[Congressional Record Volume 164, Number 97 (Tuesday, June 12, 2018)]
[House]
[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.
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