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HomeMy WebLinkAboutmed-project-for-unwanted-drugs-2025-ada MED-Project 2024 Annual Report County of Alameda (Unwanted Medicine), California Due by March 1, 2025 Prepared By: MED-Project Name Submitted To: Alameda County Department of Environmental Health Table of Contents I. Executive Summary 1 A. Notifications in the Reporting Period 1 B. Reporting Period Operations Overview 2 II. Participating Producers 3 III. Collection Method and Weight 3 A. Kiosks 3 B. Mail-Back Packages 3 C. Total Weight of Collected Unwanted Medicine 4 IV. Kiosk Drop-Off Locations, Mail-Back Distribution, and Take-Back Events 4 A. Kiosk Drop-Off Locations 4 B. Mail-Back Package Distribution Locations 4 C. Number of Mail-Back Packages Distributed and Returned 5 D. Take-Back Events 5 V. Disposal Information 5 Disposal Facility Information 5 VI. Compliance with Plan Policies 5 VII. Safety and Security Report 5 VIII. Educational Efforts and Public Outreach 6 A. Public Education Activities 6 B. Outreach Activities 7 C. Evaluation Activities 7 IX. Program Goals 9 A. Collection Goals 9 B. Education and Public Outreach Goals 10 Appendix A 12 Disposal Facilities 12 Appendix B 13 Plan Deviations 13 Appendix C 14 MED-Project Brochures and Posters 14 Appendix D 28 Promotional Material Distribution 28 Appendix E 29 MED-Project Website Pages 29 Appendix F 63 MED-Project Website Statistics 63 Appendix G 64 Social Media and Email Promotion Activity 64 Email Blasts 64 Social Media Posts 65 Appendix H 69 Media Outreach Summary 69 1 I. Executive Summary Regulations Sec 15.C.i.: “The purpose of the Executive Summary is to provide a broad understanding of the Plan as a whole and content for the data and information that will follow. This Summary should include a brief description of collection and disposal efforts during the reporting period. The executive summary should also include a description of proposals to improve collection efforts and challenges encountered during the reporting period, and how they will be addressed. (Security issues must be addressed separately as set forth below.).” MED-Project LLC (“MED-Project”) operates a Product Stewardship Plan for Unwanted Medicine from Households dated August 31, 2022 (“Approved Plan”) in Alameda County (“Jurisdiction”) under the Alameda County General Ordinance Code, Chapter 6.53, the Alameda County Safe Drug Disposal Ordinance (“Ordinance”) and the Alameda Safe Drug Disposal Regulations (“Regulations”). This 2024 Alameda County Unwanted Medicine Annual Report (“Report”) describes MED-Project’s activities between January 1, 2024, and December 31, 2024 (the “Reporting Period”). All capitalized terminology not defined in this summary is derived from the Approved Plan. MED-Project has served the Residents of Alameda County since 2015, including collecting over 430,000 pounds of Unwanted Medicine. MED-Project’s comprehensive outreach and education program has generated over 90 million impressions to County Residents. A. Notifications in the Reporting Period MED-Project submitted two notifications to the Alameda County Department of Environmental Health (“Department”) during the Reporting Period: − MED-Project submitted a notification on April 12, 2024, of a change in the supplier of liners used by the reverse distributor vendor. − MED-Project submitted a modification of the approved Plan on April 24, 2024, to add new transporters and carriers. o Clean Harbors Environmental Services Inc., - 42 Longwater Dr., Norwell, MA 02061 ▪ DOT 18073 – Closed Case1 1 Federal Motor Carrier Safety Administration 2 o Sharps Solutions, LLC – 23575 Cabot Blvd., Suite 205, Hayward, CA 94545 ▪ DOT 2810784 – No penalties found2 B. Reporting Period Operations Overview During the Reporting Period, priority was given to establishing Kiosk Drop-Off Sites throughout the Jurisdiction, and performing outreach to eligible pharmacies, hospitals, and clinics with on-site pharmacies, and Law Enforcement Agencies (“LEAs”). One challenge that has been in the news is the pressure on chain pharmacies and store closures. MED-Project was able to operate 90 Kiosk Drop-Off Sites, with one of those being newly installed in the Reporting Period. MED-Project will continue to periodically perform outreach to potential Kiosk Drop-Off sites and accept additional Kiosk Drop-Off Sites that are eligible and request participation in the Program. Kiosks were installed in pharmacies that meet all local, state, and federal requirements and that executed agreements with MED-Project. In addition, outreach and educational materials, including signage and/or brochures, were distributed to new Kiosk Drop-Off Sites. MED-Project provided disposal instructions for Kiosk Drop-Off Sites and Mail-Back Services to Residents and continues to communicate with Kiosk Drop-Off Site Hosts to distribute outreach materials upon request, review procedures as needed and improve overall Program design. As outlined in the Approved Plan, the ultimate goal of the Program is to provide Residents with convenient, safe, and accessible methods to dispose of Unwanted Medicine. The following Sections of the Report respond to specific reporting requirements in Ordinance Section 6.53.080 and Regulations Section 15. Each section of the Report restates the corresponding Ordinance and Regulations requirements and provides the required information. All figures are rounded to the nearest tenth place. 2 Federal Motor Carrier Safety Administration 3 II. Participating Producers Ordinance Sec. 6.53.080.A.1: “A list of Producers participating in the Product Stewardship Program.” Regulation Sec. 15.D.i: “All Producers participating in the Plan.” The list of participating producers is provided in an accessible spreadsheet. See Attachment A: Participating Producers. III. Collection Method and Weight Ordinance Sec. 6.53.080.A.2: “The amount, by weight, of Unwanted Products collected from Residential Generators collected at each drop-off site and in the entire County of Alameda and, if applicable, the total amount by weight collected by a Mail-Back Program.” Regulation Sec. 15.C.iv: “The Report Narrative shall include a brief description of the collection efforts over the past year.” MED-Project collected Unwanted Medicine during the Reporting Period, utilizing Kiosk Drop-Off Sites, and Mail-Back Packages distributed from the MED-Project Website and Call Center. A. Kiosks MED-Project collected a total of 77,319.2 pounds of Unwanted Medicine through Kiosk Drop-Off Sites. The list of Kiosk Drop-Off Sites is provided in an accessible spreadsheet. See Attachment B; Kiosk Drop-Off Site Locations and Collection Data for the amount of Unwanted Medicine collected at each Kiosk Drop-Off Site during the Reporting Period. B. Mail-Back Packages MED-Project collected a total of 8.5 pounds of Unwanted Medicine through the return of 11 Inhaler Mail-Back Packages. 4 MED-Project collected a total of 65.43 pounds of Unwanted Medicine through the return of 123 Standard Mail-Back Packages. MED-Project collected a total of 73.9 pounds of Unwanted Medicine through the return of Mail-Back Packages during the Reporting Period. C. Total Weight of Collected Unwanted Medicine MED-Project collected a total of 77,393.1 pounds of Unwanted Medicine through all methods. IV. Kiosk Drop-Off Locations, Mail-Back Distribution, and Take-Back Events Ordinance Sec. 6.53.080.A.3: “A description of the collection system, including the location of each collection site and, if applicable, locations where envelopes for a Mail-Back Program are provided.” Regulation Sec. 15.D.ii: “For each Collection Point: (a) Location, host site name, and address; (b) Collected Unwanted Products by weight over the past year; and (c) Number of times Unwanted Products was [sic] picked up for transportation per location.” Regulation Sec. 15.D.iii: “For any mail-back program: (a) The number of mail-back containers distributed; (b) The number of mail-back containers returned; and (c) Collected Unwanted Products by weight.” A. Kiosk Drop-Off Locations The list of Kiosk Drop-Off Sites is provided in an accessible spreadsheet. See Attachment B; Kiosk Drop-Off Site Locations and Collection Data. B. Mail-Back Package Distribution Locations There were no mail-back distribution locations in the Jurisdiction during the Reporting Period. 3 The Mail-Back Package total weight provided by Vendor includes averaged weight calculation data. 5 C. Number of Mail-Back Packages Distributed and Returned MED-Project distributed 351 Standard Mail-Back Packages and 47 Inhaler Mail-Back Packages via the Call Center or through a link on the MED-Project website for a total of 398 Mail-Back Packages. For information on the number of Mail-Back Packages returned, see Section III.B. Mail-Back Packages. D. Take-Back Events There were no Take-Back Events during the Reporting Period. V. Disposal Information Ordinance Sec. 6.53.080.A.4: “The name and location of disposal facilities at which Unwanted Products were disposed of and the weight of unwanted Products collected from Residential Generators disposed of at each facility.” Regulation Sec. 15.D.iv: “For each Disposal Facility: (a) The facility name, address and telephone number; and (b) The total weight of collected products disposed of at each facility.” Disposal Facility Information See Appendix A: Disposal Facilities. VI. Compliance with Plan Policies Ordinance Sec. 6.53.080.A.5: “Whether policies and procedures for collecting, transporting, and disposing of Unwanted Products, as established in the Plan, were followed during the reporting period and a description of any noncompliance.” MED-Project complied with the Approved Plan policies and procedures for collecting, transporting, and disposing of Unwanted Products during the Reporting Period, except for the event discussed in Appendix B. VII. Safety and Security Report Ordinance Sec. 6.53.080.A.6: “Whether any safety and secure problems occurred during collection, transportation, or disposal of Unwanted 6 Products during the reporting period and, if so, what changes have or will be made to policies, procedures, or tracking mechanisms to alleviate the problem and to improve safety and security.” Regulation Sec. 15.C.vi: “This section shall be provided on a separate page and clearly marked ‘Safety and Security Report’. This section shall: (a) Identify any known security or safety incidents at Collection Points, events and during transportation or disposal. For each such incident, the report must include the following: (1) What, if any, corrective or other action was taken in response to the incident; (2) Any law enforcement or regulatory agencies involved in the incident; and (3) Any litigation, arbitrations or other legal proceedings arising out of, or involving, the incident.” There were no safety or security incidents identified during the collection, transportation, or disposal of Unwanted Medicine during the Reporting Period. VIII. Educational Efforts and Public Outreach Ordinance Sec. 6.53.080.A.7: “A description of public education and outreach activities implemented during the reporting period, including the methodology used to evaluate the outreach and Program activities.” Regulation Sec. 15.C.v: “The Report Narrative shall include a brief description of education and public outreach efforts over the past year.” A. Public Education Activities MED-Project provided instructions for Kiosk Drop-Off Sites and Mail-Back Services to Residents during the Reporting Period. In addition, MED-Project maintained the MED- Project Website and toll-free Call Center to provide information pertaining to MED- Project disposal options and outreach materials. The MED-Project Website and Call Center were available in English and the Specified Languages as outlined in the Approved Plan: Spanish, Chinese, Vietnamese and Tagalog. Content on MED-Project’s Website, including downloadable promotional materials such as brochures and posters, can be translated into more than 100 languages via an integrated translation tool. Printed posters and brochures were available in English and Spanish. See Appendix C for examples of brochures and posters. See Appendix D for promotional material distribution information. See Appendix E for screenshots of MED-Project Website pages and Appendix F for MED-Project Website page statistics. 7 B. Outreach Activities MED-Project conducted the following outreach activities during the Reporting Period: connected TV, streaming audio, online video, and digital display advertising campaigns; distributed signage and brochures; posted information on social media platforms and to the MED-Project Website; and sent email blasts. As a part of outreach activities described above, MED-Project generated more than 2.7 million total impressions during the Reporting Period. A list of the social media and email outreach promotion activity is provided in Appendix G The reach percentage for each campaign is provided in the Media Outreach Summary. See Appendix H. C. Evaluation Activities Consistent with the Approved Plan, MED-Project conducted the biennial survey of Residents, pharmacists, veterinarians, and health professionals in the county who interact with patients to measure awareness of disposal programs for expired and/or unwanted medicine and to evaluate the effectiveness of its education and outreach activities during the Reporting Period. A total of 1,000 residents and 200 healthcare providers in Alameda County were surveyed between April 2 and April 16, 2024. Sampling was done at random throughout the population. Results of the survey were posted to the MED-Project Website on July 2, 2024. The survey found that 82% of residents and 96% of providers were aware of pharmacy drop-boxes as a way to dispose of expired or unwanted household medication. Among County residents surveyed, 46% reported utilizing a drop-off location to dispose of expired and/or unwanted medication. Further, 91% of residents find the disposal programs easy to use, 86% find the programs easy to locate, and 89% find the programs convenient. Of healthcare providers, 92% encouraged patients to safely store and dispose of expired and/or unwanted medications. 94% of Alameda County providers believe the disposal programs for expired and/or unwanted medications home are easy to use, 86% believe they are easy to locate, and 92% feel the programs are convenient. The survey found that 54% of Alameda residents indicated they learned about the takeback program for expired and/or unwanted medication through social media platforms, with 31% of residents indicating this was their preferred method of exposure to information about the program. A total of 59% of healthcare providers learned about the takeback program for expired and/or unwanted medication through social media platforms. MED-Project will continue to evaluate media and public outreach as well as collect feedback by surveys to identify and make adjustments and improvements to the 8 Program. Additionally, MED-Project may revise and/or add promotional materials based on changes to the Plan, as needed. 9 IX. Program Goals Ordinance Sec. 6.53.080.A.8: “How the Product Stewardship Program compiled with all other elements in the product stewardship Plan approved by the Department, including its degree of success in meeting any performance goals set by the Department as part of its approval of the Program;” Regulation Sec. 15.C.ii: “The Report Narrative should include a summary of the Plan goals and the degree of success in meeting those goals in the past year. The discussion should include a summary of the efforts to meet the goals, any difficulty in meeting the goals, and if any goals have not been met, what effort will be made to achieve such goals in the next year.” Regulation Sec. 15.C.iii: “The Report Narrative should include proposed goals to be accomplished in the upcoming year. If the proposed goals differ from the original Plan goals, the Annual Report should include a discussion of the reasons for the suggested change(s).” A. Collection Goals As discussed in Section VI of the Approved Plan, MED-Project performed against the following long-term collection goals during the Reporting Period: – Accept any additional potential Kiosk Drop-Off Sites that are eligible and request participation in the Program. – Reduce collection via Take-Back Events and/or Mail-Back Services by establishing additional Kiosk Drop-Off Sites throughout the County. MED-Project operated 90 Kiosk Drop-Off Sites of the 100 Kiosk Drop-Off Sites that are to be distributed jointly, in combination with the other approved product stewardship program, across the County, as outlined in the Approved Plan. Figure 1 shows a visual representation of the Kiosk Drop-off Sites during the Reporting Period. Efforts to meet the long-term goals included accepting an eligible Kiosk Drop-Off Site that requested participation in the Program. No Take-Back Events or supplemental Mail- Back Services were needed as MED-Project operated 90 Kiosk Drop-Off Sites during the Reporting Period. The goals for the upcoming year align with the long-term goals as detailed in this Report and the Approved Plan. 10 B. Education and Public Outreach Goals As discussed in Section VI of the Approved Plan, MED-Project performed against the following long-term education and public outreach goal during the Reporting Period: – Continue media program consistent with Regulations Section 8.A.viii via the: – Website – Call Center – Media campaigns MED-Project met the Approved Plan’s long-term goal by continuing a media program that is consistent with Regulations Section 8.A.viii via the MED-Project Website, Call Center, and media campaigns. See Section IX of this Report for more information. On an ongoing basis, MED-Project may revise and add promotional materials based on changes to the Approved Plan. The goals for the upcoming year align with the long-term goals as detailed in this Annual Report and the Approved Plan. 11 Figure 1: Map of Active Kiosk Drop-Off Sites during the Reporting Period 12 Appendix A Disposal Facilities Total weight of Unwanted Medicine collected using all methods during the Reporting Period. Name Address Phone Weight of Unwanted Medicine Destroyed (in Pounds) Curtis Bay Energy, LP 3200 Hawkins Point Road, Baltimore, MD 21226 (855) 228-1715 1,670.7 Lancaster County Waste to Energy Facility 1911 River Road, Bainbridge, PA 17502 (717) 397-9968 17,817.6 Stericycle, Inc., Warren, Ohio Facility 1901 Pine Avenue SE, Warren, OH 44483 (330) 393-0370 57,903.0 Indianapolis Resource Recovery Facility in Indiana, operating as Covanta Indianapolis, Inc.4 2320 S Harding St., Indianapolis, IN 46221 (317) 634-7367 1.9 Table 1: Disposal Facilities 4 During the Reporting Period, this Vendor rebranded to Reworld. 13 Appendix B Plan Deviations Event: Date: January 5, 2024 Description: During the Reporting Period, there was one event involving an Unwanted Medicine box and liner stored onsite pending Carrier pick-up for longer than the State Board of Pharmacy requirement. Corrective Action Taken: MED-Project reminded the Kiosk Drop-Off Site to notify the MED-Project Help Desk when a box and liner have been awaiting pick-up for ten or more days. MED-Project can confirm that the Unwanted Medicine box and liner was received and destroyed by the Vendor. 14 Appendix C MED-Project Brochures and Posters Figure 2: MED-Project Brochure Front (English) 15 Figure 3: MED-Project Brochure Back (English) 16 Figure 4: MED-Project Brochure Front (Spanish) 17 Figure 5: MED-Project Brochure Back (Spanish) 18 Figure Description: Figures showing the brochure: Figure 2 (Front Side, English); Figure 3 (Back Side; English; Figure 4 (Front Side, Spanish); Figure 5 (Back Side; Spanish) Description: Front Side: What items can I dispose of in a drop box? Please separate and remove any items and medication that are not accepted before disposing. Accepted: Medications in any dosage form, except for those identified as Not Accepted below, in their original container or sealed bag. If transferring medications to a sealed bag, please be sure to recycle remaining packaging. NOT Accepted: Herbal remedies, vitamins, cosmetics, batteries, mercury-containing thermometers, sharps, and illicit drugs. To learn more about items that are not accepted in your area, visit med-project.org. For more information about the MED-Project Program, visit www.med-project.org or call 1 (844) MED-PROJECT or 1 (844) 633-7765 (TTY: 711). For easy-to-use and easy-to-locate medication disposal! Back Side: Are You Done With Those? Safe and Free Medication Disposal. We Make it Easy for You! What should you do with your expired or unwanted medication? Medicine helps treat disease, manage chronic conditions, and improve health and well- being for millions of Americans. Adhering to your medication routine means taking your medicine as directed by your healthcare provider or as indicated on the label or packaging—the right dose, at the right time, in the right way. Then, store it securely, and dispose of it safely, to prevent accidental ingestion or misuse by others, including children and pets. MED-Project programs and services make it safe, free, and convenient for you to dispose of medication. Use as Directed 19 Use medication as directed. If there are specific instructions on the label, package, or package insert, please follow those instructions. If you have any questions, ask your health care providers. Store Securely Follow storage instructions as provided on medicine labels and the information accompanying the medicine. Keep medications in a secure location, safely away from people or pets. Dispose Safely Check your medicine cabinet and remove all expired and unwanted medication. If you do not know if a drug is still safe, check with your pharmacist. Count medication to keep track of amounts. Drop off or mail back expired or unwanted medications for safe disposal. Disposal of Household Medication MED-Project provides safe, free, and convenient disposal options for household medications in your community. Drop Box Conveniently located drop boxes are available in your area. To find a drop box near you, visit the Find a Location section of med-project.org. Mail-Back Mail-back packages are available in your area. All mail-back packages are pre- addressed with postage pre-paid. To order a Mail-back package, visit the Mail-Back section of med-project.org. MED-Project may have mail-back package distribution or informational sites in your area. To find out more about the disposal options in your area, visit med-project.org. To protect your privacy, patients are reminded to remove all personally identifiable information on medication labels or packaging before disposing of unwanted medication. 20 Figure 6: MED-Project Medication Mail-Back Insert (English) 21 Figure 7: MED-Project Medication Mail-Back Insert (Spanish) 22 Figure Description: Figures showing the Medication Mail-Back Insert: Figure 6 (English); Figure 7 (Spanish) Description: Medication Mail-Back Package The following items are NOT accepted in Medication Mail-Back Envelopes: Herbal remedies, vitamins, cosmetics, batteries, mercury-containing thermometers, sharps, illicit drugs, and inhalers. To learn more about items that are not accepted in your area, visit med-project.org. Please separate and remove any items and medication that are not accepted before disposing. To protect your privacy, patients are reminded to remove all personally identifiable information on prescription labels or materials before disposal. If transferring medications to a sealed bag, please be sure to recycle remaining packaging. For more information about the MED-Project program: Please visit med-project.org or call (844) MED-PROJECT (844) 633-7765 (TTY: 711) MED-Project Medication Education & Disposal 23 Figure 8: MED-Project Inhaler Mail-Back Insert (English) 24 Figure 9: MED-Project Inhaler Mail-Back Insert (Spanish) 25 Figure Description: Figures showing the Medication Mail-Back Insert: Figure 8 (English); Figure 9 (Spanish) Description: Inhaler Mail-Back Package MED-Project Medication Education & Disposal Only place undamaged inhalers in their original containers in the Inhaler Mail-Back Package. Inhaler Mail-Back Packages can only be used for inhalers and cannot accept other types of items. Please separate and remove any items and medication that are not accepted before disposing. To protect your privacy, patients are reminded to remove all personally identifiable information on prescription labels or materials before disposal. For more information about the MED-Project program: Please visit med-project.org or call 844-MED-PROJECT (844) 633-7765 (TTY: 711) 26 Figure 10: MED-Project Kiosk Poster (Multilingual) 27 Figure Description: Figures showing the MED-Project Kiosk Poster: Figure 10 (Spanish) Description: Safe & Free Medication Disposal Here MED-Project Call Center (844) MED-PROJECT | (844) 633-7765 | (TTY: 711) med-project.org MED-Project Medication Education & Disposal 28 Appendix D Promotional Material Distribution Sites that received a brochure and/or poster during the Reporting Period. Site Address City Zip CVS Pharmacy 03024 7201 Regional Street Dublin 94568 Kaiser Fremont Niles West OP Pharmacy 161 39400 Paseo Padre Pkwy Fremont 94538 Kaiser Pleasanton South 1 Pharmacy 471 7601 Stoneridge Dr Pleasanton 94588 Kaiser San Leandro Discharge Pharmacy 923 2500 Merced St Fl 1 Bldg H San Leandro 94577 Piedmont Police Department 403 Highland Ave Piedmont 94611 Rite Aid 05952 1991 Mountain Boulevard Oakland 94611 Table 2: Promotional Material Distribution 29 Appendix E MED-Project Website Pages A representative sample of MED-Project Website pages for the Jurisdiction during the Reporting Period. Figure 11: MED-Project Website Home Page 30 Figure Description: Figure showing the Alameda County MED-Project website “Home” page: Figure 11 Description: Alameda County, CA – Medicine/Sharps Disposal Program What should you do with your unwanted household medication and sharps? Medicine helps treat disease, manage chronic conditions, and improve health and well- being for millions of Americans. Take medication as directed by your health care provider and as indicated on the label or packaging, then store it securely, and dispose of it safely, to prevent accidental ingestion or misuse by others, including children and pets. Always be sure to store sharps securely to prevent accidental sticks or misuse by others, and dispose of sharps safely. MED-Project’s disposal services for your unwanted household medication or sharps are safe, convenient, and free. Learn more about the program Linked Alameda MED-Project Website pages (Many of these links are repeated on all Website pages): • Home • Medicine Usage • Safe Storage Information • Find a Location • Mail-Back Services • Take-Back Events • Learn • FAQ • Contact • Login • English (choice of language) Links to social media platforms: • Facebook • X • LinkedIn 31 Figure 12: MED-Project Website Medicine and Sharps Usage Page 32 Figure Description: Figure showing the Alameda County MED-Project website “Medicine and Sharps Usage” page: Figure 12 Description: Medicine & Sharps Usage If there are any specific instructions on the label, package, or package insert, please follow those instructions. Adhering to your medication routine means taking your medicine as directed or as prescribed – the right dose, at the right time, in the right way and frequency. Sharps is a medical term for devices with sharp points or edges that can puncture or cut skin. They may be used at home, at work, and while traveling to manage the medical conditions of people or their pets, including allergies, arthritis, cancer, diabetes, hepatitis, HIV/AIDS, infertility, migraines, multiple sclerosis, osteoporosis, blood clotting disorders, and psoriasis. Never dispose of medication or sharps down the sink or toilet and do not place sharps in the trash or recycling. Doing so may put waste management and sewage workers, custodians, housekeepers, household members, and children at risk of being harmed. If you have questions about any medication or your health, please contact your healthcare provider. 33 Figure 13: MED-Project Website Safe Storage Information Page 34 Figure Description: Figure showing the Alameda County MED-Project website “Safe Storage Information” page: Figure 13 Description: Safe Storage Information It is important to take medication as prescribed by your health care provider and as indicated on the label or packaging. Always be sure to store medicine securely to prevent accidental ingestion or misuse by others, especially children. If you have expired or unwanted household medication, proper storage and disposal are easy. To protect your family, pets, and community, follow these instructions for secure storage and safe disposal. Use as Directed Use medication as directed. If there are any specific instructions on the label, package, or package insert, please follow those. If you have any questions, ask your healthcare providers. Store Securely Follow storage instructions as provided on medicine labels and on the information accompanying medicine. Keep medication in a secure location safely away from people or pets that might come in contact with them. Dispose Safely Check your medicine cabinet and remove all expired and unwanted medication. If you do not know if a drug is still safe, check with your pharmacist. Count medication to keep track of amounts. Drop off or mail back expired or unwanted medications for safe disposal. Please separate and remove any items and medication that are not accepted before disposing. Do not place medicine in the trash or recycling and never flush them down the sink or toilet. To protect your privacy, patients are reminded to remove all personally identifiable information on medication labels or packaging before disposing of unwanted medicine. 35 Figure 14: MED-Project Website Find A Location Page-Convenient Locations Tab 36 Figure Description: Figure showing the Alameda County MED-Project website “Find A Location Page- Convenient Locations Tab” page: Figure 14 Description: Find a Location Convenient Locations MED-Project provides safe, free, and convenient disposal options for household medications in your community. Find a location for services near you. Your Coverage Area Enter your zip code to find a convenient location near you (The user can input their ZIP code and the radius of their search to display a map of nearby Kiosk Drop-Off Sites and Mail-Back Distribution Locations). 37 Figure 15: MED-Project Website Find A Location Page-What Can I Dispose Of Tab 38 Figure Description: Figure showing the Alameda County MED-Project website “Find A Location Page-What can I dispose of tab” page: Figure 15 Description: What Can I Dispose Of? Below are general guidelines for the products that will and will not be accepted in drop boxes. Medicine To protect your privacy, patients are reminded to remove all personally identifiable information on medication labels or packaging before disposing of unwanted medicine. Residents may also go to selected locations to request a Mail-Back Package for expired or unwanted medicine. Accepted Medications in any dosage form, except for those listed below, in their original container or sealed bag are accepted. Not Accepted • Herbal remedies • Vitamins • Supplements • Cosmetics • Other personal care products • Empty medical devices • Batteries • Mercury-containing thermometers • Sharps • Illicit drugs If transferring medications to a sealed bag, please be sure to recycle remaining packaging. Do not place medicine in the trash or recycling, and never flush them down the toilet. Please dispose of any items on the NOT ACCEPTED list at your local Hazardous Waste Facility. Call 1 (800) 606-6606 or visit Household-HazWaste.org for details. Sharps Accepted 39 Sharps (such as hypodermic needles, pen needles, pre-loaded sharps, auto-injectors, intravenous needles, lancets, and other devices used to penetrate the skin for drawing blood, or for the delivery of medicines) contained in U.S. Food and Drug Administration- cleared sharps containers. Not Accepted • Controlled substances (such as opioids) • Unwanted medicines not contained in sharps • Loose sharps that are not contained in U.S. Food and Drug Administration- cleared sharps containers All sharps disposal containers should be made of heavy-duty plastic; able to close with a tight-fitting, puncture resistant lid without sharps being able to come out; upright and stable during use; leak-resistant; and properly labeled as “sharps waste” or with the biohazard symbol and the word “BIOHAZARD” to warn of hazardous materials inside the container. 40 Figure 16: MED-Project Website Find A Location Page-Location Services Tab 41 Figure Description: Figure showing the Alameda County MED-Project website “Find A Location Page- Locations Services” tab: Figure 16 Description: Location Services See descriptions of our services below. Medication Drop Box Medication drop boxes are installed at nearby locations such as pharmacies and law enforcement offices for residents to simply drop off their expired or unwanted household medication for safe, free, and convenient disposal. Sharps Drop Box Sharps drop boxes are installed at nearby locations such as pharmacies and law enforcement offices for residents to simply drop off their household sharps in an approved sharps container for safe, free, and convenient disposal. NOTE: Not all services are available at each location. Visit the Find a Location page to find out what services are available at a specific collection site. 42 Figure 17: MED-Project Website Mail-Back Services Page 43 Figure Description: Figure showing the Alameda County MED-Project website “Mail-Back Services” page: Figure 17 Figure Description: Mail-Back Services MED-Project provides the following different types of Mail-Back Packages at no charge to residents. Please complete the below form to request a pre-paid, pre-addressed mail-back package. Instructions for disposal will be provided with all mail-back services. Please submit separate forms for each type of mail-back package. To protect your privacy, patients are reminded to remove all personally identifiable information on medication labels or packaging before disposing of unwanted medicine. Home healthcare professionals providing services to residents may also request a Mail- Back Package on their behalf. 44 Figure 18: MED-Project Website Medication Mail-Back Package Insert 45 Figure Description: Figure showing the Alameda County MED-Project website “Medication Mail-Back Insert” page: Figure 18 Description: Medication Mail-Back Package Insert Medication Mail-Back Package The following items are NOT accepted in Medication Mail-Back Envelopes: Herbal remedies, vitamins, cosmetics, batteries, mercury-containing thermometers, sharps, illicit drugs, and inhalers. To learn more about items that are not accepted in your area, visit med-project.org. Please separate and remove any items and medication that are not accepted before disposing. To protect your privacy, patients are reminded to remove all personally identifiable information on prescription labels or materials before disposal. If transferring medications to a sealed bag, please be sure to recycle remaining packaging. For more information about the MED-Project program: Please visit med-project.org or call 1-844-MED-PROJECT 1-844-633-7765 (TTY: 711) 46 Figure 19: MED-Project Website Inhaler Mail-Back Insert Page 47 Figure Description: Figure showing the Alameda County MED-Project website “Inhaler Mail-Back Insert” page: Figure 19 Description: Inhaler Mail-Back Package Insert Inhaler Mail-Back Package Only place undamaged inhalers in their original containers in the Inhaler Mail-Back Package. Inhaler Mail-Back Packages can only be used for inhalers and cannot accept other types of items. Please separate and remove any items and medication that are not accepted before disposing. To protect your privacy, patients are reminded to remove all personally identifiable information on prescription labels or materials before disposal. For more information about the MED-Project program: Please visit med-project.org or call 1-844-MED-PROJECT 1-844-633-7765 (TTY: 711) 48 Figure 20: MED-Project Website Learn Page 49 Figure Description: Figure showing the Alameda County MED-Project website “Learn” page: Figure 20 Description: Outreach and Education Part of MED-Project's mission is to reach out to the local community and educate residents about the proper disposal of unwanted household medication and sharps. Medicine helps treat disease, manage chronic conditions, and improve health and well- being for millions of Americans. Take medication as directed by your health care provider and as indicated on the label or packaging, then store it securely, and dispose of it safely, to prevent accidental ingestion or misuse by others, including children and pets. Always be sure to store sharps securely to prevent accidental sticks or misuse by others, and dispose of sharps safely. MED-Project’s disposal services for your unwanted household medication or sharps are safe, convenient, and free. Brochure – Medicine Program View Brochure Content Brochure – Sharps Program View Brochure Content Frequently Asked Questions View our FAQs Video Public Service Announcement (PSA) – Medicine & Sharps Program Watch PSA Survey Information & Results – Unwanted Medicine View Survey Survey Information & Results - Sharps View Survey Login to your account to order brochures or view signage. If you would like any of the unwanted Medicine Program materials emailed to you, contact: alameda@med-project.org. 50 If you would like any of the Sharps Program materials emailed to you, contact: alamedasharps@med-project.org. 51 Figure 21: MED-Project Website Brochure Page 52 Figure Description: Figure showing the Alameda County MED-Project website “Brochure” page: Figure 21 Description: Brochure – Medicine Program Outreach and Education Part of MED-Project’s mission is to reach out to the local community and educate residents about the proper disposal of unwanted household medication. Are You Done With Those? Safe and Free Medication Disposal. We Make it Easy for You! What should you do with your expired or unwanted medication? Medicine helps treat disease, manage chronic conditions, and improve health and well- being for millions of Americans. Adhering to your medication routine means taking your medicine as directed by your healthcare provider or as indicated on the label or packaging—the right dose, at the right time, in the right way. Then, store it securely, and dispose of it safely, to prevent accidental ingestion or misuse by others, including children and pets. MED-Project programs and services make it safe, free, and convenient for you to dispose of medication. Use as Directed Use medication as directed. If there are specific instructions on the label, package, or package insert, please follow those instructions. If you have any questions, ask your health care providers. Store Securely Follow storage instructions as provided on medicine labels and the information accompanying the medicine. Keep medications in a secure location, safely away from people or pets. Dispose Safely Check your medicine cabinet and remove all expired and unwanted medication. If you do not know if a drug is still safe, check with your pharmacist. Count medication to keep track of amounts. Drop off or mail back expired or unwanted medications for safe disposal. Disposal of Household Medication 53 MED-Project provides safe, free, and convenient disposal options for household medications in your community. Drop Box Conveniently located drop boxes are available in your area. To find a drop box near you, visit the Find a Location section of med-project.org. Mail-Back Mail-back packages are available in your area. All mail-back packages are pre- addressed with postage pre-paid. To order a Mail-back package, visit the Mail-Back section of med-project.org. MED-Project may have mail-back package distribution or informational sites in your area. To find out more about the disposal options in your area, visit med-project.org. To protect your privacy, patients are reminded to remove all personally identifiable information on medication labels or packaging before disposing of unwanted medication. What items can I dispose of in a drop box? Please separate and remove any items and medication that are not accepted before disposing. Accepted: Medications in any dosage form, except for those identified as Not Accepted below, in their original container or sealed bag. If transferring medications to a sealed bag, please be sure to recycle remaining packaging. NOT Accepted: Herbal remedies, vitamins, cosmetics, batteries, mercury-containing thermometers, sharps, and illicit drugs. To learn more about items that are not accepted in your area, visit med-project.org. For more information about the MED-Project Program, visit www.med-project.org or call 1 (844) MED-PROJECT or 1 (844) 633-7765 (TTY: 711). For easy-to-use and easy-to-locate medication disposal! 54 Figure 22: MED-Project Website Frequently Asked Questions Page 55 Figure Description: Figure showing the Alameda County MED-Project website “Frequently Asked Questions” page: Figure 22 Description: General Questions What is MED-Project? What should I do if I am having a medical emergency? What should I do if I think I have ingested something poisonous? What should I do if my pet has ingested medication? What should I do if I think I or someone in my household has been stuck by a used sharp? Where can I find information about California's Prop 65? Where are the MED-Project disposal locations nearest me? Medicine and Sharps Program Questions Whom should I call with a question about my medication or sharps? Where can I find information about the safe storage of medication or sharps? How do I dispose of my expired or unwanted medicine or sharps? Should I remove my personal information before disposing of my medication or sharps? Will it cost me anything to dispose of my medication or sharps? Can I flush my medication or sharps down the toilet? What items can I dispose of in a MED-Project drop box? Where else can I find information about the safe disposal of unwanted household medication or sharps? What is recommended for safe disposal of expired or unwanted household medication and/or sharps in Alameda County? I have a question not answered by this website. Is there someone I can contact with a question about MED-Project? Where can I find more information on the Alameda County Safe Drug Disposal Ordinance? 56 Figure 23: MED-Project Website Public Service Announcement Page 57 Figure Description: Figure showing the Alameda County MED-Project website “Video Public Service Announcement” page: Figure 23 Description: Outreach and Education Part of MED-Project's mission is to reach out to the local community and educate residents about the proper disposal of unwanted household medication and sharps. 58 Figure 24: MED-Project Website Signage Page 59 Figure Description: Figure showing the Alameda County MED-Project website “Signage” page: Figure 24 Description: Safe & Free Medication Disposal Here Choose the poster title you want to translate, select your preferred language, and then print. Safe & Free Medication and Sharps Disposal Here Choose the poster title you want to translate, select your preferred language, and then print. Safe & Free Sharps Disposal Here Choose the poster title you want to translate, select your preferred language, and then print. 60 Figure 25: MED-Project Website Contact Page 61 Figure Description: Figure showing the Alameda County MED-Project website “Contact” page: Figure 25 Description: Contact Residents If you are a resident of Alameda County and have questions about MED-Project, please contact: 1 (844) MED-PROJECT or 1 (844) 633-7765 or (TTY: 711) For answers to some frequently asked questions, visit the MED-Project FAQ page. Convenient Locations If you are a current drop box site, or a retail pharmacy, hospital/clinic with an onsite pharmacy or a law enforcement agency interested in hosting a drop box, please contact us: Click here: Login or Register for an Account Call us by Phone: 1 (833) MED-PROJECT or 1 (833) 633-7765 Fax us: 1 (866) 633-1812 Email us: Email Inquiries for Medicine Disposal: alameda@med-project.org Email Inquiries for Sharps Disposal: alamedasharps@med-project.org Address: Dr. Victoria Travis, PharmD, MS, MBA National Program Director MED-Project, LLC 4096 Piedmont Ave - Unit 174 Oakland, CA 94611 Convenient Locations/Host Sites - Request Materials 62 Login to your account to order brochures or contact us at 1 (833) MED-PROJECT or 1 (833) 633-7765. If you have any questions, comments, or concerns, login to your account. Drug Producers If you are drug producer interested in participating in the MED-Project Stewardship Plan contact: Phone: 1 (202) 495-3131 Email: compliance@med-project.org Sharps Producers If you are a sharps producer or a producer of medications usually injected outside of a healthcare setting and sold in the jurisdiction and are interested in participating in a MED-Project Product Stewardship Plan, please contact: Phone: 1 (202) 495-3131 Email: compliance@med-project.org If you are experiencing a medical emergency, please dial 911. If you are experiencing a non-emergency but suspect that you or another individual has ingested something poisonous, please call Poison Control at 1 (800) 222-1222. If you have questions about your medication, please call your health care provider. 63 Appendix F MED-Project Website Statistics The total number of MED-Project Website visits, by page, during the Reporting Period. Web Page URL Total Views Home https://med-project.org/locations/alameda/ 2,311 Medicine Usage https://med- project.org/locations/alameda/medicine-sharps- usage/ 491 Safe Storage Information https://med-project.org/locations/alameda/safe- storage-information/ 213 Find a Location https://med-project.org/locations/alameda/find- a-location/ 6,423 Mail-Back Services https://med-project.org/locations/alameda/mail- back-services/ 4,173 Learn https://med-project.org/locations/alameda/learn/ 695 Contact https://med- project.org/locations/alameda/contact/ 157 Privacy Policy https://med- project.org/locations/alameda/privacy-policy/ 37 Total N/A 14,500 Table 3: MED-Project Website Statistics 64 Appendix G Social Media and Email Promotion Activity Email Blasts Email blasts sent to community contacts. Date Subject 03/28/2024 Alameda County - Medicine/Sharps Disposal Program Available in your Community 06/21/2024 Alameda County - Medicine/Sharps Disposal Program Available in your Community 09/24/2024 Alameda County - Medicine/Sharps Disposal Program Available in your Community 11/14/2024 Alameda County - Medicine/Sharps Disposal Program Available in your Community Table 4: Email Blast Activity 65 Social Media Posts Date Subject Social Media Platform 01/02/2024 General Unwanted Medicine/Sharps Program Information Facebook 01/10/2024 General Unwanted Medicine/Sharps Program Information X 01/11/2024 General Unwanted Medicine/Sharps Program Information Facebook 01/17/2024 General Unwanted Medicine/Sharps Program Information X 01/18/2024 General Unwanted Medicine/Sharps Program Information Facebook 01/23/2024 General Unwanted Medicine/Sharps Program Information Facebook 01/24/2024 General Unwanted Medicine/Sharps Program Information X 01/31/2024 General Unwanted Medicine/Sharps Program Information X 02/06/2024 General Unwanted Medicine/Sharps Program Information Facebook 02/07/2024 General Unwanted Medicine/Sharps Program Information X 02/14/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 02/21/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 02/28/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 03/06/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 03/12/2024 General Unwanted Medicine/Sharps Program Information Facebook 03/13/2024 General Unwanted Medicine/Sharps Program Information X 03/19/2024 General Unwanted Medicine/Sharps Program Information Facebook 03/20/2024 General Unwanted Medicine/Sharps Program Information X 03/26/2024 General Unwanted Medicine/Sharps Program Information Facebook 03/27/2024 General Unwanted Medicine/Sharps Program Information X 66 Date Subject Social Media Platform 04/03/2024 General Unwanted Medicine/Sharps Program Information X 04/06/2024 General Unwanted Medicine/Sharps Program Information Facebook 04/09/2024 General Unwanted Medicine/Sharps Program Information Facebook 04/10/2024 General Unwanted Medicine/Sharps Program Information X 04/16/2024 General Unwanted Medicine/Sharps Program Information Facebook 04/18/2024 General Unwanted Medicine/Sharps Program Information X 04/23/2024 General Unwanted Medicine/Sharps Program Information Facebook 04/24/2024 General Unwanted Medicine/Sharps Program Information X 05/8/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 05/15/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 05/21/2024 General Unwanted Medicine/Sharps Program Information X 5/22/2024 General Unwanted Medicine/Sharps Program Information Facebook 5/29/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 06/06/2024 General Unwanted Medicine/Sharps Program Information Facebook 06/11/2024 General Unwanted Medicine/Sharps Program Information Facebook 06/12/2024 General Unwanted Medicine/Sharps Program Information X 06/18/2024 General Unwanted Medicine/Sharps Program Information Facebook 06/19/2024 General Unwanted Medicine/Sharps Program Information X 06/21/2024 General Unwanted Medicine/Sharps Program Information X 06/25/2024 General Unwanted Medicine/Sharps Program Information Facebook 06/26/2024 General Unwanted Medicine/Sharps Program Information X 07/10/2024 General Unwanted Medicine/Sharps Program Information X 67 Date Subject Social Media Platform 07/11/2024 General Unwanted Medicine/Sharps Program Information Facebook 07/16/2024 General Unwanted Medicine/Sharps Program Information Facebook 07/17/2024 General Unwanted Medicine/Sharps Program Information X 07/23/2024 General Unwanted Medicine/Sharps Program Information Facebook 07/24/2024 General Unwanted Medicine/Sharps Program Information X 07/30/2024 General Unwanted Medicine/Sharps Program Information Facebook 07/31/2024 General Unwanted Medicine/Sharps Program Information X 08/07/2024 General Unwanted Medicine/Sharps Program Information X 08/14/2024 General Unwanted Medicine/Sharps Program Information X 08/21/2024 General Unwanted Medicine/Sharps Program Information X 08/23/2024 General Unwanted Medicine/Sharps Program Information Facebook 08/25/2024 General Unwanted Medicine/Sharps Program Information Facebook 08/27/2024 General Unwanted Medicine/Sharps Program Information Facebook 08/28/2024 General Unwanted Medicine/Sharps Program Information X 08/29/2024 General Unwanted Medicine/Sharps Program Information Facebook 09/04/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 09/11/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 09/18/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 09/25/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 10/02/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 10/09/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 10/16/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 68 Date Subject Social Media Platform 10/23/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 11/04/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 11/12/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 11/18/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 11/25/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 12/02/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 12/09/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 12/16/2024 General Unwanted Medicine/Sharps Program Information Facebook and X 12/23/2024 General Unwanted Medicine/Sharps Program Information Facebook and X Table 5: Social Media Posts 69 Appendix H Media Outreach Summary Table 6: Media Outreach Summary Media Channel (Type of Media) Start Date End Date Name of Publication, Network, or Station Impressions Reach 05/06/2024- 06/03/2024 Digital Display 05/06/2024 06/03/2024 AdTheorent 1,829,736 38% Connected TV 05/06/2024 06/03/2024 AdTheorent 216,061 4% Online Video 05/06/2024 06/03/2024 AdTheorent 405,863 14% Streaming Audio 05/06/2024 06/03/2024 AdTheorent 344,637 5% Total N/A N/A N/A 2,796,297 52%