HomeMy WebLinkAboutMINUTES - 12142004 - SD2 Contra
TO: BOARD OF SUPERVISORS
Costa
FROM: William B. Walker, MD, Health Services Director County
DATE: December 14, 2004 SPt
m6
SUBJECT: Authorization of a Disease Prevention Demonstration Project
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
1) AUTHORIZE the Health Services Department to develop and implement a local Disease
Prevention Demonstration Project as authorized by SB 1159, allowing pharmacists to sell or
furnish 10 or fewer hypodermic needles or syringes at any one time to a person 18 years of age or
older without a prescription providing that pharmacist works for a pharmacy that is registered with
the Health Services Department in the Disease Prevention Demonstration Project.
2) DIRECT the Health Services Department to develop a project consistent with the legislation,
including:
• Informing Centra Costa pharmacies of the project;
• Maintaining a directory of participating pharmacies;
• Securing a statement that the pharmacy will provide the required written or verbal
counseling at the time of furnishing or sale of hypodermic needles under this project;
• Making available to the participating pharmacies written health education and referral
information and materials that may be provided or reproduced to provide written or verbal
counseling at the time of sale or furnishing of syringes under this project.
FISCAL IMPACT:
The cost of implementation is not expected to be significant but would entail maintaining a list of
registered pharmacies, providing referral information to those pharmacies and providing that data
to support the evaluation of the project.
CONTINUED ON ATTACHMENT: YES XX NO SIGNATURE: W ��
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;-�RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
.AfsPROVE OTHER
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SIGNATURE(S): t
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BOARD ON d d� APPROVE AS RECOMMENDED OTHER
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VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
IlkJ AND CORRECT COPY OF AN ACTION TAKEN
3 6VNANIMOUS(ABSENTf ) AND ENTERED ON THE MINUTES OF THE
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN.
ABSENT: ABSTAIN: t
ATTESTED ✓� . .'t
JOHN SWEETEN,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINIST ATOR
CONTACT: Christine Leiverrnann,313-6786
CC: William B.Walker,MD,CCHS Director,20 Allen,Mtz
Wendel Brunner,MD,Public Health Director,at
597 Center Avenue,#200,Mtz
BY 7 V DEPUTY
BACKGROUND:
Approximately 4900 individuals in Contra Costa are estimated to have been infected with HIV. Of
that number, more than half have been diagnosed with AIDS. More than 23% of people currently
living with AIDS in Contra Costa attribute their infection to injection drug use. Among women living
with AIDS in Centra Costa, 45.6% identify injection drug use as the mode of transmission.
Injection drug use is also a significant transmission route among those diagnosed with HIV,
accounting for 36% of the reported HIV infections in women.
The United States Public Health Service recommends that individuals who inject drugs use a new,
sterile syringe for each injection to prevent the transmission of blood-borne pathogens such as HIV
and Hepatitis C.
On duly 13, 2404, the Beard of Supervisors unanimously agreed to support the passage of Senate
Bill 1154 (Vasconcellos) to allow for the development of a time-limited demonstration project that
would allow a participating pharmacist to sell or furnish up to 10 syringes without a prescription to
an adult. On September 20, 2004, this bill was chaptered by the Secretary of State. A resolution
from the Board of Supervisors is required to establish an SB 1159 program in a county.
For the period commencing January 1, 2005, and ending December 31, 2010, this resolution
would authorize the Health Services department to develop and implement a local Disease
Prevention Demonstration project that will allow pharmacists to furnish or make available for sale
10 or fewer hypodermic needles or syringes at any one time to a person 1€3 years of age or older
without a prescription providing that pharmacist works for a pharmacy that is registered for the
Disease Prevention Demonstration project.
The Health Service Department will report back on the status of this project, including actions to
inform pharmacies, law enforcement and other agencies, the number of participating pharmacies,
and other pertinent information.
............................
SD.2
ADDENDUM TO
SD.2 DECEMBER. 14, 2404
On this date, the Board considered authorizing the Health Services Department to develop and implement a
local Disease Prevention Demonstration Project, as authorized by SB 1159 (Vasconcellos), to allow
pharmacists to furnish under limited circumstances hypodermic needles or syringes without a prescription.
Christine L,eiverman, from Health Services Department provided the report. She informed the Board that
United States Public Health Services pointed out that for those individuals who inject drugs, the best way to
prevent the transmission of HIV and other blood borne diseases is to ensure that people use a clean sterile
needle each time they inject. Christine L,eiverman also made reference to the Board supporting an
endorsement to the Governor to support the passage of Senate Bill 1159 allowing for disease prevention
demonstration project under which a pharmacist registered with the Health department could provide up to
ten sterile syringes to a consenting adult without a prescription.
Supervisor Gayle B. Uilkema expressed her concern regarding lack of controls to prevent individuals from
getting syringes from multiple pharmacies, and raised the issue of whether or not the pharmacists or
pharmacies and purchasers should be required to register under the program.
Supervisor Uilkema recommended that Health Services report back within six months the status of this
project.
The Vice Chair invited the public to comment, but there were no speakers.
After further discussion, the Board took the following actions:
• AUTHORIZED the Health Services Department to develop and implement a local Disease
Prevention Demonstration Project as authorized by SB 1159, allowing pharmacists to sell or furnish
10 or fewer hypodermic needles or syringes at any one time to a person 18 years of age or older
without a prescription providing that pharmacist works for a pharmacy that is registered with the
Health Services Department in the Disease Prevention Demonstration Project.
• DIRECTED the Health Services Department to develop a project consistent with the legislation,
including:
0 Informing Contra Costa pharmacies on the project;
o Maintaining a directory of participating pharmacies;
c Securing a statement that the pharmacy will provide the required written or verbal
counseling at the time of furnishing or sale of hypodermic needles under this project;
o Making available to the participating pharmacies written health education and
referral information and materials that may be provided or reproduced to provide
written or verbal counseling at the time of sale or furnishing of syringes under this
project.
• REQUESTED Health Services Department to report back to the Board in June 2005 with status
update.
The vete on the motion was as follows:
Ayes: Supervisors Gioia, Uilkema, Greenberg and DeSaulnier
Noes: None
Abstain: None
Absent:Supervisor Federal D. Glover
Senate Bill No. 1159
CHAPTER 608
An act to amend Sections 4145 and 4147 of, and to repeal Section
4146 of,the Business and Professions Code,to amend Section 11364 of,
and to add Chapter 13.5 (commencing with Section 121285)to Part 4
of Division 105 of,the Health and Safety Code,relating to hypodermic
needles and syringes.
[Approved by Governor September 20,2004.Filed
with Secretary of State September 20,2004.]
LEGISLATIVE COUNSEL'S DIGEST
SB 1159,Vasconcellos. Hypodermic needles and syringes.
(1) Existing law regulates the sale, possession, and disposal of
hypodermic needles and syringes.Under existing law,a prescription is
required to purchase a hypodermic needle or syringe for human use,
except to administer adrenaline or insulin.
This bill,subject to authorization by a county or city,would authorize
a licensed pharmacist,until December 31,2010,to sell or furnish 10 or
fewer hypodermic needles or syringes to a person for human use without
a prescription if the pharmacy is registered with a local health
department in the Disease Prevention Demonstration Project, which
would be created by the bill to evaluate the long-term desirability of
allowing licensed pharmacies to sell or furnish nonprescription
hypodermic needles or syringes to prevent the spread of blood-borne
pathogens, including HIV and hepatitis C.
The bill would require a pharmacy that participates in the Disease and
Demonstration Project pursuant to county or city authorization to
comply with specified requirements,including registering with the local
health department. The bill would require the State Department of
Health Services,in conjunction with an advisory panel,to evaluate the
effects of allowing the sale of hypodermic needles or syringes without
prescription,and would require a report to be submitted to the Governor
and the Legislature by January 15,2010.The bill would encourage the
State Department of Health Services to seek funding from private and
federal sources to pay for the evaluation.The bill would impose various
other duties on local health departments, thereby imposing a
state-mandated local program. The demonstration program would
terminate on December 31, 2010.
Alternatively,the bill would also authorize the sale or furnishing of
hypodermic needles or syringes to a person for human use without a
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Ch. 608 —2—
prescription
2—
prescription if the person is known to the furnisher and has previously
provided the furnisher with a prescription or other proof of a legitimate
medical need.
The bill would make it unlawful to discard or dispose of a hypodermic
needle or syringe upon the grounds of a playground,beach,park,or any
public or private elementary,vocational,junior high,or high school.The
bill would make a knowing violation of this prohibition a crime,thereby
imposing a state-mandated local program.
(2) Existing law requires a pharmacist to keep detailed records of
nonprescription sales of hypodermic needles and syringes.
This bill would delete that requirement.
(3) Existing law prohibits the possession and sale of drug
paraphernalia.
This bill, until December 31, 2010, subject to authorization by a
county or city,would allow a person to possess 10 or fewer hypodermic
needles or syringes if acquired through an authorized source.
(4) The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the state.
Statutory provisions establish procedures for making that
reimbursement, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed$1,000,000 statewide and
other procedures for claims whose statewide costs exceed$1,000,000.
This bill would provide that with regard to certain mandates no
reimbursement is required by this act for a specified reason.
With regard to any other mandates,this bill would provide that,if the
Commission on State Mandates determines that the bill contains costs
so mandated by the state,reimbursement for those costs shall be made
pursuant to the statutory provisions noted above.
(5) This bill would make the operation of its provisions contingent
upon the enactment of SB 1362.
The people of the State of California do enact as,follows:
SECTION 1. Section 4145 of the Business and Professions Code is
amended to read:
4145. (a) Notwithstanding any other provision of law,a pharmacist
or physician may,without a prescription or a permit,furnish hypodermic
needles and syringes for human use, and a person may, without a
prescription or license,obtain hypodermic needles and syringes from a
pharmacist or physician for human use, if one of the following
requirements is met:
(1) The person is known to the furnisher and the furnisher has
previously been provided a prescription or other proof of a legitimate
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medical need requiring a hypodermic needle or syringe to administer a
medicine or treatment.
(2) Pursuant to authorization by a county, with respect to all of the
territory within the county,or a city,with respect to the territory within
the city, for the period commencing January 1, 2005, and ending
December 31, 2010, a pharmacist may furnish or sell 10 or fewer
hypodermic needles or syringes at any one time to a person 18 years of
age or older if the pharmacist works for a pharmacy that is registered for
the Disease Prevention Demonstration Project pursuant to Chapter 13.5
(commencing with Section 121285) of Part 4 of Division 105 of the
Health and Safety Code and the pharmacy complies with the provisions
of that chapter.
(b) Notwithstanding any other provision of law, a pharmacist,
veterinarian,or person licensed pursuant to Section 4141 may,without
a prescription or license, furnish hypodermic needles and syringes for
use on animals, and a person may, without a prescription or license,
obtain hypodermic needles and syringes from a pharmacist,
veterinarian, or person licensed pursuant to Section 4141 for use on
animals, providing that no needle or syringe shall be .fumished to a
person who is unknown to the furnisher and unable to properly establish
his or her identity.
SEC. 2. Section 4146 of the Business and Professions Code is
repealed.
SEC. 3. Section 4147 of the Business and Professions Code is
amended to read:
4147. (a) For the purposes of this section,"playground"means any
park or outdoor recreational area specifically designed to be used by
children that has play equipment installed or any similar facility located
on public or private school grounds or county parks.
(b) Any hypodermic needle or syringe that is to be disposed of,shall
be contained,treated,and disposed of,pursuant to Part 14(commencing
with Section 117600)of Division 104 of the Health and Safety Code.
(c) It is unlawful to discard or dispose of a hypodermic needle or
syringe upon the grounds of playground,beach,park,or any public or
private elementary,vocational,junior high, or high school.
(d) A person who knowingly violates subdivision (c) is guilty of a
misdemeanor,and upon conviction shall be punished by a fine of not less
than two hundred dollars($200)and not more than two thousand dollars
($2,000),or by imprisonment in a county jail for up to six months,or by
both that fine and imprisonment.
(e) Subdivision(c)does not apply to the containment,treatment,and
disposal of medical sharps waste from medical care or first aid services
rendered on school grounds, nor to the containment, treatment, and
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Ch. 608 —4—
disposal
4—
disposal of hypodermic needles or syringes used for instructional or
educational purposes on school grounds.
SEC. 4. Section 11364 of the Health and Safety Code is amended to
read:
11364. (a) It is unlawful to possess an opium pipe or any device,
contrivance,instrument,or paraphernalia used for unlawfully injecting
or smoking(1)a controlled substance specified in subdivision(b),(c),
or(e),or paragraph(1)of subdivision(f)of Section 11054,specified in
paragraph (14), (15), or (20) of subdivision (d) of Section 11054,
specified in subdivision (b) or (c) of Section 11055, or specified in
paragraph(2) of subdivision(d) of Section 11055, or (2) a controlled
substance which is a narcotic drug classified in Schedule III,IV,or V.
(b) This section shall not apply to hypodermic needles or syringes
that have been containerized for safe disposal in a container that meets
state and federal standards for disposal of sharps waste.
(c) Pursuant to authorization by a county, with respect to all of the
territory within the county,or a city,with respect to the territory within
in the city, for the period commencing January 1, 2005, and ending
December 31, 2010, subdivision.(a) shall not apply to the possession
solely for personal use of 10 or fewer hypodermic needles or syringes if
acquired from an authorized source.
SEC. 5. Chapter 13.5 (commencing with Section 121285)is added
to Part 4 of Division 105 of the Health and Safety Code,to read:
CHAPTER 13.5. DISEASE PREVENTION DEMONSTRATION PROJECT
121285. (a) The Disease .Prevention Demonstration Project, a
collaboration between pharmacies and local and state health officials,is
hereby authorized for the purpose of evaluating the long-term
desirability of allowing licensed pharmacists to furnish or sell
nonprescription hypodermic needles or syringes to prevent the spread of
blood-bome pathogens, including HIV and hepatitis C.
(b) The State Department of Health Services shall evaluate the effects
of allowing pharmacists to furnish or sell a limited number of
hypodermic needles or syringes without prescription, and provide a
report to the Governor and the Legislature on or before January 15,2010.
The State Department of Health Services is encouraged to seek funding
from private and federal sources to pay for the evaluation. The report
shall include, but need not be limited to, the effect of nonprescription
hypodermic needle or syringe sale on all of the following:
(1) Hypodermic needle or syringe sharing practice among those who
inject illegal drugs.
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Ch. 608
(2) Rates of disease infection caused by hypodermic needle or syringe
sharing.
(3) Needlestick injuries to law enforcement officers and waste
management employees.
(4) Drug crime or other crime in the vicinity of pharmacies.
(5) Safe or unsafe discard of used hypodermic needles or syringes.
(6) Raises of injection of illegal drugs.
(c) The State Department of Health Services shall convene an
uncompensated evaluation advisory panel comprised of all of the
following: two or more specialists in the control of infectious diseases;
one or more representatives of the California State Board of Pharmacy;
one or more representatives of independent pharmacies; one or more
representatives of chain pharmacy owners; one or more representatives
of law enforcement executives,such as police chiefs and sheriffs;one or
more representatives of rank and file law enforcement officers; a
specialist in hazardous waste management from the State Department of
Health Services,one or more representatives of the waste management
industry;and one or more representatives of local health officers.
(d) In order to furnish or sell nonprescription hypodermic needles or
syringes as part of the Disease Prevention Demonstration Project in a
county or city that has provided authorization pursuant to Section 4145
of the Business and Professions Code, a pharmacy shall do all of the
following.
(1) Register with the local health department by providing a contact
name and related information,and certify that it will provide,at the time
of furnishing or sale of hypodermic needles or syringes, written
information or verbal counseling on all of the following.
(A) How to access drug treatment.
(B) How to access testing and treatment for HIV and hepatitis C.
(C) How to safely dispose of sharps waste.
(2) Store hypodermic needles and syringes so that they are available
only to authorized personnel,and not openly available to customers.
(3) In order to provide for the safe disposal of hypodermic needles and
syringes, a registered pharmacy shall provide one or more of the
following options:
(A) An onsite safe hypodermic needle and syringe collection and
disposal program.
(B) Furnish or make available for purchase mail-back sharps disposal
containers authorized by the United States Postal Service that meet
applicable state and federal requirements,and provide tracking forms to
verify destruction at a certified disposal facility.
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Ch. 608 —6—
(C)
6—
(C) Furnish or make available for purchase personal sharps disposal
containers that meet state and federal standards for disposal of medical
waste.
(e) Local health departments shall be responsible for all of the
following:
(1) Maintaining a list of all pharmacies within the local health
department's jurisdiction that have registered under the Disease
Prevention Demonstration Project.
(2) Making available to pharmacies written information that may be
provided or reproduced to be provided in writing or orally by the
pharmacy at the time of furnishing or the sale of nonprescription
hypodermic needles or syringes, including all of the following:
(A) How to access drug treatment.
(B) How to access testing and treatment for HIV and hepatitis C.
(C) How to safely dispose of sharps waste.
(f) As used in this chapter, "sharps waste" means hypodermic
needles, syringes, and lancets.
SEC. 6. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution for certain
costs that may be incurred by a local agency or school district because
in that regard this act creates a new crime or infraction, eliminates a
crime or infraction, or changes the penalty for a crime or infraction,
within the meaning of Section 17556 of the Government Code, or
changes the definition of a crime within the meaning of Section 6 of
Article XIII B of the California Constitution.
However, notwithstanding Section 17610 of the Government Code,
if the Commission on State Mandates determines that this act contains
other costs mandated by the state,reimbursement to local agencies and
school districts for those costs shall be made pursuant to Part 7
(commencing with Section 17500) of Division 4 of Title 2 of the
Government Code. If the statewide cost of the claim for reimbursement
does not exceed one million dollars($1,000,000),reimbursement shall
be made from the State Mandates Claims Fund.
SEC, 7. This act shall become operative only if Senate Bill 1362 of
the 2003--04 Regular Session is enacted and becomes effective on or
before January 1,2005.
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