BILL ANALYSIS
AB 547
Page 1
ASSEMBLY THIRD READING
AB 547 (Berg)
As Introduced February 16, 2005
Majority vote
HEALTH 8-3 APPROPRIATIONS 13-5
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|Ayes:|Chan, Berg, Cohn, |Ayes:|Chu, Bass, Berg , |
| |Dymally, Frommer, Jones, | |Calderon, Ruskin, Umberg, |
| |Montanez, Richman | |Klehs, Leno, Nation, |
| | | | De La Torre, |
| | | |Ridley-Thomas, Saldana, |
| | | |Yee |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Aghazarian, Nakanishi, |Nays:|Sharon Runner, Emmerson, |
| |Strickland | |Haynes, Nakanishi, |
| | | |Walters |
| | | | |
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SUMMARY : Creates the Clean Needle and Syringe Exchange Program.
Specifically, this bill :
1)Makes a number of findings and declarations regarding the
relationship between injection drug use and the human
immunodeficiency virus and acquired immune deficiency syndrome
(HIV/AIDS).
2)Exempts public entities, its agents, or employees from being
subject to criminal prosecution for distributing needles or
syringes as part of a locally authorized clean needle and
syringe exchange project (NEP) pursuant to this bill, without
a declaration of a local emergency.
3)Authorizes clean NEPs in any city and county, county, or city
upon the action of:
a) A county board of supervisors and the local health
officer or health commission of that county;
b) The city council, the mayor, and the local health
officer of a city with a health department; or,
AB 547
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c) The city council and the mayor of a city without a
health department.
4)Requires cities, counties, or cities and counties that act to
authorize a NEP pursuant to this bill to, in consultation with
the California Department of Health Services (DHS), 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.
5)Exempts providers of and participants in a NEP authorized by
the county, city, or city and county pursuant to this bill
from being subject to criminal prosecution for possession of
needles or syringes during participation in a NEP.
FISCAL EFFECT : According to the Assembly Appropriations
Committee analysis, this bill would have:
1)No state fiscal impact to authorize NEPs 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 : According to the author, current law authorizes
cities and counties to establish and operate NEPs only after the
declaration of a local emergency. The declaration must then be
renewed every two weeks by the board of supervisors or the city
council. This renewal process has put effective NEPs in a
perilous state; one absent supervisor can effectively make a
well-funded NEP "illegal" until the next declaration. It is
crucial that action be taken to ensure that NEPs run
efficiently, as they are a successful tool in combating HIV and
AIDS in California and throughout the nation.
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According to DHS, 1,500 new syringe-sharing HIV infections occur
annually. However, this number does not account for women
infected through sexual contact with intravenous drug users
(IDUs) or infants born to these women. Additionally, there are
5,000 new cases of needle-related hepatitis C virus in
California each year. A 2000 DHS report regarding HIV/AIDS and
racial/ethnic groups states that the link between injection drug
use and HIV is strong for women and people of color. In
California, 37% of AIDS cases among women, 24% of AIDS cases
among African Americans, and 22% of AIDS cases among Latinas are
directly attributable to needle sharing.
Currently, 14 California cities and counties have authorized
NEPs. To participate in a NEP, injection drug users are
required to exchange a used syringe for a new, sterile needle.
In over 80 cities in 38 states, NEPs have been created with the
goal of minimizing the risk of HIV infection among IDUs. In
addition to needle exchange, NEPs often provide peer education
and referrals to drug treatment centers and methadone clinics.
A study of San Francisco's NEP found that the program did not
encourage increased drug use. Over a five-year period, there
was no significant increase in new IDUs or an increase in drug
use by current users. In fact, the frequency of injecting among
study participants decreased from an average of two injections
per day to less than one, and the rate of new IDUs decreased
from 3% to 1%. In 2002, DHS concluded that there is conclusive
scientific evidence that NEPs, as part of comprehensive HIV
prevention strategies, are an effective public health
intervention that reduces transmission of HIV and does not
encourage the illegal use of drugs. The U.S. Public Health
Service recommends that drug users who continue to inject use a
new sterile syringe for each injection to prevent the
transmission of blood-borne diseases.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
FN: 0009748