BILL NUMBER: SB 372 CHAPTERED BILL TEXT CHAPTER 877 FILED WITH SECRETARY OF STATE OCTOBER 16, 1995 APPROVED BY GOVERNOR OCTOBER 13, 1995 PASSED THE SENATE SEPTEMBER 13, 1995 PASSED THE ASSEMBLY SEPTEMBER 1, 1995 AMENDED IN ASSEMBLY AUGUST 21, 1995 AMENDED IN ASSEMBLY JUNE 29, 1995 AMENDED IN ASSEMBLY JUNE 2, 1995 AMENDED IN SENATE APRIL 6, 1995 AMENDED IN SENATE MARCH 20, 1995 INTRODUCED BY Senator Wright FEBRUARY 14, 1995 An act to amend Sections 25020.5, 25022.8, 25023.2, 25023.8, 25024, 25027, 25027.5, 25041, 25055, 25061, 25062.5, 25063, 25080, 25081, 25088, 25090, and 25090.5 of, and to add Sections 25021.9, 25025.9, 25030.5, 25070.4, and 25090.6 to, the Health and Safety Code, and to add Section 21084.2 to the Public Resources Code, relating to medical waste. LEGISLATIVE COUNSEL'S DIGEST SB 372, Wright. Medical waste: management. (1) Existing law, the Medical Waste Management Act, authorizes a local enforcement agency to implement a medical waste management program with specified components to regulate the generation, hauling, treatment, containment, and storage of medical waste. The act defines terms and imposes criminal penalties upon persons who violate the act's requirements. The act requires all medical waste transported to offsite medical waste treatment facilities to be transported by registered hazardous waste transporters. A medical waste generator is authorized to apply to the enforcement agency for a limited-quantity hauling exemption. A medical waste generator is required to maintain specified records for 3 years, or for the period specified in regulations. The act requires biohazardous waste which meets specified conditions to be segregated to ensure treatment and to be disposed of in a specified manner. A person generating 20 or more pounds of medical waste per month is prohibited from storing biohazardous or sharps waste onsite above a specified temperature for more than 7 days, except as specified, and a person generating less than 20 pounds of biohazardous waste per month is prohibited from containing or storing biohazardous waste above that temperature for more than 30 days. Medical waste is defined under the act as excluding, among other things, waste containing microbiological cultures used in food processing and biotechnology and any containers or devices used in the preparation and handling of these cultures. This bill would revise that exclusion from the term "medical waste" to instead exclude waste generated in food processing or biotechnology that does not contain an infectious agent or certain waste generated in biotechnology, and would revise the definitions of the terms "biohazardous waste," "large quantity generator," "medical waste," "medical waste generator," "storage," and "transfer station" for purposes of the act. The bill would additionally define the terms "health care professional" and "parent organization." The bill would require a medical waste generator to maintain specified records if medical waste is removed from the generator's site for treatment. The bill would allow a medical waste generator, as specified, to accept home-generated sharps waste, for consolidation with the generator's medical waste stream, if specified conditions are met with regard to the handling of that waste. The bill would authorize an enforcement agency to approve a location as a point of consolidation for the collection of home-generated sharps waste, to be known as a home-generated sharps consolidation point, and would require the sharps waste, after collection, to be transported and treated as medical waste. The bill would require the consolidation point to comply with specified requirements with regard to the handling of that waste and would exempt such a point from specified requirements concerning containment and storage, permitting, fees, or the maintenance of tracking documents. The bill would allow a parent organization that employs health care professionals who generate medical waste to also apply to the enforcement agency for a limited-quantity hauling exemption and would revise the requirements for the limited-quantity handling exemption. The bill would require biohazardous waste which contains specified specimens or tissues or which is contaminated with chemotherapeutic agents to be treated by incineration or by an alternative technology prior to disposal. The bill would require biohazardous waste, which meets those conditions with regard to its content, to be labeled in a specified manner. The bill would instead prohibit a person generating 20 pounds or more of biohazardous waste from storing that waste for more than 7 days. (2) The act prohibits untreated medical waste from being processed by compactors or grinders, unless it is an integral part of an alternative treatment method approved by the department. A person generating or treating medical waste is required to ensure that the medical waste is treated by one of the specified methods to render it solid waste, including incineration. The act requires that recognizable human anatomical remains, except as specified, are to be disposed of by incineration or interment. This bill would allow a compactor to be used to compact medical waste if the type of medical waste compactor proposed to be used is evaluated and approved by the State Department of Health Services as meeting specified criteria. The bill would additionally allow medical waste to be treated prior to disposal with an alternative technology which has received express approval by the department due to the extremely high temperatures of the treatment in excess of 1300* Fahrenheit. The bill would allow recognizable human parts to be treated pursuant to such an alternative technology. Since the bill would redefine crimes, the bill would impose a state-mandated local program. (3) Under existing law, the California Environmental Quality Act, a lead agency, as defined, is required to prepare, or cause to be prepared, and certify the completion of, an environmental impact report on any project which it proposes to carry out or approve that may have a significant effect on the environment, as defined, or to adopt a negative declaration if it finds that the project will not have a significant effect, unless the project is exempt from the act. The Office of Planning and Research is required to prepare and develop guidelines for implementing the act, including preparing a list of classes of projects that have been determined not to have a significant effect on the environment. The office is required to review the guidelines at least once every 2 years. This bill would require the office, at the next revision of the guidelines after January 1, 1996, to make specified recommendations concerning the application of specified categorical exemptions in the guidelines to the treatment of medical waste by steam sterilization. (4) 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. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 25020.5 of the Health and Safety Code is amended to read: 25020.5. "Biohazardous waste" means any of the following: (a) Laboratory waste, including, but not limited to, all of the following: (1) Human or animal specimen cultures from medical and pathology laboratories. (2) Cultures and stocks of infectious agents from research and industrial laboratories. (3) Wastes from the production of bacteria, viruses, spores, discarded live and attenuated vaccines used in human health care or research, discarded animal vaccines, including Brucellosis and Contagious Ecthyma, as identified by the department, and culture dishes and devices used to transfer, inoculate, and mix cultures. (b) Human surgery specimens or tissues removed at surgery or autopsy, which are suspected by the attending physician and surgeon or dentist of being contaminated with infectious agents known to be contagious to humans. (c) Animal parts, tissues, fluids, or carcasses suspected by the attending veterinarian of being contaminated with infectious agents known to be contagious to humans. (d) Waste, which at the point of transport from the generator's site, at the point of disposal, or thereafter, contains recognizable fluid blood, fluid blood products, containers or equipment containing blood that is fluid, or blood from animals known to be infected with diseases which are highly communicable to humans. (e) Waste containing discarded materials contaminated with excretion, exudate, or secretions from humans or animals that are required to be isolated by the infection control staff, the attending physician and surgeon, the attending veterinarian, or the local health officer, to protect others from highly communicable diseases or diseases of animals that are highly communicable to humans. (f) (1) Waste which is hazardous only because it is comprised of human surgery specimens or tissues which have been fixed in formaldehyde or other fixatives, or only because the waste is contaminated through contact with, or having previously contained, chemotherapeutic agents, including, but not limited to, gloves, disposable gowns, towels, and intravenous solution bags and attached tubing which are empty. A biohazardous waste which meets the conditions of this paragraph is not subject to Chapter 6.5 (commencing with Section 25100). (2) For purposes of this subdivision, "chemotherapeutic agent" means an agent that kills or prevents the reproduction of malignant cells. (3) For purposes of this subdivision, a container, or inner liner removed from a container, which previously contained a chemotherapeutic agent, is empty if the container or inner liner removed from the container has been emptied by the generator as much as possible, using methods commonly employed to remove waste or material from containers or liners, so that the following conditions are met: (A) If the material which the container or inner liner held is pourable, no material can be poured or drained from the container or inner liner when held in any orientation, including, but not limited to, when tilted or inverted. (B) If the material which the container or inner liner held is not pourable, no material or waste remains in the container or inner liner that can feasibly be removed by scraping. SEC. 2. Section 25021.9 is added to the Health and Safety Code, to read: 25021.9. "Health care professional" means any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code; any person licensed pursuant to the Osteopathic Initiative Act, as set forth in Chapter 8 (commencing with Section 3600) of Division 2 of the Business and Professions Code, or pursuant to the Chiropractic Initiative Act, as set forth in Chapter 2 (commencing with Section 1000) of Division 2 of the Business and Professions Code; and any person certified pursuant to Division 2.5 (commencing with Section 1797). SEC. 3. Section 25022.8 of the Health and Safety Code is amended to read: 25022.8. "Large quantity generator" means a medical waste generator that generates 200 or more pounds of medical waste in any month of a 12-month period. SEC. 4. Section 25023.2 of the Health and Safety Code is amended to read: 25023.2. (a) "Medical waste" means waste which meets both of the following requirements: (1) The waste is composed of waste which is generated or produced as a result of any of the following actions: (A) Diagnosis, treatment, or immunization of human beings or animals. (B) Research pertaining to the activities specified in subparagraph (A). (C) The production or testing of biologicals. (D) The accumulation of properly contained home-generated sharps waste that is brought by a patient, a member of his or her family, or by a person authorized by the enforcement agency, to a point of consolidation approved by the enforcement agency pursuant to Section 25030.5 or authorized pursuant to Section 25070.4. (2) The waste is any of the following: (A) Biohazardous waste. (B) Sharps waste. (b) For purposes of this section, "biologicals" means medicinal preparations made from living organisms and their products, including, but not limited to, serums, vaccines, antigens, and antitoxins. SEC. 5. Section 25023.8 of the Health and Safety Code is amended to read: 25023.8. Medical waste does not include any of the following: (a) Waste generated in food processing or biotechnology that does not contain an infectious agent pursuant to Section 25022.5. (b) Waste generated in biotechnology that does not contain human blood or blood products or animal blood or blood products suspected of being contaminated with infectious agents known to be communicable to humans. (c) Urine, feces, saliva, sputum, nasal secretions, sweat, tears, and vomitus, unless they contain fluid blood, except as defined in subdivision (e) of Section 25020.5. (d) Waste which is not biohazardous, such as paper towels, paper products, articles containing nonfluid blood, and other medical solid waste products commonly found in the facilities of medical waste generators. (e) Hazardous waste, radioactive waste, or household waste. (f) Waste generated from normal and legal veterinarian, agricultural, and animal livestock management practices on a farm or ranch. SEC. 6. Section 25024 of the Health and Safety Code is amended to read: 25024. "Medical waste generator" means any person, whose act or process produces medical waste and includes, but is not limited to, a provider of health care as defined in subdivision (d) of Section 56.05 of the Civil Code. All of the following are examples of businesses which generate medical waste: (a) Medical and dental offices, clinics, hospitals, surgery centers, laboratories, research laboratories, unlicensed health facilities, those facilities required to be licensed pursuant to Division 2 (commencing with Section 1200), chronic dialysis clinics, as regulated pursuant to Division 2 (commencing with Section 1200), and education and research facilities. (b) Veterinary offices, veterinary clinics, and veterinary hospitals. (c) Pet shops. SEC. 7. Section 25025.9 is added to the Health and Safety Code, to read: 25025.9. "Parent organization" means an organization that employs or contracts with health care professionals who provide health care services at a location other than at a health care facility specified in subdivision (a) of Section 25024. SEC. 8. Section 25027 of the Health and Safety Code is amended to read: 25027. "Storage" means the holding of medical wastes, in accordance with Article 8 (commencing with Section 25080), at a designated accumulation area, offsite point of consolidation, transfer station, other registered facility, or in a vehicle detached from its means of locomotion. SEC. 9. Section 25027.5 of the Health and Safety Code is amended to read: 25027.5. "Transfer station" means any offsite location where medical waste is loaded, unloaded, stored, or consolidated by a registered hazardous waste hauler, or a holder of a limited quantity hauling exemption granted pursuant to Section 25061, during the normal course of transportation of the medical waste. "Transfer station" does not include any onsite facility, including, but not limited to, common storage facilities, facilities of medical waste generators employed for the purpose of consolidation, or onsite treatment facilities. SEC. 10. Section 25030.5 is added to the Health and Safety Code, to read: 25030.5. (a) In addition to the consolidation points authorized pursuant to Section 25070.4, the enforcement agency may approve a location as a point of consolidation for the collection of home-generated sharps waste, which, after collection, shall be transported and treated as medical waste. (b) A consolidation location approved pursuant to this section shall be known as a "home-generated sharps consolidation point." (c) A home-generated sharps consolidation point is not subject to the requirements of Article 8 (commencing with Section 25080), to the permit or registration requirements of this division, or to any permit or registration fees, with regard to the activity of consolidating home-generated sharps waste pursuant to this section. (d) A home-generated sharps consolidation point shall comply with all of the following requirements: (1) All sharps waste shall be placed in sharps containers. (2) Sharps containers ready for disposal shall not be held for more than seven days without the written approval of the enforcement agency. (e) An operator of a home-generated sharps consolidation point approved pursuant to this section shall not be considered the generator of that waste. (f) The medical waste treatment facility which treats the sharps waste subject to this section shall maintain the tracking documents required by Sections 25063 and 25073 with regard to that sharps waste. SEC. 11. Section 25041 of the Health and Safety Code is amended to read: 25041. Small quantity generators that treat waste onsite, pursuant to subdivision (a) of Section 25040, shall register with the enforcement agency prior to the commencement of treatment. SEC. 12. Section 25055 of the Health and Safety Code is amended to read: 25055. A medical waste generator required to register pursuant to this article shall maintain individual treatment, and tracking records, if medical waste is removed from the generator's site for treatment, for three years or for the period specified in the regulations. SEC. 13. Section 25061 of the Health and Safety Code is amended to read: 25061. (a) A medical waste generator or parent organization that employs health care professionals who generate medical waste may apply to the enforcement agency for a limited-quantity hauling exemption, if the generator or health care professional meets all of the following requirements: (1) The generator or health care professional generates less than 20 pounds of medical waste per week, transports less than 20 pounds of medical waste at any one time, and the generator or parent organization has on file one of the following: (A) If the generator or parent organization is a small quantity generator required to register pursuant to Article 4 (commencing with Section 25040), a medical waste management plan prepared pursuant to Section 25042. (B) If the generator or parent organization is a small quantity generator not required to register pursuant to Article 4 (commencing with Section 25040), the information document maintained pursuant to subdivision (a) of Section 25045.1. (C) If the parent organization is a large quantity generator, a medical waste management plan prepared pursuant to Section 25052. (2) The generator or health care professional who generated medical waste transports the medical waste himself or herself, or directs a member of his or her staff to transport the waste, to a permitted medical waste treatment facility, a transfer station, a parent organization, or another health care facility for the purpose of consolidation before treatment and disposal. (3) Except as provided in paragraph (4), the generator maintains a tracking document, as specified in Section 25063. (4) (A) Notwithstanding paragraph (3), if a health care professional who generates medical waste returns the medical waste to the parent organization, 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: (i) The name of the person transporting the medical waste. (ii) The number of containers and type of medical waste. This subparagraph 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 medical waste in any container. (iii) The date that the medical waste was returned. (B) This paragraph does not prohibit the use of a single document to verify the return of more than one container over a period of time, if the form or log is maintained in the files of the parent organization once the page is completed. (b) The limited-quantity hauling exemption authorized by this section is valid for a period of one year. (c) An application for an initial or a renewal of a limited-quantity hauling exemption shall be accompanied by a fee of twenty-five dollars ($25). The application shall identify each person who will transport medical waste for the transporter. If the generator or parent organization identifies more than four persons who will be transporting medical waste, the generator or parent organization shall pay an additional fee of five dollars ($5) for each person, up to a maximum additional fee of twenty-five dollars ($25). SEC. 14. Section 25062.5 of the Health and Safety Code is amended to read: 25062.5. For the purpose of transferring medical waste prior to reaching a permitted medical waste treatment facility, medical waste shall not be unloaded, reloaded, or transferred to another vehicle at any location, except at a permitted medical waste transfer station or in the case of a vehicle breakdown or other emergency. SEC. 15. Section 25063 of the Health and Safety Code is amended to read: 25063. (a) Except with regard to sharps waste consolidated by a home-generated sharps consolidation point approved pursuant to Section 25030.5, 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 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 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 25061. (2) The type and quantity 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 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 waste. The tracking document shall be shown upon demand to any enforcement agency personnel or an officer of the Department of the California Highway Patrol. If the 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 waste which 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. (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 treatment facility in the receiving state or if the medical waste is crossing an international border, the waste shall be treated in accordance with Article 9 (commencing with Section 25090) prior to being transported out of the state. SEC. 16. Section 25070.4 is added to the Health and Safety Code, to read: 25070.4. Notwithstanding any other provision of this chapter, a registered medical waste generator, which is a facility specified in subdivisions (a) and (b) of Section 25024, may accept home-generated sharps waste, to be consolidated with the facility's medical waste stream, subject to all of the following conditions: (a) The generator of the sharps waste, a member of the generator' s family, or a person authorized by the enforcement agency transports the sharps waste to the medical waste generator's facility. (b) The sharps waste is accepted at a central location at the medical waste generator's facility. (c) A reference to, and a description of, the actions taken pursuant to this section are included in the facility's medical waste management plan adopted pursuant to Section 25052. SEC. 17. Section 25080 of the Health and Safety Code is amended to read: 25080. To containerize or store medical waste, a person shall do all of the following: (a) Medical waste shall be contained separately from other waste at the point of origin in the producing facility. Sharps containers may be placed in biohazard bags or in containers with biohazard bags. (b) Biohazardous waste shall be placed in a red biohazard bag conspicuously labeled with the words "Biohazardous Waste" or with the international biohazard symbol and the word "BIOHAZARD." (c) Sharps waste shall be contained in a sharps container pursuant to Section 25082. (d) (1) Biohazardous waste, which meets the conditions of subdivision (f) of Section 25020.5 because it is contaminated through contact with, or having previously contained, chemotherapeutic agents, shall be segregated for storage, and, when placed in a secondary container, that container shall be labeled with the words "Chemotherapy Waste", "CHEMO", or other label approved by the department on the lid and on the sides, so as to be visible from any lateral direction, to ensure treatment of the waste pursuant to Section 25090.6. (2) Biohazardous waste, which meets the conditions of subdivision (f) of Section 25020.5 because it is comprised of human surgery specimens or tissues which have been fixed in formaldehyde or other fixatives, shall be segregated for storage and, when placed in a secondary container, that container shall be labeled with the words "Pathology Waste", " PATH", or other label approved by the department on the lid and on the sides, so as to be visible from any lateral direction, to ensure treatment of the waste pursuant to Section 25090.6. (e) Sharps waste, which meets the conditions of subdivision (f) of Section 25020.5, shall be placed in sharps containers labeled in accordance with the industry standard with the words "Chemotherapy Waste", "Chemo", or other label approved by the department, and segregated to ensure treatment of the waste pursuant to Section 25090.6. (f) Biohazardous waste, which are recognizable human anatomical parts, as specified in Section 25090.5, shall be segregated for storage and, when placed in a secondary container for treatment as pathology waste, that container shall be labeled with the words "Pathology Waste", "PATH", or other label approved by the department on the lid and on the sides, so as to be visible from any lateral direction, to ensure treatment of the waste pursuant to Section 25090.6. SEC. 18. Section 25081 of the Health and Safety Code is amended to read: 25081. To containerize biohazard bags, a person shall do all of the following: (a) The bags shall be tied to prevent leakage or expulsion of contents during all future storage, handling, or transport. (b) Biohazardous waste shall be bagged in accordance with subdivision (b) of Section 25080 and placed for storage, handling, or transport in a rigid container which may be disposable, reusable, or recyclable. Containers shall be leak resistant, have tight-fitting covers, and be kept clean and in good repair. Containers may be recycled with the approval of the enforcement agency. Containers may be of any color and shall be labeled with the words "Biohazardous Waste" or with the international biohazard symbol and the word "BIOHAZARD" on the lid and on the sides so as to be visible from any lateral direction. Containers meeting the requirements specified in Section 66840 of Title 22 of the California Code of Regulations, as it read on December 31, 1990, may also be used until the replacement of the containers is necessary or existing stock has been depleted. (c) Biohazardous waste shall not be removed from the biohazard bag until treatment as prescribed in Article 9 (commencing with Section 25090) is completed, except to eliminate a safety hazard, or by the enforcement officer in performance of an investigation pursuant to Section 25034.3. Biohazardous waste shall not be disposed of before being treated as prescribed in that Article 9. (d) (1) Except as provided in paragraph (5), a person generating biohazardous waste shall comply with the following requirements: (A) If the person generates 20 or more pounds of biohazardous waste per month, the person shall not contain or store biohazardous or sharps waste above 0* Centigrade (32* Fahrenheit) at any onsite location for more than seven days without obtaining prior written approval of the enforcement agency. (B) If a person generates less than 20 pounds of biohazardous waste per month, the person shall not contain or store biohazardous waste above 0* Centigrade (32 * Fahrenheit) at any onsite location for more than 30 days. (2) A person may store biohazardous or sharps waste at or below 0* Centigrade (32* Fahrenheit) at an onsite location for not more than 90 days without obtaining prior written approval of the enforcement agency. (3) A person may store biohazardous or sharps waste at a permitted transfer station at or below 0* Centigrade (32* Fahrenheit) for not more than 30 days without obtaining prior written approval of the enforcement agency. (4) A person shall not store biohazardous or sharps waste above 0* Centigrade (32* Fahrenheit) at any location or facility which is offsite from the generator for more than seven days before treatment. (5) Notwithstanding paragraphs (1) to (4), inclusive, if the odor from biohazardous or sharps waste stored at a facility poses a nuisance, the enforcement agency may require more frequent removal. SEC. 19. Section 25088 of the Health and Safety Code is amended to read: 25088. (a) Except as provided in subdivision (b), compactors or grinders shall not be used to process medical waste until after the waste has been treated pursuant to Article 9 (commencing with Section 25090) and rendered solid waste. (b) (1) Grinding or compacting may be used when it is an integral part of an alternative treatment method, approved by the department. (2) A compactor may be used to compact medical waste if the type of medical waste compactor proposed to be used is evaluated by the department, and approved by the department prior to its use pursuant to the following criteria: (A) The compactor operates without the release of liquids or pathogenic microorganisms from the medical waste during placement of medical waste into, or removal from, the compactor units, and during the compaction process. (B) The compacted medical waste will not release liquids or pathogens during any subsequent handling and no residual waste will be left in the compactor unit after the process is completed. (C) Compactor operations and maintenance personnel will not be at any substantial increased risk of exposure to pathogens. (D) The compactor has been demonstrated not to have any adverse effects on any treatment method. If only specific treatment methods are compatible with the compaction process, the department shall condition its approval of the compactor for use only in conjunction with treatment methods for which no adverse effects have been demonstrated. (c) Medical waste in bags or other containers shall not be subject to compaction by any compacting device and shall not be placed for storage or transport in a portable or mobile trash compactor, except as allowed pursuant to subdivision (b). SEC. 20. Section 25090 of the Health and Safety Code is amended to read: 25090. A person generating or treating medical waste shall ensure that the medical waste is treated by one of the following methods, thereby rendering it solid waste, as defined in Section 40191 of the Public Resources Code, prior to disposal: (a) (1) Incineration at a permitted medical waste treatment facility in a controlled-air, multichamber incinerator, or other method of incineration approved by the department which provides complete combustion of the waste into carbonized or mineralized ash. (2) Treatment with an alternative technology approved pursuant to subdivision (d), which, due to the extremely high temperatures of treatment in excess of 1300 degrees Fahrenheit, has received express approval by the department. (b) (1) Discharge to a public sewage system if the medical waste is liquid or semiliquid, and not either of the following: (A) Liquid or semiliquid laboratory waste, as defined in subdivision (a) of Section 25020.5. (B) Microbiological specimens, including those specified in subdivision (b) of Section 25020.5. (2) Medical waste discharge shall be consistent with the waste discharge requirements placed on the public sewer system by the California regional water quality control board with jurisdiction. (c) Steam sterilization at a permitted medical waste treatment facility or by other sterilization, in accordance with all of the following operating procedures for steam sterilizers or other sterilization: (1) Standard written operating procedures shall be established for biological indicators, or for other indicators of adequate sterilization approved by the department, for each steam sterilizer, including time, temperature, pressure, type of waste, type of container, closure on container, pattern of loading, water content, and maximum load quantity. (2) Recording or indicating thermometers shall be checked during each complete cycle to ensure the attainment of 121* Centigrade (250* Fahrenheit) for at least one-half hour, depending on the quantity and density of the load, in order to achieve sterilization of the entire load. Thermometers shall be checked for calibration annually. Records of the calibration checks shall be maintained as part of the facility's files and records for a period of three years or for the period specified in the regulations. (3) Heat-sensitive tape, or another method acceptable to the enforcement agency, shall be used on each biohazard bag or sharps container that is processed onsite to indicate the attainment of adequate sterilization conditions. (4) The biological indicator Bacillus stearothermophilus, or other indicator of adequate sterilization as approved by the department, shall be placed at the center of a load processed under standard operating conditions at least monthly to confirm the attainment of adequate sterilization conditions. (5) Records of the procedures specified in paragraphs (1), (2), and (4) shall be maintained for a period of not less than three years. (d) (1) Other alternative medical waste treatment methods which are both of the following: (A) Approved by the department. (B) Result in the destruction of pathogenic micro-organisms. (2) Any alternative medical waste treatment method proposed to the department shall be evaluated by the department and either approved or rejected pursuant to the criteria specified in this subdivision. SEC. 21. Section 25090.5 of the Health and Safety Code is amended to read: 25090.5. Recognizable human anatomical parts, with the exception of teeth not deemed infectious by the attending physician and surgeon or dentist shall be disposed of by interment or in accordance with subdivision (a) of Section 25090, unless otherwise hazardous. SEC. 22. Section 25090.6 is added to the Health and Safety Code, to read: 25090.6. Biohazardous waste that meets the conditions of subdivision (f) of Section 25020.5 shall be treated pursuant to subdivision (a) of Section 25090 prior to disposal. SEC. 23. Section 21084.2 is added to the Public Resources Code, to read: 21084.2. The Office of Planning and Research shall, at the next revision of the California Environmental Quality Act Guidelines (Chapter 3 (commencing with Section 15000) of Division 6 of Title 14 of the California Code of Regulations) which takes place after January 1, 1996, pursuant to Section 21087, recommend changes to those guidelines that would determine if Sections 15301, 15302, and 15304 of Title 14 of the California Code of Regulations apply to the treatment of medical waste by steam sterilization. If the office determines that those provisions of the guidelines apply, consistent with existing law, to that treatment, the office shall recommend clarifying revisions to the guidelines to expressly state that the treatment is subject to a categorical exemption under those provisions of the guidelines. If the office determines that those provisions of the guidelines do not categorically exempt that treatment, and if such an exemption is consistent with existing law, the office shall recommend a categorical exemption for the treatment in its recommended revision of the guidelines. SEC. 24. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution. Notwithstanding Section 17580 of the Government Code, unless otherwise specified, the provisions of this act shall become operative on the same date that the act takes effect pursuant to the California Constitution.