BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 547
                                                                  Page  1

          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