GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2001
H	1
HOUSE BILL 1405
     

 
Short Title:	HIV/AIDS Public Health Crisis.	()	
Sponsors:	Representatives Wright;  Adams, Bell, Blue, Bonner, Boyd-McIntyre, Cunningham, Earle, Fitch, Fox, Haire, Hall, Hunter, Lucas, Luebke, McAllister, Michaux, Miller, Oldham, Wainwright, and Womble.	
Referred to:	Health.	
April 26, 2001

A BILL TO BE ENTITLED
AN ACT finding that a Public Health emergency exists in North Carolina in regards to HIV/AIDS; increasing the income eligibility cap of the AIDS Drug Assistance Program; Increasing funding for HIV/AIDS prevention efforts; and Directing the department of health and human services to study programs relating to HIV/AIDS prevention and care.

Whereas, over 6,600 North Carolinians have died of HIV/AIDS and currently over 13,000 North Carolinians are known to be living with HIV/AIDS; and
Whereas, the actual number of people living with HIV/AIDS in North Carolina is likely higher since it has been estimated that up to one‑third of individuals in the United States who are HIV-positive are undiagnosed; and
Whereas, during year 2000 alone, 1,477 new cases of HIV/AIDS were reported in North Carolina; and
Whereas, HIV infection makes an individual more susceptible to numerous other diseases such as pneumonia, Hodgkin's disease, cervical cancer, testicular cancer, Kaposi's sarcoma, and certain types of lymphoma; and
Whereas, antiretroviral therapies for people living with HIV/AIDS alone can cost $10,000 to $12,000 annually per person with other medical treatments bringing total medical costs per person to $20,000 annually; and
Whereas, minority communities in North Carolina have been particularly affected by HIV/AIDS in that over seventy percent of reported cases of HIV/AIDS in North Carolina are attributed to members of minority communities; and
Whereas, almost an entire generation of North Carolinians has been born since the beginning of the AIDS epidemic, and there is still no cure in sight, and the Centers for Disease Control and Prevention states that the epidemic is far from over; and
Whereas, nationwide, AIDS is the leading cause of death of African‑Americans aged 25‑44, the second leading cause of death of Latino‑Americans aged 25‑44, and the fifth leading cause of death of all Americans aged 25‑44; and
Whereas, nationwide, AIDS is the leading cause of death of African‑American women aged 25‑44 and the fourth leading cause of death of all American women aged 25‑44; and
Whereas, women represent the fastest growing group of new HIV infections in the United States; and
Whereas, the most common route of HIV transmission among women in the United States is through heterosexual transmission; and
Whereas, despite dramatic medical advances, AIDS remains a serious and usually fatal disease that requires costly, complex, and difficult treatment regimens; and
Whereas, the number of new HIV infections each year has not decreased, but has remained steady at approximately 40,000 new infections per year in the United States alone; and
Whereas, while the number of AIDS cases has decreased over recent years, the number of people living with HIV/AIDS has increased; and
Whereas, research suggests that some individuals are less concerned about becoming infected than in the past and may therefore be more inclined to engage in higher‑risk behaviors; and 
Whereas, the Centers for Disease Control and Prevention has asserted that complacency about the need of HIV prevention may be among the strongest barriers communities face in planning for prevention needs; Now, therefore,
The General Assembly of North Carolina enacts:
SECTION 1.  The General Assembly finds that a public health crisis exists in North Carolina in regards to the HIV/AIDS epidemic.  This finding does not constitute a declaration of a state of emergency under Article 36A of Chapter 14 of the General Statutes or a declaration of a state of disaster under Chapter 166A of the General Statutes.
SECTION 2.  For the 2001‑2003 fiscal biennium, HIV‑positive individuals with incomes at or below two hundred fifty percent (250%) of the federal poverty level are eligible for participation in the AIDS Drug Assistance Program (ADAP).  All individuals who are eligible for participation in ADAP shall be served by the Department of Health and Human Services.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Public Health, the sum of four million five hundred thousand dollars ($4,500,000) for the 2001‑2002 fiscal year and the sum of four million five hundred thousand dollars ($4,500,000) for the 2002‑2003 fiscal year to carry out the provisions of this section.
SECTION 3.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Public Health, the sum of one million dollars ($1,000,000) for the 2001‑2002 fiscal year and the sum of one million dollars ($1,000,000) for the 2002‑2003 fiscal year for community‑based intervention efforts to combat the HIV/AIDS epidemic.  Funds appropriated under this section shall be allocated as follows:
(1)	$300,000 each fiscal year to increase, by over 600,000 persons, the capacity of existing community‑based organizations to provide outreach services to individuals at risk for HIV/AIDS.
(2)	$300,000 each fiscal year to increase the capacity of local health departments in counties where increased community‑based organization efforts occur for the examination and treatment of persons referred by the community‑based organizations and to establish alternate counseling and testing sites that are based either at the local health department or at the community‑based organization.
(3)	$400,000 each fiscal year to provide funding for the development of new community‑based organizations to provide outreach and referral services for persons at risk for HIV/AIDS. The primary focus of no fewer than one‑half of the community‑based organizations developed with funds allocated by this subdivision shall be services to racial and ethnic minority populations across the State.
SECTION 4.  The Department of Health and Human Services shall study ways to improve HIV/AIDS prevention and care programs.  The Department shall report to the General Assembly on the results of the study no later than May 1, 2002.  The study shall include the following:
(1)	Ways to improve the efficiency of current HIV/AIDS prevention and care programs to ensure that current available funds are put to the optimal use. This study shall include an analysis of the changing demographics of the HIV/AIDS epidemic to ensure that prevention funds are targeted at population subgroups most at risk.
(2)	A review of prevention programs operated by other states or localities that are not currently offered by this State. This review shall include a study of the effectiveness of the programs, any barriers to offering the programs in this State, an estimate of the costs involved with offering these programs, and ways in which a specific program might be adapted to meet the needs of this State.
(3)	A study of the effectiveness of various clean and safe syringe exchange programs operated in other jurisdictions. This study shall look at various models for clean and safe syringe exchange programs, such as government‑funded programs, privately‑funded programs, and jurisdictions where purchases of sterile syringes have been deregulated. This study shall include an analysis of transmission rates before and after the establishment of the program and of illegal drug usage rates before and after the establishment of the program.
(4)	A study of the feasibility of requiring the use of safer syringes.
(5)	Any other matter the Department finds relevant to the issue.
SECTION 5.  This act becomes effective July 1, 2001.