Field Placement: Los Angeles County
Department of Health Services, Public Health Policy
Location: Los Angeles, CA
Preceptor: Dr. Anna Long
Student Name: Rosalinda Castaneda
SB 1159: DISEASE
PREVENTION DEMONSTRATION PROJECT
Within Los Angeles alone, over 52,000 people are living with HIV or AIDS1 and injection drug use is the second most commonly reported mode of exposure.2 Sharing infected syringes and other equipment for drug injection poses a considerable risk for HIV infection. In Septemeber 2004, California’s Governor Schwarzenegger signed new legislation to increase access to sterile syringes through pharmacy-based sales to prevent the spread of blood-borne diseases, such as HIV and hepatitis C. This legislation, SB 1159, became effective January 1, 2005 in California and created the Disease Prevention Demonstration Project (DPDP) which is a collaboration between pharmacies and local and state health officials. In addition to increasing access to sterile syringes for injection drug users (IDU), the project also increases syringe access and disposal options for individuals, such as diabetics, who need sterile syringes for medical injections.
SB 1159 became effective locally in Los Angeles County in June 2005 when the Board of Supervisors approved a motion to allow pharmacies to sell up to 10 syringes without a prescription. There are an estimated 120,000 to 190,000 IDUs who reside in LA County3 and the DPDP is a program that will help to save lives by providing an additional mechanism of obtaining sterile syringes. There are seven needle exchange programs (NEP) currently operating in the county. However, due to the stigma associated with injection drug use and existing drug paraphernalia laws some individuals have been unwilling to access this service. The DPDP will complement syringe access provided by NEPs by making sterile syringes available for purchase at participating pharmacies in LA County. Additionally, drug paraphernalia laws have been amended to allow a person to possess up to 10 syringes, if acquired through an authorized source.4 The projected health impact of the DPDP will be reduced rates of blood-borne diseases such as HIV and hepatitis C in LA County.
The Board of Supervisors delegated the task of implementing the DPDP to LA County Department of Health Services (DHS) Public Health Policy, under the direction of Dr. Anna Long. Dr. Long is the Chief of Staff for DHS and oversees policy issues that impact DHS programs. Public Health Policy is presently working on implementing the DPDP, in addition to a Medical Marijuana Identification Card Program and Needle Exchange Certification for NEPs operating in LA County. As a LA County Department of Health Services Summer Administrative Aid, I worked with Dr. Long and her policy team to make the DPDP available in Los Angeles County. I was involved in several tasks over the summer. Namely, I worked on developing a program design for the DPDP and conducted formative research on existing programs in other counties and states to gain knowledge on how this program was successfully implemented. From the information obtained from the formative research, I worked on developing a draft logic model and scope of work to help guide program implementation. I was also involved in developing several administrative documents that could potentially be utilized to inform pharmacies, law enforcement and the community about this new legislation and LA County’s plan to make the DPDP available in the county. Stakeholder meetings are being held and the DPDP is still under development. The program is expected to begin in January 2006.
1 County of Los Angeles Department of Health Services. Available at: http://lapublichealth.org/images/WAD02Restos.pdf. Accessed on August 22, 2005.
2 County of Los Angeles Department of Health Services, Public Health. HIV/AIDS Semi-Annual Surveillance Summary January 2005. Available at: http://lapublichealth.org/wwwfiles/ph/hae/hiv/Semiannual_Surveillance_Summary_January_2005.pdf. Accessed on August 23, 2005.
3 Medical News Today. L.A. County Board of Supervisors Approves Resolution to Allow Pharmacies to Sell Syringes Without Prescriptions. Available at: http://www.medicalnewstoday.com/medicalnews.php?newsid=26307. Accessed on October 7, 2005.
4 Background Information About Senate Bill 1159 (Vasconcellos) Pharmacy Syringe Sale and Disease Prevention Demonstration Project. Available at: www.chipolicy.org/pdf/5609.SB%201159%20background.pdf. Accessed on July 11, 2005.
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