[HISTORY: Adopted by the Department of Health
of Allegheny County 5-2-2007 as Rule and Regulation Article II; ratified by the County
Council 2-5-2008 by Ord. No. 4-08; amended in its entirety 5-7-2014, ratified by the County Council 7-1-2014 by Ord. No. 09-14. Subsequent amendments noted where applicable.]
The Allegheny County Health Department finds the sharing of
intravenous injection apparatus among injecting drug users a threat
to public health. Sharing injection apparatus is a significant factor
in the transmission of infectious diseases, including HIV and Hepatitis
B and C. Providing clean injection apparatus and biohazard containers
through a sanctioned needle exchange program, educating injecting
drug users as to the dangers of sharing injection apparatus and continued
drug abuse, and providing condoms to prevent sexual transmission of
infectious diseases have been shown to reduce the incidence of infectious
disease transmission among injecting drug users. Repeated offerings
of drug rehabilitation services have also been demonstrated to increase
the likelihood that injecting drug users will enter treatment, and
through one or more attempts, become drug-free.
The regulation of needle exchange programs is necessary to ensure
that the distribution of clean injection apparatus and biohazard containers
is carried out in a manner consistent with the goal of preventing
infectious disease transmission among injecting drug users, and to
encourage the provision of the greatest number of treatment and prevention
strategies possible, with the ultimate goal of reducing the incidence
of HIV and Hepatitis B and C among injecting drug users, their sexual
partners, and their offspring. Such prevention will promote the health,
safety and welfare of the community.
The provisions of this chapter will become effective 10 days
after the enactment date of an ordinance of Allegheny County approving
its provisions.
The following terms, when used in this chapter, have the meanings
indicated in this section, except where the context indicates a clearly
different meaning:
Approved, limited access, puncture-proof receptacles to be
used for the safe storage of used needles or sharps.
The Allegheny County Board of Health.
The Allegheny County Health Department.
The Director of the Allegheny County Health Department or
his or her authorized representative.
Testing blood or other tissue for HIV and Hepatitis B and
C, by a Clinical Laboratory Improvement Amendments (CLIA) approved
method.
Syringes, needles, and alcohol wipes.
Individuals with actual authority over the day-to-day operations
of needle exchange programs.
A public or private enterprise with the goal of reducing
the incidence of infectious disease transmission among program participants,
their sexual partners, and their offspring, approved by the Board
of Health, through the provision of education on safe practices, counseling
opportunities, clean injection apparatus, biohazard containers, and
condoms or other barrier methods of preventing sexually transmitted
diseases.
Any natural person, corporation, partnership or association.
The specific address at which a needle exchange program provides
any materials or services to any program participant(s), whether inside
a building or at a temporary facility, including, but not limited
to, tents, outdoor tables, or mobile facilities.
Any individual receiving services, materials, or referrals
from a needle exchange program.
A.
The Department shall, subject to the approval of the Board of Health,
devise operating procedures of needle exchange programs in Allegheny
County, Pennsylvania. The Board shall not approve or alter any operating
procedure without providing written notice of the new procedure(s)
to the Allegheny County Council and Chief Executive at least 30 days
prior to the Board's vote.
B.
The Board of Health shall review each proposal for a needle exchange
program and, upon approval, shall forward written copies of all materials
pertaining to approved proposals to the County Chief Executive and
Council, and to the Mayor and Council or, if applicable, Commissioners
of each municipality where a needle exchange program is proposed at
least 90 days before the program proposes to begin operations.
C.
Persons wishing to create and operate needle exchange programs shall
submit to the Board of Health written statements of their intent to
promulgate such a program, with the names, addresses, and social security
numbers of key individuals. Each statement shall include a rationale
for the necessity for the program, the intended program location(s),
days and hours of operations, and the proposed method for tracking
program users. Any changes in this identifying information or the
identity of key individuals shall be sent to the Board of Health within
30 days. All needle exchange programs shall maintain continuously
updated records of the full names, addresses and telephone numbers
of all individuals providing services to or having contact with program
participants at any program location.
D.
No needle exchange program shall operate in any location until the
address of the program location is specifically approved by the Board
of Health and the proposed site's municipality through legislative
action.
(1)
Program locations in operation with the approval of the Allegheny
County Health Department as of January 1, 2007, shall not require
additional approval by the Department or the municipality in which
they are located, although all such program locations shall be disclosed
to the Mayor, Council, and/or Commissioners of all municipalities
in which they are located, in writing, within 10 days of the effective
date of this chapter.
(2)
Under no circumstances shall the Department approve any future program
location proposed to be within 1,500 feet of any elementary, primary
school, secondary school, licensed day-care facility, or drug treatment
facility, except in the City of Pittsburgh.
(3)
The Department shall not approve any temporary facility, including, but not limited to, tents, outdoor tables, or mobile units, as a program location unless such location is first identified by address and, in writing, by the needle exchange program, and the municipality in which the temporary facility is to be located is notified, in writing, of the address of the temporary program location in accordance with the requirements of Subsection C.
E.
Needle exchange programs shall enroll each program participant with
a unique identifier, and shall not provide services before attempting
to elicit the program participant's age, gender, self-reported
race, zip code, and disease status (HIV, Hepatitis B or C).
F.
Each needle exchange encounter shall be documented with the unique
identifier and the date and time of the encounter. The person documenting
the encounter and all individuals providing materials or services
to any program participant shall provide his or her initials. Documentation
shall be retained by the needle exchange program for at least three
years.
(1)
IDUs not known to be infected with HIV, or Hepatitis B or C infections
at first screening shall be offered testing at the first visit that
is at least six months from the date of first screening.
(2)
IDUs presenting with one or more symptoms of HIV or Hepatitis B or
C shall be informed that they should follow up immediately with their
primary care provider or the Department.
(3)
IDUs shall be counseled on safe sex practices.
G.
Needle exchange programs shall be primarily for the use of Allegheny
County residents, but nonresidents may participate if there are available
resources.
H.
The number of injection apparatus and biohazard containers dispensed
shall be no more than are reasonably necessary for one month's
worth of injections at an IDU's first interaction with the needle
exchange program.
I.
Each IDU shall be offered a referral to drug treatment and counseling
services at each needle exchange encounter. Such referral shall be
documented with the initials of the person who made the referral and
the IDU's response.
J.
Whenever possible, the Department shall provide infectious disease
testing materials as requested by needle exchange programs.
K.
Community laboratory facilities processing needle exchange program
specimens shall report positive infectious disease tests not conducted
by the Department to the Department within 72 hours.
L.
Department funds shall not be used to support any activity of any
needle exchange program without prior approval as required by law.
Needle exchange programs shall submit to the Director semiannual
reports of the disease status of all enrolled IDUs on or before December
31 and July 1 of each calendar year, in a form to be determined by
the Board of Health, but which shall include at least: the number
of encounters; the number of individual participants; the total number
of injection apparatus; the number of treatment referrals made; the
number of infectious disease tests performed.
Any needle exchange program approved by the Board of Health
that violates any of the sections contained herein shall lose its
authorization to continue to operate as a needle exchange program,
subject to the discretion of the Department or upon the repeal of
the legislative program location approval required under the terms
of Subsection D by the host municipality.
