BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 403
                                                                  Page 1

          Date of Hearing:   April 16, 2013

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                  Luis Alejo, Chair
                    AB 403 (Stone) - As Amended: :  April 8, 2013
                              As Proposed To Be Amended
           
          SUBJECT  :   Home-generated medical sharps.

          SUMMARY:  Requires businesses that sell medial sharps to  
          establish a product stewardship plan for the end of life  
          management of home-generated medial sharps.   Specifically,  this  
          bill  :

          1) Establishes a new chapter in the Public Resources Code that  
             establishes a product stewardship program for home generated  
             hypodermic needles, syringes with needles attached, pen  
             needles, intravenous needles, or any other similar device  
             intended to self-inject medication at home.

          2) Requires medical sharps producers to develop and implement a  
             program to collect transport and process home generated  
             medical sharps to be overseen by the Department of Resource  
             Recovery and Recycling (DRRR).

          3) Requires, on or before April 1, 2015, medical sharps  
             producers or a stewardship organization designated by medical  
             sharps producers to submit a medical sharps stewardship plan  
             to DRRR.  Specifies that the medical sharps stewardship plan  
             do all of the following: 

             a)    Include the development and implementation of a  
                recovery program to reduce the generation and manage the  
                collection, transporting, processing, disposal of home  
                generated medical sharps;

             b)    Include provisions to meet collection rates of 25% and  
                20% to be met in 2016, and 2017 respectively.  In  
                subsequent years, the plans will be required to meet  
                collection rates established by DRRR;

             c)    Include a funding mechanism to provide sufficient  
                funding to carry out the program;  

             d)    Include education and outreach for consumers, the  








                                                                  AB 403
                                                                  Page 2

                medical community, and retailers that would promote the  
                collection of home-generated sharps.  Authorize this  
                information to include, but is not be limited to,  
                developing, and updating as necessary, educational and  
                other outreach materials aimed at all retailers and  
                distributors of home-generated sharps:

             e)    Provides for a home-generated sharps collection point  
                to be established in every county in the state, and that  
                the number of home-generated sharps collection points is  
                equal to at least one for every 25,000 people in the  
                state;

             f)    Requires that the funding mechanism be an amount that  
                cumulatively will adequately fund the program; and,

             g)    Requires that home-generated medical sharps producers,  
                and not consumers, are responsible for implementing the  
                home-generated sharps stewardship program.

          4) Requires DRRR, within 90 days of receipt of a plan, to  
             determine if a plan is complete and to notify the submitter  
             of its determination.  Requires, if it is not complete, the  
             submitter to revise and resubmit the plan within 90 days.

          5) Allows medical sharp producers to join a stewardship  
             organization to jointly prepare and execute the medical  
             sharps stewardship plan.  Provides that the stewardship  
             organization is a non-profit organization created by one or  
             more producers with at least four additional participants  
             from local government, medical sharps distributor, a waste  
             hauler, and consumer health organization.

          6) Requires on or before July 1, 2017, and each year thereafter,  
             producer or product stewardship organization to submit a  
             report, to include:

             a)    The number of home-generated sharps collected by the  
                program in the previous calendar year and the collection  
                rate achieved in the previous calendar year;

             b)    The total sales data for sharps sold to distributors in  
                the state for the previous calendar year;

             c)    A report on the feedback from a stakeholders' meeting  








                                                                  AB 403
                                                                  Page 3

                that shall be hosted by the producers subject to the plan  
                and made available by Webcast, prior to submittal of the  
                annual report;

             d)    Independently audited financial statements that detail  
                the financing method selected to sustainably fund the  
                implementation of the plan to achieve the minimum  
                collection rates described in the plan;

             e)    Examples and descriptions of educational materials  
                distributed to various stakeholders aimed at increasing  
                collection;

             f)    An evaluation of the effectiveness of the program,  
                specific to collection, public awareness, convenience, and  
                reduced improper disposal associated with both legal and  
                illegal drug use;

             g)    Any programmatic changes the producer or the  
                stewardship organization recommends based on new data  
                provided in the report; and

             h)    The location, hours, and contact information for all  
                home-generated sharps collection points established  
                pursuant to the plan.


          7) Requires the producer or product stewardship organization to  
             submit to DRRR an annual administrative fee, to be  
             established by DRRR in an amount adequate to cover the full  
             costs of administering and enforcing this bill.

          8) Establishes administrative civil penalties for any person who  
             violates the requirement of this act of $1,000 per violation  
             and $10,000 per violation if the violation is intentional,  
             knowing, or negligent.  

          9) Allows home-generated sharps waste be transported and managed  
             at a facility or other home-generated sharps collection point  
             operated pursuant to an approved home-generated sharps  
             stewardship plan.
          
          EXISTING LAW  

          1)Prohibits the disposal of home-generated sharps waste in solid  








                                                                  AB 403
                                                                  Page 4

            waste or recycling streams.

          2)Defines "home-generated sharps waste" to mean hypodermic  
            needles, pen needles, intravenous needles, lancets, and other  
            devices that are used to penetrate the skin for the delivery  
            of medications derived from a household, including a  
            multifamily residence or household

          3)Requires pharmaceutical manufacturers that sell or distribute  
            a medication in California that is self-injected at home  
            through the use of a hypodermic needle, pen needle,  
            intravenous needle, or any other similar device to submit to  
            DRRR a plan that describes what actions, if any, the  
            manufacturer supports for the safe management of sharps waste.

          4)Requires that the safe management plan be submitted annually  
            after the initial date of July 1, 2010, and be posted on  
            DRRR's website as well as the manufacturer's website. 

           FISCAL EFFECT  :   Unknown

           COMMENTS  :

           1)Need for the bill.   According to California Product  
            Stewardship Council, the sponsors of AB 403, "Sharps in the  
            trash pose serious health risks to sanitation workers, water  
            treatment facility operators and the general public.  In  
            addition to the immediate risk of a needle stick injury,  
            sharps put individuals at risk of acquiring blood borne  
            infectious diseases, such as hepatitis or HIV.  Individuals  
            who suffer a needle stick injury must receive immediate  
            treatment and follow up care, including multiple lab tests and  
            medications.

            While the state banned needles from trash disposal in 2008,  
            there is still no consistent, statewide program that is  
            sustainably funded or has high levels of effectiveness at  
            collecting the majority of sharps disposed each year in  
            California.  This bill attempts to address the frustration  
            that people have trying to find affordable and convenient  
            sharps collection opportunities, which will in turn ensure  
            more needles do not end up improperly managed."

           2)Medical sharps  :  An estimated one million Californians inject  
            medications outside traditional health care facilities, which  








                                                                  AB 403
                                                                  Page 5

            generate approximately 389 million sharps each year.  The  
            numbers of patients using injectable medications will continue  
            to grow because it is an effective delivery method.  The most  
            common home use of sharps is to manage diabetes.  Other  
            reasons to home-inject include multiple sclerosis,  
            infertility, migraines, allergies, hemophilia and medications  
            for pets.

            California was one of the first states to address the problems  
            of sharps with the passage of SB 1305 (Figueroa, Chapter 64,  
            Statutes of 2006) to prohibit the disposal of medical sharps  
            in California's landfills.  Although illegal, most of these  
            used needles still end up in household trash and pose a  
            significant risk of injury and/or infection to children,  
            custodial workers and solid waste employees.

           3)Product stewardship  :  This is a waste management concept that  
            addresses the challenges of managing consumer products, like  
            household batteries, that pose costly and problematic issues  
            at end-of-life.  According to the California Product  
            Stewardship Council, "Product stewardship involves consumers,  
            government agencies and product manufacturers sharing the  
            responsibility of reducing the impact of product waste on  
            public health, the environment, and the economy.  Extended  
            Producer Responsibility (EPR) is a strategy to place a shared  
            responsibility for end-of-life product management on the  
            producers, and all entities involved in the product chain,  
            instead of the general public; while encouraging product  
            design changes that minimize a negative impact on human health  
            and the environment at every stage of the product's lifecycle.  
             This allows the costs of treatment and disposal to be  
            incorporated into the total cost of a product.  It places  
            primary responsibility on the producer, or brand owner, who  
            makes design and marketing decisions.  It also creates a  
            setting for markets to emerge that truly reflect the  
            environmental impacts of a product, and to which producers and  
            consumers respond."


           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           

          California Product Stewardship Council (sponsor) 








                                                                  AB 403
                                                                  Page 6


          Blue Line Transfer, Inc.

          Californians Against Waste 

          California Refuse Recycling Council/North/South

          California State Association of Counties
          City of Covina 

          City of Monterey

          City of Roseville 

          City of Sacramento
          City of San Diego
          City of Sunnyvale 

          City of Torrance
          Clean Water Action
          Contra Costa Clean Waste Program
          Sierra Club California
          Contra Costa Clean Water Program
          County of Santa Barbara
          County of Sonoma
          County of Yolo Waste Advisory Committee
          GreenWaste Recovery Inc. 

          Los Angeles County Solid Waste Management Committee/ Integrated  
          Waste Management Task Force
          Marin County Hazardous & Solid Waste Management Joint Powers  
          Authority 

          Monterey Regional Waste Management District
          Napa Recycling & Waste Services 

          Republic Services

          Rural County Representatives of California
          Waste Management
          Solid Waste Association of North America
          Sonoma County Waste Management Agency
          South San Francisco Scavenger Company, Inc. 

          Tamalpais Community Services District








                                                                  AB 403
                                                                  Page 7

          Ultimed Incorporated
           
          Opposition 

           AdvaMed
          BayBio
          BIOCOM
          California Healthcare Institute
          PhRMA
          Silicon Valley Leadership Group
          TechNet
           

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