BILL ANALYSIS                                                                                                                                                                                                    �



                                                               AB 1442
                                                                       

                        SENATE COMMITTEE ON ENVIRONMENTAL QUALITY
                          Senator S. Joseph Simitian, Chairman
                                2011-2012 Regular Session
                                             
           BILL NO:    AB 1442
           AUTHOR:     Wieckowski
           AMENDED:    June 14, 2012
           FISCAL:     Yes               HEARING DATE:   July 2, 2012
           URGENCY:    No                CONSULTANT:      Rebecca Newhouse
            
           SUBJECT  :    PHARMACEUTICAL WASTE:  COMMON CARRIER

            SUMMARY  :    
           
            Existing law  ,

           1)Under the federal Resource Conservation and Recovery Act (RCRA), 
             regulates the management of solid and hazardous wastes. 

           2)Under the Radiation Control Law (Health and Safety Code �114960 
             et seq.) regulates and controls sources of ionizing radiation. 

           3)Under the Medical Waste Management Act (MWMA) (�117600 et seq.):

              a)   Defines "pharmaceuticals" as a prescription or 
                over-the-counter human or veterinary drug including, but not 
                limited to, a drug as defined in the Sherman Food, Drug and 
                Cosmetic Law or the Federal Food, Drug, and Cosmetic Act.  
                "Pharmaceutical" does not include any pharmaceutical that is 
                regulated pursuant to either RCRA or the Radiation Control 
                Law.

              b)   Specifies that waste comprised only of pharmaceuticals is 
                hazardous, and is considered "medical waste," although it is 
                not subject to hazardous waste laws, as specified.  

              c)   Requires medical waste generators to maintain on file, or 
                file with the enforcement agency, specified documents 
                relating to the maintenance, treatment and transport of 
                medical waste.

              d)   Requires all medical waste be transported to an offsite 
                medical waste treatment facility to be transported by a 









                                                               AB 1442
                                                                 Page 2

                registered hazardous waste transporter.

              e)   Exempts specified medical waste generators from the 
                requirement in d) if they are granted a limited-quantity 
                waste hauling exemption from the enforcement agency and meet 
                specified requirements including:

                i)     Maintaining on file, or filing with the enforcement 
                  agency, specified documents relating to the maintenance, 
                  treatment and transport of medical waste. 

                ii)    The requirement that the generator or health care 
                  professional who generated the medical waste transports the 
                  medical waste himself or herself, or directs a member of 
                  his or her staff to transport the medical 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.

                iii)   Maintaining a tracking document, as specified, unless 
                  the health care professional who generates and returns the 
                  pharmaceutical waste to the parent organization, and under 
                  that case is authorized to substitute a single-page form or 
                  multiple entry log for the tracking document if the form or 
                  log contains specified information.

              f)   Requires that medical waste treatment facilities maintain 
                specified records for three years, including copies of the 
                tracking documents for all medical waste it receives for 
                treatment from offsite generators or hazardous waste haulers.

            This bill  :  

           1)Defines "common carrier" as either of the following:

              a)   A person or company that has a United States Department of 
                Transportation number issued by the Federal Motor Carrier 
                Safety Administration and is registered with the Federal 
                Motor Carrier Safety Administration as a for-hire property 
                carrier.

              b)   A person or company that has a motor carrier of property 









                                                               AB 1442
                                                                 Page 3

                permit issued by the Department of Motor Vehicles pursuant to 
                the Motor Carriers of Property Permit Act and, if applicable, 
                a carrier identification number issued by the Department of 
                the California Highway Patrol.

           2)Defines "pharmaceutical waste" as any pharmaceutical that for 
             any reason may no longer be sold or dispensed for use as a drug. 
              Excludes from this definition those pharmaceuticals that still 
             have potential value to the generator because they are being 
             returned to a reverse distributor for possible manufacturer 
             credit.

           3)Specifies that medical generators keep the name of the common 
             carrier used by the generator to transport pharmaceutical waste 
             offsite for treatment and disposal, on file, or file that 
             information with the enforcement agency, along with other 
             required information relating to the maintenance, treatment and 
             transport of medical waste.

           4)Exempts a pharmaceutical waste generator or parent organization 
             that employs health care professionals who generate 
             pharmaceutical waste from the hazardous waste hauling 
             requirement if the generator, health care professional, or 
             parent organization meets certain specified requirements, 
             including:

              a)   Maintaining on file, or filing with the enforcement 
                agency, specified documents relating to the maintenance, 
                treatment and transport of medical waste. 

              b)   The requirement that the generator or health care 
                professional who generated the pharmaceutical waste 
                transports the pharmaceutical waste himself or herself, or 
                directs a member of his or her staff to transport the 
                pharmaceutical waste to a parent organization or another 
                health care facility for the purpose of consolidation before 
                treatment and disposal, or contracts with a common carrier to 
                transport the pharmaceutical waste to a permitted medical 
                waste treatment facility or transfer station.

              c)   Maintaining and providing a tracking document, as 
                specified, to the intended destination facility, requiring 
                the destination facility to notify the generator of any 









                                                               AB 1442
                                                                 Page 4

                discrepancies between the items received and the tracking 
                document, and requiring the generator to notify the 
                enforcement agency of any discrepancies, unless the health 
                care professional who generates pharmaceutical waste returns 
                the pharmaceutical waste to the parent organization, and 
                under that case, is authorized to substitute a single-page 
                form or multiple entry log for the tracking document if the 
                form or log contains specified information.

           5)Requires that medical waste treatment facilities maintain copies 
             of tracking documents from common carriers.

            COMMENTS  :

            1) Purpose of Bill  .  According to the author, "Under existing law, 
              pharmaceutical drugs can be sent to healthcare facilities 
              through common carriers, or standard shipping means.  Unused 
              drugs can sometimes be returned to the manufacturer for credit, 
              via a common carrier.  Expired and non-dispensable drugs must 
              be shipped as "Medical Waste", requiring expensive hazardous 
              waste shipping, instead of common carrier.  This is 
              unnecessarily expensive for pharmacies, hospitals, and other 
              health care facilities, who are simply returning the exact same 
              drug that was shipped to them by common carrier." 

            2) Background  .  Some pharmaceutical wastes are classified as 
              hazardous wastes.  Others are medical waste, and still others 
              are nonhazardous wastes.  Which category a discarded 
              pharmaceutical falls into depends on its chemical, physical, 
              and toxicological properties and who generates the waste.  The 
              California Code of Regulations dictates that the generator of 
              the waste is ultimately responsible for proper classification 
              of waste streams and subsequently managing and disposing of the 
              waste according to the appropriate rule governing each waste 
              classification. 

              The Department of Toxic Substances Control regulates 
              pharmaceutical wastes that are considered hazardous under the 
              federal RCRA.  Some pharmaceutical waste that is not identified 
              under the RCRA may be deemed hazardous under California 
              standards, and subsequently classified as medical waste and 
              therefore subject to the MWMA.  The Department of Public Health 
              (DPH) oversees the MWMA and regulates medical waste.  









                                                               AB 1442
                                                                 Page 5


              The MWMA specifies that medical waste, including pharmaceutical 
              waste comprised of nonsalable and outdated prescription and 
              over-the-counter drugs must be transported by a licensed 
              hazardous waste hauler.  If they meet certain requirements, 
              medical waste generators can apply for a limited-quantity waste 
              hauling exemption, and the generator of the medical waste may 
              transfer the waste themselves to a medical waste treatment 
              facility.  These exemptions last one year, and do not allow the 
              medical waste transporter to contract with a common carrier. 

              Current law is not clear regarding what constitutes 
              "pharmaceutical waste," but according to DPH's Self-Assessment 
              Manual for Proper Management of Medical Waste, pharmaceuticals 
              that have "intrinsic value," or are creditable, are not 
              considered waste and can be returned by a common carrier to a 
              reverse distributer, which is licensed by the Board of Pharmacy 
              to handle outdated or nonsalable prescription drugs and 
              regulated by DPH to handle pharmaceuticals registered as 
              medical waste.  AB 1442 would define "pharmaceutical waste," as 
              a subset of medical waste currently included in the DPH MWMA 
              manual and allow pharmaceutical wastes to be transported by a 
              common carrier as is authorized in most other states. 

            3) Environmental concerns  .  A 2002 study by the US Geological 
              Survey (USGS) revealed widespread contamination in US waterways 
              of prescription drugs, natural and synthetic hormones, 
              detergent metabolites, plasticizers, insecticides, and fire 
              retardants at low concentrations downstream from areas of 
              intense urbanization and animal production.  The results found 
              that one or more of these chemicals were found in 80 percent of 
              the streams sampled.  Prescription drugs are of particular 
              concern because of the low concentration necessary for activity 
              in the body.  According to the US EPA, further research 
              suggests that certain drugs may cause ecological harm and that 
              more research is needed to determine the extent of harm and any 
              role they may have in potential human health effects.

              California health facilities that generate large amounts of 
              pharmaceutical waste must currently follow strict and costly 
              handling and transporting protocols for medical waste.  
              Allowing these facilities to transport pharmaceutical waste via 
              common carrier may lessen the financial burden, and improve 









                                                               AB 1442
                                                                 Page 6

              compliance with proper disposal procedures for pharmaceutical 
              waste by health facilities, and potentially reduce 
              pharmaceutical contamination in California wastewater.

            4) Amendment needed  .  To avoid conflicts with the existing Medical 
              Waste Management Act, the amendments in �118040 of AB 1442 
              should be stricken. 

            5) Arguments in support  .  Supporters say that AB 1442 will clarify 
              and reduce the burden of compliance with the Medical Waste 
              Management Act for health facilities and substantially decrease 
              the amount of pharmaceuticals entering our water system.

            6) Related legislation  .  SB 966 (Simitian) Chapter 542, Statutes 
              of 2007, required Integrated Waste Management Board model 
              programs for the collection and proper disposal of 
              pharmaceutical drug waste by December 1, 2008.

            SOURCE  :        Assemblymember Wieckowski  

           SUPPORT  :       American Federation of State, County and Municipal 
                          Employees
                          Bay Area Clean Water Agencies
                          California Product Stewardship Council
                          Californians Against Waste
                          California Veterinary Medical Association
                          Central Contra Costa Solid Waste Authority
                          City of Palo Alto
                          City of San Jose
                          City of Sunnyvale
                          Clean Water Action
                          East Bay Municipal Utility District
                          EXP Pharmaceutical Services Corp.
                          Fremont Chamber of Commerce
                          Los Angeles County Solid Waste Management   
                                Committee IWM Task Force
                          San Francisco Water Power Sewer
                          Santa Clara Valley Water District
                          Sierra Club California
                          Solid Waste Association of North America
            
           OPPOSITION  :    California Board of Pharmacy (oppose unless 
                          amended)









                                                               AB 1442
                                                                 Page 7

                          
                          Note: The latest set of amendments addressed many 
                          of the Board of Pharmacy's concerns. The Board is 
                          expected to formally remove its opposition at its 
                          July 17th Board Meeting and go neutral, as 
                          recommended by the Board's Legislation and 
                          Regulation Committee.