1-1 By: Luna S.B. No. 799
1-2 (In the Senate - Filed February 28, 1995; March 1, 1995, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 5, 1995, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 4; April 5, 1995,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 799 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to harm reduction programs to reduce the risk of
1-11 transmission of human immunodeficiency virus infection and acquired
1-12 immune deficiency syndrome.
1-13 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-14 SECTION 1. Chapter 85, Health and Safety Code, is amended by
1-15 adding Subchapter H to read as follows:
1-16 SUBCHAPTER H. HARM REDUCTION PROGRAMS
1-17 Sec. 85.161. FINDINGS; PURPOSE. (a) The purpose of this
1-18 subchapter is to establish HIV infection and AIDS harm reduction
1-19 programs to combat the spread of infectious and communicable
1-20 diseases.
1-21 (b) The legislature finds that:
1-22 (1) there is a growing public health problem in the
1-23 state due to the rapid spread of HIV infection and AIDS and other
1-24 communicable diseases such as tuberculosis and hepatitis B, which
1-25 are generally associated with the chronic disease of addiction;
1-26 (2) 25 percent of new AIDS cases reported in this
1-27 state in 1993 were in the population that injects drugs;
1-28 (3) 55 percent of heterosexual men and women who have
1-29 AIDS were injecting drug users or had a sexual partner who was an
1-30 injecting drug user;
1-31 (4) nationally, 56 percent of children younger than 13
1-32 years of age with AIDS had a parent who was an injecting drug user;
1-33 (5) 13.3 per 100,000 persons in this state have
1-34 tuberculosis and 7.3 per 100,000 persons in this state have
1-35 hepatitis B;
1-36 (6) there are an estimated 59,759 medically indigent
1-37 injecting drug users in this state and 53,648 of those persons are
1-38 not receiving drug abuse treatment, which places them at high risk
1-39 for HIV infection;
1-40 (7) preventing HIV infection is a high priority since
1-41 every symptomatic case costs a minimum of $119,000 to treat, with
1-42 the future costs of treating just the estimated 73,000 Texans who
1-43 are currently HIV positive being $6,687,000,000;
1-44 (8) a harm reduction approach to HIV infection and
1-45 AIDS provides a continuum of strategies for those who are
1-46 chemically addicted, which also protects the health and well-being
1-47 of the community;
1-48 (9) research conducted by the United States General
1-49 Accounting Office and the United States Centers for Disease Control
1-50 and Prevention of the United States Public Health Service on
1-51 programs in other states and abroad that use needle exchange as a
1-52 harm reduction strategy demonstrates that needle exchange programs:
1-53 (A) do not increase drug use and do not attract
1-54 new users;
1-55 (B) reduce the transmission of HIV infection by
1-56 injecting drug users, such as a 33 percent reduction among clients
1-57 in the New Haven, Connecticut, Needle Exchange Harm Reduction
1-58 Program;
1-59 (C) provide a link to drug treatment and other
1-60 health services;
1-61 (D) decrease the number of needles and syringes
1-62 discarded in parks and neighborhood streets; and
1-63 (E) constitute effective outreach to hard-core,
1-64 normally inaccessible drug users;
1-65 (10) the following recommendations have been made by
1-66 organizations established to study HIV infection and AIDS and
1-67 related problems:
1-68 (A) the Texas Commission on Alcohol and Drug
2-1 Abuse's HIV Networking Group, in updating the Texas State Plan to
2-2 serve substance abusers at risk of HIV infection, recommends making
2-3 sterile needles available to injecting drug users and recommends
2-4 the removal of barriers to lifesaving strategies;
2-5 (B) the department, in managing the development
2-6 of Texas Year 2000 Health Objectives, recommends:
2-7 (i) increased drug treatment services;
2-8 (ii) intensive education and outreach
2-9 efforts to reduce HIV infection among substance abusers; and
2-10 (iii) the provision of a comprehensive
2-11 range of prevention, intervention, and treatment services for all
2-12 areas of the state;
2-13 (C) the HIV/AIDS Interagency Coordinating
2-14 Council, required by Section 85.017 to make recommendations to the
2-15 legislature concerning HIV infection prevention, has recommended
2-16 that the law be changed to allow for the establishment of needle
2-17 exchange programs; and
2-18 (D) the National Commission on AIDS recommends
2-19 that "legal barriers to the purchase and possession of injection
2-20 equipment should be removed. Legal barriers do not reduce illicit
2-21 drug injection. They do, however, limit the availability of new,
2-22 clean, injection equipment, thereby encouraging the sharing of
2-23 injection equipment, and the increase in HIV transmission";
2-24 (11) the relatively low rate of HIV infection among
2-25 injecting drug users in this state as compared to 50 to 60 percent
2-26 in some east coast cities makes this an ideal time to establish
2-27 harm reduction programs in Texas;
2-28 (12) providing treatment to reduce injecting drug use
2-29 and providing means for safer injection are complementary rather
2-30 than contradictory forms of both AIDS prevention and drug abuse
2-31 prevention, and harm reduction programs should be regarded as just
2-32 one weapon in the fight against HIV infection and AIDS in a
2-33 population that is both at very high risk and traditionally hard to
2-34 reach;
2-35 (13) the key educational message of a harm reduction
2-36 program is that sharing injection equipment carries with it the
2-37 likelihood of contracting HIV infection and of infecting one's
2-38 partner or child with the deadly virus; and
2-39 (14) behaviors related to injecting drug use account
2-40 for one of the fastest-growing rates of exposure to HIV infection
2-41 in this state.
2-42 Sec. 85.162. LEGISLATIVE DECLARATION. The legislature
2-43 declares that it is in the public interest to break the deadly
2-44 connection between HIV infection and AIDS and injecting drug use by
2-45 allowing legal access to clean needles and syringes in a
2-46 comprehensive effort to reduce the spread of HIV infection and
2-47 AIDS.
2-48 Sec. 85.163. HARM REDUCTION PROGRAMS. (a) A local health
2-49 agency, with approval of the local governing entity, may establish
2-50 a harm reduction program.
2-51 (b) A program authorized by this subchapter shall:
2-52 (1) be incorporated into existing AIDS prevention and
2-53 outreach projects;
2-54 (2) provide for free and anonymous exchange of needles
2-55 and syringes and provide that program participants receive an equal
2-56 number of needles and syringes for those returned;
2-57 (3) offer education on the transmission and prevention
2-58 of HIV infection;
2-59 (4) assist program participants in obtaining drug
2-60 treatment services; and
2-61 (5) provide materials such as bleach or sterile cotton
2-62 to promote safe health practices.
2-63 (c) A program authorized by this subchapter may offer
2-64 referrals or services for other health-related issues such as
2-65 sexually transmitted diseases, tuberculosis testing, and general
2-66 health care.
2-67 Sec. 85.164. REPORT. A local health agency or a person
2-68 conducting a harm reduction program shall submit a report
2-69 evaluating the effectiveness of the program to the department.
2-70 Sec. 85.165. EFFECT OF OTHER LAW. Sections 481.125(a) and
3-1 (b) do not apply to:
3-2 (1) a person or organization conducting a harm
3-3 reduction program authorized by this subchapter; or
3-4 (2) a person receiving needles or syringes from a harm
3-5 reduction program authorized by this subchapter.
3-6 Sec. 85.166. DISTRIBUTION OF NEEDLES AND SYRINGES TO
3-7 PROGRAM. A person licensed as a wholesale drug distributor under
3-8 Chapter 431 may distribute needles and syringes to a harm
3-9 reduction program authorized by this subchapter.
3-10 Sec. 85.167. HANDLING OF NEEDLES AND SYRINGES. (a) A harm
3-11 reduction program authorized by this subchapter shall store needles
3-12 and syringes in a manner so as to be available only to authorized
3-13 personnel and not to be openly available to program clients.
3-14 (b) Used needles and syringes awaiting destruction shall be
3-15 securely safeguarded until they are destroyed.
3-16 (c) Used needles and syringes shall be destroyed in a manner
3-17 that makes those needles and syringes unrecoverable.
3-18 SECTION 2. This Act takes effect September 1, 1995.
3-19 SECTION 3. The importance of this legislation and the
3-20 crowded condition of the calendars in both houses create an
3-21 emergency and an imperative public necessity that the
3-22 constitutional rule requiring bills to be read on three several
3-23 days in each house be suspended, and this rule is hereby suspended.
3-24 * * * * *