WHEREAS, Medicaid is a joint federal-state program that has the goal of providing health care; and

WHEREAS, Medicaid programs are run by the states according to agreements with the federal government and provide for federal matching funds; and

WHEREAS, the State of Hawaii appropriated approximately $80,200,000 in federal and state funds through the QUEST program for pharmaceuticals in fiscal year 2002 and will spend approximately $100,000,000 for the same purpose in fiscal year 2003; and

WHEREAS, a 2000 study by Oklahoma State University estimated that the nation's nursing homes discard somewhere between $73,000,000 and $378,000,000 worth of unused pharmaceutical drugs; and

WHEREAS, advances have been made in the packaging of pharmaceuticals to prevent tampering, such as bubble packs and individual packing; and

WHEREAS, many states do not have laws that allow for the return of unused pharmaceuticals for subsequent reuse; and

WHEREAS, Hawaii had a law prohibiting the return of pharmaceuticals once drugs are dispensed by a pharmacy, that included an exception for long-term care beds in hospitals with in-house pharmacies; and

WHEREAS, the Legislature passed a law allowing for the return of unused pharmaceuticals; and

WHEREAS, the law was repealed within a year due to a scandal involving a large pharmacy; and

WHEREAS, during that short window, no pharmaceuticals were returned; and

WHEREAS, the rising costs of pharmaceuticals and the crisis facing many states with regard to state shares of Medicaid funding seem to necessitate revisiting possible cost-saving measures; and

WHEREAS, in 2002, several states passed laws or rules dealing with pharmaceutical return and reuse, such as Georgia, Massachusetts, Minnesota, Nebraska, New York, Utah, Vermont, and Virginia, or discussed the issue of pharmaceutical return and re-use, such as Connecticut, Montana, and Oklahoma; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-second Legislature of the State of Hawaii, Regular Session of 2003, that the Department of Human Services, Department of Health, and Board of Pharmacy are requested to conduct a joint implementation plan, including necessary administrative rule revisions, for the return of unused pharmaceuticals from institutional facilities for possible subsequent dispensing to patients; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Human Services, Director of Health, Chair of the Board of Pharmacy, and the Governor.

Report Title:

Implementation plan; return of unused pharmaceuticals