Medical Waste Management Jul-Sep 2012 (revised)

VOL. VIII NO. 3

JUl-Sep 2012

Medical Waste Management www.medicalwastemanagementnews.com

Serving Healthcare Facility Waste Management Professionals

Attention Readers !

Are you looking for Products, Equipment or Services for your business or healthcare facility?

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Consulting Firms Kuz Enterprises – pg 5

Hazardous Waste Disposal & Infection Compliance Services Clean Harbors - pg 11

Infectious & Non-Infectious Waste Containers & Linen Carts Bomac Carts – pg 10 Rehrig Healthcare Systems - pg 7 TQ Industries – pg 9

Infectious Waste Sterilizing Systems

Bondtech Corporation – pg 13 The Mark-Costello Co – pg 9 OnSite Sterilization - pg 16 Ozonator Industries – pg 15 STI Biosafe – pg 8

Liquid Disposal Systems Bemis Health Care - pg 5

Shredders

Shred-Tech – pg 11 Vecoplan LLC - pg 6 WEIMA America – pg 10

X-Ray Film Recovery Ag Medical Systems - pg 2

Arizona VA Medical Center Going Solar ! ❂

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New Solar Project Will Provide Almost 28 Percent of Facility’s Electricity Requirements When Completed

BY IRWIN RAPOPORT

y next October the Carl T. Hayden VA (Veteran Affairs) Medical Center in Phoenix, Arizona will be enjoying the complete effect of the 18,000 SANYO and Samsung solar panels (via 15 solar inverters at five locations) providing 4.45 megawatts of electricity (seven million kilowatts of clean energy) annually.

The panels were placed on newly constructed covered parking spaces, providing shade for more than 1,625 cars at the hospital. This represents the largest solar carport installation in the United States, and it is expected to eliminate 9.3 million pounds of CO2 emissions.

Last December the hospital switched on 665 kilowatts of power via Phase I of the project.

When completed, the solar panels will provide almost 28 percent of the facility’s annual electricity requirements. The balance of the system is waiting for the interconnections from the utility company and, for the moment, is considered to be the largest solar carport installation - solar photovoltaic (PV) system - in the U.S. The Carl T. Hayden Center, part of the Phoenix VA Health Care System, offers services to more than 80,000 veterans. It has 130 inpatient beds for medical and surgical patients, 80 beds for nursing home patients and 40 inpatient beds for mental health patients.

James Larson, the facility’s Energy Manager, worked with the installation company to oversee the project. He notes that the VA is bound by

two mandates – one for renewables and another to reduce energy consumption. An additional investment is being made to reduce energy consumption at the facility by replacing outdated and inefficient systems.

“The two are not necessarily linked together, but I tried to combine them,” he says, explaining that the hospital’s original plan called for a covered rooftop application, producing only about 640 kilowatts of power. “But if you put solar on your roofs and you don’t have brand new roofs, you will need to replace the roofs before you replace the solar. That didn’t make sense, especially when we had nearly 30 acres of land that we could use to generate solar and also get the benefit of covered parking for our veterans. You can’t over emphasize the benefit (to the veterans) of having covered parking in the summer in Phoenix - staying out of the sun in Arizona in the summer is the rule.”

This led to the solar project being expanded to produce 4.45 megawatts of electricity. The installation company, notes Larson, met the VA’s requirements for the highest amount of covered parking and power generation for the lowest cost. The system cost less than $20 million and the solar power generated is expected to offset approximately $300,000 worth of electricity annually that the hospital purchases.

Larsen says,“While it may not appear to make immediate financial sense to go to Arizona [to place solar panels], because our electricity rates are Continued on page 3

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Medical Waste Management JUl-aug 2012

medical waste management

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Arizona VA Medical Center Going Solar Continued from page 1 low,” - noting that the state receives inexpensive electricity via nuclear facilities and the power generated at the Hoover Dam - “we had to meet the mandates for the government as a whole, and we get about the highest amount of solar power produced per dollar spent in Arizona.”

According to Larsen, Arizona receives more direct sunlight, in comparison to neighboring states, which translates to more power generated per-square-foot of panel, thereby helping to reduce the use of fossil fuels.

Construction on the solar project began in late 2009.

In addition to the parking structures, 15 solar inverters were installed, with three being placed in landscaped areas, well hidden from public view. Inverters convert the electricity from solar panels (DC, or direct current) into a clean AC (alternating current) that can then be accessed through the electrical plugs in a building. Solar panels cannot create AC power without the help of inverters.

“In conjunction with our other capital improvement projects, we realigned most of the parking lot and demolished some buildings to maximize the power produced and retain parking, which would have otherwise been displaced by other projects,” says Larson, a supporter of solar power, who has panels installed at his home. “The construction and installation was about 18 months from start to finish. There was no interruption at all in hooking up the power system - it was totally seamless. Almost all of the work on the parking lot was done at night.”

The hospital has an extended warranty with the installer to maintain the system, and the only maintenance that needs to be done (on the hospital’s part) is to replace and/or clean the air filters within the inverter cabinets. While there is some space to add additional panels, Larson says “we could only expand it a small amount.”

Regarding the future of solar power in North America, it should be stressed that solar is not limited to areas such as the Southwest and Sunbelt.

Systems installed along the East Coast of the U.S. are making positive energy gains and performing well. Many experts note that improvements in solar panel technology are allowing for solar power to be harvested in zones that receive less sunlight and still generate serious yields to offset fossil fuel use. Countries such as Germany and Denmark are making strides to maximize solar usage and other renewables in an effort to reduce energy imports and green house gas emissions.

In the northern parts of the U.S., cities such as New York, Chicago and Boston are considered prime areas for solar. Experts in the solar power

sector have noted that the price of solar panels has gone down substantially in recent years, with some pointing out that the decrease has been as much as 150 percent in the last two years. This also applies to inverters and other materials essential for solar power installations. These lower costs are providing the necessary conditions for increased growth in commercial and institutional solar power installations.

Although the cost of solar power installation has gone down considerably, many building owners simply don’t have the available space to accommodate solar panels on their buildings or property. In such cases, a third party public/private alliances (PPA) might be a good option. A PPA works something like a farm lease – where a farmer leases another landowner’s property to grow crops.

In the case of a PPA, solar facilities are set up on properties, via a lease agreement.

The electricity generated is then sold at an agreed price to the building owner (lessor), or purchased by a local utility company. The revenue is then used to offset energy expenditures. This strategy is increasingly being pursued by those seeking to attain a situation where renewable energy production equals annual electricity needs. These arrangements can be entered into by private and public institutions to not only generate solar energy, but other renewable power sources such as biofuels, which can be harvested from breweries and food processing plants.

Larson says that the VA has essentially maximized solar potential in its Southwest area facilities. He also notes that setting up generating facilities on third party locations, with the private sector, can be difficult for a VA facilty.

“We have considered this,” he says, “but that’s one of the political questions that tend to not go anywhere fast, because it takes a lot of coordination on the part of many parties. Compared to private industry, with government you are substantially more limited on what you can do. We floated the idea of using neighboring land to provide the land-owner with covered parking and the VA with electricity produced from the system, but did not get the required support to do it based on the amount of effort it would take to try to get a land use agreement in place.”

He adds that some of the VA facilities, which share land with other federal facilities have studied using neighboring land to establish renewable energy facilities and they found that establishing agreements between two or more government agencies is much easier.

Having maximized solar at his hospital, Continued on page 14

JUl-aug 2012 Medical Waste Management

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medical waste management

LEED Certification...

Not the Only Kid on the Block!

BY IRWIN RAPOPORT

T

he growing demand for environmentallyfriendly and sustainable construction of new buildings and retrofitting of existing structures has been fueled, in-large, by the Leadership in Energy and Environmental Design (LEED) Certification. However, while this has led many developers and architects to incorporate LEED principals, technologies and design elements into their projects, many do so without actually seeking LEED certification. The reason for this is many building owners view LEED certification as being cost-prohibitive.

While LEED certification remains a popular choice, alternatives to LEED are springing up and appear to be much more cost-effective. This article looks at three such alternatives, which apply to hospital construction, as well as public and private institutions.

The Society of Environmentally Responsible Facilities (www.SERFgreen.org), created in 2010, will soon be officially certifying the construction of a multi-story tower built for a hospital in Lansing, Michigan, four years ago.

“All the co-founders of SERF come from the building ownership and construction business sectors,” says Joe Maguire, SERF’s president.

“We are an alternative that is more streamlined and cost effective. We have seven types of certification and we mainly do office buildings, as well as manufacturing and distribution facilities, healthcare and institutional buildings, and retail.

LEED has created the standards, but maintained a very high level of process and cost associated with their certification program.”

“Many property owners recognized that it was an impractical pursuit for many properties, especially existing structures,” he adds, “and we created SERF to recognize sustainable properties in a way that makes certification accessible.”

Stan Samuel, SERF’s director of sustainable construction, stresses that his certification costs less, eliminates many layers of paperwork and the need for securing third party consultants to evaluate and inspect.

“The top fee for our certification is $12,000,” he says. “There would also need to be a third party verifier – any licensed architect or engineer, and their fee could be a few thousand dollars (additional). This is in contrast with various consultants, commissioning agents or building and energy simulation consultants. LEED certification 4

could cost between $200,000 and $300,000.”

SERF standards are comparable to LEED, which are partly based on ASHRAE and other recognized industry standards.

“We have our own standards,” says Maguire, “but we rely largely on third party industry standards. We have 20 different categories and do not have prerequisites, especially for existing structures. Certain prerequisites in LEED can be absolutely cost prohibitive and that discourages property owners and developers from doing anything sustainable.”

SERF has certified 54 properties, with another 30 undertaking certification. SERF does not specifically target government and institutions, but wants to spread sustainability to a wider community, and part of its service is to tell the story of a building’s sustainability to the general public and prospective tenants via profiles, case studies and events.

“We provide a service beyond what LEED does and are much more market and business oriented,” says Maguire. “A lot of what drives certification for hospitals is to tell the story to their donor base.”

Samuel adds that some LEED standards run contrary to hospital requirements in terms of hygiene and other operational aspects, which includes low-flow taps, maintaining overall lower temperatures and the segregation of toxic waste.

“We have certified three hospitals and are working with six others,” he says.

Created in 2004, the Green Building Initiative (www.thegbi.org) and for a comparison with LEED, http://www.thegbi.org/green-globes/greenglobes-leed-green-building-certification.shtml or http://www.thegbi.org/commercial/healthcare/), a non-profit organization, offers Green Globes certification – a certification recognized by the federal government, 23 states (written into their legislation), various associations and private industry.

“Our mission is to promote the adoption of healthier environmentally conscious and energy efficient buildings in the U.S.,” says Sharene Rekow, GBI’s vice president of business development. “Both LEED and Green Globes are offshoots of BREAAM, a system out of Western Europe, and 95 percent of the information between both programs overlaps. A major difference is that Green Globes is an online solution and the software

Medical Waste Management JUl-aug 2012

tabulates and calculates as you go through the program. Therefore you know where you stand at any given point.”

Thirty-five percent of the total number of available (1,000) points in the Green Globes certification is needed to secure certification. Two Green Globes is the equivalent of LEED Silver; three is equivalent to LEED Gold; and four is equivalent to LEED Platinum.

At the start of the process, the GBI assigns an assessor to work with the project developer, and part of the registration fee provides access to that professional to answer questions and provide advice to help secure more points. The neutral assessor visits the project when it is completed to perform an inspection and confirm that the design and technology was installed to the GBI standards.

“We have quite a bit of flexibility within the Green Globes program, and 100 points are non-applicables,” says Rekow. “They are already earmarked, and if they do not make sense to the owner (for their building) they can be dropped from the 1,000 points and will not count against you.”

The GBI has certified around 600 buildings thus far. Rekow says her organization’s certification costs are “about 30 percent of the cost of doing a LEED project. The difference is that you are using software and you need fewer hours by outside personnel, which means consultants’ hours can be cut.”

In terms of hospital certification, the GBI has given accreditation to over 200 Veterans Affairs Administration hospitals and facilities, which led to the GBI creating a tool for hospitals. The VA began with a pilot project for 21 buildings.

“They liked our process a lot and wanted to certify another 200,” says Rekow, “but they wanted something more indicative of healthcare, so we revamped our existing building tool.”

Additionally, the GBI is also helping the VA develop standards to meet Executive Order 13514 – a compliance program called “Guiding Principles Compliance” (GPC), which has five different areas of criteria that match the program outlined by the federal government. “We are also working with new hospital construction, and while we don’t have a healthcare tool for this category, our new Green Globes construction tool meets those criteria.”

The VA Portland Medical Center in Oregon Continued on next page

medical waste management Continued from previous page received Three Green Globes certification in 2009. Commenting on Green Globes certification, Secretary of Veterans Affairs Eric K. Shinseki said: “We continue to take steps to assess and reduce our environmental impact. Ensuring the sustainability of our facilities across the country gives us energy efficient buildings to accomplish our primary mission - serving Veterans with the best care.”

Jane Rhode, the Green Globes assessor for the Portland project, noted the cooperation that the VA provided.

“Portland VA is a stellar example of a hospital that has taken sustainability to the next level,” she said in a case study for the project. “Not only do they have a dedicated, energetic staff, all actively working on sustainable initiatives, but they also have a creative plant staff who used innovative ideas to raise their environmental scoring within Green Globes.”

Another LEED alternative is the Living Building Challenge™ (livingbuildingchallenge. org/lbc/standard), offered by the Seattle-based International Living Future Institute. Challenge certification is currently offered in seven countries.

Pending renewed funding, a community hospital in the Seattle area is considering working towards certification, while others are expressing interest.

Three types of certification are offered.

The first is the Living Building Challenge, that Sarah Costello, the Institute’s Vice President for Communications & Development, says “looks to create a building environment that is either neutral or beneficial to the ecosystem it inhabits.”

This includes returning water to the aquifer cleaner than it was upon arrival, generating its own electricity using on-site renewable resources that have no combustion, is completely non-toxic – all materials must comply with a red list that specifies a number of chemicals that cannot be present in the building, and cannot be built on any sites that were not previously developed – “we need to work with in-fills, not continual sprawl. It is an incredibly comprehensive and very deep and ambitious program.”

This covers new construction and renovations for a variety of buildings, including hospitals, and requires all 20 imperatives be met.

A second certification, called Petal Recognition, required three of the LBC’s seven Petals (categories) to be covered, at least one of which must be either Energy, Water, or Materials.

A third, the Net-Zero Energy Building Certification, is based on five of the Challenge’s twenty Imperatives, and it requires that a project generates all the energy it consumes.

Each of these certification pathways is based on performance benchmarks, and projects

(buildings) must be continuously occupied for 12 consecutive months before the certification process can begin.

“We certify based on proven performance,” says Costello. “There are a lot of projects that think they are net-zero energy now, and we are in the process of reaching out to them in the hopes of verifying their achiemevents and putting them on the map of really advanced projects in terms of energy.”

Costello sees LEED and the Challenge as complementary programs. “LEED has been and remains a powerful tool of industry transformation.

The Challenge is about defining the end game vision for the built environment. We ask a different set of questions, and we have 20 Imperatives, with no points.”

The Challenge has also increased the demand for sustainable construction and environmental concerns.

“We’re expecting a good number of projects in the coming year,” says Costello. “Six projects

have achieved certification through one or more of our pathways and we’ve gotten plenty of press coverage in the New York Times, CNN, Time Magazine, and other national and international media outlets. At our last annual conference, we had a number of people from different federal agencies who wanted to better understand the program and explore whether it is something they want to implement in their projects. We’ve also had a lot of interest from local governments that want to revamp their construction and sustainability standards.”

In conclusion, having more sustainable buildings not only saves money in terms of operating costs, but sends a message to government and the private sector that being environmentally responsible is important. With more LEED alternatives available to building owners and developers, and the cost of certification becoming more affordable, the number of certified sustainable hospitals should continue to grow in the coming years ahead.

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JUl-aug 2012 Medical Waste Management

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news briefs

Paper Records Impede Healthcare Delivery

A

tlanta, GA–Inefficient paper records are choking the U.S. health care industry and impeding delivery of even better patient care, according to Albert Woodard, CEO of Atlanta-based Business Computer Applications.

Woodard says the current system, clogged with paper records, makes it difficult to coordinate care, routinely measure quality, reduce medical errors and react to emergency situations following natural or man-made disasters. The situation will only get worse, he says, with the 80 million baby boomers now signing up for Medicare at a rate of 7,000 a day and with the federal government’s planned overhaul of health care expected to add 32 million more patients overall.

“The healthcare industry needs to catch up with other American industries,” he says. “Tools like electronic medical records (are the ‘grease’ because they enable primary care physicians to share information, and coordinate the delivery of care,” he says. Studies show the U.S. trails a number of other countries in the use of EMR systems, with only 15-20%t of U.S. physicians’ offices and 20-25 % of hospitals adopting such systems.

“Hospitals, doctors, clinics and others are reluctant to adopt systems due to standardization, concerns about privacy, but mostly uncertainty about what’s happening in the health care industry, particularly the health care law currently being reviewed by the Supreme Court,” Woodard says.

“Physicians can take laptops, iPads and smart phones from room to room or building to building. The tools exist now to give every provider and patient access to all information necessary to prevent errors, improve patient satisfaction and improve outcomes.”

Irregularities in City Permitting Delay Operation of Georgia Medwaste Plant

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acon, GA—Macon.com reports that Medsafe LLC is petitioning the Bibb County Superior Court to rule that Payne City must document that a proposed medical waste handling facility will meet city requirements. The city council had voted in September 2011 to deny the application to build the facility as it would not meet the city’s solid waste management plan. However, Medsafe says the city said that the facility would be in compliance with requirements, and again in April 2011 indicated that the facility complied with local zoning and land use ordinances. Also at issue is whether the plant had issued the proper announcements of meetings on the topic to the public. The Georgia Environmental Protection Division cannot review the Medsafe application until the court has ruled ant these contradictions are resolved.

The plant would treat infectious waste at about 44,000 pounds per week. Treated waste could be handled with other waste at a solid waste disposal facility. The chlorine-based plant technology has been accepted by the Georgia Environmental Protection Division in Atlanta. It also has been accepted in California and North Carolina by those state’s EPDs. An alternate biomedical waste technology, the Med WasteTec LFB 12-5 process is being used in England and approved as a viable technology, so the design and operation plan should be a go, say regulators.

Residents are also worried about the location and safety issues, as well as trucks hauling waste into the city, but the land’s owner says truck traffic already exists.

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Medical Waste Management JUl-aug 2012

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news briefs

Waste Management Lets 700 Go, Names Trevathan as COO

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ouston, TX—Waste Management is planning to cut 700 jobs as part of a realignment of its corporate structure, reports chron.com. The company did not say how many of the cuts would be at the national headquarters in Houston, home base of over 2,300 people, but they are expected to be few.

The company also said that it has appointed James E. Trevathan, Jr., the former executive vice president for growth, innovation and field support, as its new chief operating officer.

The cuts represent 2% of the workforce and are expected to be made throughout the national structure of the firm as managers are cut in the various regions of the firm. The plan will improve workflow and better meet the needs of customers, says WM. The movc is seen as a cost-cutting measure in response to continued weaker prices for certain commodities.

The company is anticipating a third quarter pre-tax charge to earnings of about $50-$60 million as part of the job cutting strategy as separation agreements are made, and announced second quarter earnings of $208 million net income, versus $237 million, for the second quarter of 2011. Excluding the 2012 charge of $32 million in one-time after-tax charges, net income would have been $240 million, or $0.52 per diluted share. Revenues for the second quarter of 2012, says the firm, were $3.46 billion, compared with $3.35 billion in 2011.

Needles Found on NYC Beaches Could be Washed Up or Left Behind

N

ew York—Medical waste, including multiple syringes with exposed needles, have been found on New York beaches recently. One needle stabbed a female lifeguard at a Rockaway Beach in Queens. Three more people suffered puncture wounds from needles found on Staten Island beaches, including the Cedar Grove Beach, where a 63-year-old woman stepped on a hypodermic syringe, cutting her foot, and two incidences at South Beach, where a 37-year-old man was stuck in the hand by a needle, and in a separate incident, a 40-year-old man was stuck by a needle.

All those injured on Staten Island were taken to a hospital for evaluation.

The beaches were later cleaned up by the city Parks Department, The department cleans the beaches on a daily basis but they say it is hard to keep up with the mess because they have a limited budget.

The city was alerted to the problem at Rockaway by an NBC Channel 4 report. The beach is a popular one for families, and while this makes the problem a more dangerous one, it could also be the cause of the problem, as the beach is littered almost constantly, and it is said that few pick up after themselves.

However, it was not determined whether the needles had washed up on shore as medical waste or had been discarded by beachgoers.

www.STIBiosafe.com 8

Medical Waste Management JUl-aug 2012

Florida Medical Waste Facility Tries to Overcome Opposition with Infrastructure Promise

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acclenny, FL—Bakercountypress. com reports that the Pennsylvaniabased Integrated Waste Management Systems, Inc., has applied for a permit to build a $400,000 medical waste incinerator and a biomedical thermal reduction facility, on a 24-acre site. It is fighting opposition by asking the county to approve the project in order to save $474,000 in Florida state funds to build a road to the site as well as to realize a $22 million waste-to-energy project grant. The company initiative positioned the project as bringing in infrastructure to boost future industrial development and threatened to move it to another location.

IWMS claims that “extensive scientific research” speaks for project safety and addresses all areas of concern, but residents do not trust the claims, with worry about harm to the environment and public health risks associated with burning medical waste. The company has offered to pay for the county to conduct an independent analysis of the incinerator plans, but the county seems to be unwilling. Other public hearings have been put on hold until there is further evidence.

news briefs

Maine Hospitals Work to Reduce Food Waste

S

anford, ME—Two Maine hospitals are working to reduce food waste through recycling, reports journaltribune.com. Goodall Hospital in Sanford now has a new composting system that creates garden compost from food waste. The hospital and Casella Waste Systems and Green Waste Stream LLC have installed a food digester that can handle up to 1,000 pounds of food waste a day. The hospital and its elder care facilities generate about 750 pounds of food waste each day, enough to make 35 pounds of compost. The composting system is just one aspect of the hospital’s goal of total recycling and reduction of the hospital’s carbon footprint.

JAMA: MRSAs in Community Setting Seem to be on the Decline

W

ashington, DC—According to a study of 9.2 million active and nonactive military personnel and their immediate families, published in the July 4 issue of the Journal of the American Medical Association, the number of infections occurring in community settings caused by methicillinresistant Staphylococcus aureus is going down. It also found that the rate of serious infections known as bacteremia caused by MRSA had gone down from 2005-2010, in both community and hospital settings. Recent research seems to indicate that MRSA, particularly in hospitals, is decreasing, the study looked for a clearer focus on MRSA infections both in the community and hospital settings. These observations seem to indicate that broad shifts in the epidemiology of S. aureus infections may be occurring, but no reason was seen for the decline. Some physicians believe the decline is just a random event, while others see better use of infection-control practices and a higher awareness of the need for cleanliness.

The U.S. Centers for Disease Control and Prevention believes that about 2 percent of the U.S. population carries the MRSA bacteria in their nasal cavities, and some advise that those having elective surgery be tested for MRSAs so they can be treated before surgery.

MRSA generally causes skin infections, but the infections can spread into the blood, causing bacteremia. The percentage of soft-tissue infections caused

by MRSA in the community setting peaked in 2006 at 62% and by 2010 was down to 52%, with bacteremia caused by MRSA down in both the hospital and community settings.

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erkeley, CA—The Alameda County Board of Supervisors has passed the country’s first ordinance that will make the pharmaceutical industry responsible for disposing of expired and unused drugs, reports alameda.patch.com. The rule mandates that drug makers pay for the disposal of the drugs or pay fines of up to $1,000 a day. It is estimated that drug companies see $186 million in profits in the county each year and that the cost of a manufacturer-funded program would be 1 cent of every $3 worth of drugs sold in the county. The county now has 28 drop-off locations at which unused pills can be turned in, but keeping the program viable costs around $330,000 annually.

The regulation was passed because it was felt that the improper disposal of prescription drugs and any illegal re-sale puts the public at risk and that ground and drinking water “are being contaminated by unwanted, leftover or expired prescription drugs passing through our wastewater and treatment centers.” The county will enforce the ordinance by using a registry of drugs sold in the county and tracking them to the manufacturers.

BayBio, a regional advocacy group for the life sciences industry, has no plans to challenge the law, although individual firms may do so. The group’s spokesman says that the ordinance is “ill-advised” because it has no bearing on improving water quality and preventing the illicit use of drugs. The Pharmaceutical Research and Manufacturers of America prepared a statement in opposition to the ordinance that says it sets “a dangerous precedent for a community that is currently served by multiple safe medicine collection efforts.”

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news briefs

Kaiser Permanente Pays Fine for Medical Waste Dumping

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arbor City, CA—Harbor City officials have determined that Kaiser Permanente Medical Center must pay $70,000 in penalties for unlawful disposal of medical waste plus $3,615.40 to the county Fire Department Health and Hazardous Materials Division to pay for its investigative work, reports dailybreeze.com.

In 2010, Kaiser Permanente’s South Bay facility sent trash containing medical waste to the Carson Waste Management transfer station. The trash included blood-filled tubing, blood-soaked surgical drapes and contaminated surgical devices, said the Los Angeles City Attorney’s office. The facility was inspected in May of that year, and it was found that Kaiser was unlawfully storing medical waste not properly contained in red biohazard bags labeled with the word biohazard.

Kaiser-Permanente must also now work to train its Harbor City employees about the proper handling, storage and disposal of medical waste. “Hospitals and other health care providers must take necessary measures to properly handle their wastes and protect the public,” said Carmen Trutanich, the city attorney.

“Institutions that fail to live up to that responsibility will be held accountable.”

Two Patients Seen in RI With Rare Uber-Resistant Infections

W www.weimaamerica.com

info@weimaamerica.com

ashington, DC—Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention, reports that two patients in a Rhode Island hospital were found to harbor New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae, a bacterium which is rare in this country, last year. The hospital was able to respond quickly with treatment and infection control measures.

The bacterium is very resistant to antibiotics and more common in Asia, where antibiotics can be had over the counter and there is often poor sanitation.

The first patient was hospitalized in the U.S. following a hospitalization in Cambodia, and when the infection was discovered, she was treated with a range of antibiotics. But because only partial infection controls were used, the infection spread to another patient in the same ward.

The CDC views these occurrences as very worrisome, though isolated and not epidemic. It also does not foresee an outbreak in the U.S., though it suggests that patients from affected areas abroad be monitored. Among the plans for dealing with the bacterium and avoiding problems are controlling the bacteria with infection precautions, including patient isolation, using better sanitation in hospitals, taking better care in finding these resistant bacteria in patients, and developing new antibiotics, a discovery that has not been seen in the past 10 years.

HIPAA: Ignorance is No Excuse, Says Appeals Court

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os Angeles—An employee need not be aware of the Health Insurance Portability and Accountability Act privacy laws to be guilty of violating them, said the U.S. Court of Appeals for the Ninth Circuit. When a research assistant at the University of California at Los Angeles Health System, Huping Zhou, was fired for continued serious job deficiencies and poor judgment, he retaliated by examining the personal healthcare records of coworkers and celebrities who had been seen at UHS. He was charged with a misdemeanor under HIPAA, but sought to dismiss the charge because he said he was not aware that getting this information was illegal. The U.S. District Court for the Central District of California said he was guilty because that the law defines the crime as obtaining individually identifiable health information for a purpose other than permitted under law.

Zhou appealed the decision, but the U.S. Court of Appeals upheld the lower court’s ruling and Zhou’s misdemeanor charge, saying his knowledge of the law was irrelevant. To violate the law, Zhou only needed to know that he obtained the identifiable health information of other people. The ruling can be found in U.S. v. Zhou, U.S. Court of Appeals for the Ninth Circuit, No. 10-50231, 2012.

news briefs

Alaska DHHS Fined for Breach of HIPAA Security Measures

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ashington, DC—Legalnewsline.com reports that the Department of Health and Human Services Office for Civil Rights received a breach report from the Alaska Department of Health and Social Services saying that a portable electronic storage device possibly containing electronic protected health information was stolen from the vehicle of a DHSS employee, as required by the Health Information Technology for Economic and Clinical Health Act. The result was a fine of $1.7 million by the federal government for violations of the 1996 Health Insurance Portability and Accountability Act Security Rule. OCR found that DHSS failed to have policies and procedures in place to safeguard electronic personal health information; had not completed a risk analysis; had insufficient risk management measures; did not complete security training for its workforce members or comply with any other of the safeguards required by the HIPAA Security Rule.

Alaska DHSS must now have a corrective action plan in addition to the $1.7 million settlement and be monitored for ongoing compliance efforts. “Covered entities must perform a full and comprehensive risk assessment and have in place meaningful access controls to safeguard hardware and portable devices,” said OCR Director Leon Rodriguez. “This is OCR’s first HIPAA enforcement action against a state agency and we expect organizations to comply with their obligations under these rules regardless of whether they are private or public entities.”

OCR enforces the HIPAA Privacy and Security Rules. The Security Rule protects health information in electronic form by requiring entities covered by HIPAA to use physical, technical, and administrative safeguards to ensure that electronic protected health information remains private and secure.

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news briefs

Going Green in the Hospital Means Saving Green

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ttawa, ON—The Canadian Medical Association Journal says hospitals could save money by reducing waste water using a variety of sensible measures. The study shows that operating rooms, though a smaller part of the budget, create from a fifth to a third of a hospital’s waste.

The researchers looked at 65 prior studies to develop a plan for saving.

The first step is to better separate regular waste from biohazard waste, as biohazard waste costs around $963 per ton to process compared to the $121 per ton for regular waste. Biohazard waste should be around 15% of hospital waste, but it is estimated that 50%-85% of regular waste is incorrectly sorted as biohazard waste. This would unnecessarily increase costs by tens of thousands of dollars yearly, simply due to lack of awareness by staff. The report notes that segregating OR waste saved the University of Pittsburgh’s Magee-Womens Hospital more than $89,000 in 2010.

Savings can also be realized by installing closed collection systems for fluid waste, so it can go directly to sanitary sewers. According to the report, the Good Samaritan Hospital of Suffern New York saved over $85,000 in 2010 by diverting 250,000 pounds of fluid waste.

The risk of blood-borne infection from AIDS saw a rise in single-use medical devices, but the report sees wisdom in the reuse of surgical equipment such as saw blades and catheters that are processed by private companies to be sold back to hospitals. Using reusable sharps containers saved the University of Maryland Medical Center $70,000 per year, while reusable surgical linens saved it $38,000.

Surgical equipment often comes in pre-packed boxes from which surgeons pick preferred tools, requiring that the unused equipment must be disposed as it was “exposed to the surgical field. This overage from nearly 15 million surgical procedures cost some $125 million in 1993, but the study suggests that surgical packs be tailored to a hospital’s needs, reducing overages by 45%.

There are many other suggestions in the report, such as recycling plastics, collecting rather than venting non-metabolized anesthetic gas and avoiding incineration of medical waste. Operating room design changes are also included. For more, go to http://www.cmaj.ca/content/early/2012/06/11/ cmaj.112139.

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Boston Hospital Fined for Security Breach

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oston—Securitymanagement.com reports that Massachusetts Attorney General Martha Coakley has announced a settlement for South Shore Hospital to pay $750,000 for a 2010 security breach in which three boxes of 472 unencrypted computer tapes were shipped to an offsite location in Texas to be erased and recycled. Two of the three went astray.

South Shore’s fine includes a $250,000 civil penalty, $225,000 to support a program on protecting health information, and $275,000 for security measures taken since the breach.

South Shore failed to inform Archive Data, the company hired to erase the tapes, that they contained protected information such as names, Social Security numbers, addresses, phone numbers, birth dates, and health plan information including medical diagnoses and financial information. This violated both federal and state law as South Shore did not ensure Archive Data had procedures to safeguard the information. The lawsuit was filed under the Massachusetts Consumer Protection Act and the federal Health Insurance Portability and Accountability Act. It is thought that the missing boxes are in a landfill, and there have been no reports of unauthorized information being used. The tapes are seen as needing specialized knowledge and financial resources to be able to decipher and use.

According to the consent judgment, South Shore Hospital has agreed to take a variety of steps in order to ensure compliance with state and federal data security laws and regulations, including requirements regarding its contracts with business associates and third-party service providers engaged for data destruction purposes. The hospital also agreed to undergo a review and audit of certain security measures and to report the results and any corrective actions to the attorney general.

www.bondtech.net JUl-aug 2012 Medical Waste Management 13

medical waste management

Arizona VA Medical Center Going Solar

Continued from page 3

Larson has also studied bringing in other renewable energy systems, but notes that they did not make financial sense. While the solar system was being installed, his hospital began a $20 million program to reduce overall energy needs – an initiative that is proving very successful.

“We’ve done geothermal test wells and it’s just not cost-effective to do it right now,” he said, noting that co-generation was also no longer viable once they replaced their outdated and inefficient energy systems. “There just won’t be a consistent heat load to use the heat generated by a co-gen facility. Additionally, it is substantially more important to reduce your consumption first, rather than avoid addressing system deficiencies by installing renewables.”

In conclusion, as the demand for renewable energy increases in North America, solar power is becoming a more popular option for government institutions and private businesses. The combination of improved solar technology (panels and inverters) and price decreases for this technology is a key aspect in the growing number of solar energy generating stations being built throughout the United States and Canada.

For additional information

on solar power and commercial solar power installers, here are some websites that may be helpful: 1. Findsolar.com (directory of solar panel installation companies) 2. ASES.org (American Solar Energy Society) 3. Cansia.ca (Canadian solar Industries Assoc) 4. Interestingenergyfacts.blogspot.com

Germany Rapidly Expanded Solar Production in First Half of 2012

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ccording to a Reuters (www.reuters.com) article published on August 3rd, Germany is now the world leader in the production of solar power – more than 28,000 Megawatts (MW) of electricity annually, with 4,300 MW added to the production in the first six months of 2012.

States the report: “About 1,800 MW came in June in a building frenzy just before a 30 to 40 percent cut in government-mandated incentives took effect in July. Germany now has more than a third of the world’s installed solar-generation capacity.”

Nearly 5.3 percent of Germany’s electricity needs are met by solar – “up from four percent in 2011.” Moreover, renewable energy generation provides almost 25 percent of the country’s annual electricity demands, with 9.2 percent generated by wind and 5.7 percent from biomass.

The article noted that “on sunny days, Germany’s 1.2 million solar power plants can produce as much power as 20 nuclear plants and cover about a third of the country’s electricity needs during daylight hours on weekdays and about half on weekend days.”

It was also pointed out that “In 2011, Germany installed a total of 7,500 MW of solar-power capacity, including about 3,000 MW in December before a prior cut in its feed-in-tariff (FIT) incentives. The 7,500 MW was the previous record for a full year but it included only 1,700 MW in the first half. “ The article, entitled “Germany tops world market for solar-energy generation,” discusses the ongoing budgetary and politics of solar that is confronting elected officials.

Product/Equipment Profiles Vecoplan Introduces VNZ 80 XL Dual Shaft Shredder

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e coplan recently introduced their new VNZ 80 XL dual shaft shredder. Unlike conventional “pierce & tear” dual shaft paper shredders, the VNZ 80 XL still delivers the numerous advantages inherent to Vecoplan shredders. Plus, the absence of a feed ram provides the VNZ 80 XL with one of the smallest footprint available on a machine of this performance level.

The VNZ 80 XL produces a consistent shredded particle, with the ability to change and control the particle size through quickly and easily changed screens. The two rotors built into the machine are Vecoplan’s patented Torsion Point™ “U” rotors. Rotating at low speeds and high torques, the cutting rotors produce high throughputs at low noise levels and are virtually jam free.

Other features of the VNZ 80 XL dual shaft shredder, include the ability to shred a wide variety of materials and true dump & run operation. Fed from the top via a hopper, entire containers of plastic waste, wood processing scrap, medical waste, paper, cardboard or almost any type of waste can be dumped into the hopper and processed with no further operator interaction.

For more information contact Vecoplan at 336-861-6070 or info@vecoplanllc.com or visit www.Vecoplan.com

14 Medical Waste Management JUl-aug 2012

Rehrig Healthcare Systems Introduces New 17 Gallon Reusable Sharps Container

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ehrig Pacific Company recently introduced the Rehrig Healthcare System’s Sharps Tank, an FDA 510(k) cleared, 17 gallon reusable sharps container.

Made in the U.S.A., the Sharps Tank can be used in all clinical and laboratory environments for the disposal of both small and large sharps. It has been FDA cleared as a Class II Medical Device and is also DOT approved and PGII rated for bio-hazardous waste collection.

Perfect for areas with limited space, Rehrig Pacific designed their large sharps container with a wide opening, side-hinged main lid and a transparent sub-lid for more restricted access and monitoring fill capacity. Each lid has a two position latch; one is for daily use and the other is a full lock position for transport. Optional accessories include a hands-free foot pedal dolly and a molded 4-caster rolling dolly designed for the clinical environment.

For more information contact Jack Weber, National Sales Manager, Strategic Markets, Environmental Group at 323-262-5145 or visit www.rehrighealthcare.com

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JUl-aug 2012 Medical Waste Management 15

Medical Waste Management Serving Healthcare Facility Waste Management Professionals

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VOL. VIII NO. 3

JUl-Aug 2012

TOP STORIES Arizona VA Medical Center Going Solar

PAGE 1

LEED Certification...

Not the Only Kid on the Block!

PAGE 4

Paper Records Impede Healthcare Delivery

PAGE 6

HIPAA: Ignorance is No Excuse, Says Appeals Court

PAGE 10

Going Green in the Hospital Means Saving Green

PAGE 13

Germany Rapidly Expanded Solar Production in First Half of 2012

PAGE 14

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