A bill that would let Indiana counties and municipalities create their own needle-exchange programs is headed to Gov. Eric Holcomb, who is expected to sign it.
The state Senate approved the measure Thursday by a 32-16 vote after lengthy discussion about needle exchanges, which aim to reduce the spread of infectious diseases by providing people with clean syringes and discouraging needle sharing.
Indiana began to allow the exchanges in 2015, but only with state approval, after the state's worst-ever concentrated HIV outbreak, which was centered in Scott County in the south of the state. More than 200 HIV cases have been reported in the county in the past two years.
The new bill aims to streamline the process and give local governments more freedom to decide whether to create their own exchanges.
Federal studies have found that such programs cut down transmission of HIV and do not cause increases in drug use.
Multiple senators delivered impassioned speeches and, ultimately, 16 Republicans voted against it, citing concerns that it would encourage or enable use of intravenous drugs.
"To me, I just truly don't understand this movement, which I believe encourages drug use," said Sen. Erin Houchin, R-Salem. "What we're doing with this legislation is saying the state is sanctioning, the state is saying that this is OK. That drug use is OK."
Houchin and a few other senators voiced frustration that no amendments were considered on the floor. Holcomb said last week that he wanted the bill to advance without changes.
Some of the proposed amendments would have required a one-for-one needle exchange or asked for more reporting of drug-related crimes.
Another would have restricted exchanges to providing only needles—a response to concerns over exchanges providing other additional materials, such as cookpots, cotton filters, pure water vials and antibiotics.
In addition to granting local control, the measure authored by Republican Rep. Cindy Kirhhofer would maintain the health commissioner's power to end a program. It also would require exchanges to stock overdose prevention drugs.
In testimony before a committee in the House, Health Commissioner Dr. Jerome Adams said the state's approval, in the form of an emergency declaration, was originally mandated to "reassure" the public of the need for an exchange, but that they are no longer necessary.
Counties that feel more comfortable establishing needle-exchange programs with the emergency declaration could still continue to go through the originally established pathway if they chose to under the Beech Grove lawmaker's bill.
The bill's Senate sponsor Sen. Jim Merritt Jr. said in that when conversations about the bill began, he didn't want to author it "because it's very difficult to understand."
"Somebody used the word counterintuitive, and that's what it is. But it works," the Indianapolis Republican said. "This is about health care. It's about HIV. It's about hep C."