Needle-Exchange Bill Barely Hanging On

State Rep. Dianne White Delisi, R-Temple, is not a doctor. She does not hold a doctorate degree. She doesn't even play a doctor on TV. Still, a lack of credentials didn't stop her from playing doctor under the dome last week, where, as chair of the House Public Health Committee, she single-handedly pulled a quack job that has all but killed Senate Bill 308, one of the session's most progressive public health policies.

The bill, authored by Sen. Robert Deuell, R-Greenville, would allow a local health department to establish a one-for-one anonymous hypodermic-needle-exchange program. Needle exchange is a harm-reduction program that seeks to reduce the spread of communicable diseases, such as HIV and hepatitis C. Forty-nine states have some form of legal needle exchange, which lets intravenous drug users trade dirty needles for clean ones – in part, a way to ensure proper disposal of hazardous medical waste. Although technically illegal in Texas – needles are illegal drug paraphernalia – needle-exchange programs operate here, undercover or in a quasi-alliance with law-enforcement agencies that fully grasp the wisdom of making sure addicts shoot clean.

Texas lawmakers grasp the concept also – addicts who shoot clean pose less risk to emergency personnel, including police, paramedics, emergency doctors, and nurses – in part because Deuell did a commendable job highlighting the documented benefits of needle-exchange programs. Notably, one-for-one needle exchange does not increase drug use (as those inclined to moral panic might think), does reduce the spread of disease (studies show it can reduce the spread of HIV by up to 30%), and does provide easy access to drug rehabilitation services – a point-of-access requirement Deuell included in his bill. The measure earned the support of the state's major medical groups – including the Scott & White clinic in Temple, the Central Texas institution founded by Delisi's grandfather.

During a favorable hearing in the Senate Health and Human Services Committee, the measure earned support from Committee Chair Sen. Jane Nelson, R-Lewisville, and Sen. Kyle Janek, R-Houston, also a doctor – two lawmakers previously opposed to needle-exchange legislation when it made the rounds in 2003 and 2005. The measure passed with a healthy 22-7 vote on the Senate floor, and lawmakers and advocates seemed confident it would be similarly embraced as it moved to the House.

That didn't happen. Referred to the House Public Health Committee, chaired by Delisi, the bill sat … and sat … and sat, with no scheduled hearing date. What was going on behind legislative doors – and in particular, behind Delisi's office door – isn't clear, but it was nearly a month after the bill left the senate that Delisi finally agreed to call it up for a hearing May 14. According to lawmakers close to the action, as she did so, Delisi made it clear she had no intention of passing the bill on to the full House for consideration. She didn't even show up for the hearing.

The situation has stunned insiders who say they have no idea why Delisi is so boldly and without explanation thwarting the legislative process. Neither she nor James Cooley, her chief of staff, returned numerous calls from the Chronicle requesting comment, but Delisi told the Houston Chronicle that she opposed the measure because she has "not been persuaded that the public health benefits outweigh the concerns of many members, myself included, of providing needles for those that are using illegal drugs."

Opposition is fine, says SB 308's House sponsor, Rep. Ruth Jones McClendon, D-San Antonio – if Delisi didn't like the measure she simply had to vote "no" on its passage. But she didn't do that – instead, she has become a penny on the train track, derailing the bill without a shred of respect for the democratic process. "This is my 11th year [in the Legislature], and I've never seen anything like this," McClendon said. "I've never seen a member [refuse] to engage on the subject of a bill." Instead, Delisi has been "just a closed ear," she said. "It's just so disrespectful."

Perhaps if Delisi actually showed up to the committee hearing – where no one testified against the measure – she could have asked questions to clear up any doubts she might have, says Deuell aide Scot Kibbe. "She'd agreed to hear the bill, but that's all we were able to get," said Kibbe, even though the "votes [were] there" to pass it on to the full House for consideration. Deuell and supporters have plenty of "relevant [and] cogent" information for Delisi, he said, but presenting it to her "has not been an option," and to date, Delisi has not explained her position to Deuell. (One theory floating around the Capitol last week suggested that Delisi was carrying water for Gov. Rick Perry, as part of some as-yet-undisclosed tit-for-tat legislative back-scratching, but dome insiders say the governor's office has adamantly denied any involvement in killing the bill.)

Delisi's childlike behavior killed a comprehensive version of the progressive and fiscally responsible preventative health policy. During House floor debate on May 21, Delisi reiterated her myopic view that the public health benefits of needle exchange are considerably less important than the state's need to "do everything we can to lessen the opportunity for intravenous drug use." Delisi's confounding logic notwithstanding, McClendon resurrected a portion of the policy, successfully amending on a 71-60 vote the state's Medicaid bill (Committee Substitute Senate Bill 10) to allow for a needle pilot program in Bexar Co.