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<div style="direction: ltr;font-family: Tahoma;color: #000000;font-size: 10pt;">Good information, Ed! Our university's HIPAA compliance officers also weren't certain about using even the paint pens as a method for obscuring patient names. I believe there
is language about marker use being inadequate for pill bottles, but it was in the context of pharmacies that clearly DO have a patient/provider relationship. Many pharmacies also were placing bottles that had already been labeled for a specific patient back
into stock (because the patient never picked the med up) and they were leaving the label intact; only to then place the next label on top of the first label. Apparently, people could still read the info and/or could easily peel the top label off and read
the bottom label. With HIPAA, it seems you can never be too certain.<br>
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<div style="font-family:Tahoma; font-size:13px"><font face="Verdana"><i>Jeanie Jaramillo, PharmD</i></font>
<div><font face="Verdana"><i>Managing Director, Texas Panhandle Poison Center</i></font></div>
<div><font face="Verdana"><i>Asst. Professor, Texas Tech UHSC School of Pharmacy</i></font></div>
<div><font face="Verdana"><i>1300 S. Coulter St., Suite 105</i></font></div>
<div><font face="Verdana"><i>Amarillo, TX 79106</i></font></div>
<div><font face="Verdana"><i>(office): (806)414-9299</i></font></div>
<div><font face="Verdana"><i>(mobile): (806)376-0039<br>
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<div id="divRpF183048" style="direction: ltr;"><font face="Tahoma" size="2" color="#000000"><b>From:</b> Ed Gottlieb [EGottlieb@cityofithaca.org]<br>
<b>Sent:</b> Tuesday, August 19, 2014 3:25 PM<br>
<b>To:</b> Lucy, Burke@CalRecycle; 'pharmwaste@lists.dep.state.fl.us'<br>
<b>Subject:</b> [Pharmwaste] RE: Concerns over recycling pill bottles?<br>
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<p class="MsoNormal"><span style="font-size:10.0pt; font-family:Tahoma">Burke,<br>
<br>
I should have added that the EPA document </span></p>
<pre><span style="font-family:Tahoma"><a href="http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20111110/6d8095de/p_listedpharmaceuticalsmemo_ORCR2011-0001.pdf" target="_blank">http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20111110/6d8095de/p_listedpharmaceuticalsmemo_ORCR2011-0001.pdf</a><br>
addresses questions raised by generators.<span style=""> </span><span style="color:black">RCRA exempts household waste.<span style=""> </span>Though not required, rising the containers before recycling seems like a good idea to me.<br><br>I should also have pointed out that folks should only pour their pills from bottles into a bag when they are at the take-back location.<span style=""> </span><br>If someone were pulled over for a traffic violation, it would be hard to explain away a bag full of some controlled substance without the prescription bottle!!<br>
Finally, the nurse who advised us that black markers might not be an acceptable method to remove personal information may have been wrong.<span style=""> <br></span></span>HIPAA Q&A: De-identifying pill bottles <em><span style="font-family:Tahoma">HIM-HIPAA Insider</span></em>, March 26, 2012 http://www.hcpro.com/HIM-278107-866/HIPAA-QA-Deidentifying-pill-bottles.html</span></pre>
<p><b><span style="font-size:10.0pt; font-family:Tahoma">Q. Some of the medications we receive for our assisted living residents are in blister packs. After the pack is emptied, the labels are easily torn off and shredded. However, some medications are received
in a multidose pill bottle. Is using a felt-tip marker an acceptable means to de-identify these labels before placing the bottles in the trash?</span></b><span style="font-size:10.0pt; font-family:Tahoma"></span></p>
<p><b><span style="font-size:10.0pt; font-family:Tahoma">A.</span></b><span style="font-size:10.0pt; font-family:Tahoma"> Yes. Obliterating patient identification (including name and medical record number) with a permanent marker is a good way to protect patient
privacy before disposing of these containers.</span></p>
<p><i><span style="font-size:10.0pt; font-family:Tahoma">Editor’s note: Mary D. Brandt, MBA, RHIA, CHE, CHPS, a nationally recognized expert on patient privacy, information security, and regulatory compliance, answered this question. She is associate executive
director of Health Information Management (HIM) at Scott & White Healthcare in Temple, TX. Some of her publications were used as a basis for the Health Insurance Portability and Accountability Act of 1996 privacy regulations.</span></i><span style="font-size:10.0pt; font-family:Tahoma"></span></p>
<pre><span style="font-family:Tahoma; color:black">Considering the consequences of violations</span><span style="font-family:Tahoma">, the nurse who advised us can be forgiven if her<span style="color:black"> abundance of caution was excessive.<span style=""> </span><span style=""> </span><br>In 2011 Rite Aid agreed to pay $1 Million to settle HIPAA privacy case. Many of their stores disposed of pill bottles, with personal information, in industrial trash bins accessible to the public.<br>
Ed</span></span></pre>
<pre><span lang="en-US"><font face="Calibri,sans-serif" size="2"><span style="font-size:11pt"><font color="black" face="Tahoma,sans-serif" size="2"><span style="font-size:10pt"></span></font></span></font></span> </pre>
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<div id="divRpF963940" style="direction:ltr"><font color="#000000" face="Tahoma" size="2"><b>From:</b> pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Ed Gottlieb [EGottlieb@cityofithaca.org]<br>
<b>Sent:</b> Tuesday, August 19, 2014 3:24 PM<br>
<b>To:</b> Lucy, Burke@CalRecycle; 'pharmwaste@lists.dep.state.fl.us'<br>
<b>Subject:</b> [Pharmwaste] RE: Concerns over recycling pill bottles?<br>
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<div style="direction:ltr; font-family:Tahoma; color:#000000; font-size:10pt">Lucy,<br>
<br>
Yes, this concern came up in my community. <br>
<br>
There is no problem in recycling almost all prescription bottles as is. We strongly recommend that prescription labels be removed. The only recycling issue is for containers that contain a residue of a P-listed hazardous waste medication (primarily warfarin.)
See below for the EPA's take on this, issued in Nov 2011.<br>
<br>
It is fine for folks to mix all their pills in a sealed plastic bag for drop-off. We did ask for pills in their original containers back when we inventoried what was dropped off. Now that the DEA won't let us do that, there is no reason for the bottles to
come to us. Much better to have them recycled by the end user.<br>
<br>
At one event, we had extra volunteers and recycled the majority of the bottles we received, after inventory data was collected. To meet HIPAA requirements, we removed the labels. A nurse told us that using a black marker to obscure personal information might
not meet HIPAA requirements. Doing this was a huge effort, so I recommend getting folks to recycle there own.
<br>
<br>
Here is what the EPA has to say about the packaging for pharmaceuticals that are hazardous waste (P-waste), which account for an extremely small percent of the pharmaceuticals that are dispensed. Note that the concern is strictly with any "residue" left in
the bottle, not with the bottle itself. The bottom line is that even these bottles can be recycled if they are first triple rinsed.<br>
<br>
Regards,<br>
<br>
Ed<br>
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<div id="divRpF708892" style="direction:ltr"><font color="#000000" face="Tahoma" size="2"><b>From:</b> pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Lucy, Burke@CalRecycle [Burke.Lucy@CalRecycle.ca.gov]<br>
<b>Sent:</b> Monday, August 18, 2014 4:06 PM<br>
<b>To:</b> 'pharmwaste@lists.dep.state.fl.us'<br>
<b>Subject:</b> [Pharmwaste] Concerns over recycling pill bottles?<br>
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<p class="MsoNormal">Hi all,</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Has anyone heard of any concerns over recycling pill bottles because of the residue left behind by medications?
</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Otherwise, I’ve only heard of problems because the plastic bottle is typically #5 Polypropylene and the cap is usually not. Combined with any cotton, paper label, or foil residue, it makes recycling pill bottles difficult at least without
separating the cap from the bottle. This article out of Wisconsin is the first I’ve heard of medication residue being any problem: </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><span style="color:#1F497D"><a href="http://lacrossetribune.com/news/local/some-confused-about-new-drug-drop-off-boxes/article_43201f36-a403-524e-b9b9-055e8b410cd9.html" target="_blank">http://lacrossetribune.com/news/local/some-confused-about-new-drug-drop-off-boxes/article_43201f36-a403-524e-b9b9-055e8b410cd9.html</a></span>.
</p>
<p class="MsoNormal"><b><span style="font-size:10.0pt; font-family:"Helvetica","sans-serif"; color:#222222">Some confused about new drug drop-off boxes</span></b></p>
<p class="MsoNormal"><span class="pubdate"><span style="font-size:10.0pt; font-family:"Helvetica","sans-serif"; color:#7D7D7D">August 16, 2014 12:15 am</span></span></p>
<p class="MsoNormal">Crystal Sedevie, “a Holmen police investigator who serves on an area task force relating to prescription drug abuse” said, “Old plastic bill bottles shouldn’t even be recycled…because of the residue left behind by medications.”</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Burke</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Mr. Burke Lucy</p>
<p class="MsoNormal">Environmental Scientist<span style="color:#1F497D"></span></p>
<p class="MsoNormal">Department of Resources Recycling and Recovery (CalRecycle)</p>
<p class="MsoNormal">1001 I Street, PO Box 4025</p>
<p class="MsoNormal">Sacramento, CA 95812</p>
<p class="MsoNormal"><a href="mailto:Burke.Lucy@CalRecycle.ca.gov" target="_blank"><span style="color:blue">Burke.Lucy@CalRecycle.ca.gov</span></a></p>
<p class="MsoNormal">916.341.6592</p>
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