HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 12122011 - FHS Cte Agenda Pkt
FAMILY AND HUMAN
SERVICES COMMITTEE
December 12, 2011
11:00 A.M.
651 Pine Street, Room 108, Martinez
Supervisor Gayle B. Uilkema, District II, Chair
Supervisor Federal D. Glover, District V, Vice Chair
Agenda Items: Items may be taken out of order based on the business of the day and preference of the Committee
1. Introductions
2. Public comment on any item under the jurisdiction of the Committee and not on this agenda
(speakers may be limited to three minutes).
DISCUSSION
3. Referral #20 – Public Service Portion of the CDBG (Presenter: Brenda Kain, Conservation
and Development)
4. Referral #61 – HIV Prevention/Needle Exchange (Presenter: Christine Leiverman, Public
Health)
5. Referral #94 – Children’s Treatment Center (Presenter: Suzanne Tavanno, HSD Mental
Health Services)
6. Year-End Report (Presenter: Dorothy Sansoe)
The meeting schedule for the 2012 Family and Human Services Committee
will be released in January 2012
☺ The Family and Human Services Committee will provide reasonable accommodations for persons with disabilities planning to attend
Committee meetings. Contact the staff person listed below at least 72 hours before the meeting.
Any disclosable public records related to an open session item on a regular meeting agenda and distributed by the County to a majority
of members of the Family and Human Services Committee less than 96 hours prior to that meeting are available for public inspection at
651 Pine Street, 10th floor, during normal business hours.
Public comment may be submitted via electronic mail on agenda items at least one full work day prior to the published meeting time.
For Additional Information Contact: Dorothy Sansoe, Committee Staff
Phone (925) 335-1009, Fax (925) 646-1353
dsans@cao.cccounty.us
Glossary of Acronyms, Abbreviations, and other Terms (in alphabetical order):
Contra Costa County has a policy of making limited use of acronyms, abbreviations, and industry-specific language in its
Board of Supervisors meetings and written materials. Following is a list of commonly used language that may appear in
oral presentations and written materials associated with Board meetings:
AB Assembly Bill
ABAG Association of Bay Area Governments
ACA Assembly Constitutional Amendment
ADA Americans with Disabilities Act of 1990
AFSCME American Federation of State County and Municipal
Employees
AICP American Institute of Certified Planners
AIDS Acquired Immunodeficiency Syndrome
ALUC Airport Land Use Commission
AOD Alcohol and Other Drugs
BAAQMD Bay Area Air Quality Management District
BART Bay Area Rapid Transit District
BCDC Bay Conservation & Development Commission
BGO Better Government Ordinance
BOS Board of Supervisors
CALTRANS California Department of Transportation
CalWIN California Works Information Network
CalWORKS California Work Opportunity and Responsibility
to Kids
CAER Community Awareness Emergency Response
CAO County Administrative Officer or Office
CCHP Contra Costa Health Plan
CCTA Contra Costa Transportation Authority
CDBG Community Development Block Grant
CEQA California Environmental Quality Act
CIO Chief Information Officer
COLA Cost of living adjustment
ConFire Contra Costa Consolidated Fire District
CPA Certified Public Accountant
CPI Consumer Price Index
CSA County Service Area
CSAC California State Association of Counties
CTC California Transportation Commission
dba doing business as
EBMUD East Bay Municipal Utility District
EIR Environmental Impact Report
EIS Environmental Impact Statement
EMCC Emergency Medical Care Committee
EMS Emergency Medical Services
EPSDT State Early Periodic Screening, Diagnosis and
treatment Program (Mental Health)
et al. et ali (and others)
FAA Federal Aviation Administration
FEMA Federal Emergency Management Agency
F&HS Family and Human Services Committee
First 5 First Five Children and Families Commission
(Proposition 10)
FTE Full Time Equivalent
FY Fiscal Year
GHAD Geologic Hazard Abatement District
GIS Geographic Information System
HCD (State Dept of) Housing & Community Development
HHS Department of Health and Human Services
HIPAA Health Insurance Portability and Accountability Act
HIV Human Immunodeficiency Syndrome
HOV High Occupancy Vehicle
HR Human Resources
HUD United States Department of Housing and Urban
Development
Inc. Incorporated
IOC Internal Operations Committee
ISO Industrial Safety Ordinance
JPA Joint (exercise of) Powers Authority or Agreement
Lamorinda Lafayette-Moraga-Orinda Area
LAFCo Local Agency Formation Commission
LLC Limited Liability Company
LLP Limited Liability Partnership
Local 1 Public Employees Union Local 1
LVN Licensed Vocational Nurse
MAC Municipal Advisory Council
MBE Minority Business Enterprise
M.D. Medical Doctor
M.F.T. Marriage and Family Therapist
MIS Management Information System
MOE Maintenance of Effort
MOU Memorandum of Understanding
MTC Metropolitan Transportation Commission
NACo National Association of Counties
OB-GYN Obstetrics and Gynecology
O.D. Doctor of Optometry
OES-EOC Office of Emergency Services-Emergency
Operations Center
OSHA Occupational Safety and Health Administration
Psy.D. Doctor of Psychology
RDA Redevelopment Agency
RFI Request For Information
RFP Request For Proposal
RFQ Request For Qualifications
RN Registered Nurse
SB Senate Bill
SBE Small Business Enterprise
SWAT Southwest Area Transportation Committee
TRANSPAC Transportation Partnership & Cooperation (Central)
TRANSPLAN Transportation Planning Committee (East County)
TRE or TTE Trustee
TWIC Transportation, Water and Infrastructure Committee
VA Department of Veterans Affairs
vs. versus (against)
WAN Wide Area Network
WBE Women Business Enterprise
WCCTAC West Contra Costa Transportation Advisory
Committee
__________________________________________________________________________________________________________________
1
CONTRA COSTA COUNTY
DEPARTMENT OF CONSERVATION AND
DEVELOPMENT
2530 Arnold Drive, Suite 190
Martinez, CA 94553
Telephone: (925) 335-7200
FAX: (925) 335-7201
DATE: December 12, 2011
TO: Family and Human Services Committee
Supervisor Gayle Uilkema, Chairperson
Supervisor Federal Glover, Vice Chairperson
FROM: Brenda Kain, ESG Project Manager
SUBJECT: Transition of Emergency Shelter Grant Program to Emergency Solutions
Grant and Proposed Allocation of Additional Funds
__________________
RECOMMENDATIONS
1. APPROVE staff recommendation to allocate $73,797 in additional funds from the
Emergency Solutions Grant for FY 2011/12 to Shelter, Inc. to provide Rapid
Rehousing services to Urban County clients and $11,366 to the Department of
Conservation and Development for administrative costs.
2. DIRECT staff to prepare a report on the Committee’s actions to be considered by the
Board of Supervisors at its meeting on January 10, 2012.
BACKGROUND
The Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH
Act), enacted into law on May 20, 2009, consolidates three of the separate homeless assistance
programs administered by the U.S. Department of Housing and Urban Development (HUD)
under the McKinney-Vento Homeless Assistance Act into a single grant program, and revises the
Emergency Shelter Grants program and renames it as the Emergency Solutions Grants (ESG)
program. The HEARTH Act also codifies into law the Continuum of Care planning process, a
longstanding part of HUD’s application process to assist homeless persons by providing greater
coordination in responding to their needs.
This ruling revises the regulations for the Emergency Shelter Grants program by establishing the
regulations for the Emergency Solutions Grants program, which replaces the Emergency Shelter
2
Grants program. The change in the program’s name, from Emergency Shelter Grants to
Emergency Solutions Grants, reflects the change in the program’s focus from addressing the
needs of homeless people in emergency or transitional shelters to assisting people to quickly
regain stability in permanent housing after experiencing a housing crisis and/or homelessness.
Consequently, the intent of the new ESG program is to build upon those services developed
through the Homeless Prevention/Rapid Rehousing (HPRP) program that was funded as part of
the 2009 American Recovery and Reinvestment Act (ARRA). The County received $1,421,551
in funding for the HPRP program and contracted with Shelter, Inc. as the lead agency. Shelter,
Inc. in turn contracted with several partner agencies countywide to ensure that services were
provided throughout the Urban County. Under their direction the program has far exceeded the
original goals for number of households served and it is anticipated that all funds will be
expended well before the August, 2012, deadline. HUD has notified the County it is eligible to
receive an additional $85,163 in ESG funding for the current fiscal year.
Proposed Allocation of Additional ESG Funds: The new ESG regulations limit the amount to
be allocated to street outreach and emergency shelter activities to 60 percent of the grant amount
or the amount allocated in FY 2010/11, whichever is greater. Because the County allocated its
entire ESG grant this year for emergency shelter activities (see Exhibit 1), the additional ESG
funding must be used for the new services outlined in the regulations - specifically homeless
prevention and rapid rehousing activities.
Therefore, staff recommends $73,797 be allocated to Shelter, Inc. to provide additional rapid re-
housing services to assist approximately 21 homeless households move into permanent
housing. In addition, staff recommends allocating $11,366 to the Department of Conservation
and Development to cover administrative costs.
In response to the new requirement for greater coordination among homeless assistance
providers, staff recommendations were presented to the Contra Costa Interjurisdictional Council
on Homelessness (”CCICH”) on December 9, 2011. CCICH is charged with providing a forum
for communication and coordination about the overall implementation of the Ten Year Plan to
End Homelessness and providing advice and input on the operations of homeless services. Staff
will provide an oral update on the action taken by CCICH.
Attachment: FY 2011/12 ESG Project Spreadsheet
cc: Catherine Kutsuris, Director, Department of Conservation and Development
Robert Calkins, CDBG Program Manager
Exhibit 1FY 2011/12Emergency Shelter Grant (ESG) Projects Project IDSponsorProject Name/Location Sponsor's WebsiteProject Objective/DescriptionHUD Matrix Eligibility/ National Objective/Category of AssistanceESG Funds Total Cost11-71-ESGCounty Health Services597 Center Ave. Suite 325Martinez, CA 94553 Emergency Shelter - Single Adults847-C Brookside DriveRichmond, CA 94801www.co.contra-costa.ca.usProvide up to 175 year-round emergency shelter beds per night for homeless single adults in Contra Costa county.24 CFR 576.21(a)(3)(Operating Support: No Staff Costs) $ 100,000 $ 1,627,411 11-72-ESGCounty Health Services597 Center Ave. Suite 325Martinez, CA 94553 Calli House Youth Shelter845-B Brookside DriveRichmond, CA 94801www.co.contra-costa.ca.usProvide up to 18 year-round emergency shelter beds per night for homeless youth in Contra Costa County.24 CFR 576.21(a)(3)(Operating Support:No Staff Costs) $ 4,025 $ 416,724 11-73-ESGGreater Richmond Interfaith Program (GRIP)165 22nd StreetRichmond, CA 94801Emergency Family Shelter165 22nd StreetRichmond, CA 94801www.gripcommunity.orgProvide emergency shelter and support services year round to 70 families (215 homeless individuals) in Contra Costa County.24 CFR 576.21(a)(3)(Operating Support: Staff Costs) $ 10,000 $ 164,612 11-74-ESGSTAND! Against Domestic Violence1410 Danzig Plaza Suite 210Concord, CA 94520 Rollie Mullen Emergency Shelter/Confidential locationwww.standagainstdv.orgProvide emergency homeless shelter and support services for 15 women and their children who are displaced due to domestic violence.24 CFR 576.21(a)(2)(Essential Services) $ 31,000 $ 581,450 11-75-ESGContra Costa CountyDept. of Conservation & Development2530 Arnold Drive Suite 190Martinez, CA 94553ESG Administration www.ccreach.orgAdministrative Costs limited to 5% of ESG Funding24 CFR 576.21 (a)(5)(Administrative Costs) $ 6,376 $ 6,579 151,401$ $ 2,796,776 ESG Caps:Essential Services: Up to 30% of ESG Funding 45,420$ 15,140$ Homeless Prevention Activities: Up to 30% of ESG Funding 45,420$ Total Emergency Shelter Grant FundingOperational Costs: Staff costs included in this category are limited to 10% of ESG Funding
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 1 -
RECOMMENDATIONS
1) Accept this report on needle exchange as part of the comprehensive HIV Prevention
Program.
2) Direct the Health Services Department to continue supporting and monitoring needle
exchange services and reporting biennially as required by law.
SUMMARY
This report satisfies State requirements to maintain needle exchange services in Contra Costa
without a declaration of a State of Emergency.
Recent changes in legislation have added the California State Office of AIDS to the list of
governing agencies allowed to authorize syringe exchange in areas where the publics’ health is
at risk (AB604). The same legislation replaces the current requirement for an annual report on
syringe exchange activities with a biennial report. Additional legislative changes (SB41) allow
pharmacies to dispense up to 30 syringes without a prescription and removes Health
Department responsibility for certifying pharmacies to do so. SB 1159, the current law under
which Contra Costa pharmacies operate, also remains in effect in those areas which previously
certified pharmacy dispensation of 10 syringes without a prescription.
County general funds to support the operation of Needle Exchange services remain at $54,000
per year with no added state or federal funding. Condoms and Health Education materials are
provided by the AIDS Program as available. Mobile clinic services added during FY 2010/2011
were discontinued after a pilot period of several months due to low utilization.
The percentage of new HIV AIDS infections attributed to IDU is decreasing, and reported cases
of Hepatitis C and the number of infants with antibodies to HIV present at birth have decreased
since the State of Emergency was first formally declared in 1999.
Household generated sharps waste are not allowed in the regular household waste stream. In
addition to State-approved mail-back services, four facilities in Contra Costa accept properly
containerized, home-generated sharps waste.
The availability of needle exchange as part of a comprehensive continuum of services for
injection drug users is a necessary Public Health measure to reduce transmission of blood borne
diseases and should remain available in Contra Costa County.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 2 -
BACKGROUND
Syringe exchange programs (SEPs) have been operating in California since the 1980s. In 2000,
Assembly Bill [AB] 136 (Mazzoni, Chapter 762, Statutes of 1999) authorized the establishment
of SEPs in counties or cities that declared a local state of emergency. In 2005, AB 547 (Berg,
Chapter 692, Statutes of 2005) simplified the process for local authorization of SEPs by
replacing the continuous declaration of a local state of emergency with an annual report.
Additional legislation passed this session (below) further streamlines the process for initiating
and reporting on SEPs in California.
In 1999 the Contra Costa Board of Supervisors endorsed needle exchange as a component of a
comprehensive HIV risk reduction strategy to reduce the transmission of HIV and other blood
borne diseases attributed to injection drug use. On January 10, 2006, the Contra Costa Board
of Supervisors:
TERMINATED the local State of Emergency first declared on December 14, 1999;
AUTHORIZED the Health Services Department to administer a clean needle and syringe
exchange project pursuant to Health and Safety Code section 121349 et seq; and
DIRECTED the Health Services Director to annually report to the Board on the status of
the clean needle and syringe exchange project, with a focus on reducing transmission
among women to their unborn children, reducing HIV and Hepatitis C transmission,
ensuring access to treatment services, and not increasing risk to law enforcement.
Relevant Legislative changes1 signed into law since last year’s report include:
AB 604 Skinner. Adds the California State Office of AIDS to the list of governing agencies
allowed to authorize certain entities to provide syringe exchange services (SEP) in any location
where the State determines that the conditions exist for the rapid spread of HIV, viral hepatitis,
or other potentially deadly or disabling infections that are spread through the sharing of used
hypodermic needles and syringes. The bill also eases reporting requirements for counties
with authorized Syringe Exchange Programs - the report can now be made on a biennial
rather than annual basis - and amends the syringe possession law. The bill is effective
January 1, 2012, and sunsets January 1, 2019.
SB 41 Yee. Permits nonprescription syringe sales (NPSS) through licensed pharmacies. Allows
customers 18 years of age and older to purchase and possess up to 30 syringes for personal
use when acquired from an authorized source. Specifies that pharmacists, physicians and
syringe exchange programs are authorized sources of nonprescription syringes. Requires
pharmacies which offer NPSS to provide options for safe syringe disposal and education to
customers on safe disposal of sharps waste, access to drug treatment, and HIV/HCV testing and
treatment Requires OA and the California Board of Pharmacy to post information on their web
sites. The bill is effective Jan 1, 2012 and sunsets January 1, 2015.
1 Source: htpp://www.leginfo.ca.gov 10/12/2011
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 3 -
The CDC issued guidance to the State Office of AIDS (SOA) on the use of federal dollars for the
purpose of syringe exchange. The SOA has folded that guidance into upcoming HIV prevention
funding cycles beginning FY 12/13, in which the SOA directs the local jurisdiction to ensure
prevention services designated as “Tier 1” (which includes HIV testing, partner services, syringe
exchange, etc.) are funded before using the funding for Tier 2 services which include pre-
exposure prophylaxis, social marketing, and other services. Contra Costa’s prevention funding
award is too small to meet the Tier 1 needs, and the Contra Costa HIV/AIDS Consortium, our
local planning body, has not prioritized the use of our state funds for the provision of Syringe
Exchange Services.
REDUCING TRANSMISSION OF DISEASE
HIV and AIDS Data
As of December 31 2010, 1,875 individuals were reported living with AIDS or HIV in Contra
Costa. The distribution is largely unchanged over the past several years: slightly more than
80% are male, 19% female and nearly 1% transgender. African Americans are 30% of those
living with HIV or AIDS, Whites are about 47% and Hispanics are about 19% of the caseload.
Roughly 60% of all transmission is among men who have sex with other men (MSM).
Heterosexual contact, largely in females, is approximately 13% of cases. Injection drug use has
dropped to about 17% of all cases: despite a bump in last year’s numbers, there has been a
steady decline in the number of new infections attributed to IDU2.
2 Source: Contra Costa Health Department Epidemiology and Health Data Unit
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 4 -
Other Data
The number of Chronic Hepatitis C carriers continues to decline from the high of 1,400 cases
reported in 1999. Data for the most recent year is not reliable as the Public Health
Division has moved to a new State Reporting system which does not yet contain all the reported
cases. The State is currently working on a statewide report on Hepatitis C which should be
ready later this year.
As noted last year, funding for the Stanford research project providing data on infants testing
positive for antibodies at birth was eliminated in 09/10. Prior to termination of that project
there was a downward trend noted among infants, with most infants testing positive for
antibodies at birth reverting to negative status by two years of age. Currently, Contra Costa
has 3 children 12 years of age or younger living with HIV and 6 children 13-17 years of age
living with either HIV or AIDS. No infants with positive antibodies were reported to the Health
Department last year.
Exposure Impact on Law Enforcement and First Responders
The Public Health Division continues to provide assistance to law enforcement and first
responders potentially exposed to a communicable disease during the course of their work. The
number of needlestick exposures compared to all exposures (blood, saliva, cuts, bites, flu, etc.)
reported among all responders remains small, with 2 needlestick injuries reported out of 115
potential exposures reported between July 1 2010 and June 30 20113. A brochure for law
enforcement and all forms needed to request Public Health assistance in the event of an
exposure are available on our website at www.cchealth.org/groups/aids.
A statewide evaluation found no statistically significant difference in needle stick injuries among
law enforcement officers between localities that had authorized disease prevention projects and
those that had not. The report also found no evidence of elevated crime rates in areas that had
active disease prevention projects. 4
3 Contra Costa Health Department Communicable Disease Program
4 The full report is posted at the California Department of Public Health website at
http://www.cdph.ca.gov/programs/aids/Pages/OASyringeAccess.aspx
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 5 -
ACCESS TO CARE AND TREATMENT
Many needle exchange services in the Bay Area were eliminated following the 2009 budget
cuts, and in most neighboring jurisdictions needle exchange services rely primarily on other
funding secured by community based organizations.
Community Health Empowerment (CHE) Progress Report
Greater Richmond Interfaith Program (GRIP) is the fiscal agent for Needle Exchange services
provided in Contra Costa by CHE. The FY 1112 budget from county general funds is $54,000.
The budget supports limited Program Director time, exchange staff stipends, supplies and some
operating expenses. The drug overdose prevention project, piloted in Baypoint last fiscal year
along with vaccinations and other nursing services, was discontinued earlier this year due to
limited demand. CHE continues to try to offer an array of services to attract youth and other
participants, and remains interested in expanding services to reach more individuals.
CHE reports activities from 4 exchange sites (Richmond, North Richmond, Pittsburg, and Bay
Point), maintaining fairly stable operations this year. The agency has informed participants of
the availability of HIV testing and AODS treatment services, educated participants on wound
care and prevention of abscesses, and provided referrals for other services. The following
information on needle exchange services was provided by CHE for FY 10/11 (there is a modest
discrepancy in the number served by race/ethnicity):
Ethnicity Totals
African American 471 33%
European American 741 52%
Latino/Hispanic 203 14%
Native American 0
Asian/Pacific Islander 4
Other 0
Total 1419
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 6 -
A total of 1430 individuals were served of which 921 (65%) were male. Approximately 3% of
those reached accepted referrals for health care, substance use treatment and other resources.
Location Total Referrals
Contacts Provided
East County 940 30
West County 490 13
Total 1430 43
One-for-one syringe exchange is done. The number of individuals (1,430 “Contacts” last year)
going to the needle exchange has remained relatively constant for the last several years.
Some individuals bring in syringes to exchange for others, called a secondary exchange,
reflected as “Reported Number of People Reached by Needle Exchange Services”, below. These
figures (3,236 in the last year) are duplicated.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 7 -
The number of syringes distributed has also remained constant over the last several years, with
218,060 syringes distributed in the last fiscal year.
Alcohol and Other Drug Services (AODS)
In FY 10/11, AODS treatment sites reported about 12% fewer contacts: 4,097 encounters in FY
10/11 from 4,664 encounters in FY 09/10. Demographics have not changed substantially over
time: injection drug users are about 18% of enrollees and women are more than 37% of all
those enrolled in services. The reported number of clients served who have not previously
enrolled in AODS services continues to rise, up from approximately 39% in 0910 to 41% in
10/11.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 8 -
More than 34% of all AODS enrollees indicated that they were homeless at entry into the AODS
program. In reality, most participants identify as having a “dependent” living condition (reliant
on someone else or some other institution for their housing), with only 5% of all enrollees
indicating that they were independently housed at entry into AODS services.
The Public Health AIDS Program offers basic HIV Education and HIV rapid testing at selected
AODS residential and detox centers throughout Contra Costa. In FY 1011, 351 individuals
received HIV education services and 362 completed HIV testing. The AIDS Program continues
to offer Hepatitis C testing to individuals who are injection drug users. We also continue to
provide HIV and STD testing for youth at selected AODS centers, including the Orin Allen
facility, New Connections, and other sites serving youth. This past year 224 high risk youth
were offered STD and HIV counseling and 158 received testing for HIV and STDs.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 9 -
Pharmacy Syringe Sales
Senate Bill (SB) 41 was signed into law effective January 1, 2012 – January 1, 2015, removing
restrictions on pharmacy practices to allow nonprescription sale of syringes (NPSS) through
licensed pharmacies throughout the state, without requiring they register with a local
government. Physicians or pharmacists may sell or furnish up to 30 syringes to an adult 18
years of age or older solely for personal use. It also allows adults to anywhere in California to
purchase and possess up to 30 syringes for personal use when acquired from an authorized
source. The law now specifies that pharmacists, physician and syringe exchange programs are
authorized sources of nonprescription syringes for disease prevention purposes. Providers must
store syringes in a manner that ensures they are not accessible to unauthorized persons and
requires pharmacists and needle exchange providers to provide consumers with options for
disposal. The code governing the Disease Prevention Demonstration Project (SB 1159) is
rendered inoperative until SB 41 sunsets in 2015.
Walgreen’s and Rite Aid pharmacy chains are the predominant pharmacies continuing to
provide DPDP services in Contra Costa. No telephone survey was conducted this year. No
complaints were received by Public Health from consumers, business, or law enforcement.
Information for pharmacies remains posted on our website,
http://www.cchealth.org/groups/aids/pharmacy.php.
DISPOSAL
Environmental Health maintains a list of frequently asked questions on syringe disposal, a list of
disposal sites in Contra Costa, and links to syringe disposal mail back services. More
information is at http://www.cchealth.org/groups/eh/faqs/faqs_medical.php
West County residents East County residents All Contra Costa residents
Household hazardous waste
facility
101 Pittsburg Ave.
Richmond, CA 94801
1-888-412-9277
Delta Household Hazardous
Waste Collection Facility
2550 Pittsburg/Antioch
Highway
Antioch, CA 94509
925-756-1990
Sutter Regional Medical
Foundation
4053 Lone Tree Way
Antioch, CA 94509
925-756-3400
John Muir Pharmacy
1220 Rossmoor Parkway
Walnut Creek, CA 94598
Seven companies are listed as State-sanctioned mail in systems. More information can
be found at:
http://www.cdph.ca.gov/certlic/medicalwaste/Documents/MedicalWaste/SharpsMailBack
List.pdf.
Contra Costa Health Services
Needle Exchange Update Report to Family & Human Services Committee
November 2011
- 10 -
OTHER PREVENTION ACTIVITIES FOR INJECTION DRUG USE
Our local HIV Prevention plan will be updated early in 2012 to more closely synchronize our
services with the new State HIV Prevention strategy. We anticipate that we will continue to
prioritize needle exchange services and will use County General funds for those services in the
coming year.
In addition to more tightly targeting our prevention services at the highest risk communities,
other local prevention activities we expect to build on include:
Enhanced clinical risk reduction services targeting high risk men, supporting HIV positive
clients by building prevention skills and developing incremental behavior change plans.
Expanded Partner Counseling services offering anonymous partner notification
assistance as well as other support for individuals seeking to notify partners of potential
exposure and testing available to them.
Support for community based agencies contracted to provide HIV Care services to
strengthen their capacity to provide risk reduction and partner notification processes.
Maintenance of HIV testing services at community sites and in Alcohol and Other Drugs
Services programs. Most HIV testing uses the rapid test, providing preliminary results in
20 minutes.
Tighter linkages for making follow up medical appointments for new positives has
reduced the number of individuals falling out of care and increased adherence to HIV
medications.
Training, as available, to increase community capacity to provide prevention services in
Contra Costa.
CONCLUSIONS:
1. Access to clean needles through needle exchange and pharmacy syringe services
is making a difference in Contra Costa and remains a critical component of the
overall strategy to reduce transmission of blood borne diseases. Overall infections
attributed to injection drug use and maternal transmission have declined over time and the
availability of needle exchange and pharmacy syringe sales has played a role in this trend.
2. Reported local law enforcement exposure to potential blood borne pathogens via
needle stick injury has not increased since needle exchange and pharmacy sales
have been implemented. Materials for Law Enforcement to document potential exposure
and request assistance remain available on the website.
3. New Legislation removes the requirement for the Health Department to certify
pharmacies to dispense syringes and replaces the requirement for an annual report
on Syringe Exchange to a biennial report. No major impact is anticipated in Contra Costa
at this time.
November 2011Prepared for the Contra Costa Board of Supervisors by Contra Costa Health DepartmentNeedle Exchange Update
NEEDLE EXCHANGE In 1999, the Contra Costa Board of Supervisors endorsed a State of Emergency with respect to HIV and AIDS to allow for the provision of needle exchange services. A major interest was to reduce transmission in women and to their unborn children. Since 2006, a State of Emergency declaration is not needed.
New 2012 LegislationyAB 604 Skinner. State Office of AIDS may authorize syringe exchange services in any location where conditions exist for the spread of infections through the sharing of used hypodermic needles and syringes. ySB 41 Yee.Individuals 18 years of age and up may purchase and possess up to 30 syringes for personal use when acquired from an authorized source. Specifies that pharmacists, physicians and syringe exchange programs are authorized sources of nonprescription syringes. Requires pharmacies which offer NPSS to provide options for safe syringe disposal.
HIV/AIDS in Contra Costa County yAs of December 31 2010, 1,875 individuals were reported living with AIDS or HIV in Contra Costa. yApproximately 80% are male and 19% are female. African Americans are 30% of those living with HIV or AIDS, Whites 47% and Hispanics nearly 19%. yPredominant transmission among those living with HIV or AIDS remains men who have sex with other men (MSM). Injection Drug Use is about 17% of the caseload
HIV/AIDS Attributed to Injection Drug Use (IDU)21223418 189971219996910983583405101520253035402000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Year of DiagnosisMale IDUFemale IDU
Children with HIV and AIDSInfant Exposure is no longer tracked by Stanford University. Contra Costa has 3 children under the age of 12 with HIV and 6 children 13-17 years of age living with HIV or AIDS.
Reported Chronic Hepatitis C Cases Over Time1200900680600 600575680550810610153020040060080010001200140001/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10 10/11Note: reporting processes changed in 2010/2011 and data is not complete.
Law Enforcement and First Responder Exposures02040608010012014004/05 05/06 06/07 07/08 08/09 09/10 10/11All ExposuresNeedlestick
Needle Exchange and CHEyOne-for-one exchange offered in East and West County: roughly 60% of those served are at East County sites.yApproximately 52% of participants are White, 33% African American, and 14% Latino.yMen are 65% of those served.yApproximately 3% accept referrals.
Reported Contacts (Individuals) at Needle Exchange Sites Over Time05001000150020002500300035000405 0506 0607 0708 0809 0910 1011
Number of Syringes Distributed By CHE Over Time0500001000001500002000002500003000003500004000000405 0506 0607 0708 0809 0910 1011
Secondary Exchanges Reported By CHE Over Time0100020003000400050006000700080000405 0506 0607 0708 0809 0910 1011
AODS Service Enrollment
AODS Service Enrollment
AODS Service Enrollment
Other Prevention Strategies to Reduce Transmission of HIV in IDUsAnonymous Partner notification and counseling services;Prevention with positives program;HIV and STD testing services in community and in Alcohol and Other Drugs Services programs;Pharmacy syringe sales (State DPDP)in two chains and a few other stores.
Syringe Disposal OptionsWest CountyHousehold Hazardous Waste facility101 Pittsburg Ave., Richmond, CA 94801 1-888-412-9277East CountyDelta Household Hazardous Waste Collection Facility2550 Pittsburg/Antioch Highway, Antioch, CA 94509 925-756-1990All Contra Costa County residentsSutter Regional Medical Foundation4053 Lone Tree Way, Antioch, CA 94509 925-756-3400John Muir Pharmacy1220 Rossmoor Pkwy, Walnut Creek, CA 94598List of State-sanctioned mail in options
CONCLUSIONS1. Access to clean needles through needle exchange and pharmacy syringe services is making a difference in Contra Costa and remains a critical component of the overall strategy to reduce transmission of blood borne diseases. Overall infections attributed to injection drug use have declined over time and the availability of needle exchange and pharmacy syringe sales has played a role in this trend. 2. Reported local law enforcement exposure to potential blood borne pathogens via needle stick injury has not increased since needle exchange and pharmacy sales have been implemented. Materials for Law Enforcement to document potential exposure and request assistance remain available on the website. 3. New legislation removes the requirement for the Health Department to certify pharmacies to dispense syringes and replaces the requirement for an annual report on Syringe Exchange to a biennial report. No major impact is anticipated in Contra Costa at this time.
County of Contra Costa
OFFICE OF THE COUNTY ADMINISTRATOR
MEMORANDUM
DATE: December 12, 2011
TO: Family and Human Services Committee
Supervisor Gayle B. Uilkema, Chair
Supervisor Federal D. Glover, Vice Chair
FROM: Dorothy Sansoe, Staff
Sr. Deputy County Administrator
SUBJECT: 2011 YEAR-END REPORT ON REFERRAL ITEMS
RECOMMENDATION(S):
I. ACKNOWLEDGE that the Board of Supervisors referred three new items to the Family and
Human Services Committee (FHS) for their review and consideration during the 2011
calendar year in addition to the referrals carried over from the prior year.
II. ACCEPT the recommendation to carry forward the following twenty referrals from the 2011
Family and Human Services Committee to the 2012 Committee:
a. Referral #1 – Child Care Affordability Fund
b. Referral #2 – Oversight of the Service Integration Team
c. Referral #5 – Continuum of Care Plan for the Homeless/Healthcare for the Homeless
d. Referral #20 – Public Service Portion of the CDBG
e. Referral #25 – Child Care Planning/Development Council Membership
f. Referral #44 – Challenges for EHS
g. Referral #45 – Elder Abuse
h. Referral #56 – East Bay Stand Down for Homeless Veterans (Bi-annual)
i. Referral #61 – HIV Prevention/Needle Exchange Program
j. Referral #78 – Community Services Bureau/Head Start Oversight
k. Referral #81 – Local Child Care & Development Planning Council Activities
l. Referral #82 – Secondhand Smoke Ordinance
m. Referral #92 – Local Planning Council – Child Care Needs Assessment
n. Referral #93 – Independent Living Skills Program
o. Referral #95 – Child Welfare Improvement Plan Annual Update
p. Referral #100 – Child Poverty
q. Referral #101 – FACT Committee At-Large Appointments
r. Referral #103 – SNAP (Food Stamp Program)
s. Referral #104 – Subsidized Employment Program
t. Referral #105 - Bed Bugs
III. ACCEPT the recommendation to close Referral #94 – Children’s Treatment
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BACKGROUND/REASONS FOR RECOMMENDATION(S):
Between January and December 2011, the Board of Supervisors referred three new items to the
Family and Human Services Committee (FHS) in addition to referrals carried forward from the
2011 year. The FHS Committee heard twenty-five separate reports during the calendar year.
It is recommended that the following item be closed-out as noted:
a) Referral #94 – Children’s Treatment Oversight – The FHS has been monitoring
changes to services at the Seneca treatment facility proposed in 2007. This facility
has now been closed.