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News & Press: Hospice

SUPPORT Act Opens Federal Door for Hospices to Dispose Controlled Substances

Friday, January 4, 2019   (0 Comments)
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January 4, 2019, NAHC Report 

 

In September 2014 the Drug Enforcement Administration (DEA) issued final regulations implementing the Secure and Responsible Drug Disposal Act of 2010 in which the agency clarified (for the firs time) that hospices were prohibited from disposing or assisting in the disposal of controlled substances for hospice patients unless there was a state law granting authority to the hospice to do so.On October 24, 2018 a new law – the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act – was enacted that opened a door for hospices to dispose of controlled substances. Section 3222 of the SUPPORT for Patients and Communities Act provides authority for certain hospice staff in qualified hospices to dispose of controlled substances if those substances were lawfully dispensed to the person receiving hospice care.

Specifically, hospice nurses (RN, LPN/LVN, NP), physicians, and physician assistants are the only staff who can dispose of medications. These staff must be employed by or under arrangements made by a qualified hospice. A qualified hospice program is defined in the SUPPORT Act as one having written policies and procedures for assisting in the disposal of the controlled substances of a person receiving hospice care after the person’s death, and at the time when the controlled substances are first ordered:

  • provides a copy of the written policies and procedures to the patient or patient representative and family;
  • discusses the policies and procedures with the patient or representative and the family in a language and manner that they understand to ensure that these parties are educated regarding the safe disposal of controlled substances;
  • documents in the patient’s clinical record that the written policies and procedures were provided and discussed; and
  • at the time following the disposal of the controlled substances
    • documents in the patient’s clinical record the type of controlled substance, dosage, route of administration, and quantity so disposed; and
    • the time, date, and manner in which that disposal occurred.”

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