Aftermath Services LLC

Trauma & Crime Scene Clean Up Compliance

Regulated Medical Waste Compliance

• Medical Waste (i.e. bio) is generated in the normal course of business for trauma & crime scene clean up companies.

• Most states require that all regulated medical waste be tracked from its generation to its disposal and/or treatment.

• The tracking of regulated medical waste helps ensure that it is handled properly throughout its journey to a disposal or treatment facility and also helps ensure that it is disposed of or treated properly. Medical waste tracking rules and regulations must be followed by all parties who come in contact with the waste.

Regulated Medical Waste Compliance

• In every state except Arizona, trauma & crime scene clean up companies are considered the generator of the medical waste (i.e. bio). In Arizona, the customer is considered to be the generator. As the generator, you are required to follow certain rules and regulations with regard to how the regulated medical waste is to be handled.

Regulated Medical Waste Compliance

• In addition to being the generator, most states also require trauma & crime scene clean up companies to be registered as medical waste transporters. As a transporter, you are required to follow additional rules and regulations with regard to how the medical waste is to be handled and transported.

General Generator Requirements – Packaging

• Generators are responsible for properly packaging the waste prior to it being transported.– Packaging must be rigid, leak-resistant, impervious to

moisture, and sufficiently strong to prevent tearing or bursting under normal conditions of use and handling.

– The packaging must also be labeled as a biohazard, with the universal biohazard symbol.

• Generally, after the waste is generated, it is placed in a red biohazard bag and then the bag is placed into a corrugated cardboard box.

General Generator Requirements – Storage

• Some states allow generators to store their own regulated medical waste.– If storage is allowed, a storage permit may be

required. – The generator is also required to follow certain

rules and regulations regarding the storage of the regulated medical waste.

General Generator Requirements – Storage

• Regulations regarding the storage of regulated medical waste vary from state to state. However, generally, the waste must be stored in the following manner:– Storage area must be a secured, enclosed structure

(i.e. affords protection from weather) and must not provide a breeding place or food source for insects or rodents (i.e. kept clean and free of debris).

– Storage area must be inaccessible to unauthorized personnel.

– Storage time limits can range anywhere from 7-90 days and certain states require medical waste to be refrigerated.

General Transporter Requirements

• Many states also require Medical Waste Generators to be licensed as Medical Waste Transporters.

• Transporters are responsible for the safe and proper transportation of the medical waste.

General Transporter Requirements

• Regulations regarding the transportation of regulated medical waste vary from state to state. However, generally, the waste must be transported in the following manner:– Vehicle must be impervious to leaks and spills.– Vehicle must be completely secured when unattended.– Vehicle must have nonporous, cleanable surfaces.– Waste must be secured while being transported in a

manner so as order to avoid spills. – Many states require specific placarding of the vehicle,

such as a permit number and/or biohazard symbol.

Recordkeeping Requirements

• All parties that come in contact with the regulated medical waste are responsible for keeping track of its journey. This chain of custody of the waste helps ensure that it is being handled properly by all parties involved.

• This is normally done with a manifest tracking form. The form travels with the waste from generation to disposal. Each party is given a copy of the form when they transfer the waste to another party. Once the waste has been properly disposed, the disposal facility will keep a final copy of the form and must also provide a copy to the generator, completing the chain of custody.

Recordkeeping Requirements • Some states require the use of specific tracking forms, however most

allow crime scene & clean up companies to use their own form, provided it complies with the state-specific regulations.

Penalties for Non-Compliance of Medical Waste Regulations

• There are various penalties, fines, etc. for violating medical waste regulations. The penalties vary from state to state.

Penalties for Non-Compliance of Medical Waste Regulations

– Colorado - 6 CCR 1007-2, Part 1, Section 1.9o The Colorado Department of Public Health and Environment may file a

civil action against anyone in violation of the Act and may also seek civil penalties in the amount of $2,000.00 per violation per day.

– California – Health & Safety Code, Chapter 10, Section 118340o A first offense for anyone who stores, treats, disposes or causes the

treatment or disposal of medical waste in violation of the regulations includes being charged with a misdemeanor punishable by a fine of not less than $2,000.00 or by up to one year in county jail, or both the fine and imprisonment.

– Massachusetts – 105 CMR 480.600o Any person who violates the medical waste regulations, other than the

specific disposal regulations, shall be fined between $100.00 - $500.00 per day per violation.

o Any person who violates the disposal regulations shall be fined up to $25,000.00 or serve up to two years in a house of correction.

Violations of Medical Waste Regulations• New Mexico – Lovelace Health System

– In 2011, the New Mexico Environment Department fined Lovelace Health System more than $14,000.00 for the improper disposal of infectious waste at the Cerro Colorado Landfill in Albuquerque.

• Arizona – Star Valley Veterinary Clinic– In 2011, Star Valley Veterinary Clinic agreed to a $65,000.00 settlement with the

Arizona Department of Environmental Quality and Arizona Attorney General’s Office for biohazardous medical waste violations. The Arizona Department of Environmental Quality found that from 1999 to 2009, the clinic was disposing of untreated biohazardous medical waste syringes contaminated with blood in regular solid waste containers. The regular solid waste containers were then dumped in the Gila County landfill.

• Pennsylvania – Waste Management & Kephart Trucking– In 2003, the Pennsylvania Attorney General’s Office charged Waste Management &

Kephart Trucking with three counts each of violating the Infectious and Chemotherapeutic Disposal Waste Act for transporting infectious waste without a license. Each count was a third-degree misdemeanor and carried a penalty of up to $25,000.00 per count.

Additional Compliance Requirements for Crime & Trauma Scene Clean Up

Companies• OSHA

– Bloodborne Pathogens– Respiratory Protection – Personal Protective Equipment– Heat Illness Prevention– Hazard Communication– Asbestos Awareness– Aerial Lift Safety– Lockout/Tagout– Fall Protection– Hand and Power Tools

• EPA– Lead Paint Training

• Chemicals/Cleaning Products– Disinfectant Registration– Pesticide Registration

• State– Business Registration with

Secretary of State

• Local City/County– Business Licenses