2019S0379-1 03/07/19
By: RodrÃguez S.B. No. 2205
A BILL TO BE ENTITLED
AN ACT
relating to programs established to eliminate injection-associated
infectious diseases; providing certain civil and criminal
immunity.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. This Act shall be known as the Texas
Injection-Associated Infectious Disease Elimination (IDEA) Act.
SECTION 2. (a) In this section, "HIV" means human
immunodeficiency virus.
(b) The legislature finds that:
(1) persons of all ages who do not misuse, abuse, or
inject heroin, opioids, or other drugs may nevertheless be exposed
to and contract injection-associated infectious diseases,
including HIV and the hepatitis C virus;
(2) heroin drug use is at a 20-year high and in the
last 10 years its use has more than doubled in young adults aged 18
to 25;
(3) prescription opioid misuse and abuse has led to
increased numbers of people who inject drugs, increasing the risk
of HIV to new populations;
(4) rural and nonurban areas with limited HIV and
hepatitis C virus prevention and treatment services and substance
use disorder treatment services, traditionally areas at low risk
for HIV and hepatitis C virus, have been disproportionately
affected;
(5) Texas had 4,364 newly diagnosed cases of HIV in
2017, bringing the total living with HIV in Texas to 90,700;
infection from injection drug use accounts for 8.5 percent of all
cases of HIV in Texas;
(6) cases of acute hepatitis C virus in Texas
increased by 100 percent in the period from 2009 to 2013, and 60
percent of those cases were attributable to injection drug use;
(7) drug overdose deaths in Texas increased by 274
percent from 1999 to 2017, with a likelihood that many deaths were
underreported due to a lack of training and resources in rural and
nonurban areas;
(8) the lifetime treatment cost of an HIV patient is
conservatively estimated at $380,000;
(9) the current cost to effectively treat hepatitis C
virus is up to $95,000; and
(10) injection-associated infectious diseases such as
HIV and the hepatitis C virus can also be contracted accidentally by
health care providers, law enforcement officers, first responders,
other emergency personnel, and members of the general public
through a needlestick or other sharps injury or exposure to blood or
bodily fluids.
SECTION 3. Chapter 81, Health and Safety Code, is amended by
adding Subchapter K to read as follows:
SUBCHAPTER K. ELIMINATION OF INJECTION-ASSOCIATED DISEASES
Sec. 81.501. DEFINITIONS. In this subchapter:
(1) "Controlled substance" has the meaning assigned by
Section 481.002.
(2) "HIV" means human immunodeficiency virus.
(3) "Individual who injects drugs" means an individual
who uses a syringe or hypodermic needle to inject a controlled
substance into the individual's own body.
(4) "Infectious disease" means disease that may be
spread by intentional or unintentional needlesticks, including HIV
and the hepatitis C virus.
(5) "Local health unit" has the meaning assigned by
Section 121.004.
(6) "Program" means an injection-associated
infectious disease elimination program established under this
subchapter.
Sec. 81.502. INJECTION-ASSOCIATED INFECTIOUS DISEASE
PROGRAMS. (a) The department or a local health unit, in
conjunction with an organization that promotes scientifically
proven ways of mitigating risks associated with the use of
controlled substances, may establish and operate an
injection-associated infectious disease elimination program.
(b) The mission of a program is to:
(1) reduce the spread of HIV, the hepatitis C virus,
and other injection-associated infectious diseases;
(2) reduce needlestick injuries to health care
providers, law enforcement officers, first responders, other
emergency personnel, and the general public; and
(3) encourage individuals who inject drugs to enroll
in evidence-based treatment for substance use disorder.
(c) A program established under this subchapter must do the
following:
(1) safely dispose of used needles, hypodermic
syringes, and other injection supplies;
(2) provide needles, hypodermic syringes, and other
injection supplies at no cost and in quantities sufficient to
discourage the sharing or use of needles, hypodermic syringes, or
other injection supplies;
(3) provide educational materials on the following
subjects:
(A) overdose prevention and response;
(B) prevention of infectious diseases;
(C) drug abuse prevention; and
(D) treatment for mental illness or substance
abuse, including providing treatment referrals;
(4) provide access to kits that contain naloxone
hydrochloride, or a chemical equivalent that is approved by the
federal Food and Drug Administration, for the treatment of a drug
overdose or provide referrals to programs that provide access to
such medications;
(5) provide personal consultations for individuals
seeking assistance by a program employee or volunteer concerning
mental health or substance use disorder treatment, as appropriate;
(6) encourage each individual who injects drugs to
seek appropriate medical, mental health, or social services;
(7) use a record keeping system that ensures that the
identity of each individual who injects drugs remains anonymous;
(8) notify appropriate local law enforcement agencies
about the program, including information on the limited immunity
from criminal liability granted by Section 81.504;
(9) provide an identification card to each individual
served by the program identifying them as a participant of the
program, which shall serve as proof of the limited immunity from
criminal liability granted under Section 81.504;
(10) provide emergency medical care or referrals to
program participants in need of immediate medical attention; and
(11) comply with applicable state and federal rules
and regulations governing participant confidentiality.
Sec. 81.503. NOTIFICATION OF PROGRAM. (a) Before a
program may be established, notification must be provided to the
following interested parties in the area to be served by the
program:
(1) local law enforcement agencies;
(2) local prosecutors;
(3) representatives of substance use disorder
treatment facilities certified by the department;
(4) individuals who inject drugs and individuals in
recovery from substance use disorder;
(5) nonprofit organizations whose primary purpose is
education on or mitigation of HIV, the hepatitis C virus, substance
use disorder, or mental health; and
(6) residents of the geographical area to be served by
the program.
(b) When consulting with interested parties, the program is
encouraged to consider:
(1) the population to be served;
(2) the concerns of local law enforcement agencies and
prosecutors; and
(3) the day-to-day administration of the program,
including the need for security of program sites, equipment,
personnel, and volunteers.
Sec. 81.504. LIMITED IMMUNITY. (a) An individual who
injects drugs and who is an active participant in a program is
granted limited immunity from and shall not be subject to criminal
liability under Subchapter D, Chapter 481. The limited immunity
provided in this section applies to an individual who injects drugs
and who is an active program participant only if:
(1) the individual claiming immunity possesses the
program identification card provided in accordance with Section
81.502(c)(9); or
(2) program personnel can otherwise confirm an
individual's participant status in response to charges related to
or resulting from their participation in the program.
(b) The limited immunity in Subsection (a) shall apply to a
needle, hypodermic syringe, or other injection supply obtained
from, or to a used needle or hypodermic syringe containing residual
amounts of a controlled substance being returned for disposal to, a
program established under this subchapter.
(c) In addition to any other applicable immunity from civil
liability, a law enforcement officer who arrests or charges a
person who is later determined to be entitled to immunity from
prosecution under Subsection (a) is not subject to civil liability
for the arrest or filing of charges against the person.
(d) Any person or entity contributing funds or providing
assistance, consultations, emergency care, referrals, needles,
hypodermic syringes, or other injection supplies, or any other
materials or service, including providing educational materials or
naloxone kits, for the benefit of the program shall be immune from
civil and criminal liability as a result of such participation with
or contributions to the program.
(e) The limited immunity, including limited vicarious
liability, provided in this section shall also extend to the
members of any local health unit establishing, sponsoring,
operating, or administering a program. Immunity under this section
shall be provided to and for any employees, officers, agents of the
state, persons, and entities described in this subchapter for
personal injury, damage to or loss of property, or other civil
liability caused by or arising out of, or relating to, an actual or
alleged act, error, or omission that occurred, or that the
employee, officer, agent of the state, person, or entity had a
reasonable basis for believing occurred, in relation to or in
conjunction with the program.
(f) Nothing in this section shall impair or otherwise limit
any other immunity of any person or entity under constitutional,
statutory, or common law.
Sec. 81.505. REPORT. Not later than December 1 of each year
that a program exists, each local health unit sponsoring,
operating, or administering a program shall report the following to
the department:
(1) the number of individuals served by the program;
(2) the number of needles, hypodermic syringes, and
other injection supplies dispensed by and returned to the program;
(3) the number of naloxone kits distributed by the
program;
(4) the number of service referrals provided to
individuals served by the program, by type of treatment, including
a separate report on the number of individuals referred to programs
that provide access to naloxone hydrochloride, or a chemical
equivalent that is approved by the federal Food and Drug
Administration, for the treatment of an overdose; and
(5) the number and type of medical, mental health, and
social services referrals provided to individuals served by the
program.
SECTION 4. This Act takes effect September 1, 2019.