By Van de Putte H.B. No. 866
75R3644 MCK-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to authorizing harm reduction programs to reduce the risk
1-3 of HIV infection and AIDS.
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. HARM REDUCTION PROGRAMS. (a) A local health
1-9 authority or other organization with the approval of the local
1-10 governmental entity may establish a harm reduction program.
1-11 (b) A program authorized by this subchapter must:
1-12 (1) be incorporated into existing AIDS prevention and
1-13 outreach programs;
1-14 (2) provide free and anonymous exchange of used
1-15 needles and syringes for an equal number of new needles and
1-16 syringes;
1-17 (3) offer education on the transmission and prevention
1-18 of HIV;
1-19 (4) assist program participants in obtaining drug
1-20 treatment services; and
1-21 (5) provide materials to promote safe health-related
1-22 practices, including use of bleach and sterile cotton.
1-23 (c) A program authorized by this subchapter may offer
1-24 referrals or services for other health-related issues, including
2-1 sexually transmitted diseases, tuberculosis testing, and general
2-2 health care.
2-3 Sec. 85.162. DISTRIBUTION OF NEEDLES AND SYRINGES TO
2-4 PROGRAM. A person licensed as a wholesale drug distributor or
2-5 wholesale medical device distributor under Chapter 431 may
2-6 distribute needles and syringes to a harm reduction program
2-7 authorized by this subchapter.
2-8 Sec. 85.163. HANDLING OF NEEDLES AND SYRINGES. (a) A harm
2-9 reduction program shall store needles and syringes in a proper and
2-10 safe manner. Only authorized employees or volunteers of the harm
2-11 reduction program may have access to the needles and syringes.
2-12 Program clients may obtain needles and syringes only from an
2-13 authorized employee or volunteer.
2-14 (b) A harm reduction program shall store and dispose of used
2-15 needles and syringes in accordance with board rule.
2-16 SECTION 2. Section 481.125, Health and Safety Code, is
2-17 amended by adding Subsection (g) to read as follows:
2-18 (g) It is an exception to the application of Subsections (a)
2-19 and (b) that the person uses, possesses, delivers, or manufactures
2-20 needles or syringes that are delivered or are to be delivered
2-21 through a harm reduction program established under Subchapter H,
2-22 Chapter 85.
2-23 SECTION 3. (a) The purpose of this Act is to authorize HIV
2-24 infection and AIDS harm reduction programs to combat the spread of
2-25 infectious and communicable diseases.
2-26 (b) The legislature finds:
2-27 (1) there is a growing health problem in this state
3-1 due to the rapid spread of HIV infection and AIDS and other
3-2 communicable diseases such as tuberculosis and hepatitis B, which
3-3 are generally associated with the chronic disease of drug
3-4 addiction;
3-5 (2) in 1986, an average of 76 new cases of AIDS were
3-6 reported monthly in this state; in 1995, this average had increased
3-7 to 390 new AIDS cases a month;
3-8 (3) the proportion of AIDS cases related to injecting
3-9 drug use in Texas has risen from 15 percent in 1988 to 24 percent
3-10 in 1995; the proportion of AIDS cases among women in Texas has
3-11 risen from 3 percent in 1985 to 12 percent in 1995;
3-12 (4) 24 percent of new AIDS cases reported in this
3-13 state in 1995 were in the population that injects drugs;
3-14 (5) 39 percent of women and 6 percent of heterosexual
3-15 men who have AIDS had a sexual partner who was an injecting drug
3-16 user;
3-17 (6) 20 percent of children younger than 13 years old
3-18 with AIDS had a mother who was an injecting drug user, and 13
3-19 percent of those children had a mother who was the sexual partner
3-20 of an injecting drug user;
3-21 (7) there are an estimated 26,837 medically indigent
3-22 injecting drug users in this state, and only 4,424 of those persons
3-23 are receiving drug abuse treatment, which places 22,413 of those
3-24 persons at high risk for HIV infection;
3-25 (8) a harm reduction approach to HIV infection and
3-26 AIDS is part of a continuum of strategies for those who are
3-27 chemically addicted and also protects the health and well-being of
4-1 the community;
4-2 (9) preventing HIV infection is a high priority
4-3 because:
4-4 (A) AIDS is the leading cause of death among all
4-5 Americans aged 25 to 44;
4-6 (B) each symptomatic case of AIDS costs $119,000
4-7 to treat, with $555,373,000 being the cost of treating just the
4-8 4,667 Texans reported with AIDS in 1995; and
4-9 (C) the relatively lower rate of HIV infection
4-10 among injecting drug users in this state, as compared to 50 to 60
4-11 percent in some East Coast cities, makes the establishment of harm
4-12 reduction programs in Texas essential to prevent further increases
4-13 in infection rates;
4-14 (10) research conducted by the United States General
4-15 Accounting Office and the United States Centers for Disease Control
4-16 and Prevention on programs in other states and other countries that
4-17 use needle exchange as a harm reduction strategy demonstrates that
4-18 needle exchange programs:
4-19 (A) do not increase drug use and do not attract
4-20 new users;
4-21 (B) reduce the transmission of HIV by injecting
4-22 drug users, including a 33-percent reduction among clients in the
4-23 New Haven, Connecticut, Needle Exchange Harm Reduction Program;
4-24 (C) provide a missing connection to drug
4-25 treatment and other health services;
4-26 (D) decrease the number of needles and syringes
4-27 discarded in parks and neighborhood streets; and
5-1 (E) constitute effective outreach to normally
5-2 hard-to-reach drug users;
5-3 (11) the National Commission on AIDS recommends,
5-4 "Legal barriers to the purchase and possession of injection
5-5 equipment should be removed. Legal barriers do not reduce illicit
5-6 drug injection. They do, however, limit the availability of new,
5-7 clean, injection equipment, thereby encouraging the sharing of
5-8 injection equipment and the increase in HIV transmission";
5-9 (12) the National Academy of Sciences, after
5-10 evaluating the effectiveness of needle exchange programs at the
5-11 request of the United States Congress, concluded that needle
5-12 exchange programs can be effective in preventing the spread of HIV
5-13 and do not increase the use of illegal drugs;
5-14 (13) providing treatment to reduce injecting drug use
5-15 and providing means for safer injection are complementary rather
5-16 than contradictory forms of both AIDS prevention and drug abuse
5-17 prevention, and harm reduction programs should be regarded as just
5-18 one weapon in the fight against HIV infection and AIDS in a
5-19 population that is both at very high risk and traditionally hard to
5-20 reach; and
5-21 (14) the key educational message of a harm reduction
5-22 program is that sharing injection equipment carries with it the
5-23 likelihood of contracting HIV infection and of infecting one's
5-24 partner or child.
5-25 (c) The legislature declares that it is in the public
5-26 interest to break the deadly connection between HIV infection and
5-27 AIDS and injecting drug use by allowing legal access to clean
6-1 needles and syringes in a comprehensive effort to reduce the spread
6-2 of HIV infection and AIDS.
6-3 SECTION 4. The Texas Department of Health shall submit a
6-4 report to the legislature evaluating the effectiveness of
6-5 Subchapter H, Chapter 85, Health and Safety Code, as added by this
6-6 Act, not later than January 31, 1999. A local health authority or
6-7 other organization conducting a harm reduction program under that
6-8 subchapter shall assist the department in preparing the report.
6-9 This section expires July 1, 1999.
6-10 SECTION 5. (a) This Act takes effect September 1, 1997.
6-11 (b) The change to Section 481.125, Health and Safety Code,
6-12 made by this Act applies only to an offense committed on or after
6-13 the effective date of this Act. For purposes of this section, an
6-14 offense is committed before the effective date of this Act if any
6-15 element of the offense occurs before the effective date.
6-16 SECTION 6. The importance of this legislation and the
6-17 crowded condition of the calendars in both houses create an
6-18 emergency and an imperative public necessity that the
6-19 constitutional rule requiring bills to be read on three several
6-20 days in each house be suspended, and this rule is hereby suspended.