Historic Debate on HIV Modernization

The House Committee Substitute (HCS) of House Bills 167 & 166 was debated on the House floor on Tuesday afternoon. You know from our Weekly Perspective and Call to Action last Friday that the version voted out of committee needed some significant improvements. The floor debate was an opportunity to hear several amendments offered, get objections out in the open, and discover previously unknown champions. If you’d like to see the play-by-play, check out our Twitter feed for both Empower Missouri and the MO HIV Justice Coalition.

Sitting in the House Gallery, witnessing a full hour’s worth of debate was exciting. Majority party lead bill sponsor Rep. Holly Rehder of Sikeston spoke from a microphone at the front of the chamber, and Speaker Elijah Haahr (R—Springfield) himself stood on the dais as debate began; they held the room’s attention. Rep. Rehder expertly introduced the need to modernize Missouri’s HIV-specific criminal statutes. At one point she spoke at length with Rep. Doug Clemens (D-St. Louis) in an “inquiry” (a back-and-forth where two House members have a conversation about a bill). They complimented each other while also appearing to follow a script.

Rep. Rehder explained the concept of undetectable = untransmittable. Rep Clemens responded, “That’s incredible to me! Basically zero viral load, which is a term that I hadn’t heard until I was on committee. But it’s an amazing thing that someone carrying a zero viral load can’t infect another human being.” Rep. Rehder followed, “Right. You know, I was amazed that there’s medication for your spouse, that, you know, if you have HIV, that your spouse can be on a preventative medication so that they don’t get it. You know there’s so many advancements … this is not a death sentence anymore.”

When Rep. Hovis (R-Cape Girardeau) offered an amendment reintroducing language the HCS had stricken, he referenced scenarios where law enforcement officers may fear they’ve been exposed to HIV from someone in custody. Certainly, no one in the chamber wants to put law enforcement at any greater risk, nor do we. However, his remarks were an opportunity to correct some misinformation about how HIV is transmitted. He relayed situations where officers and guards have been spit upon or had feces thrown at them.

Rep. Cora Faith Walker (D-St. Louis) pointed out that such actions would be considered assault, and needn’t be prosecuted under an HIV-specific law, especially since saliva and feces do not transmit HIV. This highlights, perhaps, a need for increased training for those in law enforcement concerning transmission routes for HIV and infectious diseases as well as universal protocols that should always be followed when an officer is injured.

Rep. Hovis’ amendment, which did pass and is now a part of the bill, calls for health officials to divulge private patient information to law enforcement and potentially “others” who can request health department records.

The biggest point here, is that looking at the health records of a person in custody doesn’t solve the primary concern that Rep. Hovis stated. If there has been some incident of potential exposure, it is entirely possible that the person in custody has not been previously diagnosed with a transmittable infection or has contracted one since their last negative test.

If there is a legitimate cause for concern of exposure to any disease, there are standard medical protocols to address this, whether a nurse sticks themselves with a needle, or an officer has an altercation with an inmate. They should get tested whether there has been a diagnosis or not. These protocols are the best and surest way to inhibit the contraction of a disease.

Furthermore, in an adjacent statute to the one being modernized, in RsMO 191.658, the specific matter Rep. Hovis raised is addressed. With the removal of HIV-specific language in the HCS, Amendment 1’s adoption has the potential to dramatically increase the fiscal note, if the Department of Health and Senior Services has an increase in requests for health records.

Upon closing of debate, four amendments in total had been adopted: two that we recommended and two that we oppose. That might seem like an even compromise, but the concessions were bigger on our side. In addition to Rep. Hovis’ amendment, this bill sponsor also amended the penalty class for a category of crime that still uses some of the old language of “reckless” from a class A misdemeanor to a class D felony. The inclusion of the misdemeanor option was what made the class B & C felony levels present elsewhere in the bill more palatable. It is unconscionable to rationalize punishing people at a felony level when no transmission has occurred, no harm has been done, and no intent to do harm has been established. This is not consistent with Missouri statutes.

The adopted amendments we supported cleaned up some of the language to ensure that 1) confidentiality would apply to the complaining witness and the accused equally and automatically, and 2) that we addressed the fact that for there to be a risk of transmission both the route and substance need to exist, since many, if not most substances that transmit disease are harmless in many situations.

The version that advanced Tuesday still fails to appropriately address intent to transmit. Previous versions had language referring to risk reduction measures. Utilizing a condom or latex barrier, treatment as prevention, or other scientifically proven methods of prevention speaks to one’s state of mind. If a PLHIV intended to transmit the virus, they would not utilize these risk reduction measures. We need to acknowledge responsible behavior, rather than criminalize it.

 

With two weeks left in the 2019 Legislative Session, we must concede that we will not reach our goal of modernizing Missouri’s outdated and medically inaccurate HIV-specific criminal codes this year. We did, however, make progress getting the bill out of a House committee and securing an affirmative voice vote following Perfection debate. We learned much from this process that can move us forward toward ending the stigma and changing the law in a future legislative session. And while the legislature is where the change making voting happens, it is between May and December when we must really dig into the work of raising awareness, strengthening our base, and educating key stakeholders like law enforcement, prosecutors, PLHIV, and influencers in our communities. We hold trainings, tours, meetings, forums. We partner with universities and museums raising awareness through art (be sure to check our calendar of events for upcoming exhibits and events in KC and STL). We take the time to meet as a coalition, face-to-face, and strategize. We will return to the 2020 legislative session stronger than ever.

To join our HIV Justice Coalition, send an email to mohivjustice@empowermissouri.org with your name, phone number, and the region of the state you live in.

Leave a Reply