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California

Recovery Incentives Act, confronting Meth & overdose crisis passes

SB 110 authorizes Medi-Cal to fund evidence-based treatment giving those struggling with addiction financial rewards for staying sober

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Photo Credit: County of Los Angeles

SACRAMENTO — Senator Scott Wiener’s (D-San Francisco) legislation, Senate Bill 110, passed both the Assembly and the Senate on concurrence with bipartisan, unanimous votes. It will now head to the Senate for a concurrence vote, and then to Governor Gavin Newsom’s desk, where it can be signed into law.

SB 110 will address the worsening methamphetamine addiction crisis facing in the state. The Recovery Incentives Act legalizes the substance use disorder treatment known as “contingency management,” and authorizes Medi-Cal to cover it. Contingency management has proven to be the most effective method of treatment for methamphetamine addiction, and is frequently used as a treatment program by the Veterans Affairs Administration. This intervention program gives those struggling with substance use disorder financial rewards if they enter substance use treatment programs, stay in the program, and get and remain sober. This positive reinforcement helps people reduce and even fully stop substance use.

In the Biden-Harris administration’s new drug policy platform, increasing access to evidence-based treatment was slated as the number one priority. This includes contingency management. The platform cites the need to end “policy barriers related to contingency management interventions (motivational incentives) for stimulant use disorder” as part of its effort to expand evidence-based treatment.

There is currently no form of Medication-Assisted Treatment (MAT) for meth, unlike with opioids where treatment options such as methadone are available. Contingency management is thus a critical tool in addressing the meth addiction crisis. According to the San Francisco Department of Public Health (SFDPH), since 2008, meth overdose deaths in San Francisco have increased by 500%. Additionally, 50% of psychiatric emergency room admissions at San Francisco General Hospital are now meth-related. These disturbing statistics demonstrate the urgency with which San Francisco and other communities must address this epidemic.

With drug overdose deaths on the rise across the country, the state, and in San Francisco — San Francisco had a record number of overdose deaths in 2020 — effective substance use intervention programs are more important than ever. In San Francisco, according to data collected in 2019, roughly 60% of all overdose deaths were meth-related.

Meth use has spiked all over California and in San Francisco, and worsened through the COVID-19 pandemic. With social isolation, mental health issues like depression, and economic suffering all worse for many than in prior years, meth use has also increased significantly. Since COVID-19 was declared a national emergency on March 12th, The Hill reports that patients across the country “tested positive for methamphetamines at a roughly 20 percent higher rate between March and May than previous samples.”

Stimulant use has also grown rapidly in the LGBTQ and Black communities, which were already deeply impacted by the meth crisis. The LGBTQ community — particularly gay, bi and trans men — have seen a rapid increase in meth use as a party drug taken to enhance sexual experiences. SFDPH also reports that the mortality rate is highest among African American men.

Programs like the San Francisco AIDS Foundation’s PROP (Positive Reinforcement Opportunity Project) program – in which LGBTQ men who used meth are given gift cards for staying sober – are found to be highly effective. According to the San Francisco AIDS Foundation, in one year of the PROP program, 63% of participants stopped using meth entirely and another 19% reduced their use. This approach, coupled with community support meetings, proves time and again to be an effective method of treating meth addiction. Veterans Affairs hospitals throughout the state also use contingency management programs with success. This bill intends to make these programs accessible on a wider scale by authorizing them to be reimbursable by Medi-Cal.

The bill would also require the California Department of Health Care Services (DHCS) to issue guidance on the use of contingency management programs for Medi-Cal patients.

The bill is sponsored by the San Francisco AIDS Foundation, APLA Health, Equality California, the City and County of San Francisco, and the California Association of Alcohol and Drug Program Executives (CAADPE).

“We’re seeing meth overdose deaths skyrocket, and it’s clear that we need creative solutions for our addiction crisis,” said Senator Wiener. “We know that contingency management works; it’s one of the only effective and evidence-based treatments for stimulant addiction. Meth addiction is difficult to kick, and contingency management can help. We have every responsibility to help people succeed in abstaining from drugs that can be harmful to them and everyone in their community. Allowing state Medicaid funds to reimburse contingency management programs is an important step, and it’s something upon which legislators on both sides of the aisle can agree.”

“Discrimination, stigma and shame are all barriers that prevent too many LGBTQ+ people from receiving the treatment they need to overcome meth use and addition. Enough is enough.” said Equality California Executive Director Rick Chavez Zbur. “I’m grateful that the California Assembly took bold action today to increase access to a proven, evidence-based solution to this crisis. Thanks to Senator Scott Wiener’s visionary leadership, The Recovery Incentives Act will improve and save the lives of countless LGBTQ+ Californians.”

“CSAM, California’s physician specialists in evidence based treatment, is proud to support this important bill which expands the use of contingency management for stimulant use disorder in California,” said CSAM President Dr. Anthony Albanese. “Currently there is no medication proven to treat stimulant use disorder, Contingency management is therefore a critical component of treatment.”

“Contingency management programs are proven to help individuals maintain their health and are an effective relapse prevention strategy, by giving those struggling with substance use disorders positive reinforcement to remain in treatment,” said Al Senella, President, California Association of Alcohol and Drug Program Executives (CAADPE).

“With drug overdose deaths on the rise, effective substance use programs are now more important than ever – especially for the LGBTQ+ community,” said APLA Health Chief Executive Officer Craig E. Thompson. “In Los Angeles County alone, meth-related deaths increased over 900% from 2008 to 2018 and meth is now linked to more deaths than any other drug. SB 110 is a timely and urgent measure that will expand access to highly effective contingency management services and save lives. We applaud Senator Wiener for championing this critical issue and urge Governor Newsom to sign the bill into law as soon as possible.”

“Behind the rise in opioid overdose deaths in California lurks a rise in deaths by stimulant overdose,” stated Vitka Eisen, President and CEO of HealthRIGHT 360. “We must use every available evidence-based intervention in order to address this challenge. Contingency management has a strong body of research supporting its effectiveness in treating methamphetamine addiction. The passage of SB 110 will give us an additional tool that can immediately save lives.”

“With an overdose crisis that gets worse every year, it’s time to invest in programs and services that we know will prevent overdose and improve the health and lives of people who use drugs,” said Kevin Rogers, interim CEO of San Francisco AIDS Foundation. “The success of our PROP program, which takes a harm reduction approach to help people who use stimulants like methamphetamine and cocaine reduce and stop their use, and many other contingency management programs demonstrates the positive impact these programs can have if they are scaled up and replicated. SFAF strongly supports SB 110, and we call on the Governor to sign this important bill into law. Thank you Senator Wiener for your leadership on this effort.”

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California

Bill to repeal discriminatory loitering law targeting sex workers passes

SB 357 does not decriminalize soliciting or engaging in sex work. Eliminates an loitering offense for simply “appearing” to be a sex worker

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Photo Credit: Carol Leigh Scarlot Harlot

SACRAMENTO – Senator Scott Wiener’s (D-San Francisco) Senate Bill 357, the Safer Streets for All Act, passed the Senate on concurrence by a vote of 26-9. SB 357 repeals a provision of California law criminalizing “loitering with the intent to engage in prostitution.” The bill now heads to California Governor Gavin Newsom for his signature.

This criminal provision — arrests for which are based on an officer’s subjective perception of whether a person is “acting like” or “looks like” they intend to engage in sex work — results in the disproportionate criminalization of trans, Black and Brown women, and perpetuates violence toward sex workers.

SB 357 is sponsored by a large coalition made up of former and current sex workers, LGTBQ groups like Equality California, and civil rights groups like the ACLU. The Coalition to Abolish Slavery and Trafficking (CAST LA) is supporting the legislation.

SB 357 does not decriminalize soliciting or engaging in sex work. Rather, it simply eliminates an loitering offense that leads to harmful treatment of people for simply “appearing” to be a sex worker.

SB 357 repeals “loitering with intent to engage in prostitution” law, which results in profiling and harassment of sex workers, particularly transgender women and women of color

This crime is so subjective and inherently profiling that it allows a police officer to arrest someone purely based on how they are dressed, whether they’re wearing high heels and certain kinds of make-up, how they’re wearing their hair, and the like. This criminal provision is inherently discriminatory and targets people not for any action but simply based on how they look. People who engage in sex work deserve to be treated with dignity and respect.

Criminalizing sex work does not make sex workers or communities safer. Most criminal penalties for sex workers, loitering laws included, do nothing to stop sex crimes against sex workers and human trafficking. In fact, loitering laws make it harder to identify trafficking victims; trafficking victims are often afraid to come forward in fear of being arrested or incarcerated.

In February, a similar piece of legislation to repeal this type of loitering ban became law in New York. SB 357 is part of the movement to end discrimination against and violence toward sex workers, especially the most targeted communities — trans, Black, and Brown people. SB 357 is co-sponsored by Positive Women’s Network – USA, St. James Infirmary, SWOP LA, Trans [email protected] Coalition, Asian Pacific Islander Legal Outreach, Equality California and ACLU California Action.

Under current law, it is a crime to loiter in a public place with the “intent” to commit a sex work-related offense. But this law can be broadly interpreted, and thus allows for discriminatory application against the LGBTQ community and people of color.

Law enforcement can use a non-exhaustive list of circumstances to subjectively determine if someone “intends” to engage in sex work, including factors such as speaking with other pedestrians, being in an area where sex work has occurred before, wearing revealing clothing, or moving in a certain way.

Because current law regarding loitering is highly subjective and vague, law enforcement officers disproportionately profile and target Black and Brown transgender women by stopping and arresting people for discriminatory and inappropriate reasons.

This is how Black and Brown transgender women get arrested and cited for simply walking on the street. It also gives law enforcement the ability to more easily target and arrest sex workers.

People in the LGBTQ, Black, and Brown communities report high rates of police misconduct throughout the United States and are disproportionately affected by police violence. Transgender people who have done street-based sex work are more than twice as likely to report physical assault by police officers and four times as likely to report sexual assault by police.

A Black person is 3.5 times more likely to be shot by police than a white person. These statistics are a daily reality that transgender, Black and Brown people face and lead to mistrust of law enforcement.

SB 357 will repeal a discriminatory law that makes it a crime to loiter with the intent to engage in sex work, given that it fails to prevent street-based sex work and disproportionately results in the criminalization of transgender people and communities of color.

“Anti-loitering laws – which disproportionately impact Black, Brown and LGBTQ people – are racist and transphobic, and must go,” said Wiener. “Sex work is work, and sex workers have a right to live and work with dignity and respect. Arresting sex workers doesn’t make them safer, doesn’t make our communities safer, and doesn’t prevent sex work. In fact, when law enforcement arrests people who ‘look like’ they might be sex workers, simply because of how they look or dress, it makes it harder to find and help those who are being trafficked. Giving people criminal records for just standing around is wrong, and we need to reverse this law.” 

The DecrimSexWorkCA coalition released the following statement:

“For too long, our communities have been harmed by tough-on-crime laws which are used to target and harass our community members, threatening our ability to exist safely in public spaces. By passing SB 357, the Legislature recognizes the decades of harm that California’s loitering law has had on tens of thousands of people, especially Black and brown women, trans women of color and sex workers, giving us a path to clear our records. By ending one form of criminalization, the state takes a monumental step forward in protecting our safety and our livelihoods.”

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California

‘Stealthing’ condom removal bill sent to Newsom for signature

‘Stealthing’ is the nonconsensual and intentional removal or tampering with the condom during sexual intercourse.

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Graphic courtesy of Assemblymember Cristina Garcia

SACRAMENTO – An onerous practice of nonconsensual and intentional removal or tampering with the condom during sexual intercourse known as ‘stealthing’ will now have consequences and civil liabilities.

Assembly Bill 453 authored by Assemblymember Cristina Garcia (D-Bell Gardens) passed both the Senate and the Assembly with wide bi-partisan support and no opposition. The bill now awaits Governor Gavin Newsom’s signature.

“I have been working on the issue of ‘stealthing’ since 2017. And I won’t stop until there is some accountability for those who perpetrate the act. Sexual assaults, especially those on women of color, are perpetually swept under the rug,” Garcia said.

“So much stigma is attached to this issue, that even after every critic lauded Micheala Coel’s, I May Destroy for its compelling depiction of the horrors of sexual abuse including of ‘stealthing,’ it got zero Golden Globe nominations. That doesn’t seem like an accident or coincidence to me,” she added.

‘Stealthing’ is the nonconsensual and intentional removal or tampering with the condom during sexual intercourse. A study by Yale University (Columbia Journal of Gender and Law, Vol. 32, No. 2, 2017) calls “stealthing” “a grave violation of dignity and autonomy” and reports that cases of “stealthing” are on the rise among women and gay men.

The article also encourages new Torts against the practice to allow victims to establish a cause of action. Stealthing has also been labeled ‘rape-adjacent.’

“It’s disgusting that there are online communities that defend and encourage stealthing and give advice on how to get away with removing the condom without the consent of their partner, but there is nothing in law that makes it clear that this is a crime. This would be a first of its kind in the Nation, and I that urge Governor Newsom to sign AB 453 to make it clear that stealthing is not just immoral but illegal,” Garcia urged.

On Friday, Buzzfeed reported that the inspiration behind Garcia’s legislation is 31-year-old civil rights attorney, Alexandra Brodsky, who wrote the paper cited by the Assemblymember as basis for the law when she was a Yale law student.

“I wrote the paper in my third year of law school and never dreamed it would actually influence law in any kind of way,” Brodsky told BuzzFeed News.

Buzzfeed also noted that Brodsky’s paper garnered national attention and is often cited in anti-stealthing legislative efforts. Her paper contended that stealthing transformed consensual sex into nonconsensual sex and was a “grave violation of dignity and autonomy.”

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California

Bill allows victims of domestic violence to remotely report, passes Assembly

“This bill empowers victims by providing access to justice without subjecting them to the trauma of facing their abusers in a courtroom.”

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California State capitol building (Blade file photo)

SACRAMENTO, CA – The California State Assembly this week, in a 78-0 vote, passed a bill by Senator Susan Rubio (D-Baldwin Park) that will provide greater protections and safety for domestic violence victims as they try to leave dangerous situations. 

Senate Bill- SB 538 strengthens protections for survivors of domestic violence by requiring California’s Superior Courts to maintain procedures allowing parties to electronically file for Domestic Violence Restraining Orders and Gun Violence Restraining Orders. The bill will also allow parties and witnesses to appear remotely at a hearing for the petition.

“We should make it easier for victims to seek protection during one of the most terrifying times in their lives,” Senator Susan Rubio said. “We need to eliminate barriers that prevent survivors of abuse from obtaining domestic violence and gun violence restraining orders. Remote testimony is a critical part of the solution, and I am grateful to see this bill pass through the California State Assembly with bipartisan support. I want to thank San Diego Mayor Todd Gloria and San Diego City Attorney Mara Elliott for their support and collaboration.”

“I am grateful to Senator Rubio for authoring SB 538 and to the members of the California legislature who helped pass this common-sense bill to use technology to avoid further trauma to survivors in court settings,” San Diego Mayor Todd Gloria said. “The City of San Diego is a proud sponsor of this important legislation and is committed to expanding access to protective orders for survivors of gun and domestic violence, and other tools to put survivors first and preserve their rights in the criminal justice system.”

“This bill empowers victims of domestic violence by providing access to justice without subjecting them to the trauma of facing their abusers in a courtroom,” San Diego City Attorney Mara W. Elliott said. “I thank Senator Rubio for working with my Office to protect victims from intimidation and retaliation, and urge Governor Newsom to stand with them by signing SB 538 into law.”

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