Expedited review: Drug Take-Back Program Fee-Setting and Expenditures
26-02 final report | April 2026
Andrew Hatt, Amanda Eadrick, research analysts
Ryan McCord, audit director; Eric Thomas, legislative auditor
Contact information
Legislative Auditor's conclusion
The statutory fee design limits the Department of Health’s (DOH) ability to recover its oversight costs. Public reporting of DOH’s oversight costs would make the basis of its fees more transparent.
Key points
- The state’s drug take-back program collects and disposes of unused medications. It is run by two private entities with oversight from DOH.
- The entities pay fees for DOH oversight. Fee revenue has not covered costs since fiscal year 2024.
- The 2025 Legislature adjusted how the fee is calculated. Revenue remains unpredictable since it is tied to the entities’ spending.
- DOH does not publicly report the costs of its oversight activities in a way that explains its fee-setting.
- DOH oversight includes staff, contractors, and overhead. Overhead costs have risen from 21% of expenditures to 35% (fiscal year 2022 to 2025).
Legislative Auditor’s recommendations
The Legislative Auditor makes two recommendations.
Recommendation #1
DOH should publicly report its oversight expenditures and activities.
DOH should publicly report the expenditures and activities that determine its fee levels. Each time it adjusts its fee, DOH should publish current and projected costs, including staffing and overhead. This would:
- Help stakeholders understand how fees are set.
- Strengthen the accountability of the program.
- Make the fee-setting process more transparent.
Legislation required: No
Fiscal impact: None
Implementation date: December 2026
Agency response: DOH concurs.
Recommendation #2
The Legislature should amend the fee design to meet best practices and enable full cost recovery by DOH. It should remove the fee cap and its association with program operator expenditures.
Two additional changes to the fee design for legislative consideration include:
- Allowing DOH to set fees every two years to stabilize revenue.
- Requiring fees to be established in the Washington Administrative Code. DOH already uses rulemaking to set fees for the health professions it licenses. If DOH were to use rulemaking to set fees for the drug take-back program, it would support more stable revenue but also require a more time-intensive process.
Legislation required: Yes
Fiscal impact: None
Implementation date: At the Legislature's discretion.
The Joint Legislative Audit and Review Committee voted to include the following addenda with the report.
Committee comments on the recommendations
1. Legislative Auditor's recommendation #1
JLARC members concur with the Legislative Auditors Recommendation #1 for DOH to publicly report oversight costs. This is necessary for accountability and if fees are going to be set to cover costs per Recommendation #2. JLARC members are concerned that the audit found that overhead costs as a percent of the fees recovered by DOH increased from 21% to 35% between 2024 and 2025 and welcome DOH's changes in administration that should reduce these costs. JLARC members are also concerned that public records requested for DOH costs related to the program have not yet been fully disclosed after 15 months. Public records requests should not be necessary for cost transparency.
2. Legislative Auditor's recommendation #2
JLARC is doing a sunset review of the program in 2026. The review should include recommendations for best practices and how to ensure full cost recovery by DOH through legislative changes to the fee structure.
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Expedited review: Drug Take-Back Program Fee-Setting and Expenditures (HTML)
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DOH response (PDF)