ut-20261015-R384-900: R384-900. Special Measures for the Operation of Syringe Exchange Programs

1. Agency Information

Title catchline: Health and Human Services, Population Health, Health Promotion and Prevention Building: Cannon Health Building Street address: 288 N 1460 W City, state: Salt Lake City, UT 84116 Mailing address: PO Box 142104 City, state and zip: Salt Lake City, UT 84114-2104

2. Contact Persons

Name: Phone: Email: Tricia Bishop 385-261-3726 triciaabishop@utah.gov Mariah Noble 385-214-1150 mariahnoble@utah.gov Please address questions regarding information on this notice to the persons listed above.

A. Rule or section catchline:

R384-900. Special Measures for the Operation of Syringe Exchange Programs

B. Purpose of the new rule or reason for the change:

HB 205 of the 2026 General Session added rulemaking requirements to Section 26B-7-117, rendering this filing necessary. UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 23 NOTICES OF PROPOSED RULES

C. Summary of the new rule or change:

This amendment updates administrative rule language to conform with the changes HB 205, passed in the 2026 General Session, made in Section 26B-7-117, which specified restrictions on distribution materials and conditions for operating a syringe exchange activities on land owned, operated, or under the jurisdiction of a government entity. This amendment establishes procedures necessary to implement these new statutory requirements and operational restrictions for syringe exchange programs in Utah. Public comments may be submitted using the Google Form at: https://docs.google.com/forms/d/e/1FAIpQLScLMIq5KlFSUm0i16HM0Kmaf3dAnVk2pVj86MQqbtP0FuAUtQ/viewform?usp= header 4. Legislative Action Information

B. If yes, any bill number and HB 205 (2026 General Session)

session: 5. Fiscal Information Provide an estimate and written explanation of the aggregate anticipated cost or savings to:

A. State budget:

There is no anticipated cost or savings to the state budget as a result of this proposed rule change, as this filing establishes procedures for an operating entity to obtain permission from a government entity before conducting syringe exchange activities on public property. These procedures are necessary to implement new statutory requirements in Section 26B-7-117. Any additional workload to program staff as a result of the new procedures specified in this rule is anticipated to be minimal enough to be absorbed through current program infrastructure. No new state appropriations are anticipated as a direct result of this rule amendment, and these changes have no anticipated fiscal impact on the program in relation to the state budget. The state may experience minor administrative impacts associated with reviewing and issuing written authorization for syringe exchange activities occurring on property that is owned, operated, or under the jurisdiction of the state. These activities are anticipated to be infrequent and managed within existing administrative processes. Therefore, there is no anticipated fiscal impact to the state as a result of that change.

B. Local governments:

Local government entities may experience minor administrative impacts associated with reviewing and issuing written authorization for syringe exchange activities occurring on property that is owned, operated, or under the jurisdiction of a local government entity. These activities are anticipated to be infrequent and managed within existing administrative processes. Therefore, there is no anticipated fiscal impact to local governments as a result of this change.

C. Small businesses ("small business" means a business employing 1-49 persons):

Some syringe exchange programs or affiliated operators that qualify as small businesses may need to update internal policies, staff training materials, or operational procedures to ensure compliance with the revised requirements in this filing. Each small business's operating procedures vary, so while these one-time updates are expected to occur as part of routine business operations at minimal cost, if any, the amount of these costs is inestimable. 24 UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 NOTICES OF PROPOSED RULES

D. Non-small businesses ("non-small business" means a business employing 50 or more persons):

There is no anticipated fiscal impact to non-small business because there are no known operating entities that qualify as non- small businesses, and therefore this rule does not apply to this group. E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency): Some syringe exchange programs or affiliated operators that qualify as other persons, including nonprofit entities, may need to update internal policies, staff training materials, or operational procedures to ensure compliance with the revised requirements in this filing. Each nonprofit's operating procedures vary, so while these one-time updates are expected to occur as part of routine operations at minimal cost, if any, the amount of these costs is inestimable.

F. Compliance costs for affected persons:

There are no anticipated compliance costs for state or local governments as a result of this filing because any administrative impacts are anticipated to be managed within existing administrative processes. For small businesses and nonprofit entities that operate syringe exchange programs, there may be a compliance cost to update internal policies, staff training materials, or operational procedures, but as each small business and nonprofit's operating procedures vary, it is impossible to estimate how much this compliance cost will be for each operating entity. 6. Regulatory Impact Summary Table Enter the cost or savings in the relevant cell. If there is no cost or savings, enter, "$0." If a cost or savings is inestimable, enter, "inestimable." Fiscal Cost FY2027 FY2028 FY2029 FY2030 FY2031 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses inestimable $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons inestimable $0 $0 $0 $0 Total Fiscal Cost inestimable $0 $0 $0 $0 Fiscal Benefits FY2027 FY2027 FY2027 FY2027 FY2027 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses $0 $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons $0 $0 $0 $0 $0 Total Fiscal Benefits inestimable $0 $0 $0 $0 Net Fiscal Benefits Inestimable $0 $0 $0 $0 7. Regulatory Impact Analysis Approval The Commissioner of the Department of Health and Human Services, Tracy S. Gruber, has reviewed and approved this regulatory impact analysis. 8. Family Impact Information

A. The agency has considered this rule's impact on family health, stability, and fo☒mation:

UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 25 NOTICES OF PROPOSED RULES 9. Citation Information Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement: Section 26B-7-117 11. Public Notice Information The public may submit written or oral comments to the agency identified in box 1.

A. Comments will be accepted until: 11/16/2026

12. Effective Date Information This rule change MAY become effective on: 11/23/2026 (NOTE: This is the date the agency anticipates making the filing effective. It is NOT the effective date) 13. Agency Authorization Information Agency head or Tracy S. Gruber, Commissioner Date: 09/30/2026 designee and title: R384. Health and Human Services, Population Health, Health Promotion and Prevention. R384-900. Special Measures for the Operation of Syringe Exchange Programs. R384-900-1. Authority and Purpose. (1) Section 26B-7-117 authorizes this rule. (2) This rule establishes the operating and reporting requirements required of an entity operating a syringe exchange program pursuant to Section 26B-7-117. R384-900-2. Definitions. (1) "Department" means the Department of Health and Human Services. (2) "Government entity" means the same as defined in Subsection 26B-7-117(1). (3) "HBV" means hepatitis B virus. ([3]4) "HCV" means hepatitis C virus. ([4]5) "HIV" means human immunodeficiency virus. ([5]6) "Homeless shelter" means the same as defined in Section 35A-15-501. ([6]7)(a) "One-for-one plus exchange model" means the syringe exchange model in which a participant receives a set of syringes in an amount of up to nine more than the participant's return amount, with thresholds increasing in increments of ten. (b) For example, a return of: (i) one to ten used syringes receives up to ten sterile syringes; (ii) 11 to 20 used syringes receives up to 20 sterile syringes; and (iii) 21 to 30 used syringes receives up to 30 sterile syringes. ([7]8) "Operating entity" means a government or nongovernment entity authorized by Section 26B-7-117 to operate a syringe exchange program. ([8]9) "Opiate antagonist" means the same as defined in Section 26B-4-501. ([9]10) "Participant" means an individual who receives services from a syringe exchange program. ([10]11) "Substance use disorder treatment program" means the same as defined in Section 26B-2-101. ([11]12)(a) "Syringe exchange program" means a program that: ([a]i) provides access to sterile syringes in exchange for used syringes; ([b]ii) collects and properly disposes of used syringes; ([c]iii) provides information, referrals, and other services as identified by population and community needs to reduce the harms associated with drug use; and ([d]iv) may provide other clean and new prevention materials, including cotton filters, [cookers, tourniquets, ]alcohol swabs, and condoms. (b) Asyringe exchange program is subject to the requirements and restrictions of an operating entity in Subsection 26B-7-117(3). ([12]13) "Treatment" means services received by a participant from a substance use disorder treatment program. R384-900-3. Enrollment Requirements. (1)(a) An operating entity intending to begin a syringe exchange program in a local community shall meet with local stakeholders, which may include any: (i) public health, mental health, or substance use disorder treatment entity; (ii) local governing body; (iii) law enforcement agency with jurisdiction over the area; or 26 UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 NOTICES OF PROPOSED RULES (iv) community council. (b) An operating entity shall ensure that any meeting taking place in accordance with Subsection (1)(a): (i) assesses community readiness, norms, needs, and parameters for implementing a syringe exchange program in that area; (ii) creates awareness of the operating entity's plans and community partnerships; and (iii) provides education on the purposes and goals of a syringe exchange program and syringe exchange protocols. (2) At least 15 days before the start of a syringe exchange program in a new area, the operating entity shall provide the department with the following through the Violence and Injury Prevention Program'sAgency Enrollment form: (a) written notice of intent to conduct syringe exchange activities; (b) a signed attestation to comply with each applicable statute and rule, to be renewed annually; (c) a summary of any meeting held according to Subsection (1), including a list of participants, a summary of the discussion, any outcome, and any plan for implementation; (d) documentation for each service area where syringe exchange will be conducted upon enrollment; (e) a safety protocol for the prevention of needle stick and sharps injury; and (f)(i) a sharps disposal plan for each county where the operating entity will be offering services. (ii) Sharps disposal is the financial responsibility of the operating entity. R384-900-4. Operating Requirements. (1) An operating entity shall facilitate the exchange of a participant's used syringes by providing a disposable, medical grade sharps container for the disposal of used syringes. (2) An operating entity shall exchange one or more new syringes in sealed sterile packages and may provide other clean and new prevention materials to the individual free of charge. (3) An operating entity shall adhere to the one-for-one plus exchange model. (4) As available, the department may provide syringes, prevention materials, education materials, and other resources to an entity operating a syringe exchange program. (5) At least quarterly, an operating entity shall provide each participant of the syringe exchange program with verbal and written instructions on: (a) methods for preventing the transmission of blood borne pathogens, including HBV, HCV, and HIV; (b) information and referral for HCV and HIV testing; (c) information and referral to services for the treatment of a substance use disorder; and (d) how and where to obtain an opiate antagonist. (6) An operating entity shall adhere to requirements in Subsections 26B-7-117(5) and (6). (7) If an operating entity discontinues syringe exchange activities, the operating entity must submit to the department written notice through the Violence and Injury Prevention Program'sAgency Unenrollment form within 15 days of ending activities. (8) An operating entity that obtains written authorization to operate on public property in accordance with Subsections 26B-7-117(6) through 26B-7-117(7) shall maintain documentation of the authorization and provide that documentation to the department upon request. R384-900-5. Data Collection and Reporting Requirements. (1) Each operating entity shall collect the following aggregate data elements: (a) the number of individuals who exchange syringes; (b) a self-reported or approximate number of used syringes exchanged for new syringes; (c) the number of new syringes provided in exchange for used syringes; (d) the number of participants who receive services for the treatment of a substance use disorder within 12 months of exchanging syringes, assessed at least quarterly for each participant; (e) a self-reported or approximate number of participants successfully connected to treatment; (f) information on educational materials distributed, as required by the Syringe Exchange Quarterly Report Form; (g) the number of referrals provided; and (h) the number of opiate antagonists distributed to participants. (2)(a) Each entity shall report the aggregate data elements in Subsection (1) to the department quarterly through the Violence and Injury Prevention Program's Quarterly Log form. (b) The report shall include: (i) a brief description of the information the program provided to participants about recovery and treatment resources; and (ii) a brief description of the services and supplies provided to participants. R384-900-6. Confidentiality of Reports. (1) The department may collect and maintain data on syringe exchange programs and syringe exchange program participants, as provided in Sections 26B-7-117 and 26B-8-402. (2) Any identifiable information collected pursuant to this rule may not be released or made public, except as provided in Sections 26B-8-406 and 26B-8-407. R384-900-7. Compliance and Penalty. (1) The Violence and Injury Prevention Program shall evaluate each syringe exchange program through annual monitoring and site visits as necessary, pursuant to Section 26B-1-226, to ensure compliance with each applicable statute and rule. UTAH STATE BULLETIN, October 15, 2026, Vol. 2026, No. 20 27 NOTICES OF PROPOSED RULES (2) Aperson or operating entity who violates this rule or Section 26B-7-117 may be subject to a penalty, as provided in Section 26B- 1-224. (3) The department may revoke the enrollment of a syringe exchange program that does not comply with this rule. KEY: syringe exchange programs, needles, syringes Date of Last Change: [February 25, ]2026 Authorizing, and Implemented or Interpreted Law: 26B-7-117 NOTICE OF SUBSTANTIVE CHANGE TYPE OF FILING: Amendment Filing ID: 58278