A pharmacy manager retrieves a bottle of antibiotics. (Joe Raedle/Getty Images)
LINCOLN — State officials will continue to fund Nebraska’s statewide drug disposal program, reversing a midsummer decision not to renew a contract despite legislative funding having been set aside for that purpose.
Lawmakers approved an annual $289,416 appropriation for the Nebraska Department of Health and Human Services to continue contracting for such a program to properly dispose of prescription drugs. It’s the same process that’s been in place for a program the state has at least partially funded since 2015.
But state officials, as of July 1, refused to renew the contract until this week, effectively freezing the funds.
Haley Pertzborn, a pharmacist and now-CEO of the Nebraska Pharmacists Association. Nov. 15, 2023. (Zach Wendling/Nebraska Examiner)
The state restored funding after the Nebraska Examiner asked DHHS about the cut last week and sought more information from the agency and the Governor’s Office, including why the state cut came without legislative approval and whether DHHS had made any other similar administrative cuts.
“This program is money well spent,” said Haley Pertzborn, CEO of the Nebraska Pharmacists Association, which helps oversee and run the program. “We know it’s heavily utilized by Nebraskans, by communities. It’s a program that honestly runs itself for the most part.”
Elephant in the room
One Hastings pharmacist who has participated in the program since 2016, Katie Trambly, said the state’s decision left her and others in a “holding pattern” and that she was “thrilled” by the reversal.
Trambly said the program had taken a difficult situation for patients who often don’t know what to do with expired or unused medications and made it simpler. She and Pertzborn said the program is particularly helpful to dispose of medications that, if left around, might be targeted for theft or would be particularly toxic to children or pets, including opioids.
A blue whale swimming in the ocean. (Photo courtesy of National Oceanic and Atmospheric Administration Fisheries)
Nearly 280,000 pounds of unused medication, or 140 tons, have been disposed of since the program became operational in 2016, according to Amy Holman, project coordinator with the Nebraska Pharmacists Association. That is roughly the size of a blue whale, the largest animal in the world.
The association has also marketed the program’s success by saying the amount of disposed drugs would weigh as much as 16 male African elephants.
The Nebraska program allows people to drop off no longer needed prescription drugs at a participating local pharmacy at no cost to the person dropping off. Meds are then forwarded to Texas to be incinerated.
A hiccup in the program
The Nebraska MEDS Coalition, which consists of community and state partners, including DHHS and the Nebraska State Patrol, helped establish the program in 2016. The effort formed in response to studies by the U.S. Geological Survey and others finding traces of pharmaceuticals and personal care products in U.S. drinking water supplies.
The program has also helped get opioids out of Nebraska homes, with DHHS marketing the program as “every day can be a take-back day in Nebraska.”
In addition to state dollars, the Nebraska Environmental Trust has awarded the program an additional $400,000 annual grant that requires a portion of matching funds. The Trust is funded by Nebraska Lottery proceeds with a goal of funding projects that “conserve, enhance and restore the natural environments of Nebraska.”
Gov. Jim Pillen, right, talks with State Sens. Rob Clements and former State Sen. Lou Ann Linehan, at left. At center is Pillen’s communications director, Laura Strimple. July 18, 2024. (Zach Wendling/Nebraska Examiner)
DHHS and state budget officials denied the association’s attempt to renew the contract when the new fiscal year began in July and informed the association of the decision in early August, one month into the fiscal year. That decision inadvertently cut off the Environmental Trust funds, too.
“Drug disposal program costs should be funded by the pharmaceutical and health care industries, not by taxpayers,” Laura Strimple, a spokesperson for Gov. Jim Pillen, had told the Nebraska Examiner. “The decision to not spend the appropriation was made after a review of the contract in consideration of an extension beyond the original term.”
Another reason state officials cited for not renewing the contract was the loss of access to federal funding for the program, despite the association having no record of using federal funds.
‘You have to stop everything’
Pertzborn said her team had been proactive in trying to see what would be needed for a contract extension as early as January or February, partly because of the program’s daily use.
Pillen had not targeted the funding for elimination in his latest budget recommendations and did not mention it as a possible cut while lawmakers worked to close a multi-hundred-million-dollar budget shortfall.
A pop-up that has appeared on the Nebraska MEDS Coalition website explaining why Nebraska’s statewide drug distribution program run by the group has been stalled for some pharmacies. (Screenshot)
Pertzborn said DHHS officials also had repeatedly indicated to her organization that an expected contract renewal was “all good,” so pharmacists continued the program as normal in July.
About a month later, though, in early August, DHHS informed the association that the state budget administrator had denied the contract renewal, leaving Pertzborn and company “alarmed.”
Pertzborn said the association was not “at all” in a position to take on the immediate costs and worked with a network of 270 pharmacies to communicate that pharmacists could no longer order supplies to collect new medications and send them to Texas.
It also meant a pause in a contract between the pharmacists’ association and the local poison control center, which had operated an associated phone line as part of the program.
“You have to stop everything,” Pertzborn told pharmacies. “Use what you have, and we’ll provide you more information as we can.”
The DHHS notification to the association regarding the contract denial said there was a possible appeals process, yet Pertzborn said when her team inquired about how to do so, they learned there was no such process. She said her team was still waiting for documentation that the program had utilized federal funding, too.
Funding restored, contract reconsidered
Over the 10-year lifespan of the program, state lawmakers appropriated nearly $3 million from Nebraska taxpayers.
DHHS said it used federal funding to replace — not complement — state funding, such as through a targeted opioid drug disposal grant, a state opioid response drug disposal grant and a public health block grant.
A DHHS spokesperson said a total of $100,000 in federal funding had been used over the program’s existence to offset state funding. That federal investment amounts to about 3% of the state investment.
“I understand we have things to cut, I totally understand where they’re coming from,” Pertzborn said. “But I don’t understand cutting something that is so heavily utilized and that is doing a giant service to Nebraska.”
Gov. Jim Pillen, right, speaks at a town hall on his property tax reform ideas with State Sen. Rob Clements of Elmwood at the Columbus Area Chamber of Commerce on June 26, 2024. (Zach Wendling/Nebraska Examiner)
In response to Examiner questions, Strimple confirmed Tuesday afternoon that the state would, following engagement with stakeholders and policymakers, work to extend the contract for this fiscal year, through June 30, 2026.
“This extension will allow for further legislative consideration of this program,” Strimple said.
The move puts the program in the hot seat for the 2026 legislative session as lawmakers are set to address another projected budget shortfall in the middle of a two-year budgeting cycle. Without a change in law, the program would still have at least some dedicated funding through June 30, 2027.
Neither DHHS nor Strimple answered whether the Pillen administration had cut other programs administratively since lawmakers passed the 2025-27 budget in May.
‘A world of difference’
Trambly, director of pharmacy for B&R Stores Inc., which includes Russ’s Market and Super Saver, now oversees 15 pharmacies, including 12 in Nebraska.
She explained that before the statewide program began, no pharmacy she had worked for had a solid system to dispose of such medications in a healthy way for the community.
Twice-a-year drug take-back programs through the U.S. Drug Enforcement Administration are helpful, Trambly said. But, she said, that’s “if you catch wind that it’s happening and have the availability to get there that day.”
State Sen. Jana Hughes of Seward, center, one of three current senators who sits on the new School Financing Review Commission as nonvoting members. Aug. 12, 2025. (Zach Wendling/Nebraska Examiner)
Pertzborn said the DEA take-back program is also not active in every county and likely misses many Nebraskans. With a daily program, Pertzborn and Tambly said, patients can come at any time a participating pharmacy is open.
“There’s no gray area, it’s black and white. We can take these medications back,” Trambly said.
Trambly said that while she can’t speak to groundwater impacts, she can reflect as a mom of three children on the risk of medications like hormones, narcotics or chemotherapy drugs ending up in the state’s soil or water.
“I’m just really uncomfortable knowing that we wouldn’t be doing anything to prevent that from happening,” Trambly said.
Pertzborn and Trambly said the program also helps grieving families who are sometimes left with medications after a loved one dies. One pharmacy once collected a full trash bag of medicines from one family in such a case, Pertzborn said.
“It makes a world of difference to them and has just been great to be able to provide that to those people,” Trambly said.
Future funding
Multiple lawmakers the Examiner contacted said they weren’t necessarily opposed to the executive branch’s suggestion that pharmaceutical companies pay all or part of the bill. But many said the decision needed to be hashed out, including in the legislative budgeting process.
State Sen. Jana Hughes of Seward was among lawmakers hoping funding could be restored, citing groundwater concerns. She said she was happy to later learn funding would be reestablished.
“As far as who pays for it, that can be discussed, and I’m open to looking for other sources of funding,” Hughes said in a text.
Hughes had successfully worked with the Nebraska Pharmacists Association and Pillen’s team to establish a prescription drug donation program for unexpired medications with Iowa’s SafeNetRx nonprofit. That program launched July 1 despite its own budgetary problems this spring.
The drug disposal and donation programs will both be funded this year, Strimple said.
State Sen. Rob Clements of Elmwood, chair of the Legislature’s budget-writing Appropriations Committee, said his understanding was that the state had replaced federal funding and that state funding was supposed to be temporary. He noted that it’s unusual for state dollars to replace federal dollars, but in this case, the reverse had happened.
Like Pillen’s team, Clements said he thought pharmaceutical companies profiting from the drugs could contribute to their disposal, similar to how tobacco companies help fund some tobacco prevention programs.
“‘Big Pharma’ could contribute, and they would get some good public relations where they have some negative right now,” Clements said.
While future funding remains an unanswered question, Trambly, Pertzborn and Holman said they are thrilled with the contract reconsideration.
“We are open to any conversations about funding sources and are happy to look at ways that we can adjust the budget for this program going forward,” Holman said Wednesday. “But I think everyone can now see that it is a very important program in Nebraska that people care about and has been very successful for 10 years now.”