Tag: House Bill 1620 (2018)

Missouri House asked again to revamp HIV infection laws, endorse needle exchange programs

Missouri lawmakers will again consider a bipartisan effort to reduce exposure to and the transmission of HIV in the session that begins in January.

Representative Holly Rehder will again in 2019 sponsor legislation that would change Missouri laws to allow needle exchange programs; and to encourage people to be tested for HIV. (photo; Tim Bommel, Missouri House Communications)

Representatives Holly Rehder (R-Sikeston) and Tracy McCreery (D-St. Louis) have filed legislation that would change Missouri laws that criminalize exposing individuals to HIV.  Rehder will also file a bill that would let organizations give clean needles to users of illegal intravenous drugs.  Both proposals were also filed last session.

Rehder’s House Bill 168 would relax state laws against delivery of drug paraphernalia.  Programs that offer clean needles to users could register with the Department of Health and Senior Services and be allowed to continue operating.

Supporters say the offer of clean needles could reduce the spread among IV drug abusers of diseases like HIV and Hepatitis C.  Representative Rehder said it also make s users 5-times more likely to enter drug treatment because the needle exchange programs put them in direct contact with medical professionals.

“You want that person who is using a syringe to go get a clean one so then they have that contact with someone who is medically educated, who has the information on how to get treatment, where to get help, for when that time comes that they do reach out for help,” said Rehder.

Rehder refutes opponents who have argued that needle exchange programs simply enable the abuse of IV drugs.

“A free syringe isn’t going to provoke a non-IV user to start using, nor will a free syringe cause an IV user to increase their use,” said Rehder.

Last session’s needle exchange legislation, House Bill 1620, was passed out of the House 135-13, but stalled in the Senate.

House Bills 166 and 167, filed by Reps. McCreery and Rehder, respectively, both aim to change Missouri laws that criminalize the act of knowingly exposing a person to HIV.

Representative Tracy McCreery is again sponsoring legislation meant to encourage people to get tested for HIV by easing Missouri’s law regarding knowingly exposing others to the disease. (photo; Tim Bommel, Missouri House Communications)

Both bills would expand those laws to criminalize knowingly exposing a person to any serious infectious or communicable diseases.  Both would also specify that individuals who attempt to prevent transmission, including through the use of a condom or through medical treatment that reduces the risk of transmission, are not knowingly exposing others to a disease.

McCreery and other supporters said those laws have actually discouraged people from getting tested and, if necessary, treated for HIV.

“Because of the way Missouri laws are written there is no motivation for people to know, and in fact not only is there no motivation but you can actually be charged with a more severe crime if you do know your HIV status,” said McCreery.

LaTrischa Miles, treatment adherence supervisor with KC Care Health Center, said in the time since Missouri’s and other states’ HIV exposure laws were written treatments have advanced so that people who might be in violation of those laws aren’t actually exposing anyone to a risk of HIV infection.

LaTrischa Miles with KC Care Health Center, which says Missouri’s HIV transmission laws are outdated and actually discourage people from getting tested and treated for HIV. (photo; Tim Bommel, Missouri House Communications)

“Most do not account for prevention measures that reduce HIV transmission risk such as condom use; antiretroviral therapy; preexposure, which is prep; or the fact that if the virus is maximally suppressed to undetectable levels, the person living with HIV has a zero risk of transmission,” said Miles.

“If people are doing things that pose no risk of transmission then that act should not be criminalized,” said McCreery.  “Right now there are things in our laws that say if somebody commits a certain action, even if they absolutely pose no risk of transmission, they can still be charged with a crime.”

Rehder agreed with McCreery in saying that it’s time for Missouri to update its laws regarding HIV exposure and transmission, which were written in the 1990s.

“It’s important for our statutes to be updated as we become better educated and as technology and medicine advance.  Bottom line is we want people to get tested, know their status, and get treatment,” said Rehder.  “The Department of Justice along with many other national health organizations called for states to reform their HIV-specific laws many years ago because they run counter to many public health best practices.”

Last session’s versions of the HIV transmission laws legislation, House Bills 2675 (McCreery) and 2674 (Rehder) were subject to a hearing by the House Committee on Health and Mental Health Services.  The hearing was in the final days of the session so the bills did not advance, but the committee encouraged McCreery and Rehder to reintroduce the bills for 2019.

These three bills were among dozens filed by lawmakers on Monday, the first day legislation could be prefiled for the session that begins in January.

Missouri House votes to support needle exchange programs to fight IV drug abuse, disease

The Missouri House has proposed easing state law to allow organizations to give clean needles to users of illegal intravenous drugs.  Backers say the bill will help combat a potential outbreak in diseases like HIV and Hepatitis C caused by the sharing of used needles, and will get more people into drug treatment, but not all lawmakers are convinced.

Representative Holly Rehder (photo; Tim Bommel, Missouri House Communications)

Needle exchange or syringe access programs already exist in the St. Louis and Kansas City areas.  Representative Holly Rehder (R-Sikeston) said those programs are operating in violation of state law regarding drug paraphernalia, but local jurisdictions allow them to operate because of the impact they have.

Legislation sponsored by Rehder, House Bill 1620, would relax state law to allow those programs to operate and to expand to other regions in the state.

Rehder said people who use those programs to get needles are 5-times more likely to get into drug treatment because the programs put them in contact with medical professionals.

“That becomes the medical professional in their life, so they go and they get a ten-cent needle but they get so much more than that,” said Rehder.  “They get educational material explaining the harm of what they’re doing.  They get a person who’s greeting them where they’re at in life who’s explaining there are options for you.  We have places for you to go that we can get you into to help get you past this addiction, and so that becomes a relationship.”

Lake St. Louis Republican Justin Hill said as a former police officer and drug task force detective he supports the legislation.  He said law enforcement officers are always conscious, when dealing with individuals abusing intravenous drugs, to look out for needles.

“Use extreme caution because you don’t want to be pricked by what?  A dirty needle.  We want clean needles on the street because of the instances where if an officer gets pricked they don’t want to have to take tests for the next two years of their lives every month – go get tested for HIV, go get tested for AIDS, go get tested for Hep C,” said Hill.

Some Republicans who are former law enforcement officers oppose Rehder’s bill.  Cedar Hill representative Shane Roden, a reserve deputy sheriff, called the idea “stupid.”

“We’re not fixing the problem.  We’re just creating Band-Aids.  We’re not actually coming down with any solutions,” said Roden.

Representative Shane Roden (photo; Tim Bommel, Missouri House Communications)

Roden argued that with HB 1620, “We’re literally going to put the needle in their arm.”

Still the proposal has broad support including from Democrats.  St. Louis City representative Peter Merideth followed-up Rowden’s statements by asking Rehder, “Do you expect this to cure the problem of opioid addiction in Missouri?”

“No, and no one other than that gentlemen has even insinuated that this is a fix for the problem.  We all, that have stood up, have said it’s a tool in our toolbox,” Rehder replied.

Backers also say the bill will save the state money in costs to Medicaid of treating people who contract conditions like HIV and Hepatitis C by sharing needles.

The House voted 135-13 to send the legislation to the Senate.  In previous years one similar proposal was voted out of one House committee but moved no further through the process.