1. Thank you to our sponsors!
Platinum
Gold
National Association of Clean Water Agencies
Waste Treatment Division, King County, WA
San Francisco, CA – Department of the Environment
San Benito County Integrated Waste Management
Hazardous Waste Management Programs, King County, WA
Idaho Department of Environmental Quality
King County Solid Waste, WA
Los Angeles County Sanitation Districts, CA
Minnesota Pollution Control
California Integrated Waste Management Board
Silver
Santa Monica, CA
Snohomish County Solid Waste District, WA
City of Palo Alto, CA Environmental Compliance
City of Palo Alto, CA
Central Vermont Solid Waste Management
City of Santa Rosa, CA
Central Contra Costa Sanitary District, CA
Veolia ES MedServe

2. Discussion Slides: Afternoon of June 19
Sacramento, CA
June 19-20, 2008

3. Issue/Strategy Discussions
Background technical information
Clarify issues and strategies
Clarify positions
Consider and prioritize strategies
Workgroups at end of 2nd day - top 2 strategies

4. Source Reduction Leftover medicines occur for a variety of reasons
Expire
Patient no longer needs
Patient no longer chooses to use
Patient is no longer able to use
Logical starting point for considering solutions

5. Source Reduction: Strategies for Discussion
a) Modify prescribing practices to avoid excess (samples to try, small initial doses, ID potential allergies/drug interactions up front)
b) Educate consumers about taking all medications as prescribed
c) Modify reimbursement formulas and sales that currently encourage physicians to prescribe larger doses to reach thresholds for coverage 5

6. Thank you to our sponsors!
Platinum
Gold
National Association of Clean Water Agencies
Waste Treatment Division, King County, WA
San Francisco, CA – Department of the Environment
San Benito County Integrated Waste Management
Hazardous Waste Management Programs, King County, WA
Idaho Department of Environmental Quality
King County Solid Waste, WA
Los Angeles County Sanitation Districts, CA
Minnesota Pollution Control
California Integrated Waste Management Board
Silver
Santa Monica, CA
Snohomish County Solid Waste District, WA
City of Palo Alto, CA Environmental Compliance
City of Palo Alto, CA
Central Vermont Solid Waste Management
City of Santa Rosa, CA
Central Contra Costa Sanitary District, CA
Veolia ES MedServe

7. Options for Disposal: Strategies for Discussion
Develop consensus on best management practices for safe disposal from the home (either long-term or interim)
Develop best practices for collection locations, including ultimate disposal
Identify existing or develop demonstration programs to collect data on the relative costs, logistics, and performance of mail-back and/or collection through various location. 7

8. Options for Disposal: Strategies for Discussion
Develop unified and consistent messaging regarding the safe and environmentally sound disposal of waste pharmaceuticals.
Evaluate performance of existing and potential future collection programs. 8