N.J. Admin. Code § 8:42C-6.4

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:42C-6.4 - Acceptance and disposal of prescription medication

(a) A hospice may choose to accept for disposal a hospice care patient's unused prescription medication when the hospice care patient ceases to:

1. Use the prescription medication; or

2. Receive services from the hospice.

(b) A hospice that chooses to accept for disposal the unused prescription medication of its hospice care patients pursuant to (a) above shall establish a written policy setting forth procedures for requesting and accepting the surrender, and disposing, of unused prescription medication, which addresses:

1. The hospice's establishment of a written form of request for surrender of a hospice care patient's unused prescription medication consistent with (c) below;

2. The hospice's designation of one or more hospice representatives (designated hospice representative);

3. Upon the enrollment of a hospice care patient, a designated hospice representative's obligation to provide a copy of the written policy established pursuant to this section to the hospice care patient and the health care representative of the hospice care patient and to discuss with them the attendant procedures and requirements;

4. The hospice's obligation to accept, and dispose of, in accordance with the publication at (i) below, prescription medication that the hospice dispenses to a hospice care patient pursuant to the hospice care patient's hospice care plan, and any other prescription medication that the hospice care patient or the health care representative of the hospice care patient chooses to surrender to the hospice;

5. The hospice's obligation to condition its acceptance of surrendered prescription medication for disposal on:

i. The hospice care patient ceasing to either use the prescription medication or receive services through the hospice;

ii. The hospice obtaining all certifications, authorizations, or waivers that State or Federal law may require for the acceptance and disposal of surrendered prescription medication; and

iii. The hospice exclusively accepting and disposing of surrendered prescription medication at the site of the hospice care patient's receipt of care, in accordance with the publication at (i) below, by a registered professional nurse or a licensed practical nurse (nurse) whom the hospice employs.

(c) A form of request for surrender shall:

1. Request, and offer to accept and dispose of, on behalf of the hospice:

i. Unused prescription medication that the hospice dispensed to a hospice care patient pursuant to the hospice care patient's hospice care plan; and

ii. Any other prescription medication that the hospice care patient, or the health care representative of the hospice care patient, chooses to surrender to the hospice;

2. Inform the person to whom the hospice submits a request for surrender that, if the person declines to surrender a hospice care patient's unused prescription medication for disposal, the hospice will provide the person a copy of the publication identified at (i) below, and the link to the webpage of Project Medicine Drop of the New Jersey Division of Consumer Affairs at http://www.njconsumeraffairs.gov/meddrop/Pages/default.aspx;

3. Provide space at which a nurse accepting surrendered prescription medication is to record:

i. The name and quantity of each medication surrendered;

ii. The name of the person authorizing the surrender and the relationship of the person to the hospice care patient;

iii. The date and method of disposal; and

iv. The quantity and type of any unused prescription medication that the hospice prescribed and dispensed to the hospice care patient pursuant to the patient's hospice care plan, of which the nurse is aware, which is not being surrendered to the hospice or otherwise disposed of by another person in the nurse's presence; and

4. Provide space at which:

i. A person authorizing a surrender of, or declining to surrender, prescription medication is to verify and sign the form, after the nurse completes the part of the form described at (c)3 above;

ii. The nurse receiving a declination to surrender prescription medication is to verify and sign the form, to confirm the provision of the documents listed at (g) below to the person declining to surrender prescription medication pursuant to (f) below; and

iii. The nurse accepting a surrender of prescription medication is to verify and sign the form to confirm on behalf of the hospice the acceptance and disposal of the surrendered prescription medication listed on the form pursuant to (c)3 above.

(d) A hospice shall not accept unused prescription medication of a hospice care patient for disposal pursuant to this section unless:

1. The hospice care patient or the health care representative of the hospice care patient authorizes the surrender pursuant to (h) below; or

2. If the hospice care patient is unable to issue written authorization and does not have a health care representative, a third-party caregiver authorizes the surrender pursuant to (h) below.

(e) A hospice exclusively shall accept unused prescription medication pursuant to this section upon surrender to a registered professional nurse or a licensed practical nurse (nurse) whom the hospice employs, who shall dispose of the medication at the site where the hospice care patient receives care in accordance with the publication at (i) below.

(f) A designated program representative shall submit a request for surrender to a hospice care patient, or the health care representative of a hospice care patient, when the hospice care patient ceases to either use the prescription medication or receive hospice services.

(g) If a person to whom the designated program representative submits a request for surrender pursuant to (f) above declines to surrender unused prescription medication, the designated program representative shall give the person a copy of the publication identified at (i) below, and a page containing the link to the webpage of Project Medicine Drop of the New Jersey Division of Consumer Affairs at http://www.njconsumeraffairs.gov/meddrop/Pages/default.aspx.

(h) If a person to whom a designated program representative submits a request for surrender pursuant to (f) above agrees to surrender prescription medication, a nurse who is accepting and disposing of the surrendered unused prescription medication on behalf of a hospice shall:

1. Record the information listed at (c)3 above on the request for surrender;

2. Offer the person authorizing the surrender the opportunity to review, verify, and sign the request for surrender in the space on the form described at (c)4i above, to indicate the person's agreement with the information recorded therein pursuant to (h)1 above.

i. If the person authorizing a surrender declines to verify and sign the request for surrender, the nurse shall verify and sign the request for surrender in the space on the form described at (c)4iii above, to indicate that the person declined to surrender and declined to sign and verify the form, and proceed pursuant to (g) above.

ii. The nurse shall not accept a surrender unless the person to whom the request is submitted verifies and signs the request for surrender;

3. Dispose of the surrendered prescription medication at the site where the hospice provided hospice care to the hospice care patient, consistent with the instructions in the publication identified at (i) below.

i. The nurse shall not transport the surrendered prescription medications off-site for disposal or for any other purpose;

4. Sign the request for surrender to verify the nurse's acceptance and disposal of the surrendered prescription medication on behalf of the hospice; and

5. Retain the executed request for surrender in the hospice care patient's record.

(i) The pamphlet issued by the New Jersey Department of Environmental Protection, Division of Solid and Hazardous Waste, entitled, "Guidelines for Proper Disposal of Household Medication," available at http://www.state.nj.us/ddshw/rrtp/disposal.pdf, establishes instructions for proper disposal of prescription and over-the-counter medication in trash.

N.J. Admin. Code § 8:42C-6.4

New Rule, R.2021 d.040, effective 5/3/2021.
See: 51 N.J.R. 1312(a), 53 N.J.R. 700(b).