Maryland Code § HG-19-914

Section HG-19-914
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(a) (1) This section applies to a general hospice care program only when
providing hospice services in an in-home setting.
(2) This section does not apply to a general hospice care program
when providing hospice services in a nursing home, assisted living facility, or a
general hospice care program facility.
(b) A general hospice care program shall establish a written policy that
outlines the procedures for the collection and disposal of a patient's unused
prescription medication, including a procedure that requires a general hospice care
employee, at the time that a patient is enrolled in the general hospice care program,
to:
(1) Discuss with the patient and the patient's family member or
personal representative the requirements under subsection (c) of this section; and
(2) Provide a written copy of the unused prescription medication
collection and disposal policy to the patient and the patient's family member or
personal representative.
(c) (1) In accordance with a general hospice care program's policy and
subject to paragraphs (2) and (3) of this subsection, a general hospice care program
employee shall, as soon as practicable, collect and dispose of a patient's unused
prescription medication on:
(i) The death of the patient; or
(ii) The termination of a prescription medication by the
patient's prescriber.
(2) Before a general hospice care program employee collects or
disposes of a patient's unused prescription medication under paragraph (1) of this
subsection, the employee shall provide to the patient or the patient's family member
or personal representative a written request for authorization to collect and dispose
of the patient's unused prescription medication in accordance with the patient's care
plan.
(3) A general hospice care program employee may not collect or
dispose of a patient's unused prescription medication unless the patient or the
patient's family member or representative provides written authorization to the
general hospice care program.

(4) If a patient or the patient's family member or personal
representative refuses to authorize the collection or disposal of the patient's unused
prescription medication, the general hospice care program employee shall urge that
the patient or the patient's family member or personal representative dispose of any
unused prescription medication in a safe and legal manner in accordance with federal
Environmental Protection Agency and federal Drug Enforcement Administration
guidelines for the safe disposal of prescription drugs.
(d) If authorized, a general hospice care program employee shall, as soon as
practicable, dispose of a patient's unused prescription medication at the site where
hospice care was provided:
(1) In accordance with federal Environmental Protection Agency and
federal Drug Enforcement Administration guidelines for the safe disposal of
prescription drugs; and
(2) Under the witness of:
(i) The patient or the patient's family member or personal
representative;
(ii) Another general hospice care program employee; or
(iii) If none of the individuals under items (i) or (ii) of this item
are available, a local law enforcement officer.
(e) (1) The collection and disposal of a patient's unused prescription
medication by the general hospice care program shall be documented in the patient's
medical record by the general hospice care program employee who conducted the
collection and disposal.
(2) The medical record shall include the following information:
(i) The name and quantity of each unused prescription
medication;
(ii) The name of the individual who authorized the collection
and disposal of the unused prescription medication and the individual's relationship
to the patient;
(iii) The date of disposal for each unused prescription
medication;

(iv) The name of the individual who conducted the collection
and disposal; and
(v) The name of the individual who witnessed the disposal of
unused prescription medication by the employee as required under subsection (d)(2)
of this section.
(3) If a patient or the patient's family member or personal
representative refuses to authorize the collection and disposal of the patient's unused
prescription medication by the general hospice care program, the general hospice care
program employee shall document in the patient's medical record:
(i) The refusal to authorize the collection and disposal of the
patient's unused prescription medication; and
(ii) The name and quantity of each unused prescription
medication not surrendered.
(f) A general hospice care program may not be held liable in a civil or
criminal action for any good faith act or omission taken in accordance with the
requirements of this section.

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