BILL ANALYSIS                                                                                                                                                                                                    



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          SENATE THIRD READING
          SB 1029 (Yee)
          As Amended June 23, 2010
          Majority vote 

           SENATE VOTE  :21-8  
           
           HEALTH              12-6        BUSINESS & PROFESSIONS     6-2  
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Carter, |Ayes:|Hayashi, Eng, Hernandez,  |
          |     |                          |     |Hill, Ma, Ruskin          |
          |     |De La Torre, De Leon,     |     |                          |
          |     |Eng, Hayashi, Hernandez,  |     |                          |
          |     |Jones, Bonnie Lowenthal,  |     |                          |
          |     |V. Manuel Perez, Salas    |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Fletcher, Conway, Gaines, |Nays:|Conway, Smyth             |
          |     |Smyth, Audra Strickland,  |     |                          |
          |     |Gilmore                   |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      12-5                                        
           
           -------------------------------- 
          |Ayes:|Fuentes, Bradford,        |
          |     |Charles Calderon, Coto,   |
          |     |Davis, De Leon, Gatto,    |
          |     |Hall, Skinner, Solorio,   |
          |     |Torlakson, Torrico        |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Conway, Harkey, Miller,   |
          |     |Nielsen, Norby            |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Repeals the Disease Prevention Demonstration Project  
          (DPDP) in existing law.  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)Repeals the DPDP in existing law.  Permits pharmacists and  








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            physicians to furnish hypodermic needles and syringes for  
            human use, without a prescription, if the person is known 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.

          2)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.

          3)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.

          4)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.

          5)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.

          6)Requires the Department of Public Health (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  








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            link to, that information on its Internet Web site.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, absorbable workload to DPH Office of AIDS and the  
          California Board of Pharmacy to provide specified information on  
          their websites and to continue oversight of the sale and  
          disposal of needles and syringes.

           COMMENTS  :  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 hepatitis C virus (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 posses 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. 

          SB 1159 (Vasconcellos), Chapter 608, Statutes of 2004,  
          establishes a five-year DPDP 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 and four cities in California  
          have authorized a DPDP (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; cities: Long Beach, Los Angeles,  
          Sacramento, and West Hollywood).  Two other counties are  
          currently considering or planning to implement the program, and  
          four County Boards of Supervisors have rejected authorization of  








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          a DPDP.  According to DPH, in 2005, the first wave of local  
          health jurisdictions (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.


           Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097 


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