BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                    SB 41|
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                                 THIRD READING


          Bill No:  SB 41
          Author:   Yee (D)
          Amended:  5/24/11
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  5-3, 4/6/11
          AYES:  Hernandez, Alquist, Anderson, De Le�n, 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


           SUBJECT  :    Hypodermic needles and syringes

           SOURCE  :     Drug Policy Alliance
                              San Francisco AIDS Foundation


           DIGEST  :    This bill allows a person to obtain from a 
          pharmacist or physician up to 30 hypodermic needles for 
          personal use, eliminates the requirement that a local 
          government entity authorize pharmacists to provide 
          hypodermic needles or syringes without a prescription, 
          requires pharmacies that distribute non-prescription 
          needles and syringes to do the following:  (1) allow access 
          to needles and syringes only by authorized personnel; (2) 
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          give customers needle and syringe collection and disposal 
          options; and (3) provide written information or oral 
          counseling to customers on drug treatment, HIV and 
          Hepatitis C testing, and safe sharps disposal, includes a 
          three-year sunset (until December 31, 2014), 
          notwithstanding current law,  and states legislative intent 
          to improve access to needles and syringes to reduce the 
          spread of communicable diseases.

           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 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 
             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 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.

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             Also as part of the 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.
                    
          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. Allows a person to obtain from a pharmacist or physician 
             up to 30 hypodermic needles for personal use;

          2. Eliminates the requirement that a local government 
             entity authorize pharmacists to provide hypodermic 
             needles or syringes without a prescription;

          3. Requires pharmacies that distribute non-prescription 
             needles and syringes to do the following:  (a) allow 
             access to needles and syringes only by authorized 
             personnel; (b) give customers needle and syringe 
             collection and disposal options; and  (c) provide 
             written information or oral counseling to customers on 
             drug treatment, HIV and Hepatitis C testing, and safe 
             sharps disposal;


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          4. Includes a three-year sunset (until December 31, 2014), 
             notwithstanding current law, and

          5. States legislative intent to improve access to needles 
             and syringes to reduce the spread of communicable 
             diseases.

           Background 

           Injection drug use and disease prevalence
           
          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 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.  


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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  Yes

           SUPPORT  :   (Verified  5/24/11)

          Drug Policy Alliance (source)
          San Francisco AIDS Foundation (source)
          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  5/24/11)

          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 

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          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 
          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 measure 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. 

          CTW:kc  5/19/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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