BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 1893 (Stone and Eggman)
          As Amended May 23, 2014
          Majority vote 

           HEALTH              11-4        APPROPRIATIONS      11-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Ammiano, Chau,       |Ayes:|Gatto, Bocanegra,         |
          |     |Bonilla, Bonta, Chesbro,  |     |Bradford,                 |
          |     |Lowenthal, Nazarian,      |     |Ian Calderon, Campos,     |
          |     |Nestande, Ridley-Thomas,  |     |Eggman, Holden, Pan,      |
          |     |Wieckowski                |     |Quirk, Ridley-Thomas,     |
          |     |                          |     |Weber                     |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Maienschein, Ch�vez,      |Nays:|Bigelow, Donnelly, Jones, |
          |     |Patterson, Wagner         |     |Linder, Wagner            |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires that customers be given a free sharps  
          disposal container with the sale of 50 or more medical sharps  
          for self-injection.  Specifically,  this bill  :  

          1)Specifies that the sharps container shall be provided by the  
            sharps manufacturer at no cost and that the container have  
            adequate capacity to hold the number of sharps purchased.

          2)Requires the container to include a label or insert that  
            provides directions for safe disposal of sharps waste, as  
            described, and a reference to the Department of Resources  
            Recycling and Recovery's (CalRecycle) Internet Web site on  
            home-generated sharps waste disposals. 

          3)Encourages the Department of Industrial Relations (DIR),  
            Division of Workers' Compensation (DWC) to review the  
            department's practices for identifying puncture wounds caused  
            by sharps waste in non-health care occupations to determine  
            ways of encouraging more accurate reporting and collection of  
            needlestick injury data.
           
          FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)Potential unknown minor cost pressure on the Medi-Cal program  








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            (General Fund/federal).  

          2)One-time cost pressure to DWC potentially exceeding $50,000 to  
            upgrade data collection systems and develop processes to  
            incorporate data elements that allow for collection of data on  
            puncture wounds caused by sharps in non-healthcare  
            occupations.  The bill is permissive and does not require DWC  
            to collect this data.  However, to the extent DWC does,  
            additional costs will be incurred.

           COMMENTS :  According to the author, this bill is intended to  
          reduce cost to taxpayers, reduce needlestick injuries, and help  
          sharps users comply with current disposal laws by ensuring that  
          sharps users have proper disposal containers, and are more  
          informed of how to dispose of them.  Even though it is illegal  
          under current law to place home-generated sharps into regular  
          trash or recycling, the author states that many sharps users  
          don't know the law and thousands of pounds of illegally disposed  
          sharps enter the municipal waste stream each year.  The author  
          states that in order to help consumers more easily comply with  
          current law it would be useful and worthwhile to provide  
          consumers with a container and the CalRecycle Web site address  
          so that they can easily look up where to drop off their filled  
          containers.  Additionally, the author states that this bill  
          seeks to improve data collection to ascertain the impact and  
          risk of non-healthcare needlestick injuries by encouraging the  
          DIR to collect data on the frequency of these injuries. 

          Amendments taken in appropriations specify that the sharps  
          manufacturer would be responsible for providing the sharps  
          container, free of charge, to a consumer who purchases 50 or  
          more sharps.  This would include any technologies currently  
          defined as sharps, including lancets, pen needles, syringes, and  
          other devices. 

          Once used, these sharps are regulated medical waste.  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, which prohibits the disposal of home-generated sharps in  
          California's landfills.  Home-generated sharps waste is required  
          to be put into an approved sharps container before being  
          transported out of the home to an approved drop-off location or  
          via mail-back program.  CalRecycle maintains the Facility  
          Information Toolbox Web site, which lists facilities where  








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          residents can take home-generated sharps such as hospitals,  
          pharmacies, or household hazardous waste facilities.  The  
          definition of an approved sharps container is up to the local  
          enforcement agency or take-back program; some facilities will  
          accept sharps in any rigid plastic container but others can only  
          accept sharps in containers approved by the United States Food  
          and Drug Administration.

          As regulated biohazard waste, these needles post a significant  
          health risk to the public due to potential blood-borne  
          pathogens, including human immunodeficiency virus, hepatitis B,  
          and hepatitis C.  Any employee suffering a needlestick injury  
          should be seen by a physician to evaluate the need for  
          prophylactic treatment, which ranges in cost from $400 to $6,000  
          per person. 

          Municipalities and solid waste handlers support this bill,  
          stating that thousands of pounds of sharps are still being  
          disposed of in the waste stream each year, which presents a  
          dangerous dilemma for thousands of workers every day.  They  
          argue statewide efforts to hold producers responsible for sharps  
          waste management costs are needed.  Republic Services states  
          that although their facilities have the capacity to deal with  
          illegally disposed sharps, the costs (which are ultimately borne  
          by ratepayers) are driven up by the unlawful disposal of sharps.  
           The City of Sunnyvale writes that needlestick injuries drive up  
          health costs and also that major equipment downtime represents a  
          high cost to the plant.  When sharps are found on the sorting  
          line, the entire line needs to be shut down to carefully find  
          and remove them.  
           
           Opponents, including many biotechnology firms, argue this bill  
          is premature without more data on the prevalence of needlestick  
          injuries in the waste workforce.  They also argue that this bill  
          fails to recognize other effective sharps disposal technologies  
          currently on the market.  Diabetes patient advocacy groups and  
          pharmaceutical manufacturers write that this bill could have  
          devastating consequences by interfering with a patient's ability  
          to purchase life-saving medication legally prescribed to them by  
          a physician by requiring patients to purchase a product  
          unrelated to their immediate health care needs.  
           

          Analysis Prepared by  :    Dharia McGrew / HEALTH / (916) 319-2097  








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