BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          AB 604 (Skinner)
          
          Hearing Date: 7/11/2011         Amended: 4/5/2011
          Consultant: Katie Johnson       Policy Vote: Health 5-3
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          ____
          BILL SUMMARY: AB 604 would permit the California Department of 
          Public Health (CDPH) to authorize entities to provide hypodermic 
          needle and syringe exchange programs in any location the 
          department determines needs such a program.
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          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           CDPH regulations and     $46        $35      $49       Federal*
          ongoing administration
                                    2014-15               2015-16  

                                   $30 - $140 $30 - $140         Federal*

          *Centers for Disease Control and Prevention Cooperative 
          Agreement Funds
          _________________________________________________________________
          ____

          STAFF COMMENTS:
          
          This bill would authorize the California Department of Public 
          Health (CDPH) to accept applications for and to establish needle 
          and syringe exchange programs (SEPs) in local jurisdictions 
          where the department determines that there is a need for such 
          programs in order to reduce the spread of HIV, viral hepatitis, 
          and other potentially deadly bloodborne infections. The programs 
          would be required to be consistent with state and federal 
          standards, including those of the United States Public Health 
          Service.

          Costs to CDPH to promulgate regulations over a period of two and 
          a half years to further define application requirements would be 
          approximately $46,000 in FY 2011-2012, and $35,000 - $50,000 
          annually through FY 2013-2014. Ongoing costs to review and 
          approve applications and to post specified information on CDPH's 








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          website would range from minor and absorbable to up to $140,000 
          annually, commencing in FY 2013 -2014. The actual costs would 
          depend on the number of applications received annually, which is 
          unknown and could range from 5 - 50. If the number is more than 
          10, the workload would no longer be absorbable, although CDPH 
          anticipates approximately 5 applications annually. To the extent 
          there would be non-absorbable workload, it would be covered by a 
          vacant position at the department. Funding would come from the 
          federal Centers for Disease Control and Prevention Cooperative 
          Agreement Funds.

          An entity's application to CDPH would be required to demonstrate 
          its ability to provide specified SEP services, such as drug 
          abuse treatment, HIV or hepatitis screening, Hepatitis A and B 
          vaccination, screening for sexually transmitted infections, 
          housing for individuals who are homeless and victims of domestic 
          violence, and education services regarding the reduction of 
          sexually risky behaviors. An SEP would additionally be required 
          to show that it has adequate funding to provide needle and 
          syringe exchange services for all participants, HIV and viral 
          hepatitis prevention education services, and the safe recovery 
          and disposal of used syringes and sharps waste.

          This bill would exempt staff and volunteers participating in the 
          authorized program from any law related to the possession, 
          furnishing, or transfer of hypodermic needles or syringes during 
          participation in the program. Additionally, program participants 
          would be immune from criminal prosecution for the possession of 
          needles or syringes acquired from an authorized program. This 
          bill would require local health officers to report biennially, 
          instead of annually, to the county board of supervisors or city 
          council on local SEPs. Pursuant to this bill, CDPH would also be 
          required to report biennially to a local health officer of a 
          jurisdiction in which the department approved a program. This 
          bill would also permit local government, local health officials, 
          and law enforcement to comment biennially, instead of annually, 
          on local SEPs.

          To the extent that this bill were to aid in reducing future 
          cases of HIV, viral hepatitis, and other bloodborne diseases, 
          there could be future cost avoidance to publicly funded health 
          care programs.

          Staff recommends that this bill be amended to sunset December 








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          31, 2018, consistent with the sunset date of the Disease 
          Prevention Demonstration Project (DPDP). DPDP authorizes local 
          jurisdictions to allow pharmacies to distribute up to 10 needles 
          or syringes without a prescription.

          This bill is nearly identical to AB 1858 (Blumenfield, 2010), 
          which Governor Schwarzenegger vetoed saying, "I signed 
          legislation in 2005 that reflected a careful balance between 
          good public health policy and local decision-making authority. I 
          remain comfortable with that original decision and do not 
          believe it is appropriate to change this balance and instead 
          give authority to the state Department of Public Health to 
          overrule local decisions regarding syringe exchange programs."