Regardless of whether a court allows an Orange County nonprofit to run a mobile syringe exchange, the program’s organizers could find themselves barred under proposed legislation from working in the cities they hoped to serve.

State Sen. John Moorlach is behind a bill that would require city or county officials to sign off before a needle exchange could operate in their jurisdiction. Current law says programs can be authorized by either local authorities or the state Department of Public Health.

The Orange County Needle Exchange Program is proposing to provide free clean needles through a mobile exchange program, but the state’s approval has been opposed in court by officials in the county and cities where the group hoped to operate.

Moorlach said his goal is not to take sides, but to give local officials an equal say in what takes place in their community.

“All I’m saying is, you know, convince your city council,” he said. “I don’t feel comfortable with Sacramento saying, ‘We’re smarter than you and we’re going to do whatever we want.’”

But public health advocates of programs such as free, clean needles for injection drug users say Moorlach’s proposal would be a setback they fear could lead to increased transmission of HIV and Hepatitis C and even overdose deaths – syringe exchanges often also distribute naloxone, which can counteract an overdose.

Los Angeles Community Health Project Executive Director Michael Marquesen worried it will turn back the clock to before state health officials had authority to approve needle exchanges.

“It really put a damper on intervention in so many places when it was left up to the local authorities,” he said.

Needle exchanges offer clean syringes and collect used ones for proper disposal, and they typically also offer people other health-related information and referrals, such as to substance abuse treatment.

A previous program in Orange County was one of 45 syringe exchanges around California, according to state health officials. Such programs sprang up in the 1990s to stem the spread of HIV, though Orange County’s was only created in 2016.

It operated in Santa Ana’s Civic Center once a week, but in early 2018 city officials denied organizers a permit to continue after complaints about discarded needles on the ground and in public buildings and workers being pricked by them.

While some local governments sanction and even fund syringe exchange in their communities, others have been resistant. State law was changed in 2011 so the Department of Public Health could approve programs directly.

“Up until then, an individual’s access to syringe programs was determined by where they lived, not how much need there was in a community,” said Laura Thomas, deputy state director for the Drug Policy Alliance, a nonprofit focused on drug policy reform.

When the local program lost its Civic Center permit, organizers proposed a mobile program stopping in Anaheim, Costa Mesa, Orange and Santa Ana and got the state’s approval. But the county and three of the cities – citing public health concerns about stray needles and risk to recovering addicts – successfully sued to block the program before it began.

Moorlach said the needle exchange organizers surprised the cities where they hoped to operate rather than reaching out to them first, and his bill would ensure that doesn’t happen again.

Based on the Orange County Needle Exchange Program’s reported problems in the Civic Center, Costa Mesa Councilman John Stephens said he and his colleagues “did not think that their program was well thought out.”

And that is why a city should have some power to evaluate programs and regulate them in its own jurisdiction, he said.

Orange County Needle Exchange Program officials couldn’t be reached for comment, but in a March 10 op-ed in The Orange County Register they argued that Moorlach failed to propose anything that could help win acceptance for the programs and cautioned, “Local control would serve as a barrier to syringe exchange programs and not a promise to help reform and improve them.”

Meanwhile, other groups have tried to fill the service gap, including Marquesen, who said he’s seen plenty of recent clients at his Los Angeles clinics who came from Orange County because there’s no local needle exchange program.

Volunteers with the Solace Foundation, which had partnered with the Orange County Needle Exchange Program to give out naloxone, have added kits to sterilize syringes and sharps containers for disposal to the supplies they hand out on the street, the group’s founder wrote in a December op-ed.

Moorlach’s bill is scheduled for a Senate Health Committee hearing April 24.