BACKGROUND
In August 2023, the Roseville Police Department received a notification concerning an application received by the California Department of Public Health (CDPH), submitted by Safer Alternatives through Networking & Education (SANE), seeking authorization to establish a syringe exchange program that would operate in a portion of Placer County, including within the City of Roseville.
Pursuant to Health and Safety Code section 121349 et seq., CDPH may approve syringe exchange programs to provide sterile syringes and collect used syringes for people who inject drugs. Such approval may be granted by CDPH despite the objections of the local agencies in the area within which the program will operate. According to the CDPH, there are more than sixty syringe exchange programs operating in California.
While the California Health and Safety Code and California Code of Regulations provide some general parameters for operating a syringe exchange program approved by CDPH, such regulations are not exhaustive. Additionally, even though state law requires used syringes and sharps be disposed of in a very specific manner (e.g., being placed in a sharps container and transported to an authorized collection center), and prohibits the loose disposal of home-generated syringe waste (e.g., syringes cannot be discarded in trash or recycling containers), certain individuals within the community continue to dispose of their used and potentially contaminated sharps and syringes in manners that increase the risk that others will come into contact with them. Such sharps and syringe waste represents a significant public health hazard for all community members and visitors, as well as to city staff, through unnecessary exposure and risk of injury due to improper disposal of syringes. Improper disposal of used syringes and sharps has been documented in parks, roads, sidewalks, trails and open spaces, parking lots, vacant buildings, and other areas throughout the City.
Upon review of the application submitted to CDPH by SANE, City staff noted several significant concerns with the proposed operation of the syringe exchange program. Notably, SANE’s application is generally lacking in information and specific details regarding its proposed operation, creating significant questions regarding SANE’s process for dispensing syringes and an overall lack of accountability for collection of used supplies, especially sharps and syringes.
SANE has offered “home delivery/pickup” to areas in southwest Placer County. However, detailed information regarding such delivery is lacking. There is no mention of a specific fixed location or whether “home delivery” requires delivery to a location with a mailing address, or alternatively, if “home delivery” is intended to cover any type of location whereby an individual requests delivery (e.g., a park, open space, parking garage or parking lot, etc.). Without specifics regarding a delivery location or a specific location for needle drop-off, the City cannot fully evaluate the impact to the community, nor can SANE or CDPH ensure the fidelity of the program if approved. This also raises significant concerns about the ability to collect used needles in a sanitary capacity that will effectively reduce harm to either the user or innocent citizen that may contact an improperly discarded syringe at a park, walking trail, or other public location.
The information provided for the return/exchange/collection of syringes, sharps, and other waste is equally deficient, and does not appear to be specific to ensure a consistent option for returning used syringes or a location where users can responsibly dispose of the syringes in the interest of public health. The application only mentions that users can arrange for pick-up during delivery hours or drop off sharps waste during office hours. However, both delivery and office hours are limited, there is no mention of where drop-off locations will be located, and there is no information about what plan SANE has to address individuals who want to discard used syringes outside of these two limited options. It is irresponsible and contrary to public health to assume that those in need of syringe exchange services will always plan ahead with requesting pick-up of used syringes or will make arrangements to ensure return of used syringes to fixed locations (which again, are not specified in the application).
Further, SANE does not appear to offer a specific plan to account for needle and syringe exchanges. The number of syringes delivered and collected should be scrupulously accounted for. Instead, SANE appears to rely on estimated numbers of syringes dropped off or collected, which provides little confidence from the public’s standpoint about overall program management and safety practices, and again, increases the risk of community members coming into contact with improperly disposed of used and potentially contaminated sharps, syringes, and other waste.
After evaluating SANE’s application, City staff developed comments identifying the many deficiencies with respect to SANE’s proposed plan and the negative impacts to public health and safety that may be created without additional regulation, like the proper disposal and/or collection of sharps, syringes, and other waste. These comments were submitted by Chief Bergstrom to CDPH on approximately September 4th and are included herewith for reference.
If SANE’s syringe exchange program is approved as currently proposed, there will be significant and immediate risks to the public’s health, safety, and welfare due to the increased improper disposal of sharps, syringes, and other corresponding waste that will occur in light of the influx of syringes being distributed, which SANE expects to be approximately 200,000 per year.
No provisions of the existing Roseville Municipal Code specifically address syringe exchange programs. Thus, the proposed Urgency Ordinance and non-urgency Ordinance before Council for consideration will make certain actions a public nuisance and regulate syringe exchange programs within the city to ensure that such programs operate in conformity with state law. Such Ordinances will also impose regulations to minimize the significant and imminent threats to public health and safety caused by improper disposal of used sharps and syringes and the congregation of persons who regularly inject drugs near schools, parks, playgrounds, and other sensitive locations. A brief summary of the regulations and restrictions to be imposed by Chapter 9.90 are set forth below:
- All syringe exchange programs, except those specifically approved by CDPH pursuant to the California Health and Safety Code, are prohibited.
- Syringe exchange programs are prohibited from being operated within 600 feet of any public or private school, day care center, playground, public park, community center, or library, unless the services are provided on a private residential property.
- Syringe exchange programs are prohibited from providing syringes to any participant unless it also gives the participant a proper sharps container or determines to a reasonable degree of certainty that the participant already has a sharps container available for proper disposal of sharps and syringes.
- Syringe exchange programs are prohibited from providing syringes to any participant that is known to have improperly disposed of sharps or syringes previously provided to the participant.
- Each sharp or syringe used to inject drugs must be disposed of and secured in a proper sharps container after its first use.
- Disposal of sharps, syringes, and all corresponding waste must be consistent with state and local law, and discarding of sharps or syringes in any place or manner such that they may come into contact with any other person is prohibited.
City staff is aware of other local agencies that have adopted ordinances that completely ban operation of all syringe exchange programs, including those approved by CDPH under the California Health and Safety Code. At this time, city staff cannot recommend taking such action. The California Health and Safety Code provides says that CDPH may authorize such programs “notwithstanding any other law”, which suggests that any local prohibition against all syringe exchange programs is preempted and would not be enforceable. Further, in October 2021, the applicable provisions of the California Code of Regulations were amended to specifically remove language that previously stated any approved program must be subject to all “local ordinances”. This also suggests that local ordinances conflicting with syringe exchange programs operating under state law may be unenforceable.
On the other hand, it does not appear that the City is flatly prohibited from imposing some local regulations on a syringe exchange program, even if such program is approved by CDPH and operating under state law. Local regulations that supplement state law, so long as they are not in direct conflict, are permitted. Additionally, as a charter city, the City of Roseville has supremacy over all municipal affairs, and the City’s local regulations may prevail even if in conflict with state law so long as the regulation addresses local municipal issues and not those of statewide concern.
Here, the regulations being proposed through Chapter 9.90 have been drafted to supplement state law and impose additional requirements necessary to protect public health, safety, and welfare. Staff believes that such regulations do not conflict with state law, and instead, it will be possible for approved programs to follow both state law and the City’s local regulations. Further, to the extent there is any possible conflict between state law and these regulations, such regulations are intended to specifically address municipal affairs and the local impacts created by the approval and operation of syringe exchange programs within the City. They do not completely prohibit syringe exchange programs operating under state law or impede the broader health concerns that such syringe exchange programs are intended to address. It should be noted, though, that this area of the law is unsettled, and no significant guidance has been provided by the courts or the legislature regarding the interrelation between state law and local ordinances addressing syringe exchange programs.