Gov. signs bills expanding drug users' access to sterile syringes

FROM THE LATIMES.COM - OCTOBER 10

Gov. Jerry Brown on Monday signed two bills that will expand access to sterile syringes for drug users in an effort to combat the spread of hepatitis C and HIV. The first bill, SB41, written by Sen. Leland Yee (D-San Francisco), allows people to buy syringes at pharmacies without a prescription. California was one of the few states where this was illegal, other than a few pilot program areas. The second bill, introduced by Assemblywoman Nancy Skinner (D-Berkeley), allows the state to authorize needle exchange programs in areas deemed high risk for the spread of disease. As the bill made its way to the governor's desk, the issue was playing out in real-time in Fresno, which has one of the highest rates of IV drug use in the country. In September, the Fresno County Board of Supervisors voted to back away from a plan to legalize a longtime needle exchange even though county health officials warned that new infections of HIV and hepatitis C were climbing.

Dr. Marc Lasher, who runs a free medical clinic in conjunction with the Fresno needle exchange, vowed to continue the program despite the county's ban. "We're legal again!" Lasher said Monday. "This allows us to do what's right health-wise for our patients and our community, and we'll never have to ask permission ever again from the Board of Supervisors." The League of California Cities and some police organizations opposed the measure, saying it was taking away local control. In his signing message, Brown said he is directing health officials to implement the law in a "constrained way, working closely not only with local health officers and police chiefs, but with neighborhood associations as well."

Brown expands syringe sales & exchanges

By Josh Richman

FROM THE BAY AREA NEWS GROUP online, OCTOBER 10

Gov. Jerry Brown yesterday signed into law a Bay Area lawmaker’s bill that lets people buy syringes at pharmacies without a prescription – something his predecessor, Arnold Schwarzenegger, had vetoed one year ago. Brown also signed another Bay Area lawmaker’s bill to let the state Department of Public Health authorize new syringe exchange programs – a power previously held only by cities and counties – to deal with high rates of hepatitis, HIV and drug use in the state’s rural areas. Both bills take effect Jan. 1. “This is a huge victory for public health and common sense,” said Laura Thomas, the Drug Policy Alliance’s California deputy director. “Now all Californians will have the same access to proven, effective HIV and hepatitis C prevention. This gives drug users the tools that they need to protect their health and that of their partners, children, and communities, as well as protecting the California taxpayer from the cost of HIV and hepatitis C infections.”

SB 41, by state Sen. Leland Yee, D-San Francisco, expands statewide what had been a pilot program to which city councils or county supervisors could decide whether to opt in and pharmacies could choose to participate. Gov. Arnold Schwarzenegger vetoed Yee’s previous iteration of the bill last October, local officials can make the best decisions for their own jurisdictions; Yee and the bill’s backers had said most counties weren’t opting in, and blood-borne diseases don’t recognize political borders.

“SB 41 will greatly reduce healthcare costs to taxpayers and save lives,” Yee said today, noting that 47 states already let pharmacists sell syringes without a prescription. “(D)iabetics who visit our state may not even have a prescription and come here assuming they can purchase needles at a pharmacy. This new law will also ensure those diabetics or others who need syringes for health purposes will not be stranded here in California without the ability to administer life-saving insulin and other medicines.”

Besides the Drug Policy Alliance, SB 41 was supported by groups including the San Francisco AIDS Foundation, the California Academy of Family Physicians, California Nurses Association, California Medical Association, California Pharmacists Association, California Retailers Association, Rite Aid, San Francisco Hepatitis C Task Force, Health Officers Association of California, California Hepatitis Alliance, Equality California, AFSCME, ACLU, AIDS Project Los Angeles, California Psychiatric Association, and Planned Parenthood Affiliates of California.

AB 604 by Assemblywoman Nancy Skinner, D-Berkeley, lets the state from Jan. 1 through the start of 2019 authorize community organizations to create syringe-exchange programs where cities and counties have balked at doing so.

“California needs a uniform approach to syringe exchange programs, which are endorsed by all major national, state, and international health and medical associations, including the U.S. Centers for Disease Control and Prevention and the American Medical Association,” Skinner said Monday. “By signing AB 604, Governor Brown is helping ensure we have that kind of uniform approach in California, one based on public health instead of politics.”

The new law requires that if a community group’s application has merit and is from an area of demonstrably high need, CDPH must consult both the local health officer and local law enforcement leadership and then hold a 90-day public comment period before granting or denying the authorization. Skinner noted Monday that the Obama Administration recently approved use of federal funds for syringe-exchange programs, “so AB 604 will cost nothing to California’s General Fund, yet has the potential to save our state millions in healthcare costs.”

CalHEP is developing a searchable online referral guide that includes information on where to find hepatitis screening, support/education groups, syringe exchange, referrals to treatment, patient navigators, and vaccinations. If your public or nonprofit organization provides any of the above services in California, please take our survey.

This activity is a recommended strategy in the California Adult Viral Hepatitis Prevention Strategic Plan, 2010-2014. This plan was developed by the California Department of Public Health through collaborative efforts that included a stakeholder group of more than 80 representatives from a broad range of State agencies, local health departments, community-based organizations, membership organizations, and individuals living with or affected by hepatitis B virus (HBV) and hepatitis C virus (HCV).

On May 12th, the U.S. Department of Health and Human Services released an action plan to reduce the consequences of viral hepatitis. We encourage you to read Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care and Treatment of Viral Hepatitis.

The California Hepatitis Alliance and the California Health Policy Forum cosponsored a successful briefing on viral hepatitis at the California State Capitol on May 19th, California's Viral Hepatitis Awareness Day. The event focused on racial/ethnic and economic disparities, along with the opportunities provided by implementation of the Affordable Care Act (ACA) to reduce these disparities. You can find a link to the materials on the CalHEP Member Meetings page or read the California Healthline article.