BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  SB 1029|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  SB 1029
          Author:   Yee (D)
          Amended:  4/7/10
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-3, 3/24/10
          AYES:  Alquist, Cedillo, Leno, Negrete McLeod, Pavley,  
            Romero
          NOES:  Strickland, Aanestad, Cox

           SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE  :  5-1, 4/22/10
          AYES:  Negrete McLeod, Calderon, Florez, Oropeza, Yee
          NOES:  Wyland
          NO VOTE RECORDED:  Aanestad, Correa, Walters

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


           SUBJECT  :    Hypodermic needles and syringes

            SOURCE  :     Drug Policy Alliance
                       San Francisco AIDS Foundation


           DIGEST  :    This bill allows individuals to obtain up to 30  
          syringes or needles for personal use without a prescription  
          from a pharmacy, and authorizes pharmacists and physicians  
          to distribute up to 30 needles to an individual without a  
          prescription solely for personal use.

           ANALYSIS  :    

                                                           CONTINUED





                                                               SB 1029
                                                                Page  
          2

          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, 2010,  
             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 a 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  
             nonprescription hypodermic needles or syringes to  
             prevent the spread of blood-borne pathogens, including  
             HIV and hepatitis C. 

          4. 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 drug treatment, testing services, and  
             safe sharps disposal practices at the point of sale.

          5. As part of the DPDP, proscribes requirements for the  
             secure storage of needles and syringes in pharmacies,  
             and requires pharmacies to make safe disposal options  
             available to users.

          6. As part of DPDP, requires the California Department of  
             Public Health (CDPH) 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. 

          7. Authorizes clean needle exchange programs in any city  
             and county, county, or city upon the action of a county  







                                                               SB 1029
                                                                Page  
          3

             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.

          8. Requires that no person shall possess a hypodermic  
             needle or syringe except when acquired in accordance  
             with specified provisions of law.

          9. 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  
             projects authorized by law.

          This bill:

          1. Declares legislative intent to improve access to  
             syringes and hypodermic needles for the purpose of  
             protecting public health, providing sterile injection  
             equipment and allowing for education to reduce the  
             spread of communicable diseases.

          2. Deletes the December 31, 2010 sunset date for the DPDP  
             pilot program and authorizes its provisions in a  
             statewide program until December 31, 2018.

          3. 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.

          4. Allows a pharmacist, veterinarian or person licensed by  
             the California State Board of Pharmacy (Board) to  
             furnish hypodermic needles or syringes for animal use  
             without a prescription or permit if the person is known  
             to the furnisher and able to properly establish his or  
             her identity.

          5. Allows a physician or pharmacist anywhere in the state  
             the discretion to furnish 30 or fewer hypodermic needles  
             or syringes to adults 18 years of age or older without a  







                                                               SB 1029
                                                                Page  
          4

             prescription or permit solely for personal use.   
             Specifies that this provision is for the purpose of  
             preventing the transmission of HIV, viral hepatitis,  
             other blood-borne diseases and subsequent infection of  
             sexual partners, newborn children, or other persons.

          6. Removes the requirement for local authorization through  
             a vote of a Board of Supervisors or City Council.

          7. Allows individuals to possess 30 or fewer syringes  
             solely for personal use if acquired from a pharmacy,  
             physician or syringe exchange program.

          8. Requires pharmacies to store hypodermic needles and  
             syringes in a manner that ensures that they are  
             available only to authorized personnel, and are not  
             accessible to other persons.

          9. Requires all pharmacies that furnish nonprescription  
             syringes to provide for safe disposal of syringe and  
             sharps waste, by providing one or more of the following  
             options:

             A.    The pharmacy participates in a syringe take-back  
                program.

             B.    The pharmacy furnishes or makes available  
                mail-back containers approved by the US Postal  
                Service for the transportation and destruction of  
                sharps waste.

             C.    The pharmacy furnishes or makes available sharps  
                containers that meet applicable state or federal  
                standards for disposal of sharps waste.

          10.Requires all pharmacies to furnish information to  
             purchasers of nonprescription syringes about accessing  
             drug treatment, accessing HIV and hepatitis screenings  
             and safe disposal of syringe and sharps waste.

          11.Requires Office of AIDS to develop and maintain  
             information on its website about accessing drug  
             treatment, accessing HIV and hepatitis screenings and  
             safe disposal of syringe and sharps waste; requires the  







                                                               SB 1029
                                                                Page  
          5

             Board to either post or maintain a link to the same  
             information on its website.

           Background
           
          According to the CDPH/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 syringes and needles 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  
          (CDC).  California data suggests that over 1,500 new  
          syringe-sharing HIV infections occur annually.  The link  
          between injection drug use and HIV 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 hepatitis C virus  
          (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 five  
          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  5/11/10)

          Drug Policy Alliance (co-source)







                                                               SB 1029
                                                                Page  
          6

          San Francisco AIDS Foundation (co-source)
          AIDS Project Los Angeles 
          American Civil Liberties Union
          California Association of Alcohol and Drug Program  
          Executives, Inc.
          California Communities United Institute 
          California Hepatitis Alliance 
          California Medical Association 
          California Nurses Association/National Nurses Organizing  
          Committee 
          California Opioid Maintenance Providers
          California Pharmacists Association
          California Psychiatric Association 
          California Retailers Association 
          California Society of Addiction Medicine
          City and County of San Francisco 
          City of West Hollywood
          County Alcohol & Drug Program Administrators Association of  
          California
          County of Alameda
          Equality California 
          Health Officers Association of California 
          Planned Parenthood
          Planned Parenthood Advocacy Project of Los Angeles County
          Rite Aid
          San Francisco Mayor's Hepatitis C Task Force
          Walgreens

           OPPOSITION  :    (Verified  5/11/10)

          California Narcotic Officers' Association
          California Peace Officers' Association
          California Police Chiefs' Association
          League of California Cities

           ARGUMENTS IN SUPPORT  :    The California Hepatitis Alliance  
          claim that syringe sharing among injection drug users who  
          are not allowed to buy syringes without a prescription, is  
          the number one cause of hepatitis C in the state, and the  
          second most common cause of new HIV and hepatitis B  
          infections.  They contend that allowing adults to spend  
          their own money to access equipment that prevents the  
          spread of infectious diseases will save California  
          taxpayers hundreds of millions of dollars in healthcare  







                                                               SB 1029
                                                                Page  
          7

          costs.  The California Medical Association concurs with the  
          claim that making syringes and needles available without a  
          prescription at licensed pharmacies will help prevent the  
          transmission of diseases among IDUs.  The California  
          Retailers Association represents many chain drug stores  
          that chose to participate in the DPDP, and agrees with the  
          statewide expansion of pharmacy syringe and needle access  
          offered by this bill.  The County Alcohol and Drug Program  
          Administrators Association of California claims this bill  
          is consistent with their commitment to the reduction of  
          individual and community problems related to chronic  
          disease of addiction. 
          
           ARGUMENTS IN OPPOSITION  :    The California Narcotics  
          Association opposes the bill's removal of the local option  
          to approve or disapprove authorization for pharmacy syringe  
          sales.  They believe this bill will force needle furnishing  
          programs on every community in California, irrespective of  
          the wishes of that community's elected officials.  

          CTW:JJA:do  5/11/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****