BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 762
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 762 (Smyth)
          As Amended July 7, 2011
          Majority vote
           
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          |ASSEMBLY:  |78-0 |(May 19, 2011)  |SENATE: |37-0 |(July 14,      |
          |           |     |                |        |     |2011)          |
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           Original Committee Reference:    HEALTH  

           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.  

           The Senate amendments  are technical in nature and define "sharps 
          waste" and "pharmaceutical wastes."

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar 
          to its current form.
           
          FISCAL EFFECT  :  None

           COMMENTS  :  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 reusable containers be 
          used.  Finally, the author states that this bill will rectify 
          current problems that are causing the Department of Public 








                                                                  AB 762
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          Health (DPH) and local enforcement agencies of the Medical Waste 
          Management Act (MWMA) to cite hospitals for incorrectly using 
          the provisions in existing law.

          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. 

          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 Web site, 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 








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          economy, the project was shelved.

          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.


           Analysis Prepared by  :    Melanie Moreno / HEALTH / (916) 
          319-2097 


          FN:  0001721