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NAHC Supports Bill to Permit Disposal of Unused Hospice Meds in the Home
Washington, D.C., February 15, 2018:
The National Association for Home Care & Hospice (NAHC) has written a letter to Rep. Tim Walberg (R-MI-7) to support his introduction of H.R. 4051, the Safe Disposal of Unused Medication Act, legislation to permit safe disposal of unused hospice medication in the home by qualified personnel.
Reps. Debbie Dingell (D-MI-12) and Richard Hudson (R-NC-8) joined Rep. Walberg in co-sponsoring the legislation.
Under hospice, a high proportion of patients are dispensed medications to address terminal, intractable pain. Most of these drugs are classified as controlled substances, and heavily regulated by the federal government. With some frequency residual medications that will not be used by the hospice patient remain in the home. This can happen under a number of circumstances, including when a patient expires or when the hospice initiates medication changes. It is widely recognized that misuse of controlled substances is a growing public health emergency.
In recent years, and particularly since late 2014 when the Drug Enforcement Administration (DEA) finalized regulations implementing the Secure and Responsible Drug Disposal Act of 2010, many questions have arisen regarding the appropriate role of hospice professionals relative to destruction of controlled substances in patient’s homes. Under current law, unless a state or locality has enacted legislation that otherwise allows hospices to dispose of unused medications, hospice staff are not legally permitted to handle or destroy such medications in the home. As a result, it is frequently the case that hospice home visiting staff must leave dangerous medications with a high risk for diversion in the home environment.
Out of concern that existing regulations limit hospices’ ability to participate in the destruction of controlled substances that might be at risk for diversion and misuse, Rep. Walberg’s legislation will allow qualified hospices to authorize licensed employees to handle controlled substances in the residence of deceased hospice patients in order to assist in disposal of those medications. NAHC and the National Hospice and Palliative Care Organization (NHPCO) have provided technical support to Rep. Walberg in this effort.
As part of the legislation qualifying hospice programs must have written policies and procedures for assisting in the disposal of the controlled substances and (consistent with existing hospice conditions of participation) must share a copy of the hospice’s policies for disposal and discuss them with the patient at the time the medication is dispensed.
“Many patients receiving hospice care need painkillers to help with end-of-life pain, but any leftover medication can unfortunately end up in the wrong hands,” said Congressman Walberg. “Our bill equips hospices and caregivers with the right to destroy unused meds after a hospice patient passes away, helping to ensure that it is not diverted out into the community.”
The House Energy & Commerce Committee (of which Rep. Walberg is a member) is scheduled to begin a series of hearings on the opioid crisis in late February, and as part of that series plans to address a wide array of issues, including proper disposal. NAHC has endorsed the legislation and expects to continue to work with Rep. Walberg and other members of the Energy & Commerce Committee to refine the bill. Please watch NAHC Report for reporting on additional developments in this area.
About: The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nations 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more about NAHC, visit www.nahc.org.