BILL ANALYSIS
AB 547
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Date of Hearing: April 13, 2005
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Judy Chu, Chair
AB 547 (Berg) - As Introduced: February 16, 2005
Policy Committee: HealthVote:8-3
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill allows cities and counties to authorize a clean needle
and syringe exchange project without a declaration of a local
emergency, subject to specified requirements. Specifically,
this bill:
1)Repeals the requirement that there be a declaration of a local
emergency due to the existence of a critical local public
health crisis in order for public entities, their agents, or
employees to be exempt from criminal prosecution for the
distribution of hypodermic needles or syringes to participants
in clean needle and syringe exchange projects authorized by
the public entity.
2)Authorizes a clean needle and syringe exchange program in any
city or county, upon the action of the local officials.
3)Requires a city and county that acts to authorize a clean
needle and syringe exchange project pursuant to this bill, in
consultation with the Department of Health Services, to
authorize the exchange of clean hypodermic needles and
syringes, as recommended by the United States Secretary of
Health and Human Services, subject to the availability of
funding, as part of a network of comprehensive services,
including treatment services, to combat the spread of HIV and
blood-borne hepatitis infection among injection drug users.
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4)Exempts providers, of and participants in, a needle exchange
program under this bill from criminal prosecution for
possession of needles or syringes.
FISCAL EFFECT
1)No state fiscal impact to authorize needle exchange programs
for a longer period of time as these programs are established
by local governments at their option.
2)Indeterminate state treatment savings to state-funded health
programs such as Medi-Cal and the AIDS Drug Assistance Program
(ADAP) to the extent new HIV and hepatitis cases are reduced.
In 2002-03, the average monthly cost for prescriptions for
each ADAP beneficiary was $998, and the average monthly
Medi-Cal cost per user for individuals with HIV/AIDS is
$1,914.
COMMENTS
1)Purpose . This bill is sponsored by the Health Officers
Association of California (HOAC), which argues that the
elimination of the requirement for an emergency declaration
would facilitate the establishment and maintenance of needle
exchange projects. The author contends California is in the
midst of a public health crisis, that over 197 California
residents died of AIDS in 2003, and that sharing dirty
syringes is linked to approximately 20% of all AIDS cases in
the state. The author continues that there are an estimated
600,000 Californians infected with hepatitis C, which leads to
close to 10,000 deaths annually, and that 60 percent of
hepatitis C cases are related to injection drug use.
2)Background . Existing law prohibits prosecution of any public
entity, its agents, or employees for distribution of
hypodermic needles or syringes to participants in clean needle
and syringe exchange projects authorized by the public entity
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pursuant to a declaration of a local emergency due to the
existence of a critical local public health crisis. County
boards of supervisors or city councils must declare a local
emergency in order to implement a needle exchange program. If
a local government wishes to continue their needle exchange
program, they must renew the local emergency declaration every
14 to 21 days. Currently, approximately 14 California cities
and counties have authorized needle exchange projects.
3)Support . HOAC contends this bill would facilitate the use of
an effective disease prevention method, increase the ability
to control the spread of AIDS and hepatitis C, and continue to
allow locally elected officials to control the program without
declaring a state of emergency every two to three weeks.
Additionally, proponents of this bill argue there is
conclusive scientific evidence that needle exchange programs,
as part of comprehensive HIV prevention strategies, are an
effective public health intervention that reduces transmission
of HIV and do not encourage the illegal use of drugs.
4)Opposition . The California Peace Officers' Association (CPOA)
and the California Narcotics Officers' Association write in
opposition that needle exchange programs require constant
oversight and scrutiny to assure success and address public
safety issues arising from such programs. Opponents argue
this bill erodes that oversight by abolishing the requirement
for periodic oversight of needle programs.
5)Previous Legislation . This bill contains similar language to
last year's AB 2871 (Berg), which was vetoed by Governor
Schwarzenegger. In his veto message, the governor stated that
he was willing to reconsider the concept of this bill if there
are appropriate local control measures in place, and that it
is imperative that local communities, public health officials
and local law enforcement be provided the opportunity to
provide input to local leaders to ensure that the health
benefits of a syringe exchange program outweigh any potential
adverse impact on the public welfare.
SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004, subject
to authorization by a county or city, authorizes a licensed
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pharmacist to sell or furnish 10 or fewer hypodermic needles
or syringes to a person for human use without a prescription
if the pharmacy is registered with a local health department
in the Disease Prevention Demonstration Project. This
authority sunsets December 31, 2010.
Analysis Prepared by : Scott Bain / APPR. / (916) 319-2081