1. © Product Stewardship Institute, Inc. September 2008 PSI National Dialogue on Medical Sharps “Projects” Workgroup Sacramento, CA September 23-24, 2008

2. © Product Stewardship Institute, Inc. September 2008 Workgroup Participants PSI: Scott Cassel, Sierra Fletcher (Facilitators) Wesley Badillo, NY Department of Health Andy Epstein, Thera Meehan & Roy Petre, MA DPH Sue Johnson, IA DNR Burt Kunik, Sharps Compliance, Inc. Karen Le Boeuf & Cherie Fischer, Chrysalis Environmental Services, LLC Marilyn Lopes, UMass/Cape Cod Cooperative Extension Jenny Schumann, Coalition for Safe Community Needle Disposal Karl Schumann & Bob Singley, BD 2

3. © Product Stewardship Institute, Inc. September 2008 Workgroup Process Before developing a pilot project, we want to see what information we can get from existing projects Developed survey instrument Completed survey for 18 projects – Different models – Geographic range (east/west & urban/rural) 3

4. © Product Stewardship Institute, Inc. September 2008 “Models” surveyed Collection at retail pharmacies Collection at public facilities (non-HHW) Collection at HHW Syringe Exchange Programs Residential special waste pick-up Mail-back “Hybrids” (retail, various public facilities) 4

5. © Product Stewardship Institute, Inc. September 2008 Geographic range CaliforniaNew Mexico GeorgiaRhode Island IllinoisSouth Dakota Indiana Massachusetts New Hampshire 5

6. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Lessons Learned 6 Most programs: Were started by either Health or Waste Depts. (Waste is more likely to have collection data.) Are funded by local governments through grants, in- kind donations or taken out of budgets. Were not set up to collect sufficient data for our purposes. Had an initial education program but fail to continue the program.

7. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Lessons Learned, cont. 7 Most Programs: Understand that the patient will not or should not pay for the program. Are replicable, but sustainability is the greatest challenge. Intentions were great - solving a problem for the community!

8. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Priority criteria for examining projects 8 Convenient & safe - Is it convenient & safe to the consumer, collector, etc.? Cost -How much does it cost? Is it cost-effective? Publicity/education -Is there initial and ongoing education? Sustainability - Is there sustainable financing?

9. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Priority criteria for examining projects 9 **PERFORMANCE underlies all criteria and needs to be examined separately

10. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Costs 10 1.Sharps container: $1.20 - $3.00 (1.5 qt.) 2.Collection site costs: -Initial costs: kiosk/other container ($1500-$3000) -Insurance? Only cited once. -Staff time at collection site (monitor, call for pick- up) 3.Pick-up/transport 4.Treatment 5.Disposal

11. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Costs for Mail-Back 11 Fixed price: about $25 for 1 container (all inclusive)

12. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Additional Information Needed 12 Safety -# of times handled - access -spills Cost & sustainability Public education

13. © Product Stewardship Institute, Inc. September 2008 PSI Medical Sharps Dialogue Meeting Potential Projects for Coll. of Add’l Info 13 Collection at retail San Francisco, CA (mostly Walgreen’s) Sioux Falls, SD (mostly Lewis Drug) “Hybrid” (mix of public facilities/HHW & retail) Eureka (Rhode Island) HHW Pulaski County, AR Mail-back from home Orange County, CA (4 separate cities)

14. © Product Stewardship Institute, Inc. September 2008 Possible Next Steps for Workgroup 1.Contact “priority” programs to get more information, if available 2.Develop pilot using an existing program to gather necessary data 3.Develop model “package” program that is nationally replicable and test in one or more states 4.Compile cost information & “number crunch”; analyze to identify efficiencies 14