SAFE DISPOSAL OF UNUSED MEDICATION ACT; Congressional Record Vol. 164, No. 97
(House of Representatives - June 12, 2018)

Text available as:

Formatting necessary for an accurate reading of this text may be shown by tags (e.g., <DELETED> or <BOLD>) or may be missing from this TXT display. For complete and accurate display of this text, see the PDF.


[Pages H5043-H5045]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 SAFE DISPOSAL OF UNUSED MEDICATION ACT

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 5041) to amend the Controlled Substances Act to authorize 
the employees of a hospice program to handle controlled substances in 
the residence of a deceased hospice patient to assist in disposal, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5041

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Safe Disposal of Unused 
     Medication Act''.

     SEC. 2. DISPOSAL OF CONTROLLED SUBSTANCES OF A DECEASED 
                   HOSPICE PATIENT BY EMPLOYEES OF A QUALIFIED 
                   HOSPICE PROGRAM.

       Subsection (g) of section 302 of the Controlled Substances 
     Act (21 U.S.C. 822) is amended by adding at the end the 
     following:
       ``(5)(A) In the case of a person receiving hospice care, an 
     employee of a qualified hospice program, acting within the 
     scope of employment, may handle, without being registered 
     under this section, any controlled substance that was 
     lawfully dispensed to the person receiving hospice care, for 
     the purpose of disposal of the controlled substance after the 
     death of such person, so long as such disposal occurs onsite 
     in accordance with all applicable Federal, State, Tribal, and 
     local law.
       ``(B) For the purposes of this paragraph:
       ``(i) The terms `hospice care' and `hospice program' have 
     the meanings given to those terms in section 1861(dd) of the 
     Social Security Act.
       ``(ii) The term `employee of a qualified hospice program' 
     means a physician, nurse, or other person who--
       ``(I) is employed by, or pursuant to arrangements made by, 
     a qualified hospice program;
       ``(II)(aa) is licensed to perform medical or nursing 
     services by the jurisdiction in which the person receiving 
     hospice care was located; and
       ``(bb) is acting within the scope of such employment in 
     accordance with applicable State law; and
       ``(III) has completed training through the qualified 
     hospice program regarding the disposal of controlled 
     substances in a secure and responsible manner so as to 
     discourage abuse, misuse, or diversion.
       ``(iii) The term `qualified hospice program' means a 
     hospice program that--
       ``(I) has written policies and procedures for assisting in 
     the disposal of the controlled substances of a person 
     receiving hospice care after the person's death;
       ``(II) at the time when the controlled substances are first 
     ordered--
       ``(aa) provides a copy of the written policies and 
     procedures to the patient or patient representative and 
     family;
       ``(bb) discusses the policies and procedures with the 
     patient or representative and the family in a language and 
     manner that they understand to ensure that these parties are 
     educated regarding the safe disposal of controlled 
     substances; and
       ``(cc) documents in the patient's clinical record that the 
     written policies and procedures were provided and discussed; 
     and
       ``(III) at the time following the disposal of the 
     controlled substances--
       ``(aa) documents in the patient's clinical record the type 
     of controlled substance, dosage, route of administration, and 
     quantity so disposed; and
       ``(bb) the time, date, and manner in which that disposal 
     occurred.''.


[[Page H5044]]


  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, one of the best ways we can fight the opioid crisis is 
by decreasing diversion of prescription drugs. This bill does just 
that, giving hospice employees new tools to dispose of unused 
medications on-site after a patient's death.
  During the committee process, several thoughtful amendments were 
offered to perfect this language. For example, one clarified that the 
training will be conducted by the hospice program, not the Federal 
Government.
  Another added a recordkeeping standard for hospice programs to 
maintain information within patients' clinical charts of the controlled 
substance dosage, number of pills, and the way it is disposed of.
  And finally, a technical amendment incorporated comments from the 
DEA.
  Of note, there is one final technical correction incorporated into 
the suspension document, which clarifies that hospice employees may 
handle these unused controlled substances. This specification, 
obviously, improves the bill.
  In closing, Michigan Representative Tim Walberg and Representative 
Debbie Dingell should be commended for, once again, their bipartisan 
and thoughtful work on this legislation. They worked tirelessly to 
forge an inclusive process, incorporating input from people in 
Michigan, hospice groups across the country, the agencies who will 
oversee this program, and others. Even more, their staff showed real 
initiative and reason as we put this together.
  Mr. Speaker, I yield 3 minutes to the gentleman from Michigan (Mr. 
Walberg), my colleague, to discuss this legislation.
  Mr. WALBERG. Mr. Speaker, I thank the chairman for yielding.
  Mr. Speaker, H.R. 5041, the Safe Disposal of Unused Medication Act is 
a bipartisan, commonsense bill that simply allows trained hospice 
personnel to dispose of unused medications in a patient's home once the 
patient has passed away.
  For patients in hospice care, opioid medication can be effective in 
alleviating pain associated with the end-of-life care. Unfortunately, 
current DEA regulations restrict visiting home hospice personnel from 
disposing of leftover medication after the patient has passed away. As 
a result, hospice staff must leave behind dangerous medications that 
have a high risk for diversion or misuse.
  In my home State of Michigan, we have seen some real challenges with 
the diversion and misuse of leftover medications that have contributed 
to the opioid crisis.
  Earlier this year, the Energy and Commerce Committee heard testimony 
that just one hospice, caring for 2,000 patients per year, might be 
leaving behind tens of thousands of pills in need of disposal each 
year. According to the Centers for Medicare and Medicaid Services, 1.4 
million Medicare beneficiaries were enrolled in hospice care in 2016. 
This means hospice workers across the country are potentially leaving 
huge quantities of unused medication in a home after a patient's death.
  Mr. Speaker, we must act to curb the diversion of these powerful 
prescriptions. We know that, tragically, many people begin the cycle of 
addiction through the misuse of prescription medication. Hospices and 
hospice personnel could play a key role in stopping that cycle before 
it begins by ensuring powerful drugs are disposed of in a responsible 
manner once they are no longer needed by the intended patient.
  Mr. Speaker, I thank the chairman and the committee staff for all of 
their hard work in getting this commonsense bill on the floor today, as 
well as my good friends Representative Debbie Dingell, who worked 
closely with me on this legislation, and Representative Richard Hudson, 
as well, for their support on this important legislation.
  Mr. Speaker, again, I urge my colleagues to support H.R. 5041.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 5041, legislation offered by 
Representative Walberg, Representative Dingell, and Representative 
Hudson, that will allow hospice workers to safely dispose of controlled 
substances, thereby reducing the number of unused controlled substances 
that are at risk of diversion or misuse.
  Mr. Speaker, I rise in support of H.R. 5041, legislation offered by 
Representatives Walberg, Dingell, and Hudson that will allow hospice 
workers to safely dispose of controlled substances, thereby reducing 
the number of unused controlled substances that are at risk of 
diversion or misuse.
  The diversion of unused prescription opioids is one of the major 
contributors to the opioid crisis facing our country. It has been 
estimated that around 70 percent of those who abuse opioids receive 
them from a friend or family, making it critical that strategies be put 
in place that will limit the ability for leftover controlled substances 
to fall into the wrong hands.
  Current regulations prevent hospice personnel from handling or 
destroying controlled substances following a patient's passing unless a 
state or locality allows them to do so under law. As a result, hospice 
workers have no choice but to leave behind controlled substances that 
may be at risk for abuse or misuse by those who were never intended to 
have access to such medications. H.R. 5041 would clarify that hospice 
workers would have the authority to handle controlled substances for 
purposes of disposal following a patient's passing.
  H.R. 5041 also makes clear that hospice workers tasked with disposing 
of unneeded controlled substances receive training through a qualified 
hospice program on how to properly dispose of these substances to 
ensure they cannot be extracted for purposes of further abuse. In 
addition, the legislation would also require hospice personnel to keep 
records on the disposal of the controlled substance, including what 
controlled substances were destroyed, as well as the time and manner in 
which the disposal occurred.
  I want to thank the sponsors of H.R. 5041, Representatives Walberg, 
Dingell, and Hudson for their work on this legislation, as well as the 
National Association for Home Care & Hospice and the National Hospice 
and Palliative Care Organization for their support and thoughtful 
input.
  Mr. Speaker, I urge Members to support this commonsense legislation, 
and I reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I have no other speakers on this matter, and 
I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Michigan (Mrs. Dingell).
  Mrs. DINGELL. Mr. Speaker, I thank Ranking Member Pallone for 
yielding.
  Mr. Speaker, it is a good bipartisan day for Michigan right now. It 
shows you that when we want to work together, we can and do and are 
going to make a difference.
  Mr. Speaker, I rise in support of H.R. 5041, the Safe Disposal of 
Unused Medication Act, which I am proud to sponsor with my colleague 
from Michigan (Mr. Walberg). I thank him for all of his good, hard work 
on this issue as we have learned together about things that are 
happening.
  Hospices perform an essential role in our healthcare system and we 
need to make every effort to support hospice employees, who do 
incredible work providing care and comfort in those final days of life. 
We need to make their jobs as easy as possible.
  We also need to make sure that we are doing everything we can to stop 
opportunities for the diversion of opioids. This is essential if we are 
going to make a real impact in ending this epidemic, which is so 
devastating to families in every corner of our country.
  This is an important bill, which achieves both goals of supporting 
hospices and stopping opportunities for diversion. The Safe Disposal of 
Unused Medication Act closes a critical gap in our laws that prohibits 
hospice employees from disposing of unused opioids after a patient has, 
unfortunately, passed away.
  Right now, the way the law is, if a patient dies in hospice care and 
they

[[Page H5045]]

have a large vial of unused opioids, the family cannot get any help 
from the hospice staff to dispose of them. For the family, these are 
very difficult moments. They have just lost a loved one and they don't 
need any additional problems, like trying to figure out how to dispose 
of the unneeded opioids.
  This bill amends the Controlled Substances Act to permit hospice 
employees to handle controlled substances in a patient's residence in 
order to assist in drug disposal upon a patient's death. This 
commonsense fix is a win for patients and their families, a win for 
hospice employees, and a win for public health efforts to crack down on 
this diversion.
  If we continue to improve our efforts to dispose of unused opioids, 
like what we are doing in this legislation, then we will continue to 
ensure there are fewer opportunities for those pills to end up in the 
hands of those who abuse them. By passing this legislation, we can 
provide for the safe destruction of thousands, literally hundreds of 
thousands, of unused opioids that might end up otherwise on the street 
and feed the addiction of too many.
  I am pleased, as has been noted, that it has the support of both the 
National Association for Home Care and Hospice, as well as the National 
Hospice and Palliative Care Organization.
  Mr. Speaker, in closing, I, again, thank my friend and colleague, Mr. 
Walberg, for his bipartisan work on this bill and other opioid issues, 
and I urge all Members to vote in favor of H.R. 5041.
  Mr. WALDEN. Mr. Speaker, I have no other speakers on this matter. I 
urge my colleagues to support this legislation, and I yield back the 
balance of my time.

                              {time}  1545

  Mr. PALLONE. Mr. Speaker, I also urge my colleagues to support the 
bill, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Oregon (Mr. Walden) that the House suspend the rules and 
pass the bill, H.R. 5041, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. WALDEN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________