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.