BILL ANALYSIS                                                                                                                                                                                                    



                             SENATE JUDICIARY COMMITTEE
                         Senator Hannah-Beth Jackson, Chair
                             2015-2016  Regular  Session


          SB 1229 (Jackson and Stone)
          Version: March 28, 2016
          Hearing Date:  April 12, 2016
          Fiscal: No
          Urgency: No
          RD   


                                        SUBJECT
                                           
                       Pharmacies:  secure drug take-back bins

                                      DESCRIPTION  

          This bill would provide specified collectors that are authorized  
          under federal law to engage in drug take-back collection with  
          limited protection from civil and criminal liability (or  
          "qualified immunity") for maintaining secure drug take-back  
          bins.  
          Specifically, a collector would not be liable in a civil action,  
          or be subject to criminal prosecution, for maintaining a secure  
          drug take-back bin on its premises if the collector, in good  
          faith and not for compensation, takes specified steps to ensure  
          the health and safety of consumers and employees and the proper  
          disposal of the home-generated pharmaceutical waste contained in  
          the secure drug take-back bin. This qualified immunity would not  
          apply in the case of personal injury or wrongful death which  
          results from the collector's gross negligence or willful or  
          wanton misconduct in maintaining a secure drug take-back bin.  

                                      BACKGROUND 

          Prior to 2010, as a matter of federal law, individuals who  
          wanted to dispose of unused, unwanted, or expired pharmaceutical  
          controlled substances only had limited disposal options because  
          the federal Controlled Substances Act (21 U.S.C. Sec. 801 et  
          seq.) only permitted individuals to either destroy those  
          substances themselves (such as by flushing or discarding),  
          surrender them to law enforcement, or otherwise seek assistance  
          from the federal Drug Enforcement Administration (DEA).   
          According to the DEA, these restrictions resulted in the  
          accumulation of pharmaceutical controlled substances in  
          household medicine cabinets that were available for abuse,  
          misuse, diversion, and accidental ingestion.  (DEA, Final Rule,  







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          Disposal of Controlled Substances (Sept. 9, 2014)  
           p. 53520 [as of Apr. 3, 2016].)  In 2010, the federal  
          Secure and Responsible Drug Disposal Act of 2010 (Disposal Act)  
          was enacted, amending the Controlled Substances Act to authorize  
          specified individuals, called "ultimate users," to deliver their  
          pharmaceutical controlled substances to another person for the  
          purpose of disposal in accordance with regulations promulgated  
          by the U.S. Attorney General.
          Accordingly, in September of 2014, the DEA issued its final rule  
          implementing the Disposal Act and governing the secure disposal  
          of controlled substances by registrants and ultimate users.   
          Those regulations have expanded the options available to collect  
          controlled substances from ultimate users for the purpose of  
          disposal, including take-back events, mail-back programs, and  
          collection receptacle locations and, among other things, allow  
          authorized manufacturers, distributors, reverse distributors,  
          narcotic treatment programs, hospitals/clinics with an on-site  
          pharmacy, and retail pharmacies to voluntarily administer  
          mail-back programs and maintain collection receptacles (what  
          this bill refers to as "secure drug take-back bins").  (See id.)  


          While the changes to federal law are rather recent, there has  
          already been a significant push to increase the use and  
          availability of secure drug take-back programs both across the  
          nation and in this state.  (See Comment 2 for more.)  For  
          example, one major retailer, Walgreens, announced earlier this  
          year that it has begun to install safe medication disposal  
          kiosks in more than 500 drugstores in 39 states and Washington,  
          D.C. to make the disposal of medications - including opioids and  
          other controlled substances - easier and more convenient while  
          also helping to reduce the misuse of medications and the rise in  
          overdose deaths.  (Walgreens Press Release, Walgreens Leads  
          Fight Against Prescription Drug Abuse with New Programs to Help  
          Curb Misuse of Medications and the Rise in Overdose Deaths (Feb.  
          9, 2016)  
           (as of Apr. 3, 2016).)  

          Additionally, at least one state has already sought to  
          incentivize pharmacies to engage in similar activities.   








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          Specifically, the state of Virginia recently enacted a law that  
          provides that no person that participates in a drug disposal  
          program shall be liable for any theft, robbery, or other  
          criminal act related to participation in the pharmacy drug  
          disposal program or for any acts of simple negligence in the  
          collection, storage, or destruction of prescription drugs  
          collected through such pharmacy drug disposal program, provided  
          that the pharmacy practice site is acting in good faith and in  
          accordance with applicable state and federal law and  
          regulations.  (See Virginia's HB 629,  
           [as of Apr. 3, 2016]).   

          This bill would now state the intent of the California  
          Legislature to: (1) encourage the good faith participation of  
          federally-authorized entities to maintain secure drug take-back  
          bins on their premises for the convenience and public health and  
          safety of prescription drug consumers and the proper disposal in  
          the waste stream of the pharmaceutical waste contained in the  
          bins; and (2) limit the civil and criminal liability of  
          participating entities that meet certain minimum standards  
          enumerated in the bill and take reasonable care to ensure the  
          health and safety of consumers and employees when maintaining  
          secure drug take-back bins on their premises.  This bill's  
          qualified immunity would not apply in cases of gross negligence  
          or willful or wanton misconduct that causes the personal injury  
          or wrongful death of another person.  
                                CHANGES TO EXISTING LAW
           
           Existing law  provides that everyone is responsible, not only for  
          the result of his or her willful acts, but also for an injury  
          occasioned to another by his or her want of ordinary care or  
          skill in the management of his or her property or person, except  
          so far as the latter has, willfully or by want of ordinary care,  
          brought the injury upon himself or herself.  (Civ. Code Sec.  
          1714(a).)  

           Existing law  provides that a person or entity that acquires an  
          automatic external defibrillator (AED) for emergency use is not  
          liable for any civil damages resulting from any acts or  
          omissions when the AED is used to render emergency care,  
          provided that the person or entity has complied with certain  
          notice, maintenance, and other reasonable care requirements  
          under the Health and Safety Code, as specified. (Civ. Code Sec.  








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          1714.21(d)(1).)  These requirements include that the person or  
          entity must: 
           comply with all regulations governing the placement of an AED;
           notify an agent of the local EMS agency of the existence,  
            location, and type of AED acquired;
           ensure that the AED is maintained and tested according to the  
            operation and maintenance guidelines set forth by the  
            manufacturer;
           ensure that the AED is tested at least biannually and after  
            each use;
           ensure that an inspection is made of all AEDs on the premises  
            at least every 90 days for potential issues related to  
            operability of the device, as specified; and
           ensure, when an AED is placed in a building, that at least  
            once a year a demonstration is made to at least one person  
            associated with the building so that the person can be walked  
            through how to use an AED properly in an emergency, and that  
            instructions are posted next to the AED, as specified, on how  
            to use the AED.  (Health & Saf. Code Sec. 1797.196(b).)  

           Existing law  provides that the qualified immunities described  
          above do not apply in the case of personal injury or wrongful  
          death which results from the gross negligence or willful or  
          wanton misconduct of the person who uses the AED to render  
          emergency care.  (Civ. Code Sec. 1714.21(f).)

           Existing law  provides that a licensed health care provider who  
          acts with reasonable care and issues a prescription for, or an  
          order for the administration of, an opioid antagonist to a  
          person experiencing or suspected of experiencing an opioid  
          overdose is not subject to professional review, liable in a  
          civil action, or subject to criminal prosecution for issuing the  
          prescription or order.  Existing law also provides that a person  
          who is not otherwise licensed to administer an opioid  
          antagonist, but who meets certain other conditions, is not  
          subject to professional review, liable in a civil action, or  
          subject to criminal prosecution for administering an opioid  
          antagonist.  (Civ. Code Sec. 1714.22(e), (f).) 

           Existing law  provides that any prehospital emergency medical  
          care person or lay rescuer, as specified, who administers an  
          epinephrine auto-injector, in good faith and not for  
          compensation, to another person who appears to be experiencing  
          anaphylaxis at the scene of an emergency situation is not liable  








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          for any civil damages resulting from his or her acts or  
          omissions in administering the epinephrine auto-injector, if  
          that person has complied with specified requirements of the  
          Health and Safety Code. (Civ. Code Sec. 1714.23(b).)  Existing  
          law provides that this protection does not apply in a case of  
          personal injury or wrongful death that results from the gross  
          negligence or willful or wanton misconduct of the person who  
          renders emergency care treatment by the use of an epinephrine  
          auto-injector.  (Civ. Code Sec. 1714.23(c).)  

           Existing law  provides that an authorizing physician and surgeon  
          shall not be subject to professional review, be liable in a  
          civil action, or be subject to criminal prosecution for the  
          issuance of a prescription or order to a qualified supervisor of  
          health or administrator at a school district, county office of  
          education, or charter school for epinephrine auto-injectors, as  
          specified, unless the physician and surgeon's issuance of the  
          prescription or order constitutes gross negligence or willful or  
          malicious conduct.  (Ed. Code Sec. 49414(g)(4).)  

           This bill  would now provide that any collector, as defined, that  
          maintains a secure drug take-back bin, in good faith and not for  
          compensation, shall not be liable in a civil action, or be  
          subject to criminal prosecution, for maintaining a secure drug  
          take-back bin on its premises if the collector takes specified  
          steps to ensure the health and safety of consumers and employees  
          and the proper disposal in the waste stream of the  
          home-generated pharmaceutical waste contained in a secure drug  
          take-back bin.  This immunity would not apply in a case of  
          personal injury or wrongful death which results from the  
          collector's gross negligence or willful or wanton misconduct in  
          maintaining a secure drug take-back bin.

           This bill  provides that a collector must do all of the following  
          in order to be subject to the qualified civil or criminal  
          immunity protections, above: 
           comply with all applicable state and federal laws and  
            regulations relating to the collection of home-generated  
            pharmaceutical waste for disposal in secure drug take-back  
            bins, including, but not limited to, the federal Secure and  
            Responsible Drug Disposal Act of 2010; 
           notify local law enforcement and any local environmental  
            health department as to the existence and location of any  
            secure drug take-back bin on the collector's premises and the  








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            status of the collector's registration as a collector with the  
            federal Drug Enforcement Administration (DEA);
           ensure that the secure drug take-back bin is placed in a  
            location that is regularly monitored by employees of the  
            registered collector;
           ensure that conspicuous signage is posted on the secure drug  
            take-back bin that clearly notifies customers as to what  
            controlled and non-controlled substances are and are not  
            acceptable for deposit into the bin, as well as the hours  
            during which collection is allowed; 
           ensure that public access to the secure drug take-back bin is  
            limited to hours wherein employees of the registered collector  
            are present and able to monitor the operation of the secure  
            drug take-back bin;
           regularly inspect the area surrounding the secure drug  
            take-back bin for potential tampering or diversion and  
            maintain certain records and logs, as specified;
           notify local law enforcement authorities of any suspected or  
            known tampering, theft, or significant loss of controlled  
            substances within one business day of discovery, unless the  
            collector maintains daily business hours, in which case the  
            notification must be within one calendar day; and 
           notify local law enforcement as to any decision to discontinue  
            its voluntary collection of controlled substances, as  
            specified.

           This bill  provides that nothing in the above shall be construed  
          to require entities that may qualify as a collector to acquire,  
          maintain, or make available to the public a secure drug  
          take-back bin on its premise. 

           This bill  defines various terms for these purposes.   
          Specifically, among other things: 
           "Collector" includes only those entities authorized by and  
            registered with the DEA to receive a controlled substance for  
            the purpose of destruction, if the entity is in good standing  
            with any applicable licensing authority.
           "Compensation" means reimbursement or funds received from a  
            customer to compensate for the cost incurred in obtaining,  
            installing, or maintaining a secure drug take-back bin.  
            Compensation does not include reimbursement or funds received  
            from any other person or entity, other than a customer, to  
            compensate for the costs incurred in obtaining, installing, or  
            maintaining a secure drug take-back bin.








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           "Home-generated pharmaceutical waste" means a pharmaceutical  
            that is no longer wanted or needed by the consumer and  
            includes any delivery system, such as pills, liquids, and  
            inhalers.
           "Secure drug take-back bin" means a collection receptacle as  
            described in Section 1317.75 of Title 21 of the Code of  
            Federal Regulations.

           This bill  would include various findings and statements of  
          legislative intent. 

                                        COMMENT
           
          1.   Stated need for the bill  

          According to the author: 

            Home-generated pharmaceutical waste (i.e., prescription or  
            over-the-counter human or veterinary drugs that are "left  
            over" from treatment or have expired), has become an  
            increasing problem nationwide and in California. With the rise  
            of prescription drug abuse, these excess drugs-often stored in  
            medicine cabinets or under sinks for years-have found their  
            way into recreational use by teens or are otherwise misused by  
            seniors or others.  People taking un-prescribed or expired  
            drugs are creating a growing public health and safety risk.  
            Without a safe means of disposal, many people with excess  
            drugs are turning to throwing them in the trash or flushing  
            them in a toilet. This creates serious problems with soil and  
            water quality, especially since our water treatment plants are  
            not capable of removing pharmaceuticals from wastewater.

            Law enforcement and pioneering pharmacies concerned with  
            public safety and environmental health have been hosting drug  
            take-back programs and bins voluntarily.  These early efforts  
            are laudable, but the scope of these drug take-back options  
            has remained relatively small in relation to the demand for  
            convenient and safe disposal.   Many pharmacies have raised  
            concerns regarding potential liability as the reason behind  
            their reluctance to host a drug take-back bin.  [ . . . ]

            In order to help protect the public from prescription drug  
            abuse and to protect water quality from home-generated  
            pharmaceutical waste, SB 1229 would encourage [other]  








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            pharmacies to host secure drug take-back bins by:
                           
             1.   Establishing a duty of care for the proper oversight of  
               secure drug take-back bins.
             2.   Providing limited civil and criminal liability immunity  
               for pharmacies hosting drug take-back bins if they meet  
               that duty of care.

          Clean Water Action writes in support of the bill: 

            By establishing a duty [of] care for pharmacies that host  
            take-back bins with limited civil and criminal liability  
            immunity to that pharmacy, SB 1229 ensures both the safety of  
            the program and the ability of pharmacies to provide this  
            important service to their communities.

            Pharmaceuticals provide a wealth of benefits to public health.  
             However, the reality is that both prescription and over the  
            counter drugs are often not used completely and become out of  
            date or unwanted.  Advanced wastewater treatment is not  
            financially accessible to most California communities, and  
            even where it exists, it is not adequate to remove all of the  
            complex chemicals in medications.  Consequently, when drugs  
            are flushed down the toilet or thrown in the trash (where they  
            end up in groundwater or effluent that is later put through  
            the wastewater system), they enter our waterways and drinking  
            water supplies.  The effects on wildlife are well documented,  
            including reproductive harm, negative behavioral changes, and  
            endocrine disruption.  

            While improper disposal has sobering environmental impacts,  
            Clean Water Action's members also recognize that without  
            convenient options, medications are often stockpiled in the  
            home, posing a growing threat to youth and the elderly who may  
            mistakenly misuse them.  For this reason, pharmacies that  
            choose to host bins provide an important public service.   
            Again, SB 1229 ensures that such bins meet minimum standards  
            while providing these responsible retailers the assurance that  
            they too are protected from unreasonable liability.  This is a  
            win-win for the public and for pharmacies.

          2.    This bill seeks to set a statewide policy encouraging  
            voluntary participation in secure drug take-back collections  
            irrespective of mandatory local programs  








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          This bill seeks to encourage the safe disposal of left-over or  
          expired prescription or over-the-counter human or veterinary  
          drugs ("home generated pharmaceutical waste") by way of  
          collection in secure drug take-back bins.  According to the U.S.  
          Food and Drug Administration (FDA), "[m]edicines play an  
          important role in treating many conditions and diseases and when  
          they are no longer needed it is important to dispose of them  
          properly to help reduce harm from accidental exposure or  
          intentional misuse."  The FDA advises consumers and caregivers  
          to remove expired, unwanted, or unused medicines from their home  
          as quickly as possible to help reduce the chance that others may  
          accidentally take or intentionally misuse the medicine, noting  
          also that:  

            Medicine take-back programs are a good way to safely dispose  
            of most types of unneeded medicines. The U.S. Drug Enforcement  
            Administration (DEA) periodically hosts National Prescription  
            Drug Take-Back events where collection sites are set up in  
            communities nationwide for safe disposal of prescription  
            drugs. Local law enforcement agencies may also sponsor  
            medicine take-back programs in your community.  Likewise,  
            consumers can contact their local waste management authorities  
            to learn about medication disposal options and guidelines for  
            their area.
            Another option for consumers and long-term care facilities,  
            like nursing homes, to dispose of unneeded medicines is to  
            transfer unused medicines to collectors registered with the  
            DEA.  DEA-authorized collectors safely and securely collect  
            and dispose of pharmaceuticals containing controlled  
            substances and other medicines.  In your community, authorized  
            collection sites may be retail pharmacies, hospital or clinic  
            pharmacies, and law enforcement locations.  Some authorized  
            collection sites may also offer mail-back programs or  
            collection receptacles, sometimes called "drop-boxes," to  
            assist consumers in safely disposing of their unused  
            medicines.

          (FDA, Disposal of Unused Medicines: What You Should Know [last  
          updated Dec. 9, 2015]  
           [as of Mar. 29, 2016].)  









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          As noted in the Background, the federal government has only  
          recently begun to encourage the use of drug take-back programs  
          by way of mail back programs, collection receptacles, or take  
          back events.  At the same time, however, a handful of California  
          counties have adopted ordinances to require drug take-back  
          programs in their counties.  Indeed, Alameda County's 2012  
          ordinance appears to have been the first in the nation to  
          require pharmaceutical companies to fund the collection and  
          disposal of unused medications from the public.  Other  
          California counties that have since followed suit include the  
          City and County of San Francisco, and the counties of San Mateo,  
          Marin, Santa Clara, and Santa Cruz.  (See e.g. SF Environment,  
          Safe Drug Disposal Stewardship Ordinance  
           [as of Apr. 3, 2016]; County of San Mateo  
          Health System, Safe Medicine Disposal Ordinance  
           [as of Apr. 3, 2016].)  According to  
          the author of this bill, Los Angeles and Santa Barbara Counties  
          are also currently considering adopting such ordinances.  

          This bill now seeks to take a different approach from that  
          sought by various local entities, whereby, as a matter of state  
                  law, California would encourage entities authorized by the DEA  
          to act as collectors (including retail pharmacies, narcotic  
          treatment programs, distributors, wholesalers, reverse  
          distributors, and hospitals/clinics with onsite pharmacies) to  
          register with the DEA and voluntarily maintain secure drug  
          take-back bins on their premises.  To incentivize this voluntary  
          activity, this bill seeks to provide a qualified immunity to  
          participants who meet certain basic standards, discussed further  
          below.  Notably, this bill would have no bearing on those local  
          ordinances; rather, it would merely provide immunity to any  
          qualifying collector who meets the minimum standards of this  
          bill in maintaining a secure drug-take back bin. 

          3.    This bill provides limited liability protection to  
            collectors that maintain secure drug take-back bins in order  
            to promote an important public policy in a measured fashion
           
          As a general rule, California law provides that everyone is  
          responsible, not only for the result of his or her willful acts,  
          but also for an injury occasioned to another by his or her want  
          of ordinary care or skill in the management of his or her  
          property or person, except so far as the latter has, willfully  








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          or by want of ordinary care, brought the injury upon himself or  
          herself.  (Civ. Code Sec. 1714(a).)  Although immunity  
          provisions are rarely preferable because they, by their nature,  
          prevent an injured party from seeking a particular type of  
          recovery, the Legislature has in limited scenarios approved  
          qualified immunity from liability (as opposed to blanket  
          immunities) to promote other policy goals that could benefit the  
          public.  Along these lines, this Legislature has on multiple  
          occasions, enacted legislation that encourages the use of life  
          saving medications or medical interventions (such as automatic  
          external defibrillators (AEDs), epinephrine auto-injectors  
          (epi-pens), and opioid antagonists (naloxone)) in order to avoid  
          preventable deaths by limiting the liability of "Good  
          Samaritans," as long as certain minimal requirements are met.   
          Notably, none of these immunities apply in the case of personal  
          injury or wrongful death which results from the gross negligence  
          or willful or wanton misconduct by the person who renders the  
          care. (See Civ. Code Secs. 1714.21, 1714.22 and 1714.23; in the  
          context of opioid antagonists, the law specifically mandates  
          reasonable care to have been taken in order for the qualified  
          immunity to apply.)  

          Here, the author seeks to incentivize voluntary activity on  
          behalf of certain entities, including pharmacies, to maintain  
          secure drug take-back collection bins on their premises by way  
          of providing these "collectors" reasonable assurance that they  
          will not be subject to civil or criminal liability for simple  
          negligence in maintaining such a bin on their premises.  At the  
          same time, by creating a qualified immunity as opposed to  
          blanket immunity, the bill appears to recognize the importance  
          of balancing the public policy of promoting the safe and secure  
          collection and disposal of pharmaceutical waste against the  
          ability for an injured person to seek recourse for injuries  
          sustained. 

          As a preliminary matter, this bill limits the entities that can  
          qualify for the bill's immunity protections.  "Collectors,"  
          under federal regulations, can include registered manufacturers,  
          distributors, reverse distributors, narcotic treatment programs,  
          hospital/clinics with an on-site pharmacy, or retail pharmacies  
          authorized by and registered with the DEA to  receive a  
          controlled substance for the purpose of destruction.  However,  
          because many of these entities would also have to be licensed by  
          the state as a matter of California law regardless of any  








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          participation in these drug take-back activities, this bill also  
          requires that a collector be in good standing with any  
          applicable licensing authority to qualify for the immunity  
          protections of the bill.  

          Further, under this bill, a qualifying collector would then only  
          be granted immunity from civil and criminal liability for  
          maintaining a secure drug take-back bin, if it acts in good  
          faith and not for compensation, and takes specified steps to  
          ensure the health and safety of consumers and employees and the  
          proper disposal in the waste stream of the home-generated  
          pharmaceutical waste contained in the secure drug take-back bin.  
           These steps effectively operate to establish minimal standards  
          of reasonable care for immunity purposes.  For example, the  
          collector must, at minimum: 
           comply with all applicable state and federal laws and  
            regulations relating to the collection of home-generated  
            pharmaceutical waste for disposal in secure drug take-back  
            bins;
           ensure that the secure drug take-back bin is placed in a  
            location that is regularly monitored by employees of the  
            registered collector;
           ensure that public access to the secure drug take-back bin is  
            limited to hours wherein employees of the registered collector  
            are present and able to monitor the operation of the secure  
            drug take-back bin; and
           notify local law enforcement authorities of any suspected or  
            known tampering, theft, or significant loss of controlled  
            substances, within specified time periods. 

          Even still, the bill further ensures that any immunity  
          protection would not apply in any case of personal injury or  
          wrongful death that involves gross negligence or willful or  
          wanton misconduct.  

          As a matter of public policy, given the reasonable limitations  
          placed on the bill's immunity protections, above, this bill  
          arguably takes a measured approach in incentivizing a safe and  
          secure method of collecting and properly destroying  
          home-generated pharmaceutical waste.  In doing so, the bill  
          would be similar to protections already in place with respect to  
          AEDs, epi-pens, and naloxone.

          4.    Record logs serve to protect both the public health and  








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            safety and to assist the collector seeking to claim immunity  
            pursuant to this bill  

          As discussed above, to claim any immunity under this bill, a  
          collector would have to comply with certain minimum  
          requirements.  While many of these requirements help ensure that  
          basic reasonable care is taken by any collector seeking immunity  
          protection for voluntarily maintaining a secure drug take-back  
          bin on its premises, others also would assist the collector who  
          attempts to claim these immunity protections in court.  For  
          example, this bill requires that a collector regularly inspect  
          the area surrounding the secure drug take-back bin for potential  
          tampering or diversion in furtherance of public health and  
          safety, and requires that record logs of those inspections be  
          maintained and retained for four years, reflecting the date and  
          time of the inspection, and the initials of the employee  
          inspecting the area.  In the event that a collector is sued and  
          seeks to claim immunity pursuant to this bill, such logs could  
          help the collector prove it has complied with the bill's minimum  
          requirements and thus is subject to its immunity protections. 

          5.   Technical and clarifying author amendments
           
          The author provides the following amendments to: (1) ensure that  
          the good faith standard applies the bill's minimum standards,  
          (2) to reduce the minimum number of years that record logs and  
          mandated reports must be maintained to two years, and (3) to  
          make technical corrections. 

             Author's Amendments
             
            On page 2, line 12; page 3, line 33; page 4, line 39; and page  
            5, line 29, strike "Agency" and insert "Administration"

            On page 4, lines 22-23, strike "bin, in good faith and not for  
            compensation," and insert "bin"

            On page 4, line 25, strike "collector" and insert "collector,  
            in good faith and not for compensation," 

            On page 4, line 33, insert comma after "but not limited to"

            On page 5, lines 15 and 19, strike "four" and insert "two"  









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           Support  :  Californians Against Waste; City of Palo Alto; City of  
          Torrance; Clean Water Action; County Health Executives  
          Association of California; League of Cities; Los Angeles County  
          Solid Waste Management Committee/Integrated Waste Management  
          Task Force; Medication Education and Disposal Safety Coalition;  
          Napa Sanitation District; San Luis Obispo County Integrated  
          Waste Management Authority; Santa Clara County Board of  
          Supervisors; Solid Waste Association of North America
           Opposition  :  None Known 

                                        HISTORY
           
           Source  :  California Product Stewardship Council

           Related Pending Legislation  :  None Known 

          Prior Legislation  :

          SB 738 (Huff, Ch. 132, Stats. 2015) provided that an authorizing  
          physician and surgeon shall not be subject to professional  
          review, be liable in a civil action, or be subject to criminal  
          prosecution for the issuance of a prescription or order to a  
          qualified supervisor of health or administrator at a school  
          district, county office of education, or charter school for  
          epi-pens pursuant to specified law, unless the physician and  
          surgeon's issuance constitutes gross negligence or willful or  
          malicious conduct.

          SB 669 (Huff, Ch. 725, Stats. 2013), among other things,  
          authorized a trained pre-hospital emergency medical care person,  
          first responder, or lay rescuer to obtain and use epi-pens to  
          render emergency care to another person, pursuant to specified  
          requirements, and granted them qualified immunity from civil  
          liability, as specified.  

          AB 635 (Ammiano, Ch. 707, Stats. 2013) provided that a licensed  
          health care provider who acts with reasonable care and issues a  
          prescription for, or an order for the administration of, an  
          opioid antagonist to a person experiencing or suspected of  
          experiencing an opioid overdose is not subject to professional  
          review, liable in a civil action, or subject to criminal  
          prosecution for issuing the prescription or order. The bill also  
          provided that a person who is not otherwise licensed to  








          SB 1229 (Jackson and Stone)
          Page 15 of ? 


          administer an opioid antagonist, but who meets other specified  
          conditions, is not subject to professional review, liable in a  
          civil action, or subject to criminal prosecution for  
          administering an opioid antagonist.

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