heir booiths bicycles that's a great place to see what the word is like outside of the city. speaker: the meeting will come to order for audit february 26, 2015. i'm supervise yee and to my right is christensen and to my right is supervisor bree. erica major is the clerk. madam clerk, any announcements. speaker: make sure to silence all cell phones and electronic devices and copies of any documents apart of the file should be submitted to the clerk. items will appear on the march

5th agenda unless otherwise stated. speaker: madam clerk, please call the first item. ordinance amending the environment code to require any person who produces a drug offered for sale in san francisco to participate in an approved drug stewardship program for the collection and disposal of unwanted drugs from residential sources; to provide for implementation, enforcement, fees, and penalties; and making environmental findings. speaker: thank you. since supervisor bree is the primarily sponsor of this item, i'd like to turn this over to her. for the rest of the item. speaker: thank you, chairman yee. colleagues, before you today is legislation that both -- that addresses both a public safety and environmental concern. what we do with leftover medication. if you were like me or you may have a drawer or cabinet

with a bottle of expired ib pro fin or unused prescription drugs. the problem is most of us don't know what to do with them. flushes meds down the toilet send them to the sewerage plant which means the chemicals pollute the bay. chemicals can leak out of the land field into ground water or get pumped to sewerage plants where again they won't be removed. it can seem easier to just close the medicine cabinet and forget about it which many of us do. unfortunately that approach that can the worst consequences as the drugs are miss appropriated by people struggling with addiction or kids looking for a high or elderly confusing them with their daily meds. according to

the poison control, 90% of poisoning happen in the home. last year san francisco called the poison control, 4,055 times about pharmaceutical exposure. 41% were unintentional -- drug abuse is a major problem among teenagers and adults and in 2010 and 2011, san francisco saw 225 deaths due to prescription drugs. at the national level, the center for disease control reported in 2013, a total of 43900 overdose drugs in the country -- 51.8% were related to pharmaceutical. the disease control states that 15,000 people die every year from

prescription painkiller overdoses, that is more than heroin and cocaine alone. so unwanted and expired medications are not just environmental problems they can be a public safety risk. we may not be able to prevent every accidental poisoning or remove all chemicals from the bay, but we do -- we can do something to help. this legislation will require drug manufacturers with city oversight to fund and operate full collection programs just as they do throughout europe, columbia, brazil and directly to our north and south and canada and mexico. consumers can place their old medications and secure drop off bins in pharmacies or return them by mail all at no cost and without any increase in drug prices. we aim to have at least five drop off locations in each district in the city. san

francisco has actually been operating a small drug, dispose pilot program for about three years now. in that time, our pilot which now includes 12 independent pharmacies and one community center and all ten of our city's police stations has safely collected 23.5 tons of medicine. that's 47,000 pounds of chemicals that will not end up in our bay or in the wrong hands because of this program. clerkly, san francisco will use it if it's free, and convenient. imagine how much more we can collect and properly dispose if we can include more than 13 locations. the ordinance before you today, colleagues, will provide a safe disposal program. this is not a new or untested idea. it is an out

growth of our pilot and it is informed by the similar programs in alameda and king county, washington. today is a combination of years of work and there are a lot of people that i want to thank for bringing this program forward. first and foremost, thank you to debbie ralphale and rodriguez and maggie at the department of environment. your department has championed this effort for years and i'm grateful for all of your work. it has been great to see a department has engaged on a piece of legislation which is a testament both to debbie herself and the importance of this issue. i want to thank all the stakeholder who's have met with us and provided feedback and some criticism over the last few months including the california retailers association, the chamber of commerce, safe way, target, walgreens and cvs. kaiser, the hospital

council and dignity health. bay bio, nova and consumer health care products association, your feedback has made this legislation although i do realize there's still concerns. i'm grateful to alameda nate mildly who pushed the first safe drug ordinance and i want to thank my predecessor and david chiu for carrying the legislation and to erik mar, i also want to thank my legislative aide conner johnson for his hard work on this legislation as well. my office and i have had numerous meetings with stakeholders over the last few months and we have added some important amendments as a result of the conversations. we have further clarified that retailers are not obligated to participate in collecting -- collection programs though we obviously will encourage them to do so

and some seem very interested in participating. we have refined the definition of manufacturers, wholesalers and copackers to make it clear that extended producer responsibility refers to the producer, the party that actually originally created the drug. we expanded the programs availability to non englanderish -- english supporters. so we added a requirement for all city operated pharmacies to par tas -- participate in the take back program. i don't know if i worked an issue with an impressive coalition of supporters that includes the san francisco police department, the department of the environment, the public utilities commission, the department of public health, recology, the san francisco medical society representing over 1500 physicians and medical

students. the san francisco suicide prevention center, alcohol justice, the national coalition against prescription drug abuse, the california retailers association which we just received a letter of support from today. and state wide environmental and senior groups including california produce stewardship council, green city california, clean water action, and the california association of retired americans. and i have a letter of support from all 12 of the independent pharmacies that have been participating in the city's pilot program. in considering this issue, we can either side with environmentalist, police officers, doctors, drug treatment centers, seniors and our own city department or we can side with the drug companies. i know some will say this ridge legislation won't remove all pharmaceutical from our water and stop addiction. i know that. i agree. i

would never argue this legislation is a cure all. but i also don't think we should do nothing just because we can't do everything. would we be better off if the 23 tons of drugs that our pilot program has collected have gone to the land field as well. drug disposal is an important step in protecting our environment, senior, children, pets, and those struggling with addiction. and i know some have asked, why don't we fund this program by adding a fee onto retail drug prices. i will let the department of the environment explain the precedent and rationale and the concept that a company should actually be responsible for the products it creates. all i'm doing -- all i'm going say is this program will cost in the range of 4 or 500,000 compared to the millions of dollars that the drug companies do in

this city every year. i will not raise the price of grandma's pay for her health medication just to save a few pennies for some multi billion dollar company and it's important to point out that as rate payers, we're paying for disposal on our water bill. we have no responsible for the end of life of their products. it's time for them to share in the responsible, san francisco won't back down from protecting our environment or public safety. now is a time for us to pass this law and make it convenient and say for san franciscans to do the right thing with their leftover medication. colleagues, i'm asking you to join me in protecting our environment and our families. so with that, i want to first, before we make the specific amendments, i'd

like to first introduce debbie raphael and gill more rodriguez for a presentation. speaker: good morning, supervisors. thank you, everyone for taking the time with us today on this incredibly important issue. thank you president breed for that phenomenal introduction. it will make my slides go very smoothly because you have introduced many of the concepts that i wish to touch upon. as president breed said, this is an ordinance with a truly unique coalition. a very broad spectrum of individuals who have come here today to express their support for this ordinance. so you will hear from me and my remarks are going to be mostly setting the context for this. how does this relate to previous actions the board of

supervisors have taken, previous statements by our elected body and how is this viewed in the larger context nationally and internationally. then when i'm done gilmore rodriguez will talk about the details of the ordinance and he'll talk about this ordinance has been improved and altered because of that incredible level of input we've gotten from stakeholders. after you hear from the department of the environment, i want you to hear from the other city departments that find this to be a very important ordinance to meet their goals as well. that will be the police department and the department of public health. so you'll hear in the next 30 minutes, the tremendous breath of support for this ordinance and how this ordinance fits beautifully into the way we in san francisco work to protect our citizen and protect the environment.

so san francisco has a wonderful history of being the first. it has a history of taking brave action and a history of taking good care of the people who live here as well as the environment where we find ourselves and this ordinance sits perfectly within that history. in particular, i want to call attention to something that happened in 2003 that really sets the stage for the philosophy behind this ordinance. in 2003, the berd of supervisors and the mayor signed into law chapter 1 of our environment code and chapter 1 is called the precautionary principle. i'm going read the text and i'm going to say what it means. here's what the law intends where threats of serious on are irr

versalable. it should not be a reason for the city to prevent the -- or protect the health of its citizens. what this sentence is saying is that the frame which you as supervisors should judge this ordinance, is number one, is there sufficient evidence of harm? potential harm to the environment or harm to people. secondly, is there a cost defective remedy and third, are we able to do that in the presence tense. do we have the tools we need to take action now? and i think what you will see and i hope by the end of my presentation, you'll see the answer to all three questions is a resounded yes. first, is there evidence of harm? is there evidence of potential ear reversible harm. when the geological survey -- in thousands of cases they have found nearly in every case, they have

found evidence of these chemicals entering the ecosystem with a level of science we understand now with low dose effects, we understand tiny levels of these chemicals do and can have impact on the ecosystem on our fish and natural environment. you heard president breed talk about phenomenal is it a -- the phenomenal statistics when they get into the hands of children, animals or the elderly. is there a mechanism for cost effective disposal. how do we get rid of these safely? san franciscans are well aware of thinking about where things go. we're such a well trained city in terms of looking at the green, the blue, the black bin. the problem with medicines as president breed said, it's confusing. they actually don't go in

any of those places. but in fact, there is a place they can go, and that place is been exemplified by our take back pilot. another context, producer responsibility. this is something president breed alluded to her in her opening remarks. in 2006 and 2010 the board of supervisors expressed explicit support for consumer responsibility. the way i like to think about it, instead of extended producer, it's a shared responsibility. the fact is all of us have a responsibility to make sure that the products we buy don't harm people or the environment. government has been the traditional end point of that responsibility through its laws, its regulations and oversight. in san francisco, consumers have a responsibility making sure that things go in the right place. retailers have a responsibility. a

responsibility to help us beat collection sites and in san francisco, every walgreens takes back batteries. we have dozens of sites to take back paint, florescent light bulbs. the missing link in this shared responsibility is the producer. the producer making money off these product and have an obligation to help us and work with us to make sure they're safe. that's what extended producer responsibility means. in san francisco, we have examples of that on paint, on light bulbs, on thermostats, on batteries, on cell phones, the list goes on. we need that to also be the case for pharmaceuticals. so we did a take back program to prove a concept because this other question you need to answer is, is there a cost effective method. there is. we

collected 23 tons. and we did so with a voluntary system with pharmacies. we didn't have to cohearse them. we have a community center and the participation of all ten of our police stations. i want to give a shout out to chief greg. it was important for him to have safe places. the problem is and supervisor yee knows this when he looks at this map, it's not a nice equal distribution. supervisor's yee has no convenient locations. so we need a better system. we need a system that is available to everyone in this city equally.

the way it works -- this is important. is there a system in place that's cost effective and safe. this system insures the safety of those drugs once they are in the bin, that there won't be tampering with, the police have a word they call "diversion." for me, that's a good thing. in the drug world, it's bad. diversion means they didn't go to their intended place which is destruction. because of these two key system and one is with the pharmacist and the haller who is certified to pick these up and send them off for destruction. so, the residents like this. this is a chance we had to look at the data. if you look at the data over the course over our pilot. we had the pharmacies, we had the police department for controlled substance and then

we had a serious of one day event. these collection events put on by the dea and the data speaks for themselves that residents find the opportunity to go to a neighborhood drop off sight within they want to be their desired method. so in fact, these numbers show that there is a cost defective alternative to address the threat of harm that is clear from pharmaceuticals that don't end up in the right place. so the positive -- i want to say that it was very important to get the pilot kicked off. we needed some initial seed funding and we got that from farma and i want to say a big thank you to them because when this on erd nance came before this body several years ago, we didn't have a track record to answer that second question. is there a cost defective way that's effective. they gave us seed money. they kicked in as

well which i'm grateful for. we used that money as ape seed to start the pilot program and pay for the disposal cost. the problem is it's not sustainable. it only covered 41% of the cost and number two, it's on a year to year basis. it's not a long term funding. it was meant as a way to get us started. so we need a funding mechanism. we need a way to make sure that this is funded throughout -- i won't say eternity. supervisor, assembly member chiu took the lead on that and when he left, he put it in the phenomenally able hands of a true environmental health champion in president breed. we know

enough to know it works. we know enough that -- we know it's right because we know it works. the number shows it work. we have a system that's great and we know the time is right because legal challenges have larger or overcome. alameda county stepped out ahead. they got sued. the ninth circuit court of appeals ruled in favor of alameda county. it's very clear that cities have the right, cities and counties have the right to protect their residents and to do so by requiring the companies who sell products into their borders help the county do so. that is what the judges rule. the dea, the drug enforcement agency also heard the call from physicians and law enforcement that they needed to make it

clearer and easier for pharmacies to take back control substances. so they adopted those rules. those rules are very recent. we'll be working with the dea to clarify them and we'll be working actively with pharmacies to make sure they understand what's expected of them. so it allows pharmacies to take back control substances or not. pharmacies have a choice. we have ten police stations that are set up to take control substances, if a pharmacy decided they're uncomfortable doing controlled and uncontrolled substances. residents want this convenient solution. that's clear. now, one could ask, if this is good for alameda county and we have other counties considering it, why isn't there a state wide solution. i couldn't agree more. that's the right question. in fact, we had permission as a city to come out in favor of state wide legislation last legislative session. we actively educated

legislatures about this issue. the problem was we had a big concerted effort by industry to block a state wide solution. so when i hear from industries saying we need a state wide solution, i agree, and join me, my call to industry if that's what we need, join san francisco in getting a state wide solution just like we saw for the plastic bag ban. don't say we need it on the one hand and block it when there's a bill. just like president breed has said, this is not done in a vacuum. our department has had six stakeholders meetings and countless conversations over the last three years. this is a well thought out carefully crafted ordinance that you have before you. and we're not unique. these pharmaceutical companies have managed to pay for this in many, many other county -- i'm sorry, countries across the world. so canada,

many providences in canada have a pharmaceutical industry paid take back. same with mexico same with the countries in the european union. in all those cases, it is the pharmaceutical companies who pay and the governments who do oversight. that is the model that has worked throughout the world and in no case was there any measurable increase in the cost of pharmaceuticals. the pharmaceutical industry knows how to do this and they do it with the pharmacies because they take back recalls. it's set up worldwide. the farm -- the pharmaceutical companies are experts. alameda passed an ordinance. they had two hearings on stewardship plans. pharmaceutical companies have joined in alameda county to submit stewardship plans. same in king county.

well over 200 companies have joined and those in king county have stepped up to the plate to join them. we think there's lots of precedents that will work here in san francisco as well. you'll hear from industry sometimes that home disposal is the best option. what does home disposal means? it means flushing down the toilet or putting in the trash and you heard while those home disposal is not a good option. what i found really interesting was that the office of the national drug control policy, under president obama, did a major initiative to tackle the problem of prescription drug misuse in the country. one of their four pillars on that national effort was proper disposal. get them out of people's hopes and in their words, this is their words, they say take back is the best option. they acknowledge that there aren't a lot of take back

options yet. but the national drug and hold policy, that office is telling us this is the way to go. take back works. as we step back and think about that chapter 1 of the environment code, is there evidence of harm? i believe there is. is there an effective cost defective remedy for that, yes there is. is it within our authority and ability to do something about it? yes, there is. i hope in my presentation, i have made, feel comfortable about taking this bold move that i believe we all know is the right move to take. now i'm going to talk about -- and i want to say that i know this is -- this takes time and i want to thank you for this time. this is an important ordinance. it's important for you to have confidence that it's a well crafted thought out program. and so i'm going to ask gilmore rodriguez to come up and walk you through the touch points of

the ordinance and the timeline to let you know we have time also to roll this out in a way that's supportive of our partners so with that gilmore rodriguez. speaker: gilmore rodriguez, department of department. i want to walk you through what is in the ordinance and how the department fees are implementing that and serving as its oversight body for the city. the first is the ordinance requires producers who sell products in san francisco to work together to produce collection and disposal programs called store ship plans. to meet the requirements that are stated in the ordinance. producers have several options that they can follow. they can operate one of their own plans, they can join together in a multi party plan or enter into an agreement with a third party referred to as a product stewart organization to operate a plan on their behalf.

the department of the environment will review that plan and ask for a four year cycle. as was said before, the important part is an attempt to double the sites available for consumers to a minimum of 55. as you heard and you can see in this slide, district 6 and 7 have no retail pharmacy drop off sites, district 6 only has a police station drop off site, and district 7 has no drop off site at all. under the ordinance, we would double the number in each location for a total of 55 sites. just to give you a sense of, are there enough potential locations for this mandate to increase convenience? there are 137 retail pharmacies in san francisco. in addition, the ordinance requires san francisco to city run pharmacies, the one in san francisco general and the