Indiana House members discussed for less than 30 minutes Wednesday before voting 70-22 to expand state approval for syringe services programs five more years.
State lawmakers first authorized the programs in 2015, in response to a historic HIV outbreak in Scott County. The current approval ends in July.
There are programs operating in six counties, including Clark and Marion. They provide clean syringes and take in used ones, access to HIV and Hepatitis C testing and connections to addiction treatment.
"I think it's important to remember that syringe service programs are about a lot more than needles," Republican Rep. Ed Clere said on the House floor ahead of the vote Wednesday. He pointed to 2023 information from the Indiana Department of Health showing referrals for substance use treatment, HIV testing and housing, and naloxone distribution.
"These programs get people in the door with access to sterile syringes and then they provide so much more."
Clere is a sponsor of the bill and authored legislation authorizing the programs more than a decade ago.
The bill's original language, authored by Republican Sen. Michael Crider, would have extended approval to 2036. But there have been big changes in the House version compared with what the Senate passed in late January.
It now includes residency and ID requirements, and for the programs to adhere to a one-to-one exchange and be a certain distance from certain buildings, like schools and places of worship, unless they give explicit approval.
Some advocates have said some of the new changes — such as the ID requirement — will mean lower participation.
Multiple people spoke against it at a recent House committee hearing.
Tony Hostetler, a community organizer with the Care, Not Cuffs chapter of Hoosier Action, told LPM News ahead of the vote Wednesday that it takes a lot to get people to walk in the door as it is.
"Absolutely yes, because we are so stigmatized," he said.
Having to show ID could compromise trust.
"I don't know if they'll feel safe doing that, because now, their name is attached to it," he said, adding that clients might worry about who can see that data.
"These new provisions no question present challenges, but I think they also provide opportunities," Clere said on the House floor.
Clere's amendment modifying the geographic requirement to allow people in counties connected to Marion to use services there was one of three passed during second reading this week. It also increased the extension by five years. The bill passed out of committee with a two-year extension.
The five-year extension, Clere said, will allow time for more data collection and community conversations which he said he hopes sparks additional local buy-in.
"I think over time, it will strengthen syringe service in Indiana, and as a result, strengthen all of the other services that are provided through these programs," Clere said.
Several representatives spoke ahead of the vote asking for support including Republican Rep. Brad Barrett, who chairs the House Public Health Committee.
He said it's not a matter of whether a person who injects drugs will do so, but that "if they don't have a clean syringe, they're going to use a dirty syringe."
He also said the added requirements are a meaningful way to address concerns.
"As long as I've been in this body, all we've done is kick the can down the road. Every two years, every four years, we change the sunset date," he said.
"This is the first time that I remember we've actually put some guardrails and some accountability and some one-to-one on this…"
He also pointed out that no state dollars pay for the programs, unless for treatment for someone with HIV or Hepatitis C.
Republican Rep. Matt Hostettler referenced 2023 information from the state showing that the programs had distributed around 11.9 million syringes since 2015, and brought in nearly 9.9 million. He said that means around 2 million more needles were put into the system than what was returned, or more than 232,000 a year.
"It's been a very successful needle distribution program so far," he said.
He also pointed out that while the legislation has an ID requirement, there's not an age limit, like for alcohol or tobacco.
"This is sending a really mixed message on our priorities," Hostettler said.
Information from the report shows that in the first nine months of 2023, the main reason clients gave for not returning syringes was that it was their first visit. The second most common response was that the syringes were lost or stolen.
Clark County, a neighbor to Scott County, started its program in 2017 and as of last August, had more than 1,800 participants since opening.
Between July 2024 and July 2025, the program's syringe return rate among participants was more than 87%, with an overall rate – including those turned in by the wider community — of more than 100%.
Last summer, the program stopped giving out certain federally funded harm-reduction supplies that had already been purchased, following an executive order from President Donald Trump.
The program continues to provide those supplies from private funding and has always used private funding for syringes themselves.
The amended bill will need final Senate approval before heading to the governor's office.
The session is expected to wrap up next week.
Coverage of Southern Indiana is funded, in part, by Samtec Inc., the Hazel & Walter T. Bales Foundation, and the Caesars Foundation of Floyd County.
Copyright 2026 LPM News
