Motion by Supervisor Zev Yaroslavsky

AUGUST 22, 2000

MOTION BY SUPERVISOR ZEV YAROSLAVSKY

During the 1999 legislative session, Governor Davis signed AB 136, which permits the operation of needle exchange programs in counties and cities as a public health measure to prevent the spread of HIV/AIDS and other communicable diseases. The legislation protects counties, cities and their agents who operate such programs, from criminal liability under state law relating to the possession and distribution of needles and syringes.

This protection is contingent upon a declaration of local emergency due to the existence of a critical local public health crisis. Based on an opinion prepared by County Counsel, this would not necessitate an emergency declaration under the California Emergency Services Act. AB 136 provides the legal framework for the development of a local needle exchange program.

There is a public health crisis in Los Angeles County which justifies the development of a needle exchange program. The spread of communicable diseases, including HIV/AIDS and hepatitis, is associated with the sharing of common needles among multiple users of illicit drugs. Approximately ten percent of injection drug users in Los Angeles County are infected with HIV, and a much larger percentage is infected with hepatitis.

Research has documented that needle exchange programs are effective weapons in the war against HIV/AIDS. In 1998, Donna Shalala, Secretary of Health and Human Services, issued a statement that "meticulous scientific review has now proven that needle exchange programs can reduce the transmission of HIV and save lives without losing ground in the battle against illicit drugs." The Secretary’s statement also emphasized that successful needle exchange programs are operated "on a replacement basis only." A properly managed needle exchange program will permit the disposal of dirty, used needles and their exchange for clean, new ones, thus reducing the number of infectious needles in circulation. This will also minimize the hazard of accidental injury and infections from dirty needles discarded in public places. Needle exchange programs can also serve as a bridge to drug treatment and reduction of drug abuse.

Given the public health crisis associated with the spread of communicable disease through intravenous drug use, the Board should make the appropriate declaration under AB 136 to permit the certification and, thereafter, the operation of needle exchange programs in Los Angeles County. The Board should also initiate the development of guidelines for such needle exchange programs. Such programs must be developed and operated according to appropriate standards, including stringent controls to protect the public from any potential risk associated with the distribution of needles. Standards and procedures should be developed in the context of our goals of reducing the spread of communicable disease, treating drug abuse and reducing the illegal use of drugs. The standards should include appropriate requirements for community notification and acceptance. It is imperative that such procedures be developed before the first needle is exchanged through any County sanctioned needle exchange program.

I THEREFORE MOVE that the Board:

Declare the existence of a critical local public health crisis under AB 136.
Instruct the Director of Health Services to report to the Board in 90 days with a plan for the implementation of needle exchange programs, on a replacement basis only, in Los Angeles County. This plan shall include criteria related to the certification of needle exchange operators in Los Angeles County, policies and procedures related to the operation and monitoring of needle exchange programs (including the role of needle exchange programs as a bridge to drug treatment); and appropriate requirements for community notification and acceptance.
Instruct the Director of Health Services, in conjunction with development of this plan, to seek the advice of the County Sheriff, the Narcotics and Dangerous Drugs Commission, the Commission on HIV Health Services, the Public Health Commission, the Second District HIV/AIDS Coalition, the Prevention Planning Committee, the Los Angeles City AIDS Coordinator and other appropriate groups.