By Van de Putte H.B. No. 1963 A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to harm reduction programs to reduce the risk of 1-3 transmission HIV infection of acquired immune deficiency syndrome. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Chapter 85, Health and Safety Code, is amended by 1-6 adding Subchapter H to read as follows: 1-7 SUBCHAPTER H. HARM REDUCTION PROGRAMS 1-8 Sec. 85.161. FINDINGS; PURPOSE. (a) The purpose of this 1-9 subchapter is to establish HIV infection and AIDS harm reduction 1-10 programs to combat the spread of infectious and communicable 1-11 diseases. 1-12 (b) The legislature finds that: 1-13 (1) there is a growing public health problem in the 1-14 state due to the rapid spread of HIV infection and AIDS and other 1-15 communicable diseases such as tuberculosis and hepatitis B, which 1-16 are generally associated with the chronic disease of addiction; 1-17 (2) 25 percent of new AIDS cases reported in this 1-18 state in 1993 were in the population that injects drugs; 1-19 (3) 55 percent of heterosexual men and women who have 1-20 AIDS were injecting drug users or had a sexual partner who was an 1-21 injecting drug user; 1-22 (4) nationally, 56 percent of children younger than 13 1-23 years of age with AIDS had a parent who was an injecting drug user; 2-1 (5) 13.3 per 100,000 persons in this state have 2-2 tuberculosis and 7.3 per 100,000 persons in this state have 2-3 hepatitis B; 2-4 (6) there are an estimated 59,759 medically indigent 2-5 injecting drug users in this state and 53,648 of those persons are 2-6 not receiving drug abuse treatment, which places them at high risk 2-7 for HIV infection; 2-8 (7) preventing HIV infection is a high priority since 2-9 every symptomatic case costs $119,000 to treat, with the future 2-10 costs of treating just the estimated 73,000 Texans that are 2-11 currently HIV positive being $6,687,000,000; 2-12 (8) a harm reduction approach to HIV infection and 2-13 AIDS provides a continuum of strategies for those who are 2-14 chemically addicted, which also protects the health and well-being 2-15 of the community; 2-16 (9) research conducted by the United States General 2-17 Accounting Office and the United States Centers for Disease Control 2-18 and Prevention of the United States Public Health Service on 2-19 programs in other states and abroad that use needle exchange as a 2-20 harm reduction strategy demonstrates that needle exchange programs: 2-21 (A) do not increase drug use and do not attract 2-22 new users; 2-23 (B) reduce the transmission of HIV by injecting 2-24 drug users, such as an 33 percent reduction among clients in the 2-25 New Haven, Connecticut Needle Exchange Harm Reduction Program; 3-1 (C) provide a link to drug treatment and other 3-2 health services; 3-3 (D) decrease the number of needles and syringes 3-4 discarded in parks and neighborhood streets; and 3-5 (E) constitute effective outreach to hard-core, 3-6 normally inaccessible drug users; 3-7 (10) the following recommendations have been made by 3-8 organizations established to study HIV infection and AIDS related 3-9 problems: 3-10 (A) the Texas Commission on Alcohol and Drug 3-11 Abuse's HIV Networking Group, in updating the Texas State Plan to 3-12 serve substance abusers at risk of HIV infection, recommends making 3-13 sterile needles available to injecting drug users and recommends 3-14 the removal of barriers to lifesaving strategies; 3-15 (B) the department, in managing the development 3-16 of Texas Year 2000 Health Objectives, recommends: 3-17 (i) increased drug treatment services; 3-18 (ii) intensive education and outreach 3-19 efforts to reduce HIV infection among substance abusers; and 3-20 (iii) provision of a comprehensive range 3-21 of prevention, intervention and treatment services for all areas of 3-22 the state; and 3-23 (C) the HIV/AIDS Interagency Coordinating 3-24 Council, required by Section 85.017 to make recommendations to the 3-25 legislature concerning HIV prevention, has recommended that the law 4-1 be changed to allow for the establishment of needle exchange 4-2 programs; and 4-3 (D) the National Commission on AIDS recommends 4-4 that "Legal barriers to the purchase and possession of injection 4-5 equipment should be removed. Legal barriers do not reduce illicit 4-6 drug injection. They do, however, limit the availability of new, 4-7 clean, injection equipment, thereby encouraging the sharing of 4-8 injection equipment, and the increase in HIV transmission." 4-9 (11) the relatively low rate of HIV infection among 4-10 injecting drug users in this state as compared to 50 to 60 percent 4-11 in some east coast cities makes this an ideal time to establish 4-12 harm reduction programs in Texas; 4-13 (12) providing treatment to reduce injecting drug use 4-14 and providing means for safer injection are complementary rather 4-15 than contradictory forms of both AIDS prevention and drug abuse 4-16 prevention, and harm reduction programs should be regarded as just 4-17 one weapon in the in the fight against HIV infection and AIDS in a 4-18 population that is both at very high risk and traditionally hard 4-19 to reach; 4-20 (13) the key educational message of such a harm 4-21 reduction program is that sharing injection equipment carries with 4-22 it the likelihood of contracting HIV infection and of infecting 4-23 one's partner or child with the deadly virus; and 4-24 (14) behaviors related to injecting drug use account 4-25 for one of the fastest growing rates of exposure to HIV infection 5-1 in this state. 5-2 Sec. 85.162. LEGISLATIVE DECLARATION. The legislature 5-3 declares that it is in the public interest to break the deadly 5-4 connection between HIV infection and AIDS and injecting drug use by 5-5 allowing legal access to clean needles and syringes in a 5-6 comprehensive effort to reduce the spread of HIV infection and 5-7 AIDS. 5-8 Sec. 85.163. HARM REDUCTION PROGRAMS. (a) A local health 5-9 agency with approval of the local governing entity may establish 5-10 harm reduction programs. 5-11 Sec. 85.164. REPORT. A local heath agency or a person 5-12 conducting a harm reduction program shall submit a report 5-13 evaluating the effectiveness of the program to the department. 5-14 Sec. 85.165. EFFECT OF OTHER LAW. Sections 481.125(a) and 5-15 (b) do not apply to: 5-16 (1) a person or organization conducting a harm 5-17 reduction program authorized by this subchapter; or 5-18 (2) a person receiving needles or syringes from a harm 5-19 reduction program authorized by this subchapter. 5-20 Sec. 85.166. DISTRIBUTION OF NEEDLES AND SYRINGES TO 5-21 PROGRAM. A person licensed as a wholesale drug distributor or 5-22 wholesale medical device distributor under Chapter 431 may 5-23 distribute needles and syringes to a harm reduction program 5-24 authorized by this subchapter. 5-25 Sec. 85.167. HANDLING OF NEEDLES AND SYRINGES. (a) A harm 6-1 reduction program authorized by this subchapter shall store needles 6-2 and syringes in a manner so as to be available only to authorized 6-3 personnel and not to be openly available to program clients. 6-4 (b) Used needles and syringes awaiting destruction shall be 6-5 securely safeguarded until they are destroyed. 6-6 (c) Used needles and syringes shall be destroyed in a manner 6-7 that makes those needles and syringes unrecoverable. 6-8 SECTION 2. This Act takes effect on September 1, 1995. 6-9 SECTION 3. The importance of this legislation and the 6-10 crowded condition of the calendars in both houses create an 6-11 emergency and an imperative public necessity that the 6-12 constitutional rule requiring bills to be read on three several 6-13 days in each house be suspended, and this rule is hereby suspended.