Syringe Access Disposal Program Policies Guidelines HIV Prevention

Syringe Access & Disposal Program Policies & Guidelines HIV Prevention Section Presentation to San Francisco HIV Prevention Planning Council (HPPC) September 11, 2008 San Francisco Department of Public Health Community Programs AIDS Office HIV Prevention Section

Introduction to Document (p. 1) n Provides history and data on the importance of Syringe Access & Disposal Programs (Syringe Programs) n States a clear purpose of the document: n “to provide a framework that summarizes best practices based on public health strategies” n Defines the terms: n n ‘must’ – indicates a mandatory practice required by law or by Departmental directive. ‘should’ – indicates a strongly recommended practice. 2

Goal, Objective & Strategies (p. 2) n Goal: To eliminate the transmission of bloodborne viruses among people who inject drugs or other substances. n Objective: To reduce risk behaviors that may lead to the transmission of bloodborne viruses among people who inject drugs. n Strategies: n n n Provide access to sterile syringes, injection supplies, and safer sex supplies. Promote safe disposal of syringes and injection supplies, including collection and disposal of used syringes. Develop & deliver education programs relevant to the goal. 3

Guiding Principles of Syringe Programs (p. 2) Government Support n Stakeholder Empowerment n Community Involvement n Support principles of the SFDPH Harm Reduction Policy n 4

Authorization of Syringe Programs (p. 3) n This section provides the history and process of authorization: n 2001: California Assembly Bill (AB) 136 n n n Created State of Emergency and H&S Code Section 11364. 7 Protected local government organizations, their employees, and authorized subcontractors from criminal prosecution for distribution of syringes in jurisdictions that declared a local health emergency. 2005: The law changed to allow counties and cities to authorize SPs in their jurisdictions without declaring a state of local emergency and provided a process for the California Department of Public Health to set regulations to support local health jurisdictions. 5

Models of Service Delivery (pp. 4 -6) n Coordination and Development n n Type of Providers n n n n Pharmacy Providers Community Providers Service Modality n n Assessing level of coverage needed Fixed Site Venue Based Pedestrian Community Events Satellite Syringe Access Hormone Syringe Access Additional and Ancillary Services 6

Operating a Syringe Program (pp. 710) n n n Service Delivery Approval of SP Providers SP Workforce n n n n Core Skills & Knowledge Workforce Development Orientation Ongoing Development Provision of Syringes Syringe Possession Provision of Associated Equipment n n n Confidentiality Referrals Education & Health Promotion n Overdose Education Bleach Education Condoms & Lubricant 7

Operating a SP (pp. 10 -13) n Crisis Intervention n n Access & Equity n n Participants Under the Influence Participants in Crisis/Distress Aggressive & Challenging Behavior Addressing Barriers to Access Occupational Health & Safety n n n Service Advertising & Promotion Media Liaison Police Relations n n n Police Operations Police Liaison SP Responsibilities Staff Safety Needle stick injury 8

Syringe Disposal (pp. 14 -16) n n n n n Management of Sharps Return of Used Sharps Community Sharps Management Community Sharps Disposal Kiosk Promotion of Safe Disposal in Garbage Bins Disposal in Recycling Bins Community Education on Safe Disposal Citywide Hotline Collection of Discarded Syringes 9

Evaluation & Monitoring (p. 17) n Data Collection n Cost Efficiency n Changes to Service Delivery n Participant Satisfaction and Complaints 10

Additional Resources (pp. 1826) n Acronyms n References n Appendix A: Supporting Literature n Appendix B: Community Providers summary of “Must” & “Should” n Appendix C: Expanded list of SP Staff Core Skills and Knowledge n Appendix D: Examples of SP Outcome Objectives 11

Motion to approve the Document n On August 6 th the Strategies, Interventions, and Evaluation Committee voted to approve Syringe Access and Disposal Program Polices and Guidelines. The SIE Committee makes the following motion: n “SIE moves that the HPPC approves the Syringe Access and Disposal Program Polices and Guidelines. ” 12

Questions & Answers n Since the motion comes from a committee, we can go directly into discussion. n “SIE moves that the HPPC approves the Syringe Access and Disposal Program Polices and Guidelines. ” 13