BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 333 (Wieckowski) - Medical waste.
          
          Amended: June 24, 2014          Policy Vote: EQ 7-0
          Urgency: No                     Mandate: Yes (see staff comment)
          Hearing Date: August 4, 2014                      Consultant:  
          Marie Liu     
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 333 makes numerous changes to the Medical Waste  
          Management Act (MWMA) including, among other things, codifying  
          existing federal preemptions and requirements, modifying  
          definitions, creating procedures for the generation of medical  
          waste from a temporary event, modifying contracts with medical  
          waste transporters for the collection of fees, and preempting  
          local programs regarding infectious waste.

          Fiscal Impact: 
               Initial costs of $340,000 annually from the Medical Waste  
              Management Fund (special) for FY 2015-16 and FY 2016-17 to  
              assist with compliance with the changes to the MWMA.
               Initial costs of $166,000 for FY 2015-16 and FY 2016-17  
              then $145,000 thereafter from the Medical Waste Management  
              Fund to DPH to review and approve treatment technologies.
               Minor revenue losses to the Medical Waste Management Fund  
              (special) by allowing medical waste transporters to keep an  
              additional 2.5% of the small generator annual fee for  
              administrative costs.
               Unknown, possibly minor, cost pressures to the Medical  
              Waste Management Fund (special) by deleting the ability for  
              DPH to adjust multiple fees through regulation.

          Background: The MWMA was created in response to several  
          incidents of medical waste washing up on San Diego County  
          beaches, as well as several reports of medical waste being  
          disposed of in dumpsters and trashbins.  In 1989 and 1990, AB  
          109 (Hayden) and AB 1641 (Mojonnier) were ultimately combined to  
          form the MWMA to, according to the original Legislative intent,  
          "comprise a single, integrated, and complementary approach to  
          the storage, treatment, transportation, and disposal of medical  
          waste."








          AB 333 (Wieckowski)
          Page 1



          The MWMA allows any local ordinance regulating infectious waste  
          that was in existence before 1990 and regulated both large and  
          small quantity generators to continue.

          The MWMA also allows local governments to elect to be the  
          enforcement agency of the MWMA and to assess appropriate fees  
          for their enforcement activities. Currently 25 counties rely on  
          the state for enforcement.

          Proposed Law: This bill has numerous provisions to modify the  
          MWMA. Specifically, this bill would (only provisions that  
          potentially have a fiscal impact are listed):
           Specify that a "medical waste management plan" is a document  
            completed by generators of medical waste that describes how  
            the medical waste generated at their facility shall be  
            segregated, handled, stored, packaged, treated, or shipped for  
            treatment (§117710).
           Require DPH to approve treatment technologies for the  
            treatment of medical waste (§117918).
           Delete the ability for the Department of Public Health (DPH)  
            to adjust by regulation the registration and inspection fees  
            for small quantity generators, registration and inspection  
            fees for large quantity generators, application and annual  
            fees for transfer stations, and application fees alternative  
            treatment technologies (§§117920, 117990, 118045, and 118245)  
            However, DPH would retain the ability to adjust fees by  
            regulations for medical waste treatment facility permits and  
            inspections.
           Allow a medical waste transporter to retain 7.5% rather than  
            5% of the annual small quantity generator fee which it  
            collects pursuant to a contract with DPH. This bill would also  
            specify that generators are only required to pay the fee once  
            annually (§117924).  

          Staff Comments: Due to the large number of changes that this  
          bill makes to the MWMA, DPH anticipates additional temporary  
          workload to assist compliance with the new requirements  
          including meeting with stakeholder groups and local enforcement  
          agencies, developing training and guidance materials to assist  
          local enforcement agencies and the regulated industry. DPH  
          anticipates approximately $340,000 of additional staff workload  
          annually for FY 2015-16 and 2016-17 for these activities. 









          AB 333 (Wieckowski)
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          This bill also requires DPH to approve all types of treatment  
          technology for infectious waste. To complete this task, DPH  
          anticipates initial costs of $166,000 for two years to meet with  
          stakeholders, review treatment technologies, and promulgate  
          regulations establishing a method for approval. Ongoing costs  
          after the initial period to review and approve new technologies  
          would be $145,000 annually.

          This bill raises the amount that a medical waste transporter can  
          keep as an administrative fee from 5% to 7.5% when it has  
          contracted with DPH for the collection of small quantity  
          generator annual fees. Currently the only medical waste  
          transporter that has such a contract with DPH is Stericycle, the  
          sponsor of the bill. According to Stericycle, because the annual  
          fee that is being collected is only $25, the current  
          administrative fee of 5% or $1.25 does not cover the cost of  
          collecting the fee, particularly since it the fee must be  
          collected separately from any other billing. DPH estimates that  
          this provision will result in a loss of approximately $2,000 in  
          revenue annually.

          This bill deletes the ability for DPH for adjust certain fees  
          through regulations, though the ability for the fees to be  
          adjusted by Department of Finance to reflect changes in salaries  
          and operating expenses will remain. Staff notes that deleting  
          the ability to adjust fees to cover program costs other than  
          through the Department of Finance for certain program increases  
          may make it difficult to assure that fees cover DPH's  
          enforcement and oversight costs. Staff notes that it is not  
          clear why DPH should maintain the ability to adjust fees by  
          regulations regarding medical waste treatment facilities, but  
          not other fees.