26:2H-81.1 Definitions relative to hospice care, disposal of unused prescription medications.
1. a. As used in this section:
"Family member" means a hospice care patient's spouse, parent, adult sibling, adult child, or adult grandchild.
"Health care representative" means a person, including a member of the patient's family, who is authorized to make health care decisions on behalf of a hospice care patient.
"Hospice care patient" means a person currently receiving hospice care services in a private home or an assisted living facility through a licensed hospice care program.
"Third party caregiver" means a person who:
(1) is 18 years of age or older;
(2) provides care or assistance to a hospice care patient; and
(3) is not the patient's health care representative, a family member of the patient, or employed by the patient's hospice care program.
b. A hospice care program licensed pursuant to P.L.1997, c.78 (C.26:2H-79 et seq.) may choose, but shall not be required, to accept for disposal, at such time as a hospice care patient ceases to use the drug or medication or ceases to receive hospice care services through the program, the hospice care patient's unused prescription drugs and medications. A hospice care program that chooses to accept unused prescription drugs and medications for disposal pursuant to this section shall:
(1) Establish a written policy setting forth procedures for accepting and disposing of unused prescription drugs and medications;
(2) Furnish a copy of the written policy to each patient, and to the patient's health care representative, at the time the patient is enrolled in the hospice care program, and designate a program representative who shall discuss the procedures and requirements for surrendering unused prescription drugs and medications with the patient and the patient's health care representative;
(3) Accept drugs and medications prescribed and dispensed to the patient pursuant to the patient's hospice care plan, as well as any other prescription drugs and medications that the patient, or the patient's health care representative, chooses to surrender to the program;
(4) Not accept any drug or medication for surrender except at such time as the patient ceases to use the drug or medication or ceases to receive hospice care services through the program;
(5) Obtain any certifications, authorizations, or waivers as may be required under State or federal law in order to accept and dispose of unused prescription drugs and medications pursuant to this section; and
(6) (a) at the time the patient is enrolled in the hospice care program, at such time as any change is made to the patient's course of treatment that results in a change in the drugs or medications prescribed for the patient, or in the patient discontinuing the use of a prescription drug or medication, and at such time as the patient ceases to receive hospice care services through the program, provide the patient or the patient's health care representative with oral instructions and written informational materials advising that when unused, unwanted, or expired drugs and medications are not properly, safely, and promptly disposed of:
(i) there is a risk that the drug or medication can be stolen, diverted, abused, misused, or accidentally ingested, which can pose a risk to the health and safety of the patient and other members of the patient's household;
(ii) children are particularly at risk of accidentally ingesting unused, unwanted, and expired medications that have not been properly, safely, and promptly disposed of;
(iii) when drugs or medications are disposed of in the household trash or flushed down the drain, the drugs and medications can leak into the ecosystem, which can have a potentially adverse or harmful effect on the environment; and
(iv) when drugs or medications are disposed of in the household trash without the drug or medication having been rendered deactivated, inaccessible, or otherwise unusable, the drug or medication may be stolen by individuals seeking to divert, abuse, or misuse the drug or medication;
(b) make available on-site, for purchase or at no cost to the patient, at least one consumer method for individuals to dispose of unwanted or expired prescription drugs, including, but not limited to over-the-counter at-home or site-of-use solutions or secured medication collection kiosks or boxes; and
(c) provide the patient with oral and written instructions on how to properly, safely, and promptly dispose of unused, unwanted, or expired drugs and medications, which may include, but shall not be limited to, providing instructions concerning the use of an over-the-counter at-home or site-of-use solution furnished to the patient pursuant to subparagraph (b) of this paragraph, and advising the patient of the availability of secure prescription medication drop-off receptacles and prescription medication take back programs.
c. At the time a hospice care patient ceases to receive hospice care services, a program representative shall provide a written request for surrender of unused drugs and medications to the patient or the patient's health care representative, which shall:
(1) request that the patient or the patient's health care representative surrender any unused prescription drugs or medications that were prescribed and dispensed to the patient pursuant to the patient's hospice care plan;
(2) offer to accept and dispose of any other prescription drug or medication which the patient will not use; and
(3) urge that the patient or the patient's health care representative dispose of any unused prescription drug or medication that is not surrendered to the program in a safe and legal manner, so as to avoid the risk of theft, diversion, or accidental ingestion.
d. No hospice care program may accept and dispose of an unused prescription drug or medication pursuant to this section unless the patient or the patient's health care representative authorizes, in writing, the surrender of the unused prescription drug or medication to the program; except that, if the patient is unable to provide written authorization and the patient does not have a health care representative, a third party caregiver may provide written authorization for the surrender. A hospice care program shall not accept an unused prescription drug or medication unless the drug or medication is identified for inclusion in the authorization for surrender.
e. (1) Unused prescription drugs and medications surrendered to a hospice care program pursuant to this section shall be surrendered to a registered professional nurse or a licensed practical nurse employed by the program.
(2) A nurse accepting the surrender of unused prescription drugs or medications pursuant to this section shall dispose of the drugs or medications at the site where hospice care was provided; in no case shall the nurse transport the unused prescription medications off-site for disposal or for any other purpose. The nurse may dispose of the unused drugs or medications using an over-the-counter at-home or site-of-use solution that meets the requirements of paragraph (2) of subsection a. of section 1 of P.L.2019, c.509 (C.45:14-67.6).
(3) A nurse who accepts and disposes of an unused prescription drug or medication pursuant to this section shall document:
(a) the name and quantity of each drug or medication surrendered;
(b) the name of the person authorizing the surrender, and the relationship of the person to the patient;
(c) the date and method of disposal; and
(d) the quantity and type of any unused prescription drug or medication, of which the nurse is aware, that was prescribed and dispensed to the patient pursuant to the patient's hospice care plan, but was not surrendered to the program or otherwise disposed of by another person in the nurse's presence.
(4) The person authorizing the surrender of a drug or medication shall be provided with the opportunity to review, verify, and sign the documentation required under paragraph (3) of this subsection.
f. Nothing in this section shall prohibit any person from disposing of an unused prescription drug or medication by any means authorized by law, including, but not limited to, disposing of the drug or medication pursuant to subparagraph (b) of paragraph (6) of subsection b. of this section or surrendering the medication at a secure prescription medication drop-off receptacle.
g. No person shall be subject to civil or criminal liability or professional disciplinary action for any act or omission undertaken in good faith consistent with the requirements of this section.
L.2017, c.135, s.1; amended 2019, c.509, s.2.