BILL NUMBER: AB 604	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 17, 2011

INTRODUCED BY   Assembly Member Skinner

                        FEBRUARY 16, 2011

    An act relating to public health.   An act
to amend Sections 121349, 121349.1, 121349.2, and 121349.3 of the
Health and Safety Code, relating to public health. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 604, as amended, Skinner.  Medical home multipayer
program.   Needle exchange programs.  
   Existing law, with certain exceptions, makes it a misdemeanor for
a person to deliver, furnish, transfer, possess with intent to
deliver, furnish, or transfer, or manufacture with the intent to
deliver, furnish, or transfer, drug paraphernalia, knowing, or under
circumstances where one reasonably should know, that it will be used
to plant, propagate, cultivate, grow, harvest, compound, convert,
produce, process, prepare, test, analyze, pack, repack, store,
contain, conceal, inject, ingest, inhale, or otherwise introduce into
the human body a controlled substance. Existing law provides an
exception to this general rule by authorizing a city, county, or city
and county to conduct a clean needle and syringe exchange project
authorized by the public entity to combat the spread of HIV and
bloodborne hepatitis. Existing law exempts providers participating in
an exchange project from criminal prosecution for possession of
needles or syringes during participation in the project. Existing law
also provides a specified annual comment and reporting process
relating to the needle and syringe exchange projects.  
   This bill would authorize the State Department of Public Health to
authorize, as specified, certain entities to provide hypodermic
needle and syringe exchange services in any location where the
department determines that the conditions exist for the rapid spread
of HIV, viral hepatitis, or any other potentially deadly or disabling
infections that are spread through the sharing of used hypodermic
needles and syringes.  
   This bill would exempt staff and volunteers participating in an
authorized exchange project from criminal prosecution for violation
of any law related to the possession, furnishing, or transfer of
hypodermic needles or syringes during participation in an exchange
project and would exempt program participants from criminal
prosecution for possession of needles and syringes acquired from an
authorized exchange project entity. The bill would also make the
comment and reporting process for the projects biennial. 

   Existing law establishes the State Department of Public Health and
sets forth its powers and duties, including, but not limited to, the
licensing and regulation of health facilities.  
   This bill would declare the intent of the Legislature to
subsequently amend this bill to include provisions that would
establish a medical home multipayer program to improve patient access
to health care services, and to improve the continuity and
coordination of health care services. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 121349 of the   Health
and Safety Code   is amended to read: 
   121349.  (a) The Legislature finds and declares that scientific
data from needle exchange programs in the United States and in Europe
have shown that the exchange of used hypodermic needles and syringes
for clean hypodermic needles and syringes does not increase drug use
in the population, can serve as an important bridge to treatment and
recovery from drug abuse, and can curtail the spread of human
immunodeficiency virus (HIV) infection among the intravenous drug
user population.
   (b) In order to  attempt to  reduce the spread of
HIV infection and  blood-borne   bloodborne
 hepatitis among the intravenous drug user population within
California, the Legislature hereby authorizes a clean needle and
syringe exchange project pursuant to this chapter in any city
 and county  , county, or city  and county 
upon the action of a county board of supervisors and the local
health officer or health commission of that county, or upon the
action of the city council, the mayor, and the local health officer
of a city with a health department, or upon the action of the city
council and the mayor of a city without a health department. 
   (c) In order to reduce the spread of HIV infection, viral
hepatitis, and other potentially deadly bloodborne infections, the
State Department of Public Health may, notwithstanding any other law,
authorize entities that provide services set forth in paragraph (1)
of subdivision (d), and that have sufficient staff and capacity to
provide the services described in Section 121349.1, as determined by
the department, to apply for authorization under this chapter to
provide hypodermic needle and syringe exchange services consistent
with state and federal standards, including those of the United
States Public Health Service, in any location where the department
determines that the conditions exist for the rapid spread of HIV,
viral hepatitis, or any other potentially deadly or disabling
infections that are spread through the sharing of used hypodermic
needles and syringes.  
   (d) In order for an entity to be authorized to conduct a project
pursuant to this chapter, its application to the department shall
demonstrate that the entity complies with all of the following
minimum standards:  
   (1) The entity provides, directly or through referral, any of the
following services:  
   (A) Drug abuse treatment services.  
   (B) HIV or hepatitis C screening.  
   (C) Hepatitis A and hepatitis B vaccination.  
   (D) Screening for sexually transmitted infections.  
   (E) Housing services for the homeless, for victims of domestic
violence, or other similar housing services.  
   (F) Services related to provision of education and materials for
the reduction of sexual risk behaviors, including, but not limited
to, the distribution of condoms.  
   (2) The entity has the capacity to commence needle and syringe
exchange services within three months of authorization.  
   (3) The entity has adequate funding to do all of the following at
reasonably projected program participation levels:  
   (A) Provide needles and syringe exchange services for all of its
participants.  
   (B) Provide HIV and viral hepatitis prevention education services
for all of its participants.  
   (C) Provide for the safe recovery and disposal of used syringes
and sharps waste from all of its participants.  
   (4) The entity has the capacity, and an established plan, to
collect evaluative data in order to assess program impact, including,
but not limited to, all of the following:  
   (A) The total number of persons served.  
   (B) The total number of syringes and needles distributed,
recovered, and disposed of.  
   (C) The total numbers and types of referrals to drug treatment and
other services.  
   (5) If the application is provisionally deemed appropriate by the
department, the department shall, at least 45 days prior to approval
of the application, provide for a period of public comment as
follows:  
   (A) Post on the department's Internet Web site the name of the
applicant, the nature of the services, and the location where the
applying entity will provide the services.  
   (B) Send a written and an electronic mail notice to the local
health officer of the affected jurisdiction.  
   (e) The department shall establish and maintain on its Internet
Web site the address and contact information of programs providing
hypodermic needle and syringe exchange services.  
   (c) 
    (f)  The authorization provided under this section shall
only be for a clean needle and syringe exchange project as described
in Section 121349.1
   SEC. 2.    Section 121349.1 of the   Health
and Safety Code   is amended to read: 
   121349.1.   A city and county, or a   The
State Department of Public Health or a city,  county, or a city
 and county  with or without a health department, that acts
to authorize a clean needle and syringe exchange project pursuant to
this chapter shall, in consultation with the State Department of 
Public  Health  Services  , authorize the
exchange of clean hypodermic needles and syringes, as recommended by
the United States  Secretary of Health and Human Services
  Public Health Service  , 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   bloodborne  hepatitis
infection among injection drug users.  Providers 
 Staff and volunteers  participating in an exchange project
authorized by the  state,  county, city, or city and county
pursuant to this chapter shall not be subject to criminal prosecution
for  possession of   violation of any law
related to the possession, furnishing, or transfer of hypodermic
 needles or syringes during participation in an exchange
project.  Program participants shall not be subject to criminal
prosecution for possession of needles or syringes acquired from an
authorized needle and syringe exchange project entity. 
   SEC. 3.    Section 121349.2 of the  Health
and Safety Code   is amended to read: 
   121349.2.  Local government, local  public 
health officials, and law enforcement shall be given the opportunity
to comment on clean needle and syringe exchange programs on 
an annual   a biennial  basis. The public shall be
given the opportunity to provide input to local leaders to ensure
that any potential adverse impacts on the public welfare of clean
needle and syringe exchange programs are addressed and mitigated.
   SEC. 4.    Section 121349.3 of the   Health
and Safety Code   is amended to read: 
   121349.3.  The health officer of the participating jurisdiction
shall present  annually   biennially  at an
open meeting of the board of supervisors or city council a report
detailing the status of clean needle and syringe exchange programs
 ,  including, but not limited to, relevant statistics on
 blood-borne   bloodborne  infections
associated with needle sharing activity and the use of public funds
for these programs. Law enforcement, administrators of alcohol and
drug treatment programs, other stakeholders, and the public shall be
afforded ample opportunity to comment at this  annual
  biennial  meeting. The notice to the public shall
be sufficient to assure adequate participation in the meeting by the
public. This meeting shall be noticed in accordance with all state
and local open meeting laws and ordinances, and as local officials
deem appropriate.  For hypodermic needle and syringe exchange
services authorized by the State Department of Public Health, a
biennial report shall be provided by the department to the local
health officer based on the reports to the department from service
providers within the   jurisdiction of that local health
officer.  
  SECTION 1.    It is the intent of the Legislature
to subsequently amend this measure to include provisions that would
establish a medical home multipayer program to improve patient access
to health care services, and improve the continuity and coordination
of health care services.