BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 41|
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UNFINISHED BUSINESS
Bill No: SB 41
Author: Yee (D)
Amended: 8/15/11
Vote: 21
SENATE HEALTH COMMITTEE : 5-3, 4/6/11
AYES: Hernandez, Alquist, Anderson, De León, DeSaulnier
NOES: Strickland, Rubio, Wolk
NO VOTE RECORDED: Blakeslee
SENATE PUBLIC SAFETY COMMITTEE : 5-1, 4/26/11
AYES: Hancock, Anderson, Liu, Price, Steinberg
NOES: Harman
NO VOTE RECORDED: Calderon
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SENATE FLOOR : 24-13, 5/31/11
AYES: Alquist, Anderson, Calderon, Corbett, De León,
DeSaulnier, Evans, Gaines, Hancock, Hernandez, Kehoe,
Leno, Lieu, Liu, Lowenthal, Negrete McLeod, Padilla,
Pavley, Price, Simitian, Steinberg, Vargas, Wright, Yee
NOES: Blakeslee, Cannella, Correa, Dutton, Fuller, Harman,
Huff, La Malfa, Rubio, Runner, Strickland, Walters,
Wyland
NO VOTE RECORDED: Berryhill, Emmerson, Wolk
ASSEMBLY FLOOR : 52-26, 8/22/11 - See last page for vote
SUBJECT : Hypodermic needles and syringes
CONTINUED
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SOURCE : Drug Policy Alliance
San Francisco AIDS Foundation
DIGEST : This bill suspends certain provisions of the
Disease Prevention Demonstration Project, including the
ability for a city or county to authorize pharmacists to
provide up to 10 hypodermic needles and syringes without a
prescription, until January 1, 2015, and until then permits
pharmacists and physicians to furnish up to 30 hypodermic
needles and syringes for human use, without a prescription
or city/county authorization, to a person 18 years or
older, as specified.
Assembly Amendments make technical, non-substantiate
changes.
ANALYSIS :
Existing law:
1. Allows a pharmacist or physician to furnish hypodermic
needles or syringes for human use without a prescription
or permit if the person is known to the furnisher and
the furnisher has been previously provided with a
prescription or proof of legitimate medical need.
2. Allows counties to authorize pharmacists to furnish or
sell 10 or fewer hypodermic needles or syringes to
persons 18 years of age or older, for the period
commencing January 1, 2005 and ending December 31, 2018,
if the pharmacy is registered for the Disease Prevention
Demonstration Project (DPDP) and if the pharmacy
complies with other specified provisions.
3. Establishes the DPDP as collaboration between pharmacies
and local and state health officials for the purpose of
evaluating the long-term desirability of allowing
licensed pharmacists to furnish or sell non-prescription
hypodermic needles or syringes to prevent the spread of
bloodborne pathogens, including HIV and hepatitis C. As
part of the DPDP, requires participating pharmacies to
register with their local health department and certify
that they will provide written or verbal information on
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drug treatment, testing services, and safe sharps
disposal practices at the point of sale.
Also as part of the DPDP, prescribes requirements for
the secure storage of needles and syringes in
pharmacies, and requires pharmacies to make safe
disposal options available to users.
Also as part of the DPDP, requires the Department of
Public Health (DPH) to evaluate the effects of allowing
pharmacists to furnish or sell a limited number of
hypodermic needles or syringes without prescription, and
to provide a report to the Governor and the Legislature
on or before January 15, 2010.
4. Authorizes clean needle exchange programs in any city
and/or county 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.
5. Requires that no person shall possess a hypodermic
needle or syringe except when acquired in accordance
with specified provisions of law.
6. Stipulates that no public entity, its agents, or
employees will be subject to criminal prosecution for
the distribution of hypodermic needles or syringes to
participants in clean needle and syringe exchange
programs authorized by law.
This bill:
1. Suspends certain provisions of the DPDP, including the
ability for a city or county to authorize pharmacists to
provide up to 10 hypodermic needles and syringes without
a prescription, until January 1, 2015, and until then:
A. Permits pharmacists and physicians to furnish up
to 30 hypodermic needles and syringes for human use,
without a prescription or city/county authorization,
to a person 18 years or older if the person is known
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to the furnisher and the furnisher has previously
been provided a prescription or other proof of a
legitimate medical need requiring a hypodermic needle
or syringe to administer a medicine or treatment.
Permits a person 18 years of age or older, without a
prescription or license, to obtain 30 or fewer
hypodermic needles and syringes solely for personal
use from a physician or pharmacist;
B. Requires pharmacies that furnish nonprescription
hypodermic needles and syringes to store them in a
manner that ensures that they are available only to
authorized personnel and to provide consumers with
one or more of the following disposal options:
(1). An onsite, safe, hypodermic needle and syringe
collection and disposal program;
(2). Mail-back sharps disposal containers authorized
by the United States Postal Service that meet
applicable state and federal requirements, and
that provide tracking forms to verify destruction
at a certified disposal facility; and,
(3). A personal medical sharps disposal container
that meets applicable state and federal standards
for disposal of medical sharps waste.
C. Requires pharmacies that furnish nonprescription
syringes to provide written information or verbal
counseling to consumers at the time of furnishing or
sale of nonprescription hypodermic needles or
syringes on how to access drug treatment and testing
and treatment for HIV and hepatitis C, and how to
safely dispose of sharps waste.
2. Requires the DPH Office of AIDS to develop and maintain
specified information regarding HIV and hepatitis
testing and treatment, safe needle disposal, and drug
treatment on its Internet Web site. Requires the
California State Board of Pharmacy to also post, or
maintain a link to, that information on its Internet Web
site.
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Background
Injection drug use and disease prevalence
According to the DPH/OA, injection drug use is the second
leading cause of HIV transmission and the leading cause of
hepatitis C virus (HCV) infection in California. Sharing
of contaminated syringes and other injection equipment is
linked to 19 percent of all reported AIDS cases in the
state. The shared use of needles and syringes was
recognized as being associated with HIV transmission among
injection drug users at the onset of the HIV/AIDS pandemic.
Nationwide, injection drug use accounted for 17 percent of
new HIV/AIDS diagnoses in adults and adolescents in 2007,
according to the Centers for Disease Control and
Prevention. California data suggests that over 1,500 new
syringe-sharing HIV infections occur annually. The link
between injection drug use and HIV/AIDS is particularly
strong for women and people of color. In California, 37
percent of cumulative AIDS cases among women, 24.3 percent
of cases among African American men and women, and 22.4
percent of cases among Latinas are directly attributable to
syringe-sharing.
In addition, there are an estimated 500,000 to 600,000
Californians currently infected with HCV with an estimated
5,000 new infections annually due to injection drug use.
Viral hepatitis is a major cause of liver cancer and the
leading cause of liver transplants nationwide. In the
United States, there are more than 5 million people living
with chronic hepatitis B virus (HBV) or chronic HCV. In
2007 alone, HBV- and HCV-related hospitalization costs in
California totaled $2 billion. Over the next 20 years,
annual medical costs for people with HCV nationwide are
expected to increase more than 2.5 times, from $30 billion
to more than $85 billion.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/22/11)
Drug Policy Alliance (source)
San Francisco AIDS Foundation (source)
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AIDS Project Los Angeles
Alameda County Board of Supervisors
American Civil Liberties Union
American Federation of State, County and Municipal
Employees
California Association of Alcohol and Drug Programs
Executives, Inc.
California Communities United Institute
California Family Health Council
California Medical Association
California Nurses Association
California Opioid Maintenance Providers
California Pharmacists Association
California Psychiatric Association
California Public Defenders Association
California Retailers Association
City and County of San Francisco
County Alcohol and Drug Program Administrators Association
of California
County of Santa Clara Board of Supervisors
Equality California
Friends Committee on Legislation of California
Health Officers Association of California
Los Angeles County Solid Waste Management
Committee/Integrated Waste Management Task Force
Planned Parenthood Affiliates of California, Inc.
Rite Aid
San Francisco Hepatitis C Task Force
OPPOSITION : (Verified 8/23/11)
California District Attorneys Association
California State Sheriffs' Association
Chief Probation Officers of California
Peace Officers Research Association
ARGUMENTS IN SUPPORT : The Drug Policy Alliance and the
San Francisco AIDS Foundation are sponsoring this bill
because they believe legal access to sterile syringes for
adults is a proven method for reducing the transmission of
HIV, hepatitis C and other costly, deadly bloodborne
diseases. They claim that preventing disease transmission
is sound fiscal policy and believe expanding access to
sterile syringes statewide will reduce costs to California
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taxpayers.
Rite Aid supports this bill and claims their respective
experiences in other states demonstrates that allowing
pharmacists to dispense needles without a prescription
enhances public health. They also support creating a
statewide policy on pharmacy sale of syringes, in contrast
to the current patchwork of county programs, because it
will decrease confusion for pharmacies which are located in
multiple jurisdictions. The California Retailers
Association also supports the statewide solution
established by this legislation and believes all
communities benefit from this highly effective, no-cost
approach to disease prevention.
ARGUMENTS IN OPPOSITION : Groups oppose this bill due to
the potential for needle dumping and for careless
distribution of the actual needles in the pharmacy and
nearby areas. They claim that this bill does not stop at
its broad-based approach to needle distribution but also
makes changes regarding additional drug implements as well.
They believe that needle furnishing programs should not
harm public safety, nor should a community lose its right
to retain control of such an important matter.
ASSEMBLY FLOOR : 52-26, 8/22/11
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fong, Fuentes,
Galgiani, Gatto, Gordon, Hall, Hayashi, Roger Hernández,
Hill, Huber, Hueso, Huffman, Knight, Lara, Bonnie
Lowenthal, Ma, Mendoza, Mitchell, Monning, Norby, Pan, V.
Manuel Pérez, Portantino, Skinner, Solorio, Swanson,
Torres, Wieckowski, Williams, Yamada, John A. Pérez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Fletcher, Beth Gaines, Garrick, Grove, Hagman, Halderman,
Harkey, Jeffries, Jones, Logue, Mansoor, Miller, Morrell,
Nestande, Nielsen, Olsen, Perea, Silva, Smyth, Valadao,
Wagner
NO VOTE RECORDED: Furutani, Gorell
CTW:kc 8/23/11 Senate Floor Analyses
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SUPPORT/OPPOSITION: SEE ABOVE
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