BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 762
                                                                  Page  1

          Date of Hearing:   May 3, 2011

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                     AB 762 (Smyth) - As Amended:  March 31, 2011
           
          SUBJECT  :  Public health: medical waste.

           SUMMARY  :  Deletes a provision in existing law that requires a 
          specified extremely high heat technology (plasma arc technology) 
          to be used on medical waste, biohazardous waste, and sharps 
          waste in order for it to be consolidated into a common 
          container, in effect permitting that waste to be incinerated in 
          a common container.  Permits that common container to be 
          reusable.  

           EXISTING LAW  :

          1)Establishes the Medical Waste Management Act (MWMA), 
            administered by the Department of Public Health (DPH), to 
            regulate the management and handling of medical waste.

          2)Establishes requirements for containing or storing medical 
            waste.  Permits medical waste, biohazardous waste, and sharps 
            waste to be consolidated into a common container provided that 
            the consolidated waste is treated by plasma arc technology.

           FISCAL EFFECT  :  None.

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, from a 
            scientific and operational standpoint, the consolidation of 
            sharps and certain pharmaceutical wastes into a single 
            reusable container for treatment in a medical waste 
            incinerator provides several advantages.  First, treating 
            sharps waste by incineration is better for the environment and 
            worker safety at the treatment plant than allowing the unused 
            residual pharmaceuticals in the sharps to be aerosolized by 
            autoclave treatment.  The author states that additionally, 
            waste water treatment authorities no longer want 
            pharmaceutical wastes to go into their sewers either through 
            direct discharge or via leachate from landfills or waste 
            condensation from autoclaves and that landfill operations do 
            not want pharmaceutical leachate from autoclave treated 
            sharps.  The author contends that this bill will also reduce 
            plastics going into the waste streams by requiring that 






                                                                  AB 762
                                                                  Page  2

            reusable containers be used.  Finally, the author states that 
            this bill will rectify current problems that are causing DPH 
            and local enforcement agencies of the MWMA to cite hospitals 
            for incorrectly using the provisions existing law.

           2)BACKGROUND  .  SB 419 (Scott), Chapter 477, Statutes of 2004, 
            changes the MWMA to allow consolidation of certain medical 
            waste if it is sent for high heat treatment of at least 1300?F 
            in an "alternative treatment technology" (specifically, plasma 
            arc technology).  Sewering, autoclave, and incineration 
            treatments were recognized as acceptable treatment methods at 
            the time the MWMA was adopted and any other type of treatment 
            came to be known as alternative (to these recognized) 
            treatments.  Over time and with no alternative high heat 
            treatment being introduced in California, some hospitals used 
            the SB 419 provision incorrectly to consolidate sharps and 
            pharmaceutical wastes into a single container and send it for 
            incineration.  The incorrect application of the SB 419 
            provision was that the medical waste incinerators were not 
            "alternative" treatment technologies under a strict 
            interpretation of the MWMA.
            According to background materials submitted by the author, 
            hospitals had looked forward to implementation of plasma arc 
            treatment and the provisions of SB 419 to reduce their medical 
            waste handling costs through consolidation of the wastes.  
            This provision would have reduced the amount of professional 
            staff time spent deciding how to properly segregate the 
            medical waste stream components as well as time devoted to 
            training staff in proper segregation techniques. 

           3)PLASMA ARC TECHNOLOGY  .  According to a November 2000 paper of 
            the International Centre for Science and High Technology of 
            the United Nations Industrial Development Organization, in 
            plasma arc treatment, an electric current is directed through 
            a low-pressure gas stream, which creates a thermal plasma 
            field.  These plasma arc fields can reach 5000 to 15000?C. The 
            intense high temperature zone can be used to dissociate waste 
            into its atomic elements by injecting the waste into the 
            plasma, or by using the plasma arc as a heat source for 
            combustion.  According to information provided by the sponsor 
            of this bill, the California Hospital Association (CHA), a 
            Plasma Arc company called InEntec had approval to build a 
            "Plasma Enhanced Melter" in Red Bluff, CA.  According to the 
            InEntec Website, this technology transforms municipal, 
            industrial, medical, and hazardous waste into clean energy 
            products for transportation fuels, electricity generation and, 
            industrial products.  CHA states that with the downturn of the 






                                                                  AB 762
                                                                  Page  3

            economy, the project was shelved.

           4)SUPPORT  .  CHA states that one of the main threats to 
            California's streams and other waterways is contamination from 
            pharmaceutics, which occurs through leachate from landfills or 
            waste condensation from autoclaves.  CHA states that treating 
            those wastes in one common container, which may be reusable, 
            is better for the environment and for hospital workers.  The 
            Association of California Health Care Districts writes that 
            this bill provides overdue clarity to the appropriate handling 
            of medical waste, while affording appropriate safety for 
            medical personnel as well as protecting the environment. 
            Catholic Healthcare West writes that this bill will reduce the 
            amount of time spent deciding the appropriate segregation 
            option at the point of waste generation, especially where care 
            is rendered and the risk of occupational exposure and error by 
            providing a direct, accessible single container at the point 
            of generation will be reduced.  Kaiser Permanente writes that 
            this bill will encourage health care organizations to put 
            medical waste in reusable containers and reduce health care 
            worker confusion over how to safely and legally dispose of 
            medical waste.

           5)DOUBLE REFERRAL  .  This bill is double referred.  Should it 
            pass out of this committee, it will be referred to the 
            Assembly Committee on Environmental Safety and Toxic 
            Materials.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support  
          California Hospital Association (sponsor)
          Association of California Health Care Districts
          Catholic Healthcare West
          Kaiser Permanente

           Opposition  
          None on file.
           
          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916) 
          319-2097