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 one at community behavioral health services in sylma serve as sites. we're halfway there and then you add the -- our public police stations. we're over halfway there. we think we have an opportunity to make this convenience a reality. next i really want to stress that the ordinance really was designed with a lot of flexibility. to allow producers to be very creative, and their approach to bringing convenience forward. as was said earlier, producers knows their industry best. they can leverage their knowledge in creating a take back site. they don't have to provide collection sites. they can use pre-paid mailed

envelopes where for seniors and others who are maybe home bound or disabled and can't get to a location, you can use that. they can do collection events and many other things. if they can't reach the five pharmacies or five drop off locations in a soup -- it allows flexibility. they can come to the department and said we tried and we couldn't find every facility available, but here's what we're going to do to make sure consumer in that district have ability and access and convenience. there's flexibility built into the system. next, we really heard a lot and we experienced a lot in working with our pilot program. both working with pharmacies and working with consumers. that's teaching consumers how to use the system. and so there's a significant component in the ordinance. it talks about education and outreach. the big thing we think is exciting is we require producers to follow the city's

example by adhering to our action ordinance and making sure that term materials are available to the public in languages they can under and comfortable with. the department isn't going to let the producers loan on this issue. we plan to work with them on an education and outreach component. we have a lot of experience -- the city has great experience at this. we plan to provide assistance and help with the department, and designing a single system of promotion. and then, what's also important to mention is that the board of supervisors in 2011, passed the safe drug disposal information ordinance which requires all pharmacies who are not participating in a take back program to make available to their customers, locations of where their customers can go take their unuse and unwanted medicine and that will continue. and another discussion has been in the ordinance, how do we measure success? how do we

know we're doing the right thing and doing it well? the first is awareness. producers in the ordinance, producers must conduct a survey of resident and pharmacy and other health care professionals every two years. the survey will test awareness of the plan, and the survey will evaluate whether medicine collection are convenient and easy to use. two, is convenience. producers must provide an annual report to the department detailing the number of location and events and utilization to the event. and how much has been collected. they must update their plan every four years, again, to allow new opportunities and ways of making the program successful. and finally the department shall report by annually to the board of supervisors on the effectiveness on the program. let me talk about the implementation and

oversight. the ordinance designates the department of the environment as the lead agency for implementation and oversight. what does that mean. for the department, it really means one providing technical assistance and that is working hand and hand with producers to develop and design effective programs. we're not just going to assume that they know all the answers. weaver -- we're going to be there to help make connections and connect the dots and introduce them to the programs and make it successful and then it's the review plan and finally enforcement. it gives the department rules necessary to make sure requirements are being met. supervisors, let me give you a sense of what the timeline is. the ordinance spells out lots of dates and i want to give you a sense that we're not rushing into trying to produce a program overnight that the ordinance really does allow for 18 months to

develop an effective program. first, within two months of the effective date, wholesalers must notice the department of producers selling into san francisco. basically who all is selling covered drugs in san francisco. second, within six months of the effective date, these producers must acknowledge to the department that they are subject to the ordinance. and as debbie mentioned in her comments, we really believe that producers will participate in san francisco. if you look at alameda county, 229 producers are participating there. and in king county, 271 producers are participating there. we believe producers will be responsive and follow the law in san francisco. next is within 9 months of the effective day, producers must invite all pharmacy and law offices in san francisco to participate. again, in drafting the ordinance, we took this and found it as a mile stone.

there's discussions as to what if we can't find enough pharmacies to participate. let's look at king county as an example. up there, the producers received commitments from 93 pharmacies and are in discussion with 174. as i mentioned earlier, we have 130 retailers in san francisco. we believe the retailers won't have problems finding willing partners in san francisco. fourth, within 12 months of the effective date, producers will submit a stewardship plan. next, the department will have three months to review the plan, ask then finally we will approve a plan and then within 18 months, we should have a program up and running. should the board and the mayor approve this ordinance, we have between 18 and 24 months to work and develop a world class model program. we're not rushing into this.

we have a lot of good evidence, we have a lot of good data. we plan to do this right. we plan to be engaged with producers on this. we want this to work for san franciscans. this is the outline of the ordinance. thank you for your time. speaker: thank you, very much. there are a few questions before we move onto the next presentation. supervisor yee. excuse me. so the next presentation will be from dr. judith martin who is with the department of public health. followed by the public utilities commission, and the police department, finally. so there's three other presenters. if you want to ask questions of any of the departments as they come up, supervisor christensen, would you like to ask the department of environmental a few questions. speaker: i would. if i might

ask, mr. raphael just a few -- first my congratulations. it's delightful to see city employees excited in knowing they can make a difference. i appreciate that. a few technical questions about the implementation. so does the department have an estimate of how many producers are likely impacted by this ordinance? speaker: supervisor, no, we don't have that information. we built into the ordinance, the requirement that wholesalers and distributors and retail pharmacies, their requirements in the ordinance is to inform the department of the environment, who their producers are, so the way we will collect and understanding of all manufacturers that sell covered drugs, and the program is by relying on -- according to the ordinance, our retail partners

to provide information to us of who their providers are and wholesalers so we'll collect that answer based on responses from the retailers and wholesalers or distrib ters. -- distributors. speaker: you don't know how many there are. there's some in nor way and switzerland. you're correct that we don't know that yet. we're looking that we're not the first, so we can look at what's going on in alameda county and king county. they had 250 drug producers, 320, 270. they join together in coalitions. so they had two stewardship plans, not 270 stewardship plans, so those producers then pitch in money to a non

profit that creates the stewardship plan. we don't be dealing with hundreds of people. we're dealing, at the end of the day with stewardship organizations. speaker: let me see if i understand that correctly. we have maybe two or three hundred, assuming alameda did a good job collecting -- speaker: we have two or three hundred companies head quartered all over the world and we're going to use walmart and rite aid and the retailer who's are purchasing from these companies to help identify them self. so some of those drug companies, probably the orders are being placed at their head quarters some where else and some are buying from wholesalers. if you run a small neighborhood pharmacy, you would have to get to your wholesaler who would then have to provide the context information for the drug companies. speaker: you're right. this is not

trivial, but it's not impossible. speaker: nothing is impossible. so then you talked a little bit about the idea that they'll be an entity that would represent these companies. if i'm a swift drug manufacturer and i'm selling in san francisco, so through the pharmacies you're going to find out that i exists and i'm going to get a note if -- i'm going to get a notification from the city of san francisco. speaker: that's correct. speaker: i receive this ordinance that tells me my company must comply, so then -- has the department been able to identify any pharmaceutical representative entity or any organization in the city that

might be a -- speaker: good morning. there's two, one -- i'm sorry. speaker: who are you? speaker: i'm maggie johnson with the department of environment. i'm the project manager for the pilot program. there are two existing organizations that we know of. one is called the pharmaceutical product stewardship working group. i always get it wrong, sorry and then the other is a group that's called, i believe, return meds. and it's actually organized by another product stewardship organization for -- that has focused in the past on rechargeable batteries and it's call to recycle. you might have seen them. both of those organizations have done plans and submitted them to king county. speaker: king county? speaker: king county, washington. speaker: so these groups have a presence in the bay area

already? speaker: yes. speaker: so then the city having collected the contact information and notified the pharmaceutical companies all over the world, is the city in a position then to suggest to the pharmaceutical companies who are located miles away, how they might take a step toward implementing this or do these potential coalition organizations reach out to those companies? speaker: it could be either. i know both king county and alameda county posted the names and contact information on their websites and they receive many calls as a result of the letters. speaker: so legally it's okay for the city -- if you send a notice to zip a flap drug company in ziric and we say we have an ordinance and you're

responsible for helping getting rid of your drugs that people don't take, we suggest you contact return meds. speaker: we wouldn't say suggest, but we know these organizations are providing this type of service. speaker: so then it's up to these pharmaceutical companies which may not have relationships with one another, to then somehow come together and agree on a funding mechanism for this coalition organization. if this was never done before, i would say this is a lot to ask from people. but this is being done all over the world and they know how to come together and they have stewardship programs so it's a question of saying, you've done it now -- you've done it in mexico and british columbia which is not that far away, we want you to do the same thing. speaker: we're accustomed to

it. speaker: my last question is, so as you acknowledge being an early adopter of this process, there's a certain amount of challenge in getting an organization together. i'm familiar with other models so for example, if any of us, you know, have a car accident and we go to the body shop and have our car fix or you get a tune up, there's a waste disposal fee and my understanding is that goes to the bureaucracy. there's a bureaucratic solution where you pay a few cent and that forms a bureaucracy that manages the system. there's people who might profit from -- we have electronic facilities. or there are

models where the manufacturer's responsible. if you're a volkswagen in germany, you have to take back the volkswagen. those are three models that i'm aware. this is new to me because it's the creation of an entity that has to be funded by people. the thing that's interesting to me, we're asking this entity to do outreach, the way we would like or the way you would like to see it done. we're asking them to brand the program, we're asking them to do reporting. and we're asking them to manage a fairly complicated system, so we have a great deal of faith that this tough little ordinance is then going to result in a robust enough organization that they can do this the way we want it. so are there punitive measures that will urge them to be good at what you want them to do? speaker: i will --