The Missouri House again will weigh bills aimed at fighting intravenous and prescription drug abuse, as well as a bipartisan effort to fight a stigma against those infected with HIV.
Representative Holly Rehder (R-Sikeston) has prefiled legislation to legalize programs that give drug abusers clean needles, and for the seventh consecutive year has filed legislation to make statewide a monitoring program for drug prescriptions. She and Representative Tracy McCreery (D-St. Louis) have also filed bills to change Missouri law that criminalizes exposing someone to HIV.
Supporters say needle exchange programs have been operating in the state for years, and don’t entice people to start abusing intravenous drugs. Rather, they say, they ensure abusers aren’t transmitting diseases through dirty needles and it puts them in contact with medical providers who can facilitate getting them into treatment.
Several such programs already operate in Missouri, though they are doing so against the letter of the law. House Bill 1486 would exempt those programs from the crime of “unlawful delivery of drug paraphernalia.”
House Bill 1693, dubbed the “Narcotics Control Act,” would make statewide a prescription drug monitoring program (PDMP) like that maintained by the St. Louis County Health Department. That program covers about 87-percent of Missouri’s population, in just over half its counties. Rehder said that program has had great results but the whole state must be covered.
A PDMP is a database that physicians and pharmacists could use to track pill purchases and pharmacy visits, in an effort to find those who are potentially filling multiple prescriptions to support abuse. Such proposals have met stiff opposition in past years, generally from those who say creating such a database would put sensitive medical information in danger of being breached.
House Bills 1691 (Rehder) and 1692 (McCreery) would reduce or eliminate the penalties for knowingly exposing someone with HIV. Backers say the current penalties are too steep – the punishment for knowingly exposing to HIV someone who contracts the disease is on par with those for murder, rape, and forcible kidnapping.
Supporters say the harsh penalties are actually helping the spread of HIV by discouraging people from getting tested.
Both bills have been filed for the session that begins January 8.
Reps. Rehder and McCreery and advocates discuss the legislation in the video below:
The Missouri House has passed a bill that would legalize programs already operating in the state that give drug abusers clean needles. Supporters say those fight the spread of intravenous diseases and expose drug users to treatment options.
Representative Holly Rehder (photo: Tim Bommel, Missouri House Communications)
Those running needle exchanges in Missouri now could be charged with violating the state’s drug paraphernalia law. They are protected only by handshake agreements with local law enforcement who recognize the benefit of the programs.
House Bill 168 would exempt from that law needle exchange programs that are registered with the Department of Health and Senior Services.
She said the CDC has identified 13 counties in Missouri as ripe for an outbreak of Hepatitis C and HIV. She said preventing an outbreak would save lives and save the state money.
Supporters say in places with needle exchange programs, drug users are five times more likely to enter treatment. That’s because when users go to get needles, they’re getting them from a health care professional who can tell them about treatment options.
The House’s 124-27 vote sends the bill to the Senate, where it stalled last year. Rehder has said she has assurances from members of that chamber that it will be supported this year.
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.
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.
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)
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.
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.
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.
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.
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.”
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.
