BILL ANALYSIS �
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 1743|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: AB 1743
Author: Ting (D), et al.
Amended: 5/27/14 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 7-2, 6/11/14
AYES: Hernandez, Beall, De Le�n, DeSaulnier, Evans, Monning,
Wolk
NOES: Morrell, Nielsen
SENATE PUBLIC SAFETY COMMITTEE : 7-0, 6/24/14
AYES: Hancock, Anderson, De Le�n, Knight, Liu, Mitchell,
Steinberg
ASSEMBLY FLOOR : 45-28, 4/10/14 - See last page for vote
SUBJECT : Hypodermic needles and syringes
SOURCE : Drug Policy Alliance
San Francisco AIDS Foundation
DIGEST : This bill deletes the limit on the number of syringes
a pharmacist has the discretion to sell to an adult without a
prescription and extends, until January 1, 2021, the statewide
authorization for pharmacists to sell syringes without a
prescription, as specified.
ANALYSIS :
Existing law:
CONTINUED
AB 1743
Page
2
1.Permits pharmacists and physicians to furnish up to 30 hypodermic
needles and syringes for human use, without a prescription or
local government authorization, to a person 18 years or older
until January 1, 2015.
2.Permits a person 18 years of age or older, without a prescription
or license, to obtain up to 30 hypodermic needles and syringes
from a physician or pharmacist solely for personal use until
January 1, 2015.
3.Requires pharmacies that furnish non-prescription syringes to
provide written information or verbal counseling to consumers
at the time of furnishing or sale of non-prescription
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.
4.Permits, until January 1, 2015, a city or county to authorize a
licensed pharmacist to sell or furnish up to 10 hypodermic
needles or syringes to a person for human use without a
prescription if the pharmacy is registered with a local health
jurisdiction in disease prevention demonstration projects
(DPDP).
This bill deletes the limit on the number of syringes a
pharmacist has the discretion to sell to an adult without a
prescription and extends, until January 1, 2021, the statewide
authorization for pharmacists to sell syringes without a
prescription, as specified.
Background
The Department of Public Health (DPH) Office of AIDS estimates
that of the 117,553 persons reported to be living with HIV/AIDS
in California in 2012, 16.4% reported injection drug use (IDU)
as a risk factor, including approximately 9,672 men who reported
both IDU and having sex with men as risk factors. The Center
for Disease Control and Prevention (CDC) estimates that 50% to
90% of HIV-infected persons who use injection drugs are also
infected with hepatitis C virus (HCV). IDU is the most commonly
reported risk for HCV infection and is the second most common
risk factor for hepatitis B virus (HBV) infection. DPH's Office
of Viral Hepatitis Prevention estimates that at least 60% of
CONTINUED
AB 1743
Page
3
prevalent cases of HCV infection in California are associated
with IDU, and reports an estimated 750,000 people living with
hepatitis C in the state.
Public health experts, including the CDC, 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
(NABP), the National Alliance of State and Territorial AIDS
Directors, and the Association of State and Territorial Health
Officials. California is one of only five states having
statewide limitations on the purchase of syringes, according to
a 2014 survey by the NABP. Although statewide sales are
currently legal, there is a restriction as to the number.
DPDP . SB 1159 (Vasconcellos, Chapter 608, Statutes of 2004)
established 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, 16 counties and four cities in California
authorized a DPDP. By February 2010, over 650 pharmacies were
registered to participate in the program.
According to an evaluation of DPDP published in July 2010 by
DPH, SB 1159 appeared to have the desired effect of augmenting
access to sterile syringes to prevent transmission of
blood-borne viral infections among IDUs without many of the
negative consequences that some had feared. DPH's evaluation
suggests that counties authorizing over-the-counter (OTC) sale
of syringes without a prescription possess lower syringe sharing
levels among IDUs than counties that have not authorized OTC
sale. Additionally, since implementation of SB 1159, fewer
clients presenting for testing for HIV at state-funded testing
sites report injecting illegal drugs, suggesting that
authorization of OTC syringe sales did not have the negative
impact of increased injection drug activity, a concern expressed
by some prior to authorization. DPH's evaluation found no
increase in unsafe discard of syringes since implementation of
SB 1159. Finally, comparing time periods prior to and following
SB 1159 authorization, DPH found no evidence of an increase in
CONTINUED
AB 1743
Page
4
drug use or crime in the state of California as a whole or in
areas that authorized sale of syringes without a prescription.
The overall findings are consistent with those of other states
that have transitioned, as California has, from a complete
prohibition on sale and possession of syringes, to allowing a
limited number to be sold to adults. The program was considered
successful by the localities that implemented it and the DPDP
was suspended when statewide sales were authorized by SB 41
(Yee, Chapter 738, Statutes of 2011).
Prior Legislation
SB 41 (Yee, Chapter 738, Statutes of 2011) permits
non-prescription syringe sales of a maximum of 30 hypodermic
needles or syringes to a person without a prescription through
licensed pharmacies throughout the state until January 1, 2015
and makes inoperative until that date, portions of the law
establishing the DPDP.
AB 1701 (Chesbro, Chapter 667, Statues of 2010) 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 110 (Laird, Chapter 707, Statutes of 2007) permits a public
entity that receives General Fund money from the Department of
Health Services (now DPH) for HIV prevention and education to
use that money to support needle exchange programs. AB 1597
(Laird, 2005) contained substantially similar provisions to AB
110, but was vetoed by Governor Schwarzenegger.
AB 547 (Berg, Chapter 692, Statutes of 2005) creates the Clean
Needle and Syringe Exchange Program to permit needle exchange
programs without a local declaration of emergency.
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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local:
CONTINUED
AB 1743
Page
5
No
SUPPORT : (Verified 6/27/14)
Drug Policy Alliance (co-source)
San Francisco AIDS Foundation (co-source)
A New PATH
ACLU of California
AIDS Legal Referral Panel
Asian & Pacific Islander Wellness Center
California Association of Alcohol and Drug Program Executives
California Communities United Institute
California Medical Association
California Nurses Association
California Pharmacists Association
California Primary Care Association
California Public Defenders Association
California Retailers Association
California Society of Addiction Medicine
California Society of Health-System Pharmacists
Center for Living and Learning
City and County of San Francisco
County Alcohol and Drug Program Administrators Association of
California
Dolores Street Community Services
Friends Committee on Legislation of California
HealthRIGHT 360
HIV Prevention Justice Alliance
Homeless Health Care Los Angeles
Los Angeles County Board of Supervisors
Los Angeles Gay and Lesbian Center
National Association of Social Workers, California Chapter
National Viral Hepatitis Roundtable
Planned Parenthood Affiliates of California
San Francisco AIDS Foundation
San Francisco HIV/AIDS Provider Network
San Francisco Medical Society
Tarzana Treatment Centers, Inc.
Transgender Law Center
UCSF Alliance Health Project
Westside Community Services
OPPOSITION : (Verified 6/27/14)
CONTINUED
AB 1743
Page
6
Los Angeles County Solid Waste Management Committee/Integrated
Waste Management Task Force
ARGUMENTS IN SUPPORT : The Drug Policy Alliance and San
Francisco AIDS Foundation, co-sponsors of this bill, argue this
bill will continue cost-effective HIV and hepatitis prevention
policy in California. Lifting the current sunset and allowing
pharmacists and physicians the discretion to furnish sterile
syringes, will be an important part of the state's comprehensive
approach to preventing the spread of HIV, hepatitis B, and
hepatitis C. They note over 200 studies from the United States
and abroad concur that improved syringe access reduces the rate
of syringe sharing and disease transmission without increasing
rates of drug use, drug injection, or crime. The co-sponsors
also note that maintaining access to sterile syringes reduces
costs to taxpayers; the cost of treating one case of HIV can
exceed $600,000.
ARGUMENTS IN OPPOSITION : The Los Angeles County Solid Waste
Management Committee/Integrated Waste Management Task Force
(Task Force) writes in opposition to this bill stating that
local governments continue to be burdened with the financial
responsibility of managing the syringe waste gathered at
household hazardous waste collection events or other public
facilities, and believe this bill will most likely increase the
number of syringes that enter the waste stream. The Task Force
is requesting amendments that intend to shift the burden of
collection and disposal of the syringes to manufacturers of the
syringes and the pharmaceuticals administered with the syringes,
as well as the distributors of these products.
ASSEMBLY FLOOR : 45-28, 4/10/14
AYES: Alejo, Ammiano, Atkins, Bloom, Bocanegra, Bonilla, Bonta,
Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau,
Chesbro, Daly, Dickinson, Eggman, Fong, Garcia, Gatto, Gomez,
Gonzalez, Gordon, Gorell, Hall, Roger Hern�ndez, Holden,
Jones-Sawyer, Levine, Lowenthal, Mullin, Nazarian, Pan, Quirk,
Rendon, Ridley-Thomas, Rodriguez, Skinner, Stone, Ting, Weber,
Wieckowski, Williams, Yamada, John A. P�rez
NOES: Achadjian, Allen, Ch�vez, Conway, Cooley, Dahle, Fox,
Frazier, Beth Gaines, Gray, Grove, Hagman, Harkey, Jones,
Linder, Logue, Maienschein, Mansoor, Medina, Melendez,
Muratsuchi, Nestande, Olsen, Patterson, Perea, Quirk-Silva,
Wagner, Wilk
CONTINUED
AB 1743
Page
7
NO VOTE RECORDED: Bigelow, Dababneh, Donnelly, V. Manuel P�rez,
Salas, Waldron, Vacancy
JL:k 6/27/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED