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<p class="MsoNormal"><span style="color:#1F497D">Today’s press coverage on the California Board of Pharmacy hearing Thursday on the draft regulations for medicine take-back with quotes from Karin North in Palo Alto, Adam Link with the California Association
of Sanitation Agencies (CASA), and me. The article also covers the situation where the feds are giving mixed messages on meds disposal (FDA says flush some, EPA say not to flush).<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><br>
Heidi<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">********************************************************************</span><span style="color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><b><span style="color:#1F497D">Heidi Sanborn, Executive Director
<br>
</span></b><span style="color:#1F497D">(916) 706-3420 office (916) 402-3911 cell
<a href="mailto:Heidi@CalPSC.org"><span style="color:#0F26CF">Heidi@CalPSC.org</span></a> <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:12.0pt"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black"><img border="0" width="250" height="86" id="Picture_x0020_1" src="cid:image005.jpg@01D11570.991F2290" alt="cpsc_logo_350_pix">
<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:12.0pt"><a href="http://www.calpsc.org/"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black;text-decoration:none"><img border="0" width="18" height="18" id="Picture_x0020_3" src="cid:image007.jpg@01D11570.98384500" alt="cid:image001.png@01CC57C5.8223CD60"></span></a><span style="color:#1F497D"><a href="http://www.calpsc.org/"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:blue">Web</span></a></span><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black">
</span><a href="http://www.youtube.com/calpsc"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black;text-decoration:none"><img border="0" width="18" height="18" id="Picture_x0020_4" src="cid:image008.jpg@01D11570.98384500" alt="cid:image002.png@01CC57C5.8223CD60"></span></a><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black"> </span><span style="color:#1F497D"><a href="http://www.youtube.com/calpsc"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:blue">YouTube</span></a></span><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black">
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</span><a href="http://linkedin.com/companies/275758/california+product+stewardship+council"><span style="font-size:10.0pt;color:#404040;text-decoration:none"><img border="0" width="17" height="17" id="Picture_x0020_7" src="cid:image011.jpg@01D11570.98384500" alt="cid:image013.png@01CC47A7.7F3D5C20"></span></a><span style="font-size:10.0pt;color:#404040"> </span><span style="color:#1F497D"><a href="http://linkedin.com/companies/275758/california+product+stewardship+council"><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:blue">Linked
In</span></a></span><span style="font-size:8.0pt;font-family:"Verdana",sans-serif;color:black"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:12.0pt"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">********************************************************************</span><span style="color:#1F497D"><o:p></o:p></span></p>
<div>
<div style="border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b>From:</b> Christopher Lester <br>
<b>Sent:</b> Monday, November 02, 2015 1:11 PM<br>
<b>To:</b> Heidi Sanborn <<a href="mailto:Heidi@calpsc.org">Heidi@calpsc.org</a>><br>
<b>Subject:</b> CA Healthline article - Local Drug Take-Back Programs Could Be Pre-Empted by State Regulations<o:p></o:p></p>
</div>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><a href="http://www.californiahealthline.org/"><span style="color:windowtext;text-decoration:none"><img border="0" width="422" height="53" id="image1.png" src="cid:image001.png@01D1156F.C0D1C0A0"></span></a><o:p></o:p></p>
<h1 style="mso-margin-top-alt:12.75pt;margin-right:0in;margin-bottom:12.0pt;margin-left:0in;line-height:18.75pt">
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</v:shapetype><v:shape id="Picture_x0020_8" o:spid="_x0000_s1026" type="#_x0000_t75" alt="http://www.californiahealthline.org/~/media/Images/General/Shutterstock%20Partnership%20Images/Pharmacy%20and%20Rxs/PillBottle.ashx" style='position:absolute;margin-left:356.2pt;margin-top:92.65pt;width:140.25pt;height:140.25pt;z-index:251659264;visibility:visible;mso-wrap-style:square;mso-width-percent:0;mso-height-percent:0;mso-wrap-distance-left:9pt;mso-wrap-distance-top:0;mso-wrap-distance-right:9pt;mso-wrap-distance-bottom:0;mso-position-horizontal:right;mso-position-horizontal-relative:text;mso-position-vertical:absolute;mso-position-vertical-relative:text;mso-width-percent:0;mso-height-percent:0;mso-width-relative:page;mso-height-relative:page'>
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</v:shape><![endif]--><![if !vml]><img width="187" height="187" src="cid:image002.jpg@01D1156F.C0D1C0A0" align="right" hspace="12" alt="http://www.californiahealthline.org/~/media/Images/General/Shutterstock%20Partnership%20Images/Pharmacy%20and%20Rxs/PillBottle.ashx" v:shapes="Picture_x0020_8"><![endif]><span style="font-size:19.0pt;color:#6D1618;font-weight:normal">Local
Drug Take-Back Programs Could Be Pre-Empted by State Regulations<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-right:32.0pt"><span class="blockheaderauthor"><i><span style="font-size:10.0pt">by George Lauer, California Healthline Features Editor</span></i></span><span class="blockheaderauthor"><i><span style="font-size:9.0pt"><br>
</span></i></span>Monday, November 2, 2015<span style="font-size:12.0pt"><o:p></o:p></span></p>
<p style="mso-margin-top-alt:0in;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333"><o:p> </o:p></span></p>
<p style="mso-margin-top-alt:0in;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">A patchwork system for getting rid of old drugs is being sewn together in California, but questionable seams and weak spots in the fabric are gumming up the works.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:0in;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<!--[if gte vml 1]><v:shape id="_x0000_s1027" type="#_x0000_t75" alt="Image from Shutterstock" style='position:absolute;margin-left:893.65pt;margin-top:35.8pt;width:130.45pt;height:22.25pt;z-index:251661312;visibility:visible;mso-width-percent:0;mso-height-percent:200;mso-wrap-distance-left:9pt;mso-wrap-distance-top:3.6pt;mso-wrap-distance-right:9pt;mso-wrap-distance-bottom:3.6pt;mso-position-horizontal:absolute;mso-position-horizontal-relative:text;mso-position-vertical:absolute;mso-position-vertical-relative:page;mso-width-percent:0;mso-height-percent:200;mso-width-relative:margin;mso-height-relative:margin'>
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</v:shape><![endif]--><![if !vml]><span style="mso-ignore:vglayout;position:absolute;z-index:251661312;margin-left:1192px;margin-top:48px;width:174px;height:30px"><img width="174" height="30" src="cid:image004.png@01D11570.F3B01A20" alt="Image from Shutterstock" v:shapes="_x0000_s1027"></span><![endif]><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">In
the absence of state or federal systems for proper disposal of prescription drugs, cities and counties in California are creating their own. But some local regulations may come up against new state rules being hammered out now.</span>
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333"><o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Last week the California State Board of Pharmacy </span><a href="http://www.californiahealthline.org/~/media/Files/2015/PDFs/Proposed%20TakeBack%20Regs.ashx" target="_blank"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#6D1618">approved
a draft plan</span></a><span class="apple-converted-space"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333"> </span></span><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">for statewide drug take-back that
calls on pharmacies to voluntarily participate in the program. That approach is at odds with city and county ordinances already passed that require pharmacies to participate.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">At last week's meeting, Amy Gutierrez, president of the Board of Pharmacy, asked:<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"What happens if ordinances say required and our guidelines say voluntary? Who wins out?"<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">After several seconds of silence, Supervising Deputy Attorney General Joshua Room said board members would "set the policy that you want and then we'll figure out how the counties will
respond."<br>
<br>
"These are not questions that have clear answers," Room said. "The state has the authority to pre-empt. It can prevent local agencies from making something mandatory. But it's less clear in this instance in the absence of statute."<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">During almost two hours of public comment representatives from the California Pharmacists Association and California Retailers Association argued in favor of making participation in
the take-back program voluntary and representatives from cities and counties argued that the state should avoid the issue and let local governments shape their own programs.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">The 13-member board voted to retain the voluntary language and called for a 45-day comment period.<o:p></o:p></span></p>
<h3 style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-family:"Arial",sans-serif;color:#333333"><br>
City, County Programs Multiplying<o:p></o:p></span></h3>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Several cities and counties in California have created local drug take-back programs, a few of which require pharmacies to participate. Sacramento, Galt, cities in Tulare County and
all of San Luis Obispo County mandate that pharmacies participate. Programs in San Francisco, Alameda, Marin, Contra Cost and other counties do not.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">More cities and counties are exploring possibilities of creating their own systems, but the formulation of statewide guidelines from the Board of Pharmacy may put things on hold in
some areas, advocates said.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"This might spur more people to get involved," said Heidi Sanborn, executive director of the California Product Stewardship Council. "If you're not at the table, you're going to be
on the menu," Sanborn said. <o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"I've never suggested that local rules were the best way to go about this, but nobody else is doing anything," Sanborn said.<o:p></o:p></span></p>
<h3 style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-family:"Arial",sans-serif;color:#333333">More Health Care Participation Sought<o:p></o:p></span></h3>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Sanborn, in comments before the Board of Pharmacy last week, said disposing of prescription drugs was a health care problem and needed more attention form the health care industry.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"I've been a little bit stunned by the health care industry's lack of participation in this. We're trying to solve a health care problem. Why isn't the health care industry leading
the charge?"<o:p></o:p></span></p>
<h3 style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-family:"Arial",sans-serif;color:#333333">'There Needs To Be a State Law'<o:p></o:p></span></h3>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Last year, state Sen. Hannah-Beth Jackson (D-Santa Barbara) introduced a bill in the California Legislature to require drug manufacturers to create, finance and manage a statewide system
for collecting and disposing of unwanted drugs. SB 1014, opposed by the Pharmaceutical Research and Manufacturers of America, did not get much traction and died in committee. Jackson did not reintroduce the bill this session, but the idea of a statewide take-back
program is not dead, advocates say.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"There needs to be a state law," said Karin North, watershed protection program manager for the city of Palo Alto.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"I've been working on this issue since 2001. It's good to see that it's getting a little more widespread recognition but there's still a lot of confusion. We are really behind in this
compared to other parts of the world and we're trying to catch up."<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Local and regional programs will continue to operate and more will be formed, North said, adding, "When it seems like the time is right again, we might see another attempt to create
a statewide system."<o:p></o:p></span></p>
<h3 style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-family:"Arial",sans-serif;color:#333333">National Confusion as Well<o:p></o:p></span></h3>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">California isn't alone in grappling with the problem of properly disposing of prescription drugs. Federal agencies take different approaches to the problem, adding to the confusion,
according to advocates.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">FDA issued new guidelines last month that urged consumers to flush some drugs down the toilet, a practice the Environmental Protection Agency and most advocates say is never a good
idea.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"We never recommend that things go down the drain, but I somewhat understand why the FDA came out with those guidelines for specific drugs because we don't have a great structure for
take-back," said Adam Link, director of government affairs for the California Association of Sanitation Agencies.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"We have specific days where consumers can bring in unwanted drugs, but usually there are only a couple a year and that just doesn't cut it a lot of the time," Link said.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"Now that we're seeing this patchwork of ordinances form around the state, maybe we'll see more action toward state legislation for a comprehensive system," Link said.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">Nobody in California predicts imminent movement toward a national system.<o:p></o:p></span></p>
<p style="mso-margin-top-alt:15.0pt;margin-right:32.0pt;margin-bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:15.0pt">
<span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#333333">"I wouldn't expect strong federal action on this anytime soon," Link said.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-right:32.0pt"><span style="font-size:12.0pt;font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
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<p class="MsoNormal"><a href="http://www.californiahealthline.org/insight/2015/local-drug-takeback-programs-could-be-preempted-by-state-regulations">http://www.californiahealthline.org/insight/2015/local-drug-takeback-programs-could-be-preempted-by-state-regulations</a><span style="font-size:8.5pt;font-family:"Times New Roman",serif"><o:p></o:p></span></p>
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