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HomeMy WebLinkAboutMINUTES - 06262012 - C.47RECOMMENDATION(S): SUPPORT AB 1442 (Wieckowski): Pharmaceutical Waste, a bill that would authorize the transportation of outdated or otherwise unsalable non-creditable pharmaceuticals, which are designated as medical waste, via a common carrier as recommended by the Legislation Committee. FISCAL IMPACT: The fiscal impact on the State of California has been estimated as follows: 1) Annual special fund costs of approximately $280,000 (equivalent to three positions) in 2012-13 through 2014-15 to the Department of Public Health-the state agency that enforces medical waste transport-to coordinate with stakeholders statewide, oversee rule-making process and develop regulations. 2) Annual special fund costs of approximately $159,000 (equivalent to two positions) to the department to review exemption requests and ensure compliance with documentation requirements. The fiscal impact on the County is unknown. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 06/26/2012 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: L. DeLaney, 925-335-1097 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: June 26, 2012 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C. 47 To:Board of Supervisors From:Legislation Committee Date:June 26, 2012 Contra Costa County Subject:Support AB 1442 (Wieckowski): Pharmaceutical Waste BACKGROUND: SUMMARY: Defines pharmaceutical waste for purposes of the Medical Waste Management Act. Authorizes a medical waste generator or parent organization that employs health care professionals who generate pharmaceuticals to apply to the enforcement agency for a pharmaceutical waste hauling exemption if the generator meets specified requirements. Authorizes such waste to be transported by specified entities to include the generator, health care professional, or a common carrier. According to the author, "Under existing law, pharmaceutical drugs can be sent to health care facilities through standard common carriers, or standard shipping means. Unused drugs can sometimes be returned to the manufacturer for credit, via a common carrier. Expired and non-dispensable drugs must be shipped as "Medical Waste," requiring expensive hazardous waste shipping, instead of common carrier. This is unnecessarily expensive for pharmacies, hospitals, and other health care facilities, who are simply returning the exact same drug that was shipped to them by common carrier." The regulation of pharmaceutical waste falls under the Medical Waste Management Act (MWMA). Pharmaceutical wastes that must be managed according to the MWMA are those that are classified as "California only hazardous waste" by Chapter 11, Title 22. If a pharmaceutical waste meets the criteria of a California hazardous waste, it must be segregated in an appropriate container, properly labeled, stored, manifested, transported and incinerated at a regulated medical waste incinerator or destroyed through another method approved by the California Department of Public Health (CDPH). The MWMA prohibits a person from hauling medical waste unless the person is either a registered hazardous waste hauler or has an approved limited-quantity exemption. It is common practice for pharmacies and other health care facilities to return unused pharmaceuticals to the manufacturer for credit or disposal. Health care facilities have the option of hiring reverse distributors to manage their unused and/or expired medication that could be returned to the manufacturer or wholesaler for credit. The reverse distributor determines which medications may be returned to the manufacturer or wholesaler for credit and arranges for disposal of unused medications that are waste. Once the unused pharmaceutical is determined to be ineligible for credit, it becomes waste and must be managed as such. In California, reverse distributors are regulated by both the Board of Pharmacy (BOP) and the CDPH. The BOP regulates activities involving "dangerous drugs," as defined in Business and Professions Code (BPC) Section 4022, which includes prescription medications. Reverse distributors that intend to receive "outdated or nonsalable dangerous drugs," which could include potentially creditable drugs, must register with the BOP as "drug wholesalers" (BPC Sections 4040.5, 4043 and 4160). However, once a pharmaceutical is designated as "medical waste" pursuant to the MWMA, it is regulated by the CDPH (HSC Section 117690). For purposes of the MWMA, the term "pharmaceutical" isn't restricted to "dangerous drugs" as set forth in the BPC, but rather is intended to cover all pharmaceuticals, including both prescription and over-the-counter drugs (HSC Section 117747). The MWMA requires that medical waste pharmaceuticals be sent to reverse distributors via a licensed hazardous waste hauler (HSC Section 118000). However, according to DPH's Self-Assessment Manual for Proper Management of Medical Waste, pharmaceuticals that have "intrinsic value" (such as outdated or otherwise unsalable pharmaceuticals that are returned for credit) are not considered "waste" and, thus, may be shipped to a reverse distributor via a common carrier. Therefore, under current law, whether or not a pharmaceutical is creditable determines whether it must be transported via a registered waste hauler or is authorized to be transported via common carrier. As is authorized under current law for outdated or otherwise unsalable creditable pharmaceuticals, this bill authorizes the transportation of outdated or otherwise unsalable non-creditable pharmaceuticals, which are designated as medical waste, via a common carrier. DISPOSITION: Pending LOCATION: SENATE At its June 7, 2012 meeting, the Legislation Committee reviewed this bill and recommends that the Board of Supervisors take a position of "support." CONSEQUENCE OF NEGATIVE ACTION: If the Board does not take a position on this bill, it will not have an official position from which to advocate. CHILDREN'S IMPACT STATEMENT: ATTACHMENTS Assembly Appropriation Analysis for AB 1442 AB 1442 Bill Text AMENDED IN ASSEMBLY MARCH 27, 2012 AMENDED IN ASSEMBLY FEBRUARY 6, 2012 california legislature—2011–12 regular session ASSEMBLY BILL No. 1442 1 2 3 Introduced by Assembly Member Wieckowski (Coauthor: Coauthors:Assembly Member Members Allen and Williams) January 4, 2012 1  2  3  An act to amend Sections 117935, 117945, 117960, 118000, 118040, and 118165 of, and to add Sections 117637, 117748, and 118032 to, the Health and Safety Code, relating to pharmaceutical waste. legislative counsel’s digest AB 1442, as amended, Wieckowski.Pharmaceutical waste. The existing Medical Waste Management Act, administered by the State Department of Public Health, regulates the management and handling of medical waste, as defined. Existing law requires that all medical waste be hauled by either a registered hazardous waste hauler or by a person with an approved limited-quantity exemption granted pursuant to specified provisions of law. Violation of these provisions of law is a crime. This bill would define pharmaceutical waste for purposes of the Medical Waste Management Act, and would authorize a medical waste generator or parent organization that employs health care professionals who generate pharmaceuticals to apply to the enforcement agency for a pharmaceutical waste hauling exemption if the generator, health care professional, or parent organization retains specified documentation and meets specified requirements and if the facility receiving the medical 97 waste retains specified documentation. The bill would authorize pharmaceutical waste to be transported by the generator or health care professional who generated the pharmaceutical waste, a staff member of the generator or health care professional, or common carrier, as defined, pursuant to these provisions. By expanding the definition of a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. The people of the State of California do enact as follows: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 1.Section 117637 is added to the Health and Safety Code, to read: 117637.“Common carrier” means either of the following: (a)  A person or company that has a United States Department of Transportation number issued by the Federal Motor Carrier Safety Administration and is registered with the Federal Motor Carrier Safety Administration as a for-hire property carrier. (b)  A person or company that has a motor carrier of property permit issued by the Department of Motor Vehicles pursuant to the Motor Carriers of Property Permit Act (Division 14.85 (commencing with Section 34600) of the Vehicle Code) and, if applicable, a carrier identification number issued by the Department of the California Highway Patrol pursuant to Section 34507.5 of the Vehicle Code. SEC. 2.Section 117748 is added to the Health and Safety Code, to read: 117748.(a)  “Pharmaceutical waste” means any pharmaceutical, as defined in Section 117747, that for any reason may no longer be sold or dispensed for use as a drug. (b)  For purposes of this part, “pharmaceutical waste” does not include any pharmaceutical that still has potential value to the generator because it is being returned to a reverse distributor, as defined in Section 4040.5 of the Business and Professions Code, that is licensed both as a wholesaler of dangerous drugs by the 97 — 2 —AB 1442 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 California State Board of Pharmacy pursuant to Section 4160 of the Business and Professions Code and as a permitted transfer station pursuant to Section 117775, for possible manufacturer credit. SEC. 3.Section 117935 of the Health and Safety Code is amended to read: 117935.Any small quantity generator required to register with the enforcement agency pursuant to Section 117930 shall file with the enforcement agency a medical waste management plan, on forms prescribed by the enforcement agency containing, but not limited to, all of the following: (a)  The name of the person. (b)  The business address of the person. (c)  The type of business. (d)  The types, and the estimated average monthly quantity, of medical waste generated. (e)  The type of treatment used onsite. (f)  The name and business address of the registered hazardous waste hauler used by the generator for backup treatment and disposal, for waste when the onsite treatment method is not appropriate due to the hazardous or radioactive characteristics of the waste,, the name of the registered hazardous waste hauler used by the generator to have untreated medical waste removed for treatment and disposal, and, if applicable, the name of the common carrier used by the generator to transport pharmaceutical waste offsite for treatment and disposal pursuant to Section 118032. (g)  A statement indicating that the generator is hauling the medical waste generated in his or her business pursuant to Section 118030 and the name and any business address of the treatment and disposal facilities to which the waste is being hauled, if applicable. (h)  The name and business address of the registered hazardous waste hauler service provided by the building management to which the building tenants may subscribe or are required by the building management to subscribe and the name and business address of the treatment and disposal facilities used, if applicable. (i)  A statement certifying that the information provided is complete and accurate. SEC. 4.Section 117945 of the Health and Safety Code is amended to read: 97 AB 1442— 3 — 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 117945.Small quantity generators who are not required to register pursuant to this chapter shall maintain on file in their office all of following: (a)  An information document stating how the generator contains, stores, treats, and disposes of any medical waste generated through any act or process of the generator. (b)  Records of any medical waste transported offsite for treatment and disposal, including the quantity of waste transported, the date transported, the name of the registered hazardous waste hauler or individual hauling the waste pursuant to Section 118030, and, if applicable, the name of the common carrier transporting pharmaceutical waste pursuant to Section 118032. The small quantity generator shall maintain these records for not less than two years. SEC. 5.Section 117960 of the Health and Safety Code is amended to read: 117960.Any large quantity generator required to register with the enforcement agency pursuant to Section 117950 shall file with the enforcement agency a medical waste management plan, on forms prescribed by the enforcement agency containing, but not limited to, all of the following: (a)  The name of the person. (b)  The business address of the person. (c)  The type of business. (d)  The types, and the estimated average monthly quantity, of medical waste generated. (e)  The type of treatment used onsite, if applicable. For generators with onsite medical waste treatment facilities, including incinerators or steam sterilizers or other treatment facilities as determined by the enforcement agency, the treatment capacity of the onsite treatment facility. (f)  The name and business address of the registered hazardous waste hauler used by the generator to have untreated medical waste removed for treatment, if applicable, and, if applicable, the name and business address of the common carrier transporting pharmaceutical waste pursuant to Section 118032. (g)  The name and business address of the registered hazardous waste hauler service provided by the building management to which the building tenants may subscribe or are required by the building management to subscribe, if applicable. 97 — 4 —AB 1442 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 (h)  The name and business address of the offsite medical waste treatment facility to which the medical waste is being hauled, if applicable. (i)  An emergency action plan complying with regulations adopted by the department. (j)  A statement certifying that the information provided is complete and accurate. SEC. 6.Section 118000 of the Health and Safety Code is amended to read: 118000.(a)  Except as otherwise exempted pursuant to Section 118030 or 118032, all medical waste transported to an offsite medical waste treatment facility shall be transported in accordance with this chapter by a registered hazardous waste transporter issued a registration certificate pursuant to Chapter 6 (commencing with Section 118025) and Article 6.5 (commencing with Section 25167.1) of Chapter 6.5 of Division 20. A hazardous waste transporter transporting medical waste shall have a copy of the transporter’s valid hazardous waste transporter registration certificate in the transporter’s possession while transporting medical waste. The transporter shall show the certificate, upon demand, to any enforcement agency personnel or authorized employee of the Department of the California Highway Patrol. (b)  Except for small quantity generators transporting medical waste pursuant to Section 118030 or small quantity generators or common carriers transporting pharmaceutical waste pursuant to Section 118032, medical waste shall be transported to a permitted offsite medical waste treatment facility or a permitted transfer station in leak-resistant and fully enclosed rigid secondary containers that are then loaded into an enclosed cargo body. (c)  A person shall not transport medical waste in the same vehicle with other waste unless the medical waste is separately contained in rigid containers or kept separate by barriers from other waste, or unless all of the waste is to be handled as medical waste in accordance with this part. (d)  Medical waste shall only be transported to a permitted medical waste treatment facility, or to a transfer station or another registered generator for the purpose of consolidation before treatment and disposal, pursuant to this part. 97 AB 1442— 5 — 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 (e)  Facilities for the transfer of medical waste shall be annually inspected and issued permits in accordance with the regulations adopted pursuant to this part. (f)  Any persons manually loading or unloading containers of medical waste shall be provided by their employer at the beginning of each shift with, and shall be required to wear, clean and protective gloves and coveralls, changeable lab coats, or other protective clothing. The department may require, by regulation, other protective devices appropriate to the type of medical waste being handled. SEC. 7.Section 118032 is added to the Health and Safety Code, to read: 118032.A medical waste generator or parent organization that employs health care professionals who generate pharmaceutical waste may apply to the enforcement agency for a pharmaceutical waste hauling exemption if the generator, health care professional, or parent organization meets all of the following requirements: (a)  The generator or parent organization has on file one of the following: (1)  If the generator or parent organization is a small quantity generator required to register pursuant to Chapter 4 (commencing with Section 117915), a medical waste management plan prepared pursuant to Section 117935. (2)  If the generator or parent organization is a small quantity generator not required to register pursuant to Chapter 4 (commencing with Section 117915), the information document maintained pursuant to subdivision (a) of Section 117945. (3)  If the generator or parent organization is a large quantity generator, a medical waste management plan prepared pursuant to Section 117960. (b)  The generator or health care professional who generated the pharmaceutical waste transports the pharmaceutical waste himself or herself, or directs a member of his or her staff to transport the pharmaceutical waste to a parent organization or another health care facility for the purpose of consolidation before treatment and disposal, or contracts with a common carrier to transport the pharmaceutical waste to a permitted medical waste treatment facility or transfer station. 97 — 6 —AB 1442 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 (c)  Except as provided in subdivision (d), the generator maintains and the facility receiving the medical waste maintain a tracking document, as specified in Section 118040. (d)  (1)  Notwithstanding subdivision (c), if a health care professional who generates pharmaceutical waste returns the pharmaceutical waste to the parent organization for the purpose of consolidation before treatment and disposal over a period of time, a single-page form or multiple entry log may be substituted for the tracking document, if the form or log contains all of the following information: (A)  The name of the person transporting the pharmaceutical waste. (B)  The number of containers of pharmaceutical waste. This clause does not require any generator to maintain a separate medical waste container for every patient or to maintain records as to the specified source of the pharmaceutical waste in any container. (C)  The date that the pharmaceutical waste was returned. (2)  The form or log described in paragraph (1) shall be maintained in the files of the health care professional who generates the pharmaceutical waste and the parent organization or another health care facility that receives the waste. (2) (3)  This subdivision does not prohibit the use of a single document to verify the return of more than one container to a parent organization or another health care facility for the purpose of consolidation before treatment and disposal over a period of time, if the form or log is maintained in the files of the parent organization or another health care facility that receives the waste once the form or log is completed, provided the form or log meets the requirements specified in paragraphs (1) and (2). SEC. 8.Section 118040 of the Health and Safety Code is amended to read: 118040.(a)   Except with regard to sharps waste consolidated by a home-generated sharps consolidation point approved pursuant to Section 117904, a hazardous waste transporter or generator transporting medical waste shall maintain a completed tracking document of all medical waste removed for treatment or disposal. A hazardous waste transporter or generator who transports medical waste to a facility, other than the final medical waste treatment 97 AB 1442— 7 — 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 facility, shall also maintain tracking documents which show the name, address, and telephone number of the medical waste generator, for purposes of tracking the generator of medical waste when the waste is transported to the final medical waste treatment facility. At the time that the medical waste is received by a hazardous waste transporter, the transporter shall provide the medical waste generator with a copy of the tracking document for the generator’s medical waste records. The transporter or generator transporting medical waste shall maintain its copy of the tracking document for three years. (b)   The tracking document shall include, but not be limited to, all of the following information: (1)   The name, address, telephone number, and registration number of the transporter, unless transported pursuant to Section 118030. (2)   The type of medical waste transported and the quantity or aggregate weight of medical waste transported. (3)   The name, address, and telephone number of the generator. (4)   The name, address, telephone number, permit number, and the signature of an authorized representative of the permitted facility receiving the medical waste. (5)   The date that the medical waste is collected or removed from the generator’s facility, the date that the medical waste is received by the transfer station, the registered large quantity generator, or point of consolidation, if applicable, and the date that the medical waste is received by the treatment facility. (c)   Any hazardous waste transporter or generator transporting medical waste in a vehicle shall have a tracking document in his or her possession while transporting the medical waste. The tracking document shall be shown upon demand to any enforcement agency personnel or officer of the Department of the California Highway Patrol. If the medical waste is transported by rail, vessel, or air, the railroad corporation, vessel operator, or airline shall enter on the shipping papers any information concerning the medical waste that the enforcement agency may require. (d)   A hazardous waste transporter or a generator transporting medical waste shall provide the facility receiving the medical waste with the original tracking document. 97 — 8 —AB 1442 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (e)   Each hazardous waste transporter and each medical waste treatment facility shall provide tracking data periodically and in a format as determined by the department. (f)   Medical waste transported out of state shall be consigned to a permitted medical waste treatment facility in the receiving state. If there is no permitted medical waste treatment facility in the receiving state or if the medical waste is crossing an international border, the medical waste shall be treated in accordance with Chapter 8 (commencing with Section 118215) prior to being transported out of the state. SEC. 9.Section 118165 of the Health and Safety Code is amended to read: 118165.On and after April 1, 1991, all persons operating a medical waste treatment facility shall maintain individual records for a period of three years and shall report or submit to the enforcement agency upon request, all of the following information: (a)  The type of treatment facility and its capacity. (b)  All treatment facility operating records. (c)  Copies of the tracking documents for all medical waste it receives for treatment from offsite generators, hazardous waste haulers, or, pursuant to Section 118032, common carriers. SEC. 10.No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution. O 97 AB 1442— 9 — 2011 CA A 1442: Bill Analysis - Assembly Appropriations Committee - 04/18/2012 BILL ANALYSIS Date of Hearing: April 18, 2012 ASSEMBLY COMMITTEE ON APPROPRIATIONS Felipe Fuentes, Chair AB 1442 (Wieckowski) - As Amended: March 27, 2012 Policy Committee: Environmental Safety and Toxic Materials Vote: 8-0 Urgency: No State Mandated Local Program: Yes Reimbursable: No SUMMARY This bill authorizes a pharmaceutical waste hauling exemption that allows pharmaceutical waste to be transported according to requirements that are less stringent than those applicable to medical waste. Specifically, this bill: 1) Defines pharmaceutical waste as any pharmaceutical that may no longer be sold or dispensed as a drug. 2) Creates new documentation requirements of medical waste generators who use a common carrier to transport pharmaceutical waste offsite for treatment and disposal. 3) Authorizes a medical waste generator to apply for an exemption from medical waste requirements so as to allow pharmaceutical waste to be transported by a common carrier. FISCAL EFFECT 1) Annual special fund costs of approximately $280,000 (equivalent to three positions) in 2012-13 through 2014-15 to the Department of Public Health-the state agency that enforces medical waste transport-to coordinate with stakeholders statewide, oversee rulemaking process and develop regulations. 2) Annual special fund costs of approximately $159,000 (equivalent to two positions) to the department to review exemption requests and ensure compliance with documentation requirements. COMMENTS 1) Rationale. The author notes that new pharmaceuticals, as well as unused pharmaceuticals, may be shipped by standard common carrier transport. The author further notes that current law classifies pharmaceutical waste, such as expired or otherwise unusable medications, as medical waste, which generally must be treated, for transport purposes, as hazardous waste. The author contends this stringent shipping requirement creates costs for hospitals, pharmacies and other medical facilities without increasing public health or safety. 2) Background. The California Medical Waste Management Act defines certain types of waste comprised of pharmaceuticals a biohazardous waste, which must be handled and transported as a hazardous waste, consistent with the California Hazardous Substances Act (CHSA). According to the Department of Toxic Substance Control, the state agency charged with implementing the CHSA, hazardous waste can be transported only by a registered hazardous waste hauler and compliant with stringent handling requirements. According to DPH, which enforces requirements on the transport of medical waste, there are nearly 11,000 entities in 28 counties that could apply for the exemption to medical waste transport requirement provided by this bill. 3) Support. This bill is supported by EXP Pharmaceutical Services (sponsor), the California Product Stewardship Council and several other organizations. 4) There is no formal opposition registered to this bill. Analysis Prepared by: Jay Dickenson / APPR. / (916) 319-2081 Copyright (c) 2012 State Net. All rights reserved. Page 1 of 1State Net | 2011 CA A 1442: Bill Analysis - Assembly Appropriations Committee - 04/18/2012 6/3/2012http://client2.statenet.com/secure/pe/resources.cgi?id=ID:bill:CA2011000A1442;show_resource=ANALY...