State Legislation for State Legislation for Secure Medicine Return:Secure Medicine Return:

A Comparison of Maine and WashingtonA Comparison of Maine and Washington

Ann Pistell, Maine Department of Ann Pistell, Maine Department of Environmental ProtectionEnvironmental Protection

Cheri Grasso, Local Hazardous Waste Cheri Grasso, Local Hazardous Waste Management Program in King CountyManagement Program in King County

October 2009

States with Bills in 2009States with Bills in 2009

Florida (SB 2650)Florida (SB 2650)Maine (LD 821)Maine (LD 821)Minnesota (HB 1217)Minnesota (HB 1217)Oregon (SB 598)Oregon (SB 598)Washington (2SHB 1165, Washington (2SHB 1165, SB 5279)SB 5279)

Washington and MaineWashington and Maine

Similarities Between the BillsSimilarities Between the BillsIn 2009In 2009

Producer ResponsibilityProducer Responsibility

Producers provide & pay for programProducers provide & pay for program

No fee to customer at time of No fee to customer at time of sale or collectionsale or collection

WhatWhat’’s Covereds Covered

All medicinesAll medicinesOverOver--thethe--countercounter

Prescriptions, Prescriptions, including controlled including controlled substancessubstances

veterinaryveterinary

From households From households & residential & residential sourcessources

Not PrescriptiveNot PrescriptiveProducers determine Producers determine how to collect drugshow to collect drugsPharmacy takePharmacy take--back , back , mailmail--in, combination, or other ideain, combination, or other idea

Pharmacies not required to Pharmacies not required to to be collection sitesto be collection sites

Expect many pharmacies to Expect many pharmacies to be eager to participatebe eager to participate

AdministrationAdministration

All producers must participate in an All producers must participate in an approved plan approved plan

WA WA -- Board of PharmacyBoard of PharmacyME ME –– MEME DEP & ME DEA & ME DHHSDEP & ME DEA & ME DHHS

Can coordinate with other producers or Can coordinate with other producers or have their own planhave their own plan

MustMust accept all medicines regardless accept all medicines regardless of who produced themof who produced them

Oversight Oversight –– State RoleState Role Washington Board of PharmacyWashington Board of Pharmacy

Maine DEA/DEP/DSHSMaine DEA/DEP/DSHS

Review & approve plansReview & approve plansWA WA –– in consultation with DOEin consultation with DOEME ME –– DEP in consultation with DEA & DHHSDEP in consultation with DEA & DHHS

Adopt rulesAdopt rulesWA WA –– BOP shall adopt rulesBOP shall adopt rulesME ME –– MEME BEP will adopt rules as necessaryBEP will adopt rules as necessary

EnforcementEnforcementWA WA –– BOPBOPME ME –– MEME DEA and ME DEPDEA and ME DEP

Outreach & EvaluationOutreach & Evaluation

Producers provide Producers provide education and education and outreach about the outreach about the programprogram

Final DisposalFinal DisposalMust be disposed at Must be disposed at hazardous waste hazardous waste facilityfacility

Allows for superior Allows for superior technology if approved technology if approved by WA Department of by WA Department of Ecology or Maine DEPEcology or Maine DEP

ReportingReporting

Annual report must includeAnnual report must includeList of producers that participatedList of producers that participatedAmount of medicines collectedAmount of medicines collectedDescription of collection system Description of collection system The disposal facility usedThe disposal facility usedIdentification of any problemsIdentification of any problemsDescription of outreach & educationDescription of outreach & education

Washington and MaineWashington and Maine

Differences Between the BillsDifferences Between the BillsIn 2009In 2009

Producer ResponsibilityProducer ResponsibilityMaineMaine

No fee to recover No fee to recover DEP or DHHS DEP or DHHS administrative administrative expenses. If DEA expenses. If DEA runs some aspects of runs some aspects of program, program, manufacturers cover manufacturers cover the costs.the costs.

WashingtonWashington

State agency may State agency may establish fees on establish fees on producers to recover producers to recover expensesexpenses

PharmaciesPharmaciesBoth Maine & WashingtonBoth Maine & Washington

If producers set up pharmacy takeIf producers set up pharmacy take--back back program, pharmacies may voluntarily program, pharmacies may voluntarily participate as collection sites.participate as collection sites.

MaineMainePharmacies must make program Pharmacies must make program information available to customers. If information available to customers. If mailmail--in established, pharmacies must in established, pharmacies must make mailers available. make mailers available.

Program EvaluationProgram Evaluation

Maine Maine Annually evaluates Annually evaluates program performance program performance and recovery rates. and recovery rates. Year 4 can require Year 4 can require modifications.modifications.

WashingtonWashingtonMust annually Must annually evaluate outreach & evaluate outreach & program including:program including:

% of residents aware % of residents aware of programof programWhat extent residents What extent residents find program find program convenientconvenient

Recovery RequirementsRecovery RequirementsMaineMaine

Recovery goals Recovery goals established through established through stakeholder process for stakeholder process for year 4 and beyondyear 4 and beyond

WashingtonWashingtonNo recovery goals or No recovery goals or requirements BUT:requirements BUT:

Board of Pharmacy may Board of Pharmacy may establish performance establish performance standardsstandardsCollection must be Collection must be provided in all counties & provided in all counties & in cities of 10,000 or in cities of 10,000 or greater populationgreater populationBoard of Pharmacy must Board of Pharmacy must invite comments on invite comments on satisfaction with servicessatisfaction with services

Data RequirementData Requirement

WashingtonWashingtonProducers encouraged Producers encouraged to collect datato collect data

Maine Maine requires random requires random sampling to develop sampling to develop unbiased and unbiased and statistically significant statistically significant data including:data including:

Brand/generic nameBrand/generic nameStrengthStrengthQuantity returnedQuantity returnedQuantity prescribedQuantity prescribedZip code if scriptZip code if script

Maine PoliticsMaine PoliticsSponsor: Rep. Anne Perry of Sponsor: Rep. Anne Perry of MachiasMachias(esteemed moderator and public health nurse).(esteemed moderator and public health nurse).

9 co9 co--sponsorssponsorsOverwhelming support during testimony by Overwhelming support during testimony by health, law enforcement and health, law enforcement and environmental groups and some environmental groups and some pharmacies. pharmacies. Opposition was pharmaceutical Opposition was pharmaceutical coco’’ss..Held over to January 2010 session.Held over to January 2010 session.

Supporters of LD 821Supporters of LD 821 MaineMaine’’s Drug Take Back Programs Drug Take Back Program

Environmental OrganizationsEnvironmental OrganizationsBath Garden ClubBath Garden ClubCherwonkiCherwonki FoundationFoundationEnvironmental Health Strategy CenterEnvironmental Health Strategy CenterFriends of Casco BayFriends of Casco BayFriends of Friends of MerrymeetingMerrymeeting BayBayGarden Club of WiscassetGarden Club of WiscassetMaine DEP Maine DEP ME AudubonME AudubonNatural Resources Council of MaineNatural Resources Council of Maine

Health OrganizationsHealth OrganizationsBrunswick Stroke Support GroupBrunswick Stroke Support GroupCHANS Home Health CareCHANS Home Health CareME Alliance of Substance AbuseME Alliance of Substance AbuseME DHHSME DHHSMidCoastMidCoast Health ServicesHealth ServicesNorthern NE Poison Control CenterNorthern NE Poison Control CenterPlanned Parenthood of Northern NEPlanned Parenthood of Northern NEYouth Alternatives Youth Alternatives IngrahamIngraham

Local GovernmentLocal GovernmentBath Housing AuthorityBath Housing AuthorityBath Water DistrictBath Water DistrictBath City Councilor Bath City Councilor PagurkoPagurkoBrunswick Sewer DistrictBrunswick Sewer DistrictMaine Wastewater Control AssociationMaine Wastewater Control AssociationME Water Utilities AssociationME Water Utilities Association

BusinessesBusinessesMiller DrugsMiller Drugs

Law enforcementLaw enforcementCommunity Justice ProjectCommunity Justice ProjectME DEAME DEAME Association of PoliceME Association of PoliceProject AWAREProject AWARESagadahoc County SheriffSagadahoc County Sheriff’’s Departments Department

Organizations on AgingOrganizations on AgingAARP MaineAARP MaineAroostook Area Agency on AgingAroostook Area Agency on AgingEastern Area Agency on AgingEastern Area Agency on AgingElder Abuse Task Force of Elder Abuse Task Force of MidCoastMidCoast MEMEHill House Assisted LivingHill House Assisted LivingHome Instead Senior CareHome Instead Senior CareMaine Association of TRIADSMaine Association of TRIADSMaine Association of Area Agencies on AgingMaine Association of Area Agencies on AgingMerrymeetingMerrymeeting Bay TRIADBay TRIADSeniors PlusSeniors PlusSpectrum GenerationsSpectrum GenerationsSouthern Maine Agency on AgingSouthern Maine Agency on AgingState Elder Abuse Task ForceState Elder Abuse Task ForceUniversity of Maine Center on AgingUniversity of Maine Center on Aging

OthersOthersArnold Arnold BesierBesier of St. Charles Parish Churchof St. Charles Parish ChurchDavenport TrustDavenport TrustHussonHusson School of PharmacySchool of PharmacyME Council of ChurchesME Council of ChurchesProduct Stewardship InstituteProduct Stewardship InstituteVolunteers of America of Northern NEVolunteers of America of Northern NE

Washington PoliticsWashington PoliticsPrime sponsors = championsPrime sponsors = champions

Rep. Dawn MorrellRep. Dawn MorrellSen. Adam KlineSen. Adam Kline

33 House sponsors33 House sponsors16 Senate sponsors16 Senate sponsors

Passed out of House policy & fiscal committeesPassed out of House policy & fiscal committeesMoved out of RulesMoved out of RulesRan out of timeRan out of time

Washington: EndorsersWashington: EndorsersBusinesses & AssociationsBusinesses & AssociationsBartellBartell DrugsDrugsJimJim’’s Pharmacy, Sequims Pharmacy, SequimWashington State Recycling AssociationWashington State Recycling Association

Local Governments & AssociationsLocal Governments & AssociationsCity of KirklandCity of KirklandCity of SeattleCity of SeattleClark CountyClark CountyCoalition for Clean WaterCoalition for Clean WaterKing CountyKing CountyLocal Hazardous Waste Management Program in King Local Hazardous Waste Management Program in King

CountyCountyPublic Health Public Health –– Seattle & King CountySeattle & King CountySnohomish CountySnohomish CountyWashington State Association of CountiesWashington State Association of Counties

Environmental OrganizationsEnvironmental OrganizationsAmerican RiversAmerican RiversEnvironment WashingtonEnvironment WashingtonNational Wildlife FoundationNational Wildlife FoundationPeople For Puget SoundPeople For Puget SoundSierra Club Cascade ChapterSierra Club Cascade ChapterSurfriderSurfrider FoundationFoundationThe Nature ConservancyThe Nature ConservancyWashington Citizens for Resource ConservationWashington Citizens for Resource ConservationWashington Environmental CouncilWashington Environmental CouncilWashington Toxics CoalitionWashington Toxics Coalition

Civic & Faith OrganizationsCivic & Faith OrganizationsEarth MinistryEarth MinistryLeague of Women Voters of WashingtonLeague of Women Voters of WashingtonLutheran Public Policy Office of Washington StateLutheran Public Policy Office of Washington StateRyanRyan’’s Solutions SolutionWashington State Senior CitizensWashington State Senior Citizens’’ LobbyLobbyWashPIRGWashPIRG

Law EnforcementLaw EnforcementClallam County SheriffClallam County SheriffSnohomish County SheriffSnohomish County Sheriff’’s Offices OfficeWashington Association of Sheriffs and Police ChiefsWashington Association of Sheriffs and Police ChiefsWashington Council of Police and Sheriffs (WACOPS)Washington Council of Police and Sheriffs (WACOPS)

Health & Medical OrganizationsHealth & Medical OrganizationsAmerican Academy of Pediatrics American Academy of Pediatrics –– WA State ChapterWA State ChapterAssociation of Advanced Practice Psychiatric NursesAssociation of Advanced Practice Psychiatric NursesBreast Cancer FundBreast Cancer FundChildrenChildren’’s Alliances AllianceCompassion & Choices of WashingtonCompassion & Choices of WashingtonHome Care Association of WashingtonHome Care Association of WashingtonInstitute for ChildrenInstitute for Children’’s Environmental Healths Environmental HealthInstitute for Institute for NeurotoxicologyNeurotoxicology & Neurological Disorders& Neurological DisordersPlanned Parenthood Public Policy Network of WAPlanned Parenthood Public Policy Network of WASchool Nurse Organization of WashingtonSchool Nurse Organization of WashingtonScience and Management of Addictions (SAMA) Science and Management of Addictions (SAMA)

FoundationFoundationWA Acupuncture and Oriental Medicine AssociationWA Acupuncture and Oriental Medicine AssociationWashington Association for Substance Abuse and Washington Association for Substance Abuse and

Violence PreventionViolence PreventionWashington Chapter of the American College of Washington Chapter of the American College of

Emergency PhysiciansEmergency PhysiciansWashington Poison CenterWashington Poison CenterWashington Private Duty AssociationWashington Private Duty AssociationWashington State Assoc of Local Public Health OfficialsWashington State Assoc of Local Public Health OfficialsWashington State Assoc of Occupational Health NursesWashington State Assoc of Occupational Health NursesWashington State Hospice and Palliative Care Washington State Hospice and Palliative Care

OrganizationOrganizationWashington State Medical AssociationWashington State Medical AssociationWashington State Nurses AssociationWashington State Nurses AssociationWashington State Psychological AssociationWashington State Psychological Association

This issue isnThis issue isn’’t going awayt going away ……Shirley

Producer responsibilityProducer responsibilitywould make a would make a

medicine return program medicine return program possible for the long termpossible for the long term

Next StepsNext Steps

Continue participating in Continue participating in PSIPSI’’ss National Stakeholder National Stakeholder DialogueDialogueDrug manufacturer support?Drug manufacturer support?Continue local conversations Continue local conversations with stakeholderswith stakeholdersBroaden & deepen supportBroaden & deepen supportBill passageBill passage

Additional InformationAdditional InformationAnn Ann PistellPistell, Maine DEP, Maine DEPAnn.E.Pistell@maine.govAnn.E.Pistell@maine.gov

Maine billMaine billhttp://http://www.maine.gov/legiswww.maine.gov/legis// (type in 821 beside (type in 821 beside ““LDLD””))

Cheri Grasso, Local Hazardous Waste Management Cheri Grasso, Local Hazardous Waste Management Program in King CountyProgram in King County

Cheri.grasso@kingcounty.govCheri.grasso@kingcounty.gov

Washington Bill Washington Bill www.leg.wa.govwww.leg.wa.gov (type in 1165 under (type in 1165 under ““bill searchbill search””))