COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

July 8, 2005

BOARD MEETING DATE:

July 26, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Scott Morrow, MD, Health Officer, Health Department

SUBJECT:

Needle Exchange Task Force Report

RECOMMENDATION:

1.

Accept the report from the Needle Exchange Task Force

2.

Adopt a resolution authorizing licensed pharmacists to sell or furnish 10 or fewer hypodermic needles or syringes to a person for use without a prescription if the pharmacy is in the Disease Prevention Demonstration Project

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal(s): Goal 8: Help vulnerable people – the aged, disabled, mentally ill, at-risk youth and others – achieve a better quality of life.

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

Number of Needles Exchanged

116,631

125,625

BACKGROUND:

In the Fall of 2001, your Board approved harm reduction—a public health model that aims to protect drug users and the community from drug related harm by implementing practical strategies for safer use, managed use, and abstinence —as an operating principle. The Board also established the Needle Exchange Task Force to respond to the dual epidemics of HIV/AIDS and Hepatitis C related to injection drug use in the county. The Task Force began meeting to review scientific literature and the experience of other needle exchange programs locally and around the world. In May 2002, your Board accepted the Task Force’s report which included four operating principles to guide current and future efforts and serve as foundation for expanding needle exchange activities in San Mateo County. These include:

• Minimize barriers to accessing clean needles and syringes

• Maximize access to clean needles and syringes both by geographic location and time

• Maximize collection of used needles

• Use needle exchange as a conduit to support services and ultimately recovery.

The report also outlined several recommendations including a request for community based needle exchange activities. Your Board approved funding in May 2002 for the Alcohol and Other Drug Program to contract with Free At Last and the AIDS Prevention Action Network for these services. The Free At Last contract started in March 2003 and the AIDS Prevention Action Network contract started in July 2003. Over 26,000 needles have been removed from circulation since the program began. These contracts were moved to the Health Department in the approved FY 2005-06 budget.

At your Board’s request, in March 2005, the Health Department reconvened the Needle Exchange Task Force to make recommendations regarding SB 1159, which subject to the Board’s authorization, allows local pharmacies to sell up to 10 syringes at a time without a prescription.

DISCUSSION:

The Task Force held meetings to discuss SB 1159 on March 8, 2005 and April 12, 2005. The Task Force reviewed the current status of needle/syringe exchange in the county and discussed the impacts of implementing SB 1159 in San Mateo County. There was discussion on the following items: Bay Area Implementation, Additional Benefits, Problems Identifying Needle Source, Participation of Pharmacies, Legal Concerns, Methamphetamine Use and Treatment Services.

The Task Force recommends the following next steps: 1) Authorization of the implementation SB 1159, 2) Establishment of an SB 1159 implementation committee and 3) Expansion of needle exchange activities throughout the County, because residents in the northern region do not have the same level of access.

FISCAL IMPACT:

There is no additional net county cost associated with accepting the report or authorizing the implementation of SB 1159. The Health Department and the Human Services Agency have included salaries and benefits related to staff time to participate in implementation planning in the approved 2005-2006 budget.