<HTML >
<HEAD>
<META http-equiv="Content-Type" content="text/html; charset=us-ascii">







<meta name=Generator content="Microsoft Word 12 (filtered medium)">
<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]-->
<style>
<!--
 /* Font Definitions */
 @font-face
        {font-family:Calibri;
        panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
        {font-family:Tahoma;
        panose-1:2 11 6 4 3 5 4 4 2 4;}
 /* Style Definitions */
 p.MsoNormal, li.MsoNormal, div.MsoNormal
        {margin:0in;
        margin-bottom:.0001pt;
        font-size:12.0pt;
        font-family:"Times New Roman","serif";}
a:link, span.MsoHyperlink
        {mso-style-priority:99;
        color:blue;
        text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
        {mso-style-priority:99;
        color:purple;
        text-decoration:underline;}
span.EmailStyle17
        {mso-style-type:personal-reply;
        font-family:"Times New Roman","serif";
        color:#1F497D;}
.MsoChpDefault
        {mso-style-type:export-only;
        font-size:10.0pt;}
@page Section1
        {size:8.5in 11.0in;
        margin:1.0in 1.0in 1.0in 1.0in;}
div.Section1
        {page:Section1;}
-->
</style>
<!--[if gte mso 9]><xml>
 <o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
 <o:shapelayout v:ext="edit">
  <o:idmap v:ext="edit" data="1" />
 </o:shapelayout></xml><![endif]-->
</HEAD>
<BODY lang=EN-US link=blue vlink=purple>
<DIV>
<DIV>

<div class=Section1>

<p class=MsoNormal><span style='font-size:11.0pt;color:#1F497D'><o:p>&nbsp;</o:p></span></p>

<p class=MsoNormal><span style='font-size:11.0pt;color:#1F497D'><o:p>&nbsp;</o:p></span></p>

</div></DIV>
<DIV><BR><BR></DIV>
<DIV STYLE="FONT-SIZE: 9pt; FONT-FAMILY: Courier New"><EM><FONT FACE="Arial" SIZE="2">The Department of Environmental 

Protection values your feedback as a customer. DEP Secretary Michael W. Sole is committed to continuously assessing and 

improving the level and quality of services provided to you. Please take a few minutes to comment on the quality of 

service you received. <eXclaimer:HTML_ONLY>Simply click on <A TARGET="_blank" HREF="http://survey.dep.state.fl.us/?refemail=Laurie.Tenace@dep.state.fl.us">this link to the DEP Customer 

Survey</A>.</eXclaimer:HTML_ONLY> Thank you in advance for completing the survey.</FONT></EM></DIV>
<DIV STYLE="FONT-SIZE: 9pt; FONT-FAMILY: Courier New"><EM><FONT FACE="Arial" SIZE="2">
</FONT></EM> </DIV>
<DIV STYLE="FONT-SIZE: 9pt; FONT-FAMILY: Courier New"><div class=Section1><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>

<p class=MsoNormal style='margin-left:.5in'><b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'> mcmireles@communityofcompetence.com
[mailto:mcmireles@communityofcompetence.com] <br>
<b>Sent:</b> Monday, June 22, 2009 4:22 PM<br>
<b>To:</b> VeoraLittle@aol.com; MMccarro@dtsc.ca.gov;
wamore@gw.dec.state.ny.us; pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> Re: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12<o:p></o:p></span></p>

</div>

<p class=MsoNormal style='margin-left:.5in'><o:p>&nbsp;</o:p></p>

<p class=MsoNormal style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom:
12.0pt;margin-left:.5in'><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>We
conduct the Annual Survey of non-institutional drug take-back programs and
publish the National Directory of Drug Take-Back and Disposal Programs.&nbsp;
We have been in contact with 80 such programs organized by community
coalitions.&nbsp; Our Survey has provided some valuable &quot;baseline
info&quot; that we wish to measure over time.&nbsp; <br>
<br>
We don't survey healthcare instititions because most are involved with
commerical reverse distributors for disposal of unused and expired meds
(UEMs).&nbsp; You may be able to get some info from the companies.&nbsp;
However, I don't believe you can obtain a total picture of all the institutions
because of the number of vendors involved.&nbsp; No federal agency is
collecting this info.<br>
<br>
However, we set up the National UEM Registry in 2004 and have been receiving,
coding, and analyzing a large volume of UEM data shared by several drug
take-back programs.&nbsp; They mainly submit the data to us for
evaluation.&nbsp; We enter all the info into the Registry for national
comparison.&nbsp; We are seeing several best practices and are offering a handy
Manual of Procedures to assist any group in organizing a drug take-back
program.&nbsp; <br>
<br>
If anyone wants a copy of these publications, please contact me directly.<br>
<br>
<br>
Matthew C. Mireles, PhD, MPH<br>
President and CEO<br>
Community Medical Foundation for Patient Safety<br>
6300 West Loop South, Suite 288<br>
Bellaire, TX 78401<br>
832-778-7777<br>
<a href="http://www.communityofcompetence.com">www.communityofcompetence.com</a></span><span
style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><o:p></o:p></span></p>

<div class=MsoNormal align=center style='margin-left:.5in;text-align:center'><span
style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>

<hr size=2 width="100%" align=center>

</span></div>

<p class=MsoNormal style='margin-left:.5in'><b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'>From</span></b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'>: VeoraLittle@aol.com<br>
<b>Sent</b>: Monday, June 22, 2009 11:53 AM<br>
<b>To</b>: MMccarro@dtsc.ca.gov, wamore@gw.dec.state.ny.us,
pharmwaste@lists.dep.state.fl.us<br>
<b>Subject</b>: Re: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif"'><br>
<br>
<br>
<span style='color:black'><o:p></o:p></span></span></p>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>Consider this program, Operation
Medicine Cabinet, A pharmaceutical take-back program.&nbsp; This program
utilizes many community partners including Waste Management, Law enforcement
and coalitions for drug free spaces.<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>is a community event that Collier
County Sheriff's Office and Drugfreecollier have been doing for many
years.&nbsp; We have worked with Collier County Solid Waste Management (Danette
Huff and Beth Ryan) for several years.&nbsp; They have <o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>We know that it is illegal to collect
controlled substances without Law enforcement present.&nbsp; We know that not
only our environment but our youth and seniors (overdose, errors, abuse,
selling) are in danger.&nbsp;&nbsp; Attached is a wonderful program we
can&nbsp;&nbsp;start in all communities to bring education and the beginnings
of a solution.&nbsp; <o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>Veora Little,CRNA &nbsp;
239-649-4202&nbsp; <a href="mailto:veoralittle@gmail.com">veoralittle@gmail.com</a>&nbsp;&nbsp;
a volunteer with <a href="http://www.drugfreecollier.org">www.drugfreecollier.org</a>
<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>In a message dated 6/22/2009
11:32:16 A.M. Central Daylight Time, MMccarro@dtsc.ca.gov writes:<o:p></o:p></span></p>

</div>

<blockquote style='border:none;border-left:solid blue 1.5pt;padding:0in 0in 0in 4.0pt;
margin-left:3.75pt;margin-top:5.0pt;margin-bottom:5.0pt'>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>This would seem to call for a
&quot;baseline assessment&quot; of the industry's handling practices, so that
we can look at &quot;take back&quot; efforts with more informed vision.<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>I would add that we&nbsp;would
need&nbsp;the same assessment for:<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-long term care facilities<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-Skilled nursing/rehabilitation
facilities<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-mental heath facilities<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-Medical Clinics <o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-retirement complexes with
medial clinics<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-veterinary hospital/kennels<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>-veterinary services for
agricultural purposes -livestock/ feed lot/dairy<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>There may be others.<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Matt McCarron<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Pollution Prevention/Green
Business<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>CA Dept. of Toxic Substances
Control<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>700 Heinz Ave. Suite 300&nbsp;
MS R2 - 2-3<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Berkeley, CA 94710<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>510-540-3828<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Sustaining our resources
sustains our future generations<o:p></o:p></span></p>

</div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'><br>
<br>
&gt;&gt;&gt; &quot;William More&quot; &lt;wamore@gw.dec.state.ny.us&gt;
6/22/2009 7:57 AM &gt;&gt;&gt;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>So what <u>is</u> the present
compliance rate with our Hospitals Pharmacies with the RCRA - Hazardous waste
regulations? <o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>How are they achieving Hazardous
Waste Determinations? How do they segregate wastes, and when?<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>How many have a program that
know where the stuff that the reverse distributors don't want to take go?&nbsp;
What happens to the waste - contaminated packaging - that comes from dispensing
drugs that&nbsp;can be&nbsp;a &quot;P&quot; waste?&nbsp; Do the reverse
distributors(RDs) tell the hospitals about these materials? Do they, the RDs,
take these back?<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Does that make them a
TSDF?&nbsp; Are they manifested? &nbsp;What mechanisms are the Hospital Pharmacies
using to recover these materials from the patient floors?<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>What are the RDs doing with
those materials that are never credited? The partials that can't be reused
because that are not factory sealed?&nbsp; Those materials that are <u>so</u>
far out of date?&nbsp; The RDs know what they are. Do they pick them up anyway.
Does that make them a TSDF? Are they manifested?<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>Have all of the Hospital
Pharmacies had their Formulary,(likely stocked Drugs), reviewed as to which
ones can be a Hazardous Waste when unusable ,unreturnable, un credited, when a
waste. Have they looked for characteristic Hazardous Waste? Mercury compounds
that may be used as a preservative? Metals in vitamins or dietary supplements?
Alcohol or CFCs in inhalers?<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>What are we seeing when we look
at these questions???????<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'>&nbsp;<o:p></o:p></span></p>

</div>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif";color:black'><br>
<br>
---<br>
Note: As a courtesy to other listserv subscribers, please post messages to the
listserv in plain text format to avoid the garbling of messages received by
digest recipients.<br>
---<br>
TO SUBSCRIBE, go to:&nbsp;&nbsp; http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste
<br>
TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to
pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of
the e-mail should be blank.<br>
If you believe you may be subscribed with a different email address, please
visit the subscriber listing at
http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste <br>
FOR PROBLEMS:&nbsp; Contact List Administrator Laurie.Tenace@dep.state.fl.us <br>
SEND MAIL to the list server at:&nbsp; pharmwaste@lists.dep.state.fl.us</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>

</blockquote>

</div>

<div id=4bcc0a0db4d5bffb8919fa63a9260325>

<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p>&nbsp;</o:p></span></p>

<div class=MsoNormal align=center style='mso-margin-top-alt:7.5pt;margin-right:
0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;text-align:center'><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'>

<hr size=2 width="100%" align=center>

</span></div>

<p class=MsoNormal style='mso-margin-top-alt:7.5pt;margin-right:0in;margin-bottom:
0in;margin-left:.5in;margin-bottom:.0001pt'><b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>An Excellent Credit Score is 750.
<a
href="http://pr.atwola.com/promoclk/100126575x1221823273x1201398689/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=JuneExcfooterNO62">See
Yours in Just 2 Easy Steps!</a></span></b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif"'><o:p></o:p></span></p>

</div>

<p class=MsoNormal style='mso-margin-top-alt:7.5pt;margin-right:0in;margin-bottom:
0in;margin-left:.5in;margin-bottom:.0001pt'><o:p>&nbsp;</o:p></p>

</div>

</DIV>
</DIV></BODY></HTML>