HomeMy WebLinkAboutMINUTES - 08162005 - C104 TO: BOARD OF SUPERVISORS
Contra
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FROM: William B. Walker, M.D., Director Costa - - z
Contra Costa Health Services Count °;;_�.;; „'`
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DATE: August 10, 2005
SUBJECT: EXTENSION OF EMERGENCY DECLARATION AND AUTHORIZATION OF THE COUNTY
HEALTH DEPARTMENT IN SUPPORT FOR NEEDLE EXCHANGE PROGRAMS
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
Recommendation:
CONTINUE with the emergency action originally taken by the Board on December 14, 1999 based on the
increasing/epidemic number of AIDS/HIV and Hepatitis C cases among injection drug users in Contra Costa
County.
Background:
Continued.Need for Emergency
The spread of disease,particularly HIV and Hepatitis C, through the sharing of needles continues to be a grave
concern in Contra Costa County. 30%of all people living with AIDS in Contra Costa were infected by injec-
tion drug use with the highest number of AIDS cases in West County. As of December 1997, Richmond had
the highest cumulative incidence of AIDS (4.8 per 1,000 population) among Contra Costa cities,with at least
50 cases. Injection drug use was the estimated mode of infection among 40% of all individuals diagnosed
with AIDS in Richmond. Among African Americans diagnosed with AIDS in Richmond between 1952-1998,
53%were most likely infected through injection drug use.
Contra Costa Health Services does not currently provide needle exchange services (it is prohibited from doing
so absent a declared public health emergency). CCHS does provide services focused on injection drug users
including: 1-HIV/AIDS Outreach and Education; 2-HIV antibody testing; 3-Substance Abuse Treatment;
4-Health on Wheels Van; and 5-Substance Abuse Counseling and Treatment for HIV-infected clients.
Exchange Works, a community-based needle exchange service currently in operation in Contra Costa cur-
rently distributes clean needles on a one-to-one basis. Their volunteer staff currently exchanges 5,000 needles
per week at two sites. There are no established needle exchange programs in East or Central County.
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CONTINUED ON ATTACHMENT x Yes No SIGNATURE:
_,,,,ffECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
&--APPROVE OTHER
SIGNATURE(S).
ACTION OF BDON ,� APPROVED AS RECOMMENDED
VOTE OF SUPERVISORS
UNANIMOUS(ABSENT I HEREBY CERTIFY THAT THIS IS A TRUE AND
AYES: NOES. CORRECT COPY OF AN ACTION TAKEN AND
ABSENT: ABSTAIN: ENTERED ON THE MINUTES OF THE BOARD OF
SUPERVISORS ON T E DATE SHOWN.
ATTESTED
Contact Person: William Walker, M.D. JOHN SWEETJW,CLERK OF THE BOARD OF
SRVISOF&AND COUNTY ADMINISTRATOR
cc: Health Services Department Admin.(20 Allen St.,Martinez)
Public Health Admin.(597 Center Ave.,Martinez) .
DEPUTY
Board of Supervisors
Emergency.Declaration for Support of Needle Exchange Programs Page 2
Progress Since Emergency Declaration on December 14, 1999
At the Board of Supervisors meeting on December 14, 1999, CCHS was directed to take four ac-
tions. As of January 7, 2000 the following has been completed:
• CCHS has entered into discussions with Exchange Works in West County.
• Supplies for the ongoing provision of the services have been identified.
• CCHS staff have been identified to assist with the provision of information and referrals.
0 Documentation forms are being reviewed and revised as necessary to ensure that specific in-
formation is available to the Board.
• Planning for an East County process will begin later this quarter after the preliminary
process in West County is completed.
Additional Background for Continuous Emergency Declaration for Support of Needle Ex-
change Programs (Public Health Division,AIDS Program, Contact: Christine Leivermann, 5-6786)
■ February 11, 2003 —Board Order submitted to recommend and accept"The Status of HIV
Prevention Efforts in Contra Costa County"report to the Board of Supervisors.
■ February 26, 2003 —Report submitted to the Family and Human Services Committee, "Op-
tions for Continuing Needle Exchange for HIV Prevention."
■ March 3,2003 —Report submitted to the Family and Human Services Committee, "Needle
Exchange Follow-up Report—Strategies to Support the Non-Direct Costs of Needle Ex-
change."
■ April 16, 2003 —Report submitted to the Family and Human Services Committee, "Activi-
ties to Maintain Threshold Needle Exchange Services in Contra Costa County"(4/21/03).
■ July 28, 2003 —Report submitted to the Family and Human Services Committee, "Further
Options for Continuing Needle Exchange for HIV Prevention."
■ September 9, 2003 —Board of Supervisors accepted Health Services reports of April 16 and
July 28, and approved a one-year contract with Corruiunity Health Empowerment(CHE)to
provide needle exchange and HIV prevention services; Contract#22877 with Opportunity
West(fiscal agent for CHE); contract term 9/l/03 —8/31/04.
■ As of December 22, 2004, 27%of the 957 individuals living with AIDS in Contra Costa
County attribute their infection to injection drug use. This figure is inclusive of men who
have sex with men and also inject drugs (approximately 4%of the total). Among women
living with AIDS, 44%identify injection drug use as their mode of infection. Approxi-
mately 54% of men living with AIDS and 74%of women living with AIDS who identify
injection drug use as the cause of their infection are African American. Regionally, 38% of
people living with AIDS reside in West County, 38%in Central County and 24%in East
County.