California Enacts Laws to Further Protect Public Health

The California governor signed into law three significant pieces of legislation aimed at improving and normalizing testing and protecting syringe service programs that operate in the state. Together, these laws push California forward in its ability to engage communities that are most at risk, ensure that HIV and STI testing is better integrated into primary care, while protecting syringe exchange programs from politically motivated interference. The Academy’s California-Hawaii chapter sent the governor a letter in support of these bills.

The legislation, S.B. 306, The STD Coverage and Care Act; and A.B. 789, which increases hepatitis testing; requires health plans to cover at-home test kits for both HIV and STDs, mandates syphilis screenings for persons in the first and third trimester of pregnancy, allows HIV counselors to provide rapid STD tests, allows for “expedited partner therapy,” and requires health facilities to offer voluntary testing for Hepatitis B and C during routine medical appointments – as well as care and treatment for those with a positive result. Together, these laws will have a tremendous impact on the health of patients and communities.

The rates of STDs have been steadily increasing over the last several years, with a 40 percent increase between 2013 and 2018; and those numbers have gotten even higher during the COVID-19 pandemic. Academy members know that people who are aware of their HIV status are more commonly connected with care, maintain their health, and reduce or eliminate further transmission. These laws also allow the state to take important steps in addressing the health inequities that new HIV and STI infections represent. HIV disproportionately affects Black and Latino communities, particularly regarding new cases, and Hepatitis B disproportionately impacts California’s Asian American communities. Hopefully, these laws will make the state’s healthcare system more just.

The third bill, A.B. 1344, regarding needle and syringe exchange services, is a little different in that it improves existing law by discouraging politically motivated attacks on these critical programs. Despite needle and syringe exchange programs (SEPs) having operated in California since the 1980s, opponents continue to use innovative tactics in an attempt to shutter the programs. The latest attempt uses the California Environmental Quality Act (CEQA) as the basis for litigation.

Lawsuits have been filed against programs in at least three counties, with one court finding that the program was subject to CEQA “because the program could not demonstrate that it collected all the syringes that it distributed,” forcing the program to shut down. According to the bill sponsor, not only do SEPs “have a proven track record of reducing the transmission of many deadly diseases, including HIV and hepatitis C…[but due] to the pandemic, SEPs have expanded their services in the form of providing COVID education, PPE distribution, sharing information on access to housing and health services, and other vitally needed services.”