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
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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."