General Update on the Expanded Syringe Access Program (ESAP)

In May 2000, the New York State Legislature enacted Chapter 56 of the Laws of 2000 creating the Expanded Syringe Access Demonstration Program (ESAP). Since the program became permanent in the summer of 2009, it is now known as the Expanded Syringe Access Program (ESAP). The purpose of this program is to reduce the transmission of blood borne diseases, including HIV and hepatitis, by enhancing access to clean (new) syringes. Under this program, up to ten syringes may be sold or furnished to a person 18 years of age or older without a prescription by pharmacists, health care facilities, and health care practitioners who have registered with the New York State Department of Health.

Over 3,200 providers have registered with ESAP, 97% of which are pharmacies. The other 3% includes 12 hospitals, 29 clinics, 9 nursing homes, 5 pharmacies located in hospitals and 32 health care practitioners at multiple sites. Since the ESAP Provider Directory is currently being updated only a partial ESAP provider directory is available on the New York State Department of Heath website.

Another important component of ESAP is the promotion of safe sharps disposal. In New York State, all hospitals and nursing homes (930) are required by law to accept household sharps, but not all are convenient to customers. Pharmacies, clinics and health care practitioners that wish to accept household sharps for safe disposal must register separately with the NYS Safe Sharps Collection Program (NYSSSCP). Today, there are over 125 agencies/facilities hosting kiosks or wall mounted units in 20 counties. With the current 7 mobile van programs, the number of sites increased to over 150 sites. Ten of the agencies/facilities registered with the NYSSSCP are for their clients only.  Venues for disposal have broadened to include, landfills, waste transfer stations, community based organizations (CBO) mobile vans, housing projects, a community college, a bus depot, an airport, federal hospitals and a police station. As of June, 2010, the NYSSSCP have collected 49,600 pounds of sharps.

A listing of registered ESAP providers by county, as well as sharps collection sites, is available at the NYS Department of Health website. The website provides ESAP-related materials including an overview of the law and regulations, information on ESAP for providers and consumers, guidelines to sell or furnish syringes without prescription, guidelines for health care facilities, and the application to register for ESAP. It also contains information on how to dispose of household sharps properly, the application for sites interested in accepting syringes for disposal outside a health care setting, and additional resources.

The AIDS Institute supports demonstration projects that promote access to sterile needles and syringes, as well as the safe disposal of used ones. Not all demo projects are the same. Some demo projects involve coalitions supporting safe syringe disposal. Others involve community based organizations (CBOs) partnering with pharmacies to provide education about ESAP and safe disposal. Other projects involve the partnership of a CBO and pharmacies to establish ESAP voucher programs. Other CBOs promote safe disposal, while others may employ ESAP-registered health care providers to furnish syringes in a storefront, mobile van or on the street. Currently, there are 32 ESAP demonstration projects throughout the state.

For additional updates on ESAP and to learn more about the ESAP Projects contact: Dr. Wesley E. Badillo, ESAP Coordinator, at or call (212) 417 4746.