Title
Supervisors Thomas and Parlin, in concert with Sheriff Leikauf, District Attorney Pierson, and the Chief Administrative Officer, recommending the Board approve sending a letter to the California Department of Public Health (CDPH) requesting they deny the updated application of Sierra Harm Reduction Coalition's services for a syringe exchange program in El Dorado County.
FUNDING: N/A
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DISCUSSION / BACKGROUND
The California Legislature provides for syringe exchange programs to operate in California cities and counties in two different ways under California Health and Safety Code Section 121349: 1) By action of the local government, or 2) By authorization of the State Department of Public Health which enables entities that provide syringe exchange services to apply for authorization to provide services in “any location where the department determines that the conditions exist for the rapid spread of HIV, viral hepatitis, or any other potentially deadly or disabling infections that are spread through the sharing of used hypodermic needles and syringes”. Sierra Harm Reduction has been operating in El Dorado County under the State of California’s authorization since January 2020, not by any local order or authorization through El Dorado County or the City of Placerville.
Per the requirement of their authorization, Section 121349.3 states that “health officer of the participating jurisdiction shall present biennially at an open meeting of the board of supervisors or city council a report detailing the status of clean needle and syringe exchange programs, including, but not limited to, relevant statistics on bloodborne infections associated with needle sharing activity and the use of public funds for these programs”. On October 11, 2022, the Board received a presentation and report detailing the status of the Sierra Harm Reduction Coalition’s (SHRC) syringe exchange program authorized by the California Department of Public Health (CDPH).
Additionally, Section 121349 states that authorization shall not be for more than two years, and that “before the end of the two-year period, the department may reauthorize the program in consultation with the local health officer and local law enforcement leadership”. Section 121349.2 states that “Local government, local health officials, and law enforcement shall be given the opportunity to comment on clean needle and syringe exchange programs on a biennial basis.”
The California Department of Public Health provides guidelines and details for presentations to Board of Supervisors and City Council’s stating that the presentation must include local statistics including “relevant county public health data, including HIV and hepatitis C viral (HCV) infection, opiate and stimulant overdoses, endocarditis, soft tissue infections, congenital syphilis and other diseases and health conditions associated with injection drug use”.
At the biennial presentation on October 11, 2022, the Board of Supervisors was unanimous in their discussion and agreement that local data was not sufficient to warrant a syringe exchange program in El Dorado County, and that the program was creating more harm than public benefit. The Board was led to believe that the comment period to the State was open until the end of 2022, and by unanimous vote the Board directed staff to 1) Provide each Board member with the contact information for the Office of AIDS and the California Department of Public Health; and 2) Contact the Office of AIDS to coordinate a discussion with the Board in a local format in order to demand that the State not reauthorize syringe exchange programs in El Dorado County.
Following the October 11, 2022 board item and after individual board members contacted the State, it was determined that the authorization date was actually September 1, 2023, not January 1, 2023. Additionally, Section 121349 states before the two-year authorization ends, “the department may reauthorize the program in consultation with the local health officer and local law enforcement leadership”.
On April 12, 2023, Supervisors Thomas and Parlin met with El Dorado County Sheriff Leikauf to discuss the perspective and experience of local law enforcement regarding the syringe exchange program in El Dorado County. Prior to this meeting, community members had been extremely vocal about their experience with open access to drug paraphernalia, even for youth under 18, and despite the claims of needles being reclaimed by Sierra Harm Reduction, discarded needles continue to pollute trails, camps and public spaces. Sheriff Leikauf also expounded on the criminal activity that our local law enforcement has experienced.
On May 18, 2023, Supervisors Thomas and Parlin along with Sheriff Leikauf, Undersheriff Golmitz and CAO Tiffany Schmid had a meeting with Alessandra Ross, MPH and Marjorie Katz from CDPH/Office of Aids to introduce and discuss our request that syringe and needle exchange programs in El Dorado County not be reauthorized. The meeting was very productive in gaining a shared understanding of our respective roles as well as clarifying what we are experiencing at a local level.
On June 20, 2023, the County sent a letter to CDPH reiterating the County's request not to reauthorize SHRC's contract for a syringe exchange program in El Dorado County. On September 1, 2023, despite the County recommendation to not reauthorize SHRC's contract, CDPH reauthorized SHRC's contract effective September 1, 2023.
On October 13, 2023, the County received notice from CDPH that SHRC had submitted an updated application and that CDPH was opening the 45 day public comment period and reaching out to the County for consultation. On November 8, 2023, the County met with CDHP for this consultation. The meeting was attended by Supervisors Thomas and Parlin, Chief Administrative Officer Tiffany Schmid, Undersheriff Golmitz, District Attorney Pierson, Placerville Police Chief Wren, South Lake Tahoe Police Chief Stevenson, Placerville City Manager Cleve Morris, Placerville Vice Mayor Jackie Neau, Assistant CAO Laura Schwartz, Chief Assistant District Attorney James Clinchard and Deputy District Attorney Miles Perry. CDPH representatives included Marjorie Katz and Alessandra Ross along with four other staff from CDPH. The County and City representatives reiterated the negative impacts of the syringe exchange program and recommended against the approval of the updated application for the SHRC
The action today recommends that the Board approve sending a letter to the California Department of Public Health, in concert with the El Dorado County Sheriff’s Office, and the El Dorado County District Attorney, requesting that the California Department of Public Health deny the updated application for the reauthorization of Sierra Harm Reduction Coalition’s services for a syringe exchange program in El Dorado County.
ALTERNATIVES
The Board could not approve sending a letter to the California Department of Public Health, in concert with the El Dorado County Sheriff’s Office and the El Dorado County District Attorney, requesting that the California Department of Public Health deny the updated application for reauthorization of Sierra Harm Reduction Coalition’s services for a syringe exchange program in El Dorado County. With this course of action, it is likely that a syringe exchange program would be reauthorized for two years by the California Department of Public Health.
PRIOR BOARD ACTION
Legistar 23-0884, June 20, 2023 - BOS approval to send letter requesting that CDPH deny the 2023 reauthorization of the Sierra Harm Reduction Coalition contract.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
El Dorado County Sheriff’s Office
El Dorado District Attorney's Office
City of Placerville
City of South Lake Tahoe
Chief Administrative Office
FINANCIAL IMPACT
N/A
CLERK OF THE BOARD FOLLOW UP ACTIONS
Obtain Chair, Sheriff and District Attorney signatures on letter and forward to CA Department of Public Health.
STRATEGIC PLAN COMPONENT
Value of collaboration - We engage, communicate and connect to achieve the best possible outcomes together.
Safe and Healthy Communities - Priority of developing a continuum of support for unhoused individuals. The County feels that the Sierra Harm Reduction Coalition syringe exchange program is working against everything the County is trying to accomplish.
CONTACT
Supervisors Thomas & Parlin
Sheriff Leikauf
District Attorney Pierson