Medical Waste Management Act Webinar March 19, 2015 CHA Webinar Welcome and Program Overview Mary Barker Vice President, Publishing & Education California Hospital Association CHA Staff Cheri Hummel Vice President, Emergency Management and Facilities Roger Richter 3 1
CDPH Staff Alison Dabney is a Senior Environmental Scientist and Chief of the Medical Waste Management Program for the California Department of Public Health. She has been in the Program since 2006 and has performed over 460 inspections at hospitals, clinics, research and clinical labs, veterinary hospitals, prisons, and medical waste treatment facilities. 4 CDPH Staff Shannon George Research Program Specialist I, Medical Waste Management Program, California Department of Public Health 5 AB 333 Changes for Medical Waste Management Medical Waste Management Program California Department of Public Health Alison Dabney, Chief 6 2
Objectives Summarize Changes in the Medical Waste Management Act Stakeholder Meetings and Report 7 State vs. Local Enforcement Agencies The State is the enforcement agency for 25 Counties and 1 City (Berkeley) The CDPH = Gray County LEA = White 8 CDPH Jurisdiction Alpine, Amador, Butte, Calaveras, Fresno, Glenn, Humboldt, Imperial, Inyo, Lake, Los Angeles, Mariposa, Mendocino, Mono, Nevada, Placer, Plumas, San Benito, San Luis Obispo,Santa Barbara, Sierra, Solano, Sutter, Trinity, Yolo and the City of Berkeley 3
Local Enforcement Counties in which are the Local Enforcement Agency: Alameda Colusa Contra Costa Del Norte El Dorado Kern Kings Lassen Madera Marin Merced Modoc Monterey Napa Orange Riverside Sacramento San Bernardino San Diego San Francisco San Joaquin San Mateo Santa Clara Santa Cruz Shasta Siskiyou Sonoma Stanislaus Tehama Tulare Tuolumne Ventura Yuba Total: 33 Cities in which are the Local Enforcement Agency: Long Beach Vernon 10 Assembly Bill 333 Became effective January 1, 2015 Revised the Medical Waste Management Act (Health and Safety Code 117600 et seq.) 11 AB 333 Key Elements for Generators - Summary Shipping Document Elimination of the Limited Quantity Hauling Exemption & Substitution of Materials of Trade Exemption Red Bags, Labeling, Hand-Carrying Temporary Events Medical Waste Management Plan Controlled Substances 12 4
Shipping vs. Tracking Shipping and tracking documents are required Tracking document provides cradle-tograve record for proper disposal of the waste and prevents improper disposal Some overlap of information 13 Shipping Document Shipping document: intended to be carried on the transport vehicle to provide CHP or first responders with information about the material on board The shipper must provide a copy to the generator 117975 14 Shipping Document (continued) Shipping document must conform to Department of Transportation requirements United Nations (UN) number = 3291 Hazard class = 6.2 Packing group = PGII Number and type of packages Quantity or weight of packages 15 5
Shipping Document (continued) Proper Shipping Name = Regulated Medical Waste, Not Otherwise Specified (NOS) Shipper s certification Shipper s signature Emergency response telephone number 16 Tracking Document Shipping Document Copies must be left at generator and must be in the hauler s possession during transport of medical waste Medical Waste Transfer Station T + S Hauler Tracking Document Shipping Document Medical Waste 17 Treatment Facility Materials of Trade Hauling Exemption Replaces Limited Quantity Hauling Exemption (LQHE) Allows generators to transport limited quantities of medical waste to a central point of accumulation Packaging and weight limits (35.2 lbs.) Must maintain log book Federal regulations call it an exception 117976 18 6
Red Bags Red Bags must be marked and certified by the manufacturer for American Society for Testing and Materials impact and tear resistance standards Generators may opt to use white bags for pathology waste and yellow bags for trace chemotherapy waste Must be noted in the medical waste management plan 19 117630 Pharms Waste Labeling Pharmaceutical waste containers, or combined sharps and pharmaceutical waste containers, must be labeled with HIGH HEAT OR INCINERATION ONLY on the same label. 118275 20 Treatment and Tracking Records Tracking, shipping and onsite treatment records must be kept for 2 years 117975 21 7
Transport within a Facility 22 Hand-Carrying Patient Room Hand-Carrying Surgery Suite Place waste into a biohazard bag hung on a hamper stand Remove bag from the hamper stand after completion of the procedure Place into a biohazard container stored in a soiled utility room or other biohazard waste storage area 118280 24 8
Temporary Events Registered generators may conduct temporary events (i.e. veteran stand downs, health fairs, vaccination clinics, etc.) without an additional permit Notice of the temporary event must be given to the enforcement agency at least 72 hours in advance 117895 25 Waste Management Plan Needs to Include: Steps taken to properly dispose of controlled substance waste Name & address of transporter Closure plan for termination of onsite treatment to return the facility to proper sanitary condition 117960 26 Proper Management of Controlled Substances The facility is responsible for ensuring that a controlled substance placed in a pharmaceutical waste container is non-retrievable. 9
Proper Management of Controlled Substances (continued) 28 Proper Management of Controlled Substances (continued) Squirt controlled substances into a pharmaceutical waste container Do not squirt non-controlled substance pharms = 90% of Rx pharms Do not use a container intended solely for sharps waste autoclave Use a pharms or pharma/sharps waste container incineration 29 Proper Management of Controlled Substances (continued) The addition of a sequestering agent to the container is an added benefit, since it creates an irreversible alteration May also send to a DEA registrant; reverse distributor (4 registered in CA) 30 10
AB 333 Stakeholder Process CDPH is required to conduct stakeholder meetings to examine the interrelationship between state and federal law regarding the transportation of medical waste Culminates in report to the Legislature due January 1, 2016 31 AB 333 Stakeholder Process (continued) Meetings are being held throughout the State Schedule is available on CDPH Medical Waste Program website 32 Technical Advisory Meetings 33 11
Regional Stakeholder Meetings 34 Regional Stakeholder Meetings (cont.) 35 For More Information Regarding Stakeholders Meetings Contact: Shannon George (916) 449-5590 or Shannon.George@cdph.ca.gov 36 12
For More Information Contact: Alison Dabney (916) 449-5692 or alison.dabney@cdph.ca.gov Or, if applicable, your county s local enforcement agency. Questions Online questions: Type your question in the Q & A box, hit enter Phone questions: To ask a question hit 14 To remove a question hit 13 Thank You and Evaluation Thank you for participating in today s program. An online evaluation will be sent to you shortly. For CHA questions, contact Cheri Hummel at (916) 552-7681 or chummel@calhospital.org 13