HOUSE VOTES FOR STATE'S FIRST NEEDLE-EXCHANGE PROGRAM, BUT ONLY IN BEXAR COUNTY

By R.A. DYER Star-Telegram Staff Writer The Texas House voted to
allow the state to create the first ever needle-exchange program for
intravenous drug users -- but only as a pilot project around San
Antonio. The provision was added to a broad Medicaid bill, Senate
Bill 10, which was sponsored in the House by Rep. Dianne White
Delisi, R-Temple.

Rep. Ruth McClendon, D-San Antonio, at first tried to add an
amendment to the bill that would create a statewide needle-exchange
program. But she limited her amendment to Bexar County, where San
Antonio is, when it appeared that she did not have support in the
House for the broader program.

McClendon said Texas is the only state without a needle-exchange
program. "The purpose of the clean-needle program is to keep them
from spreading the disease," she said, referring to hepatitis C and
HIV, which are commonly spread by intravenous drug use.

Delisi did not dispute the public health benefits but said that
constituent concerns about appearing to support illegal drug use
outweighed those benefits.

"Our constituents [are concerned] about [whether] promoting the free
exchange of needles for the illegal use of intravenous drugs is
something the state should be doing," she said.

Under the program, IV drug users could anonymously exchange their
used syringes for clean ones. The details of the program remain to be
worked out. The amendment was adopted in the House 71-60.

Senate Bill 10 would reward adults on Medicaid for quitting smoking,
losing weight and taking other steps toward healthier lifestyles. It
also would allow the Texas Health and Human Services Commission to
develop healthcare packages tailored to recipients' needs and to pay
private insurers to provide coverage.

Many of the elements in the legislation would require federal
waivers. But the federal government is encouraging states to develop
cost-saving ways to deliver Medicaid coverage as Congress tries to
lower the federal deficit.

Under the legislation:

Managed-care programs would be encouraged to enroll Medicaid
recipients with an emphasis on preventive health services. The state
would probably bear the cost, but backers of the legislation say it
would be cheaper than providing such services directly.

State health officials would develop a pilot program in one part of
the state to encourage Medicaid recipients to join smoking-cessation,
weight-loss and other programs to reduce the risk of long-term health issues.

Efforts to stop fraud and abuse would expand, including verifying
that applicants and recipients of Medicaid are U.S. citizens.

Hospital emergency rooms could charge Medicaid recipients a
co-payment if they seek services that could be provided in a clinic
or a doctor's office.

Medicaid is a federal program administered by the states that pays
for indigent healthcare. The state and federal governments share the costs.

A decade ago, 14 percent of the state budget was spent on Medicaid.
Today, it's 25 percent, and in 2017, it's projected to be 40 percent.