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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

California expands culturally competent Program for LGBTQ Foster Youth

The services will be designed to address the barriers LGBTQ youth encounter in their interpersonal, familial, and community relationships

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LGBTQ+ youth (Los Angeles Blade file photo)

LOS ANGELES — Governor Gavin Newsom’s final 2022-23 fiscal year budget included $5 million for LGBTQ+ foster youth programming. The pilot program will require the California Department of Social Services (DPSS) to improve the child welfare system by providing affirming services designed specifically for LGBTQ+ foster youth.

The services will be designed to address the barriers LGBTQ+ youth encounter in their interpersonal, familial, and community relationships due to their actual or perceived sexual orientation, gender identity, and expression (SOGIE).

“We are delighted that Governor Newsom has taken this important step towards creating an equitable foster care system for California’s LGBTQ+ youth,” said LA LGBT Center CEO, Joe Hollendoner. “This funding will improve capacity, training, and culturally responsive care that addresses the unique needs of—and offers meaningful protections for—LGBTQ+ youth. The Center has been a pioneer in LGBTQ+-inclusive programming for youth, and we will continue working with our partners to help protect LGBTQ+ foster youth from hate, violence, and discrimination. Every youth deserves a loving home with a caring family and culturally affirming support systems.”

LGBTQ foster youth are over-represented in the foster care system, and youth of color are disproportionately represented among those LGBTQ+ youth. A Williams Institute report finds that one in five foster care youth are LGBTQ+; of those youth, 90% are youth of color. Additionally, LGBTQ+ youth are twice as likely as non-LGBTQ+ youth to end up in a congregate care setting.

LGBTQ+ foster youth also face greater challenges when in custody with non-affirming foster families as they are disproportionately at risk for physical, sexual, emotional, and mental abuse. On average, 56% of LGBTQ+ youth report that they have felt safer living on the streets than with foster parents. For these reasons and others, robust continuums of care that are culturally responsive for supporting LGBTQ+ youth are critical.

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California

California ends loitering for prostitution law

This repeals “loitering with intent to engage in prostitution” law, which results in profiling of sex workers particularly trans women

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California Governor Gavin Newsom (Blade file photo)

SACRAMENTO – Senate Bill 357, the Safer Streets for All Act, authored by Out state Senator Scott Wiener (D-San Francisco)’s was signed into law by Governor Gavin Newsom on Friday. 

“As trans people are being criminalized across the country, Governor Gavin Newsom has once again shown that California stands with the LGBTQ community and communities of color,” said Wiener. “Everyone – no matter their race, gender or how they make a living – deserves to feel safe on our streets. Thank you, especially, to our coalition of former and current sex workers and LGBTQ advocates who made this day a reality. Your leadership is inspiring.”

SB 357 repeals a provision of California law criminalizing “loitering with the intent to engage in prostitution.” 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 Transgender Gender-variant and Intersex Justice Project (TGIJP), 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.

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 of 2021, 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.

“For far too long, California law has been used to profile, harass and arrest transgender and gender-nonconforming people simply for existing in public spaces,” said Equality California Executive Director Tony Hoang. “We all deserve to live in public peacefully without fear of arrest. Thanks to Governor Newsom and Senator Wiener’s leadership, California boldly stands on the side of justice. This law will make our communities safer for all Californians. We are immensely proud to be in this fight as part of a coalition that has been trans led since the beginning.”

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California

Proud Boys disrupting a California Pride drag show get pepper sprayed

“There was an altercation, obviously people are here & are upset about the bar having their Pride event,” said the deputy police chief

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Woodland police officers after Proud Boys disrupt drag show (Screenshot KCRA 3 News)

WOODLAND, Ca. – An end of Pride month drag show in this suburban city Northwest of Sacramento was disrupted by Proud Boys at the The Mojo Lounge bar and restaurant in the downtown business district.

As the group attempted to gain access to the establishment, a now viral video by local ABC10 television reporter Luke Cleary showed them and the near-by police officers getting pepper-sprayed by an unseen person inside the bar.

Screams of pain erupted along with one Proud Boy who can be heard shouting “fuck you paedophile motherfuckers,” after being sprayed. Woodland police officers can also be seen retreating wiping their eyes from the effects of the irritant self-defensive spray weapon.

Another reporter, Lee Anne Denyer from NBC News Sacramento affiliate KCRA 3 noted that the event, which was initially advertised as an an all-ages Drag Show by the bar was at first postponed and then scaled back.

Denyer posted video that showed the heavy law enforcement presence after the Proud Boys attempted to storm the restaurant demanding to know how many children were in attendance at the show.

“There was kind of rumors that things were brewing on main street but there was obviously a presence by the Woodland Police Department so that made us feel more comfortable. Then it escalated, it escalated pretty quickly,” Julie Ramos, who attended the event, told KCRA. “This really was a positive event and everyone was having a great time. So I think most people were angry but I would say resilient.”

Woodland Police Department, Woodland, California

“There was an altercation, obviously people are here and are upset about the bar having their Pride event,” Anthony Cucchi, the deputy chief of the Woodland Police Department told KCRA. “We tried to intervene as quickly as we could, it was a pretty chaotic scene. Our main priority was to get a safe scene and then make sure anybody that needed help got the help that they needed. We will work on the investigation.”

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