By: Luna S.B. No. 799 A BILL TO BE ENTITLED AN ACT 1-1 relating to harm reduction programs to reduce the risk of 1-2 transmission HIV infection of acquired immune deficiency syndrome. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Chapter 85, Health and Safety Code, is amended by 1-5 adding Subchapter H to read as follows: 1-6 SUBCHAPTER H. HARM REDUCTION PROGRAMS 1-7 Sec. 85.161. FINDINGS; PURPOSE. (a) The purpose of this 1-8 subchapter is to establish HIV infection and AIDS harm reduction 1-9 programs to combat the spread of infectious and communicable 1-10 diseases. 1-11 (b) The legislature finds that: 1-12 (1) there is a growing public health problem in the 1-13 state due to the rapid spread of HIV infection and AIDS and other 1-14 communicable diseases such as tuberculosis and hepatitis B, which 1-15 are generally associated with the chronic disease of addiction; 1-16 (2) 25 percent of new AIDS cases reported in this 1-17 state in 1993 were in the population that injects drugs; 1-18 (3) 55 percent of heterosexual men and women who have 1-19 AIDS were injecting drug users or had a sexual partner who was an 1-20 injecting drug user; 1-21 (4) nationally, 56 percent of children younger than 13 1-22 years of age with AIDS had a parent who was an injecting drug user; 1-23 (5) 13.3 per 100,000 persons in this state have 2-1 tuberculosis and 7.3 per 100,000 persons in this state have 2-2 hepatitis B; 2-3 (6) there are an estimated 59,759 medically indigent 2-4 injecting drug users in this state and 53,648 of those persons are 2-5 not receiving drug abuse treatment, which places them at high risk 2-6 for HIV infection; 2-7 (7) preventing HIV infection is a high priority since 2-8 every symptomatic case costs $119,000 to treat, with the future 2-9 costs of treating just the estimated 73,000 Texans that are 2-10 currently HIV positive being $6,687,000,000; 2-11 (8) a harm reduction approach to HIV infection and 2-12 AIDS provides a continuum of strategies for those who are 2-13 chemically addicted, which also protects the health and well-being 2-14 of the community; 2-15 (9) research conducted by the United States General 2-16 Accounting Office and the United States Centers for Disease Control 2-17 and Prevention of the United States Public Health Service on 2-18 programs in other states and abroad that use needle exchange as a 2-19 harm reduction strategy demonstrates that needle exchange programs: 2-20 (A) do not increase drug use and do not attract 2-21 new users; 2-22 (B) reduce the transmission of HIV by injecting 2-23 drug users, such as an 33 percent reduction among clients in the 2-24 New Haven, Connecticut Needle Exchange Harm Reduction Program; 2-25 (C) provide a link to drug treatment and other 3-1 health services; 3-2 (D) decrease the number of needles and syringes 3-3 discarded in parks and neighborhood streets; and 3-4 (E) constitute effective outreach to hard-core, 3-5 normally inaccessible drug users; 3-6 (10) the following recommendations have been made by 3-7 organizations established to study HIV infection and AIDS related 3-8 problems: 3-9 (A) the Texas Commission on Alcohol and Drug 3-10 Abuse's HIV Networking Group, in updating the Texas State Plan to 3-11 serve substance abusers at risk of HIV infection, recommends making 3-12 sterile needles available to injecting drug users and recommends 3-13 the removal of barriers to life-saving strategies; 3-14 (B) the department, in managing the development 3-15 of Texas Year 2000 Health Objectives, recommends: 3-16 (i) increased drug treatment services; 3-17 (ii) intensive education and outreach 3-18 efforts to reduce HIV infection among substance abusers; and 3-19 (iii) the provision of a comprehensive 3-20 range of prevention, intervention, and treatment services for all 3-21 areas of the state; and 3-22 (C) the HIV/AIDS Interagency Coordinating 3-23 Council, required by Section 85.017 to make recommendations to the 3-24 legislature concerning HIV prevention, has recommended that the law 3-25 be changed to allow for the establishment of needle exchange 4-1 programs; 4-2 (11) the relatively low rate of HIV infection among 4-3 injecting drug users in this state as compared to 50 to 60 percent 4-4 in some east coast cities makes this an ideal time to establish 4-5 harm reduction programs in Texas; 4-6 (12) providing treatment to reduce injecting drug use 4-7 and providing means for safer injection are complementary rather 4-8 than contradictory forms of both AIDS prevention and drug abuse 4-9 prevention, and harm reduction programs should be regarded as just 4-10 one weapon in the fight against HIV infection and AIDS in a 4-11 population that is both at very high risk and traditionally hard to 4-12 reach; 4-13 (13) the key educational message of such a harm 4-14 reduction program is that sharing injection equipment carries with 4-15 it the likelihood of contracting HIV infection and of infecting 4-16 one's partner or child with the deadly virus; and 4-17 (14) behaviors related to injecting drug use account 4-18 for one of the fastest growing rates of exposure to HIV infection 4-19 in this state. 4-20 Sec. 85.162. LEGISLATIVE DECLARATION. The legislature 4-21 declares that it is in the public interest to break the deadly 4-22 connection between HIV infection and AIDS and injecting drug use by 4-23 allowing legal access to clean needles and syringes in a 4-24 comprehensive effort to reduce the spread of HIV infection and 4-25 AIDS. 5-1 Sec. 85.163. DEMONSTRATION AIDS HARM REDUCTION PROGRAMS. A 5-2 local health agency with approval of the local governing entity may 5-3 establish a demonstration program in each of the five 5-4 municipalities with the highest incidences of reported AIDS cases 5-5 as of September 1, 1994. 5-6 Sec. 85.164. REPORT. A governmental unit that elects to 5-7 establish a demonstration program or a person conducting a program 5-8 shall submit a report evaluating the effectiveness of the program 5-9 to the legislature. 5-10 Sec. 85.165. EFFECT OF OTHER LAW. Sections 481.125 (a) and 5-11 (b) do not apply to: 5-12 (1) a person or organization conducting a harm 5-13 reduction program authorized by this subchapter; or 5-14 (2) a person receiving needles or syringes from a harm 5-15 reduction program authorized by this subchapter. 5-16 Sec. 85.166. DISTRIBUTION OF NEEDLES AND SYRINGES TO 5-17 PROGRAM. A person licensed as a wholesale drug distributor under 5-18 Chapter 431 may distribute needles and syringes to a harm reduction 5-19 program authorized by this subchapter. 5-20 Sec. 85.167. HANDLING OF NEEDLES AND SYRINGES. (a) A harm 5-21 reduction program authorized by this subchapter shall store needles 5-22 and syringes in a manner so as to be available only to authorized 5-23 personnel and not to be openly available to program clients. 5-24 (b) Used needles and syringes awaiting destruction shall be 5-25 securely safeguarded until they are destroyed. 6-1 (c) Used needles and syringes shall be destroyed in a manner 6-2 that makes those needles and syringes unrecoverable. 6-3 SECTION 2. This Act takes effect on September 1, 1995. 6-4 SECTION 3. The importance of this legislation and the 6-5 crowded condition of the calendars in both houses create an 6-6 emergency and an imperative public necessity that the 6-7 constitutional rule requiring bills to be read on three several 6-8 days in each house be suspended, and this rule is hereby suspended.