BILL ANALYSIS
SB 1029
Page 1
Date of Hearing: June 29, 2010
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 1029 (Yee) - As Amended: June 23, 2010
SENATE VOTE : 30-0
SUBJECT : Hypodermic needles and syringes.
SUMMARY : Permits pharmacists and physicians to distribute to
individuals, and individuals to receive, up to 30 needles
without a prescription solely for personal use, as specified.
Specifically, this bill :
1)Permits pharmacists and physicians to distribute to
individuals, and individuals to obtain, as a public health
measure, as specified, up to 30 needles without a prescription
solely for personal use until December 31, 2018.
2)Requires pharmacies that furnish nonprescription syringes to
store them in a manner that ensures that they are available
only to authorized personnel.
3)Requires pharmacies that furnish nonprescription hypodermic
needles and syringes to provide consumers with one or more of
the following disposal options:
a) An onsite, safe, hypodermic needle and syringe
collection and disposal program;
b) 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,
c) A personal medical sharps disposal container that meets
applicable state and federal standards for disposal of
medical sharps waste.
4)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
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treatment, testing and treatment for human immunodeficiency
virus (HIV) and hepatitis C (HCV), and how to safely dispose
of sharps waste.
5)Requires the Department of Public Health (DPH) Office of AIDS
and the California State Board of Pharmacy to develop and
maintain specified information regarding HIV and HCV testing
and treatment, safe needle disposal, and drug treatment on
their Internet Web sites, as specified.
6)Repeals the Disease Prevention Demonstration Project (DPDP).
7)States legislative intent.
8)Makes conforming, technical changes.
EXISTING LAW :
1)Regulates the sale, possession, and disposal of hypodermic
needles and syringes and requires a prescription to purchase a
hypodermic needle or syringe for human use, with certain
exemptions.
2)Permits a city or county to authorize a licensed pharmacist to
sell or furnish 10 or fewer hypodermic needles or syringes to
a person for human use without a prescription if the pharmacy
is registered with a local health jurisdiction (LHJ) in the
DPDP until December 31, 2010.
3)Prohibits the possession and sale of drug paraphernalia;
however, exempts persons authorized by a city or county to
possess 10 or fewer hypodermic needles or syringes if acquired
through an authorized source, until December 31, 2010.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author, "The deficiency
in law prompting the bills' introduction is the sunset of the
5-year pilot program and evaluation authorized by SB 1159
(Vasconcellos), [Chapter 608, Statutes of 2004]. California is
one of three states that still require a pharmacist verify a
prescription before furnishing syringes to an adult. Most
states never prohibited furnishing of syringes by pharmacist
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without prescription, and of those that did, most amended their
laws when it became clear that syringe scarcity was encouraging
the sharing of used syringes and that sharing was the second
most common cause of HIV transmission.
"Further, California is suffering an unnecessarily high rate of
HIV and viral hepatitis due to syringe scarcity. While many
states allow an unlimited number of syringes to be sold to an
adult, this bill is an incremental move away from complete
prohibition of sale and possession of syringes, allowing an
adult to purchase and possess 30 or fewer syringes for personal
use."
Background . According to the DPH Office of AIDS, in 2009
injection drug use (IDU) was associated with 19% of the 190,000
reported HIV/AIDS cases, and it is estimated that approximately
750 new HIV infections may be attributed to IDU each year. The
link between IDU and HIV transmission is particularly strong for
women and minorities. It is also estimated that at least 60% of
prevalent cases of HCV infection are associated with IDU. In
2008, 36 acute HCV infections and 69,519 unique chronic HCV
cases were reported in California, and HCV-related deaths in the
state more than doubled from 503 in 1995 to 1,195 in 2004.
Public health experts, including the Centers for Disease Control
and Prevention, have identified access to sterile syringes as
one component of a comprehensive HIV prevention strategy
designed to reduce HIV transmission among IDUs. In the last 10
years, a number of national organizations have endorsed
deregulation to allow IDUs to purchase and possess syringes and
needles without a prescription, including the American Medical
Association, the American Pharmaceutical Association, the
National Association of Boards of Pharmacy, the National
Alliance of State and Territorial AIDS Directors, and the
Association of State and Territorial Health Officials.
DPDP . SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004,
establishes a five-year pilot program to allow California
pharmacies, when authorized by a local government, to sell up to
10 syringes to adults without a prescription. According to the
DPH Office of AIDS, 15 counties (Alameda, Contra Costa,
Humboldt, Los Angeles, Marin, San Francisco, San Luis Obispo,
San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano,
Sonoma, Yolo, and Yuba) and four cities (Long Beach, Los
Angeles, Sacramento, and West Hollywood) in California have
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authorized a DPDP. According to DPH, in 2005, the first wave of
LHJs and pharmacies in California began to authorize and
implement local DPDPs. By the end of 2007, 532 pharmacies in 17
LHJs registered to participate in the program. Among the LHJs
not planning to authorize DPDP, the top four reasons were:
limited time (38%) or interest (31%), pharmacy disinterest
(29%), and law enforcement opposition (22%). While the
proportion of LHJs that authorized a DPDP is relatively small,
those that have implemented one are home to 70% of Californians
currently living with HIV/AIDS.
Analyses of HIV counseling and testing data found that reported
use of pharmacies as a source for sterile syringes increased
significantly in early adopting counties from 2004-2006: Sonoma
(2.9% vs. 28.8%), Los Angeles (6.5% vs. 21.3%), Contra Costa
(1.5% vs. 16.2%), San Francisco (1.9% vs. 13.5%), and Alameda
(1.5% vs. 5.3%). Syringe sharing levels among IDUs attending
HIV counseling and testing sites were consistently lower in LHJs
that had authorized the sale of syringes without a prescription
than sharing levels in LHJs that had not. While these
differences in syringe sharing levels cannot be solely
attributed to the DPDP, from a public health perspective it is
another indication that enhanced syringe access can help reduce
injection-associated risks.
Related legislation . AB 1701 (Chesbro) establishes,
indefinitely, the DPDP, permitting cities or counties to
authorize licensed pharmacists to sell or furnish 10 or fewer
hypodermic needles or syringes to a person for use without a
prescription, as specified. AB 1701 is pending the Senate
Health Committee.
AB 1858 (Blumenfield) deletes the prohibition against any person
possessing hypodermic needles or syringes, deletes the December
31, 2010 sunset date for DPDP, and increases the number of
hypodermic needles and syringes permitted to be obtained or
possessed without a prescription from 10 needles to 30 needles.
AB 1858 also permits DPH to authorize entities to provide
hypodermic needle and syringe exchange services in any location
where it 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 sharing needles
and syringes. AB 1858 is pending the Senate Health Committee.
Previous legislation . AB 110 (Laird), Chapter 707, Statutes of
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2007, permits a public entity that receives General Fund (GF)
money from the Department of Health Services (now DPH) for HIV
prevention and education to use that money to support needle
exchange programs.
AB 547 (Berg), Chapter 692, Statutes of 2005 created the Clean
Needle and Syringe Exchange Program to permit needle exchange
programs without a local declaration of emergency.
AB 1597 (Laird) of 2005, would have permited a public entity
that receives GF money from the Department of Health Services
(now DPH) for HIV prevention and education to use that money to
support clean needle and syringe exchange projects, as
specified. AB 1597 was vetoed.
AB 2871 (Berg) of 2004 would also have repealed the requirement
that a city or county authorize its needle exchange program
through a declaration of a local emergency. AB 2871 was vetoed.
SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004,
established the DPDP to evaluate 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.
AB 946 (Berg) of 2003 would have authorized cities and counties
to develop clean needle and syringe exchange projects. AB 946
was vetoed.
SB 774 (Vasconcellos) of 2003 would have permitted a pharmacist,
who works for a pharmacy that is registered for the DPDP, to
furnish without a prescription 30 or fewer hypodermic needles
and syringes at any one time to a person 18 years of age or
older. SB 774 was vetoed.
SB 1785 (Vasconcellos) of 2002 would have permitted the
furnishing of syringes without a prescription. SB 1785 was
vetoed.
AB 136 (Mazzoni), Chapter 762, Statutes of 1999, exempts public
entities and their agents and employees who distribute
hypodermic needles or syringes to participants in clean needle
and syringe exchange projects authorized by the public entity
pursuant to a declaration of a local emergency from criminal
prosecution.
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Support . The California Medical Association writes, "CMA
physicians support making syringes and needles available without
prescription at licensed pharmacies in order to prevent
transmission of HIV and hepatitis among injection drug-users.
These are costly, deadly diseases that can be easily prevented
in this population by the provision of sterile syringes. We
urge your support of this important public health measure."
Additionally, the California Pharmacists Association (CPHA)
writes, "CPHA support access to hypodermic needles as a matter
of public health. Current law has reduced the spread of
infectious diseases, and we believe your legislation will make
an even greater impact. We know that some in law enforcement
continue to have concerns about such programs. However, we
believe the data supports the tremendous value in fighting blood
born diseases."
REGISTERED SUPPORT / OPPOSITION :
Support
San Francisco AIDS Foundation (Sponsor)
AIDS Project Los Angeles
Alameda County Board of Supervisors
American Civil Liberties Union
California Association of Alcohol and Drug Program Executives,
Inc.
California Communities United Institute
California Hepatitis Alliance
California Nurses Association/National Nurses Organizing
Committee
California Medical Association
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 and Drug Program Administrators Association of
California
Drug Policy Alliance
Equality California
Friends Committee on Legislation of California
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Health Officers Association of California
Osteopathic Physicians and Surgeons of California
Planned Parenthood Action Fund of San Diego & Riverside Counties
Planned Parenthood Advocacy Project of Los Angeles County
Planned Parenthood Affiliates of California
Republican Liberty Caucus
Rite Aid
San Francisco Mayor's Hepatitis C Task Force
Walgreens
Opposition
None on file.
Analysis Prepared by : Rebecca May / B.,P. & C.P. / (916)
319-3301