Title
Health and Human Services Agency recommending the Board:
1) Receive a presentation and report as a requirement of and in accordance with California Health and Safety Code Section 121349.3, detailing the status of the Sierra Harm Reduction Coalition’s (SHRC) syringe exchange program authorized by the California Department of Public Health (CDPH); and
2) Receive a follow-up presentation from the Executive Director of SHRC to provide information about how SHRC operates with the purpose of reducing the incidence of blood-borne pathogens and other harms associated with drug use in the County.
FUNDING: N/A
Body
DISCUSSION / BACKGROUND:
As part of California’s efforts to prevent the spread of human immunodeficiency virus (HIV) and other blood-borne diseases, Health and Safety Code (HSC) Section 121349 was authored to enable the California Department of Public Health (CDPH) to authorize syringe exchange services in any location where CDPH determines that the conditions exist for rapid spread of HIV, viral hepatitis, or other blood-borne diseases. CDPH then requires annual reporting by authorized programs, which may apply to have their authorizations for operation renewed periodically if they continue to meet CDPH standards. Beginning in 2020, CDPH determined that El Dorado County continues to be at risk for blood-borne pathogens and other harms associated with drug use and that Sierra Harm Reduction Coalition (SHRC) meets the state requirements to address the identified public health need. In accordance with the requirements of HSC 121349, CDPH authorized SHRC to operate syringe exchange services in El Dorado County. In 2021, CDPH assessed SHRC and extended SHRC’s authorization to continue to operate in El Dorado County.
In addition to providing services intended to directly reduce incidence of blood-borne disease transmission in people who inject drugs, SHRC provides referrals to organizations who offer services such as counseling, screening, and treatment for HIV, hepatitis C virus, and sexually transmitted disease; treatment for substance use disorder; housing; food access; services for veterans; legal services; financial assistance; and transportation services.
The County of El Dorado provides no funds, staff, or other support to SHRC. The only burden placed on the County by HSC 121349.3 is the following requirement, which is the subject of this proposed board item:
“The 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 blood-borne infections associated with needle sharing activity and the use of public funds for these programs. Law enforcement, administrators of alcohol and drug treatment programs, other stakeholders, and the public shall be afforded ample opportunity to comment at this biennial meeting. The notice to the public shall be sufficient to ensure adequate participation in the meeting by the public. This meeting shall be noticed in accordance with all state and local open meeting laws and ordinances, and as local officials deem appropriate. For hypodermic needle and syringe exchange services authorized by the State Department of Public Health, a biennial report shall be provided by the department to the local health officer based on the reports to the department from service providers within the jurisdiction of that local health officer.”
The Health and Human Services Agency (HHSA) Public Health Division (PHD) therefore is required to present a brief summary to meet the above regulations, and to allow SHRC’s Executive Director to give a brief presentation about how SHRC operates the program with the purpose of reducing the incidence of bloodborne pathogens and other harms associated with drug use in the County. Per the State regulation, and unless amended, HHSA PHD will continue to be required to return to the Board biennially to provide a report and update detailing the status of the syringe exchange program operating in El Dorado County.
The attachments to this staff report evidence the required reports:
1. Most recent El Dorado County HIV, Hepatitis C, and congenital syphilis data.
2. Most recent El Dorado Opioid Overdose Snapshot (publicly available from the State's opioid dashboard).
3. Excerpt from Center for Disease Control's evidence-based strategies to prevent drug overdoses report (syringe services programs section).
ALTERNATIVES:
The Board could choose not to receive the follow up presentation that includes additional information from SHRC about how it operates and its purposes of harm reduction. However, the State requires, at a minimum, that a presentation about statistics related to diseases associated with injection drug use in counties where syringe exchange programs are permitted to operate be delivered at a Board meeting.
PRIOR BOARD ACTION:
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
Receive the presentation as required.
FINANCIAL IMPACT:
There is no financial impact associated with this agenda item.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT:
Healthy Communities
CONTACT:
Evelyn Schaeffer, Director, Health and Human Services Agency