BILL ANALYSIS
AB 547
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 547 (Berg)
As Amended July 11, 2005
Majority vote
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|ASSEMBLY: |45-30|(April 28, |SENATE: |24-15|(August 23, |
| | |2005) | | |2005) |
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Original Committee Reference: HEALTH
SUMMARY : Creates the Clean Needle and Syringe Exchange Program.
The Senate amendments :
1)Require local government, local public health officials, and
law enforcement to be given the opportunity to comment on
syringe exchange programs on an annual basis. Require the
public to be given the opportunity to provide input to local
leaders to ensure that any potential adverse impacts on the
public welfare of syringe exchange programs are addressed and
mitigated.
2)Require the health officer of the participating jurisdiction
to present annually at an open meeting of the board of
supervisors or city council a report detailing the status of
syringe exchange programs including, but not limited to,
relevant statistics on blood-borne infections associated with
needle sharing activity. Require law enforcement,
administrators of alcohol and drug treatment programs, other
stakeholders, and the public to be afforded ample opportunity
to comment at this annual meeting and require public notice to
be sufficient to assure adequate participation in the meeting
by the public. Require the meeting to be noticed in accordance
with all state and local open meeting laws and ordinances, and
as local officials deem appropriate.
AS PASSED BY THE ASSEMBLY , this bill:
1)Exempted 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
AB 547
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a declaration of a local emergency.
2)Authorized clean NEPs in any city and county, county, or city
upon the action of a county board of supervisors and the local
health officer or health commission of that county; the city
council, the mayor, and the local health officer of a city
with a health department; or, the city council and the mayor
of a city without a health department.
3)Required 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.
4)Exempted 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 no state fiscal impact
to authorize NEPs for a longer period of time as these programs
are established by local governments at their option. The
analysis also states that there would be 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
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AIDS in California and throughout the nation.
According to DHS, 1,500 new syringe-sharing HIV infections occur
annually. 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 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 United States 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:
0012000