BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 333
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          Date of Hearing:   April 16, 2013

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                  Luis Alejo, Chair
                  AB 333 (Wieckowski) - As Amended:  March 12, 2013
           
          SUBJECT  :   Medical waste.

           SUMMARY  :   Makes technical and conforming changes to the Medical  
          Waste Management Act (MWMA).  Specifically,  this bill  :

          1)Deletes the existing definition of "biohazard bag," and  
            instead replaces it with the definition in the Code of Federal  
            Regulations (CFR) Title 49:  Part 173.197.  Includes in the  
            definition the requirement that the color of the bag to be  
            red, except when other colors are used to further segregate  
            the waste stream.  Requires, if additional colors are used  
            other than the standard red bag, the color assignments to be  
            designated in the facility's medical waste management plan.

          2)Amends the definition of "medical waste management plan" to  
            specify that the document that is completed by generators of  
            medical waste describes how the medical waste generated at  
            their facility shall be segregated, handled, stored, packaged,  
            treated, or shipped for treatment, as applicable.  Specifies  
            that the medical waste management plan is to be completed on  
            forms prepared by the enforcement agency, only if those forms  
            are provided by the enforcement agency.

          3)Requires a solid waste transporter who discovers that he or  
            she has (unknowingly) hauled untreated medical waste to a  
            landfill or materials recovery facility to contact the  
            originating generator of the medical waste to respond to the  
            landfill or recovery facility to provide ultimate proper  
            disposal of the medical waste.

          4)Clarifies that statutory requirements for treatment of animals  
            that die of infectious diseases includes those that are  
            euthanized because they are suspected of having been exposed  
            to infectious disease.

          5)Makes other conforming changes to the MWMA.

           EXISTING LAW  :









                                                                  AB 333
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          1)In federal law, sets requirements for specified packaging,  
            including that a film bag must be marked and certified by its  
            manufacturer as having passed the tests prescribed for tear  
            resistance in ASTM D 1922, "Standard Test Method for  
            Propagation Tear Resistance of Plastic Film and Thin Sheeting  
            by Pendulum Method" and for impact resistance in ASTM D 1709,  
            "Standard Test Methods for Impact Resistance of Plastic Film  
            by the Free-Falling Dart Method."  Requires that the film bag  
            meet an impact resistance of 165 grams and a tearing  
            resistance of 480 grams in both the parallel and perpendicular  
            planes with respect to the length of the bag.  (CFR, Title 49:  
            Part 173.197)

          2)Establishes the MMWA to regulate the management of medical  
            waste. (Health and Safety Code (HSC) § 117600 et seq.)  Under  
            the MWMA:

             a)   Requires the Department of Public Health (DPH) to adopt  
               regulations that will establish and ensure statewide  
               standards for uniformity in the implementation and  
               administration of the MWMA and that will promote waste  
               minimization and source reduction.  (HSC § 117610)

             b)   Authorizes a local agency to implement a medical waste  
               management program by the adoption of an ordinance or  
               resolution by the local governing body. (HSC § 117800)

             c)   Requires any local agency that has elected to implement  
               a medical waste management program to maintain a program  
               that is consistent with MWMA statute and the regulations  
               adopted pursuant to MWMA statute.  Authorizes, with the  
               approval of DPH, the local agency to administer or enforce  
               the MWMA.  (HSC § 117815)

             d)   Defines "biohazard bag" as a disposable red bag that is  
               impervious to moisture and has the strength sufficient to  
               preclude ripping, tearing, or bursting under normal  
               conditions of usage and handling of the waste-filled bag.   
               Requires a biohazard bag to be constructed of material of  
               sufficient single thickness strength to pass the 165-gram  
               dropped dart impact resistance test as prescribed by  
               Standard D 1709-85 of the American Society for Testing and  
               Materials and certified by the bag manufacturer.  (HSC §  
               117630)









                                                                  AB 333
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             e)   Defines "medical waste" as waste that meets both of the  
               following requirements:

               (1)    The waste is composed of waste that is generated or  
                 produced as a result of any of the following actions:   
                 diagnosis, treatment, or immunization of human beings or  
                 animals; research pertaining to the activities above; the  
                 production or testing of biological; the accumulation of  
                 properly contained home-generated sharps waste that is  
                 brought by a patient, a member of the patient's family,  
                 or other specified person to an approved point of  
                 consolidation; and, removal of a regulated waste from a  
                 trauma scene by a trauma scene waste management  
                 practitioner.

               (2)    The waste is either bio-hazardous waste or sharps  
                 waste.

             f)   Defines "medical waste management plan" as a document  
               that is completed by generators of medical waste on forms  
               prepared by the enforcement agency. (HSC § 117710)

             g)   Requires that animals that die from infectious diseases  
               be treated in accordance with treatment standards as  
               described in the MWMA if, in the opinion of the attending  
               veterinarian or local health officer, the carcass presents  
               a danger of infection to humans. (HSC § 118240)

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :

           Need for the bill  :  According to supporters of the bill,  
          "Twenty-three years ago when the Medical Waste Management Act  
          was enacted, California became one of the first states in the  
          Nation setting statutory standards governing this waste stream.   
          During these intervening years, there have been many changes in  
          medical waste treatment, transportation oversight, and new  
          requirements by landfill and waste water treatment operators  
          regarding acceptance of portions of this waste stream.  The  
          purpose of AB 333 is to update the Act.  Since enactment of the  
          Medical Waste Management Act, the federal Department of  
          Transportation (DOT) has increased its regulatory oversight of  
          transportation of medical waste which preempts state law.   
          Similarly, the United States Postal Service (USPS) requirements  








                                                                  AB 333
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          for the mail back of medical waste also preempt state law.  [AB  
          333] would repeal transportation requirements from the Medical  
          Waste Management Act in favor of the preemptive DOT and USPS  
          standards."


           Medical waste:   Medical waste is waste materials generated at  
          health care facilities, such as hospitals, clinics, physician's  
          offices, dental practices, blood banks, and veterinary  
          hospitals/clinics, as well as medical research facilities and  
          laboratories.  Medical waste can contain pathogens, blood, low  
          levels of radioactivity, discarded needles, syringes, scalpels,  
          expired drugs and vaccines, which can pose a hidden risk of  
          infection, radioactivity exposure and needle-stick injuries.

           

          Management of medical waste in California:   According to the  
          DPH, in order to protect the public and the environment from  
          potentially infectious disease causing agents, the Medical Waste  
          Management Program (MWMP) in the Environmental Management Branch  
          in the DPH regulates the generation, handling, storage,  
          treatment, and disposal of medical waste by providing oversight  
          for the implementation of the MWMA.  The MWMP permits and  
          inspects all medical waste offsite treatment facilities and  
          medical waste transfer stations.  Additionally, the MWMP acts as  
          the local enforcement agency in a number of local jurisdictions  
          that elected to have the State implement the quantity generator  
          inspection program for medical waste management.



          This bill is intended to update the MWMA to ensure consistency  
          with federal law, and to reflect current medical waste  
          practices.



           Recent related bills  :



          AB 1442 (Wieckowski) Chapter 689, Statutes of 2012, authorized  
          the transportation of pharmaceutical waste by a common carrier.









                                                                  AB 333
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           REGISTERED SUPPORT / OPPOSITION  :

           Support
           
          Stericycle

           Opposition
           
          None received.
           

          Analysis Prepared by  :    Shannon McKinney / E.S. & T.M. / (916)  
          319-3965