authorized a 30-day exchange last month for the center of the HIV surge, Scott County, where more than 130 cases linked to intravenous opioid use occured in the past two months. The governor extended the exchange for another 30 days earlier this week. But Pence said he opposes a broad needle-exchange program, arguing it would encourage drug use.

Yesterday Maureen Hayden of CNHI reported:

INDIANAPOLIS – Attorney General Greg Zoeller wants lawmakers to give local health officials room to implement needle exchanges to contain the spread of HIV in southeastern Indiana.

Zoeller, a Republican, spent Thursday urging lawmakers to act quickly on legislation that Gov. Mike Pence, also a Republican, has threatened to veto.

Zoeller said he’s convinced that an outbreak of the virus that causes AIDS has spread beyond Scott County. So far, 135 cases have been confirmed as part of the Scott County outbreak.

“Before everybody in every county knows someone with HIV, we’ve got to do something. And we’ve got to do it now,” he said. * * *

With less than a week left in the Legislature's session, Zoeller went public with his lobbying yesterday. As the state’s top law enforcement officer, he said he can give cover to lawmakers who fear they’ll be perceived as enablers of drug abuse if they vote for a needle exchange.

“This is not the time to be risk averse,” he said.

Zoeller made the statement just a day after the state's prosecutors came out strongly opposed to the idea. The Association of Indiana Prosecuting Attorneys said tougher enforcement is a better approach to giving clean needles to illegal drug users.

Zoeller said prosecutors don’t want to be seen as “soft on crime," and neither does he. But he argued that needle exchanges can be life-saving if they keep the deadly HIV virus from spreading among drug users.

“I’m not going to have anybody put to death with HIV just because they’ve broken the law,” he said.

Earlier this week, the state's 120-member Prescription Drug Abuse Task Force endorsed the needle exchange measure proposed by House Public Health Chairman Ed Clere, R-New Albany.

House and Senate leaders have been working to come up with language that both lawmakers and Pence will support. Their aim is to let health officials in high-risk communities intervene before an HIV outbreak.

Their proposal allows counties with high levels of IV drug abuse and Hepatitis C – a blood-borne disease also spread by contaminated needles – to act without first getting an emergency declaration from the governor.

As of late Thursday, it also included a provision that requires those county health officials to work directly with the state’s public health commissioner to launch a needle exchange.

On Thursday, Senate Democrats threw support behind the proposal but called for an expansion of HIV testing and treatment throughout the state. Currently the health department offers HIV testing in 27 of 92 counties.

“There’s a three-part, comprehensive approach that’s needed to address this crisis,” said Senate Minority Leader Tim Lanane, “and that is testing, treatment, and needle exchange.”

Late this morning the CDC issued this CDC Health Advisory that begins:
The Indiana State Department of Health (ISDH) and the Centers for Disease Control and Prevention (CDC) are investigating a large outbreak of recent human immunodeficiency virus (HIV) infections among persons who inject drugs (PWID). Many of the HIV-infected individuals in this outbreak are co-infected with hepatitis C virus (HCV). The purpose of this HAN Advisory is to alert public health departments and healthcare providers of the possibility of HIV outbreaks among PWID and to provide guidance to assist in the identification and prevention of such outbreaks.

Posted by Marcia Oddi on April 24, 2015 01:38 PM
Posted to Indiana Government