1. La Crosse County Medication Collection Program Jeff Gloyd Special Waste Manager La Crosse County Hazardous Materials Program

2. La Crosse County Medication Collection Program Program Goal: Develop a priority strategy for managing the disposal of expired, discontinued and unnecessary medications for La Crosse County residents, area residents, and qualifying area businesses.

3. La Crosse County Medication Collection Program History: 4/2003: Cty discussions to build HHW facility 11/2003: HHW Facility opens: Paint, Aerosols, Pesticides, Automotive Fuels, Acids, Base 2004: NAHMMA “Best in Program” Award 10/2004: Mobile Collection begins in La Crosse Cty 5/2005: Program expands to other counties. 6/2006: Program expands: E-Waste/Sharps 1/2007: Regional expansion (#5 counties) 6/2007: Medication “Take Back” Program begins. 2008 Operational Plan: RX Collection to #10 Counties. Expanded Hours. Future: Access: Mail Order and/or Kiosks

4. La Crosse County Medication Collection Program The Problem: Years of indiscriminate disposal through water and landfill systems. Water filtration systems can not detect or filter. Medications found in streams and lakes. Probable environmental impact. Longstanding problem………..

5. La Crosse County Medication Collection Program Rules and Regulations: WI DNR: Relaxed regulations for hazardous waste DOT: Transportation issues DEA: Controlled Substances WI Administrative Codes (WAC) NR 666 (VSQG Business Regulations).

6. La Crosse County Medication Collection Program Why it works: Capacity to manage ALL expired, unused and unnecessary medications. Offers best management practice for environment. Meets intent of Resource Conservation and Recovery Ace 1976 (RCRA). Meets EPA guidelines. DEA License EXEMPT. Supported by La Crosse Cty Law Enforcement (Deputized). Facility Security/Alarm System (upgrade). Expands/improves upon Federal guidelines. Tracking and Reporting capacity.

7. La Crosse County Medication Collection Program How it works……..the process. Continuous and Permanent. Very Small Quantity Generators Tracking Method: Medication Wt and Zip Codes. Simple Collection Process: 1.Tablets/Capsules/Liquids 2.Topicals, Powders, Transdermals 3.Inhalation Aerosol Medication Stored Non-Retrievable/Secured Hazardous Waste Incineration off site No medications are lost to the system

8. La Crosse County Medication Collection Program Cost to Participate: La Crosse County Households: FREE Business: $15.00 + $3.00/lb NET WT. Comparisons: Nursing Home: #33lbs net/$110 Antibiotic Stockpile:Expired Doxycycline/Ciprofloxicin #2467lbs/$7000. Estimated Cost other vendors: 4X

9. La Crosse County Medication Collection Program STATS: 2007 Projected: Number of participants: 500 Households 30 Businesses. Actual YTD: Number of Participants: 350 Households. 17 Businesses.

10. La Crosse County Medication Collection Program Participants: Disposal vendor for Grant Cty: #1 day “clean sweep” collection. 82 lbs medications Others (Juneau County, Adams County, Dane County) Pharmacy Closure (DEA Referral ): Controlled Substance. State Pandemic Stock Pile: expired Ciprofloxicin and Doxycycline. Mobil Collections scheduled for Vernon and Monroe Cty’s. Fall 2007.

11. La Crosse County Medication Collection Program Tracking: YTD 4125 lbs NET MonthMedication Wt.(lbs) June 07569 July 07597 August 07649 September 072310

12. La Crosse County Medication Collection Program Marketing Program: Brochures. TV and Radio. Newspapers. Pharmacy Providers (electronic message on RX receipts). Nursing Homes. Regional and State (PSW, Coulee Region Pharmacists, State Bd of RX). National Partners.

13. La Crosse County Medication Collection Program Program Barriers: Controlled vs. Non-Controlled. Funding Sources: Grant opportunities. Participation. WI State Board “buy in”. Community participation. DNR, EPA, DEA support and consensus.

14. La Crosse County Medication Collection Program Summary Points: Big Problem with Easy Solution Low Cost to participate Best Available Option…. Promotion and Prevention.