HOUSE BILL No. 5575

 

December 13, 2007, Introduced by Rep. Miller and referred to the Committee on Regulatory Reform.

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 13805, 13807, 13809, 13810, 13811, 13813,

 

13815, 13817, 13819, 13821, 13823, 13825, 13827, 13829, 13830, and

 

13831 (MCL 333.13805, 333.13807, 333.13809, 333.13810, 333.13811,

 

333.13813, 333.13815, 333.13817, 333.13819, 333.13821, 333.13823,

 

333.13825, 333.13827, 333.13829, 333.13830, and 333.13831),

 

sections 13805, 13807, 13809, 13810, 13811, and 13815 as added by

 

1990 PA 21, sections 13813, 13817, 13819, 13823, 13825, 13827,

 

13829, 13830, and 13831 as added by 1990 PA 18, and section 13821

 

as amended by 1996 PA 67, and by adding sections 13812, 13820,

 

13832, and 13833.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 13805. (1) "Advisory council" means the interdepartmental

 


medical waste advisory council created in section 13827.

 

     (1) "Alternative treatment technology" means a method for the

 

decontamination of medical waste other than incineration.

 

     (2) "Autoclave" means to sterilize using a vessel used to

 

decontaminate medical waste by superheated steam under pressure.

 

     (3) "Biohazard symbol" means the symbol depicted in 29 CFR

 

1910.1030.

 

     (4) "Body art facility" means a facility that practices

 

physical human body adornment by an operator utilizing body

 

piercing, tattooing, branding, or permanent cosmetics.

 

     (5) "Body piercing" means the perforation of human tissue,

 

other than an ear, for a nonmedical purpose.

 

     (6) "Branding" means a permanent mark made on human tissue by

 

burning with a hot iron or other instrument.

 

     (7) (3) "Decontamination" means rendering the process of

 

reducing potential pathogens in medical waste to render it safe for

 

routine handling as solid waste.

 

     (8) "Department" means the department of environmental quality

 

or its authorized representative.

 

     (9) (4) "Fund" means the medical waste emergency response fund

 

created in section 13829.

 

     (10) (5) "Health facility or agency" means that term as

 

defined in section 20106.

 

     (11) (6) "Household" means a single detached dwelling unit or

 

a single unit of a multiple dwelling.

 

     (12) (7) "Infectious agent" means a pathogen that is

 

sufficiently virulent so that if exposure of a susceptible host is

 


exposed to the pathogen in an adequate concentration and through a

 

portal of entry , the result could be result in transmission of

 

disease to a human.

 

     (13) "Laboratory" means any of the following that generates

 

medical waste:

 

     (a) A research facility.

 

     (b) An analytical facility.

 

     (c) A clinical facility that performs analysis or research.

 

     (14) "Landfill" means a municipal solid waste landfill as

 

defined by R 299.4104 of the Michigan administrative code.

 

     (15) (8) "Medical waste" means any of the following: that are

 

not generated from a household, a farm operation or other

 

agricultural business, a home for the aged, or a home health care

 

agency:

 

     (a) Cultures and stocks of infectious agents and associated

 

biologicals toxins, including, but not limited to, laboratory

 

waste, biological production wastes, discarded live and attenuated

 

vaccines, culture dishes, and related devices.

 

     (b) Liquid human and animal waste, including blood and blood

 

products and body fluids, but not including urine or materials

 

stained with blood or body fluids.

 

     (c) Pathological waste.

 

     (d) Sharps.

 

     (e) Contaminated wastes Wastes from animals used in research

 

that have been exposed to agents infectious to humans, these being

 

primarily research animals including, but not limited to,

 

carcasses, body parts, blood, body fluids other than urine, and

 


feces or bedding visibly contaminated with blood or body fluids.

 

     (f) Trauma waste.

 

     Sec. 13807. (1) "Pathogen" means a microorganism an agent that

 

produces causes disease in humans.

 

     (2) "Pathological waste" means human organs, tissues, body

 

parts other than teeth, products of conception, and fluids removed

 

by trauma or during surgery, or autopsy, or other medical

 

procedure, and not fixed in formaldehyde or other fixative agent. A

 

specific organ, body part, or tissue removed by trauma or during

 

surgery, autopsy, or other medical procedure that is not known to

 

be or is not highly likely to be contaminated with an infectious

 

agent and that is requested by an individual to be returned for

 

religious, ethnic, or personal reasons is not pathological waste.

 

     (3) "Person" means an individual, partnership, corporation,

 

association, governmental entity, or other legal entity.

 

     (4) (3) "Point of generation" means the point at which medical

 

waste leaves the producing facility site.

 

     (5) (4) "Producing facility", subject to subsection (6), means

 

a facility that generates, stores, removes, decontaminates, or

 

incinerates transports medical waste, . including, but not limited

 

to, all of the following:

 

     (a) A transfer station where medical waste is stored.

 

     (b) A home health care agency where medical waste is stored

 

that was generated during delivery of home health care services and

 

returned to the home health care agency by its employees.

 

     (c) A trauma waste management practitioner.

 

     (6) "Producing facility" does not include the following:

 


     (a) A funeral home that does not practice embalming and does

 

not generate medical waste.

 

     (b) A residence.

 

     (c) A farm operation or other agricultural business.

 

     (d) A facility licensed by the department of human services

 

that provides residential care services, such as adult and child

 

foster family and group homes, child day care centers, child care

 

institutions, child or adult foster care camps, and homes for the

 

aged.

 

     (7) "Public sharps collection program" means a program

 

operated by a public authority or nonprofit organization designed

 

to assist the home user in the safe disposal of discarded sharps

 

only.

 

     (8) (5) "Release" means any spilling, leaking, pumping,

 

pouring, emitting, emptying, discharging, injecting, escaping,

 

leaching, dumping, or disposing of medical waste into the

 

environment in violation of this part.

 

     (9) (6) "Response activity" means an activity necessary to

 

protect the public health, safety, welfare, and the environment,

 

and includes, but is not limited to, evaluation, cleanup, removal,

 

containment, isolation, treatment, monitoring, maintenance,

 

replacement of water supplies, and temporary relocation of people.

 

     (10) (7) "Sharps" means needles, syringes, scalpels, and

 

intravenous tubing with needles any object that is able to cut or

 

penetrate the skin or packaging material. This includes, but is not

 

limited to, a needle, a syringe with an attached needle, a scalpel,

 

a lancet, a broken vaccine vial, a culture slide or dish, a

 


capillary tube, and intravenous tubing with a needle attached.

 

     (11) (8) "Storage" means the containment of medical waste in a

 

manner that does not constitute disposal of the medical waste.

 

     (12) "Tattooing" means 1 or more of the following:

 

     (a) Making an indelible mark upon the human body by the

 

insertion of a pigment under the skin.

 

     (b) Making an indelible design upon the human body by

 

production of scars other than by branding.

 

     (13) (9) "Transport" means the movement of medical waste from

 

the point of generation or from a trauma scene to any intermediate

 

point and finally to the point of treatment or disposal. Transport

 

does not include the movement of medical waste from a health

 

facility or agency to another health facility or agency for the

 

purposes of testing and research.

 

     (14) "Trauma" means either of the following:

 

     (a) Illness or death other than in a hospital, clinic, or

 

other medical setting.

 

     (b) Bodily injury.

 

     (15) "Trauma scene" means a site contaminated with trauma

 

waste. The site may be, but is not limited to, a fixed physical

 

structure or a mobile physical structure, such as a mobile home,

 

recreational vehicle, motor vehicle, aircraft, watercraft, or

 

vessel.

 

     (16) "Trauma waste" means human organs, tissues, body parts

 

other than teeth, products of conception, and fluids removed by

 

trauma, and not fixed in formaldehyde or other fixative agent. A

 

specific organ, body part, or tissue removed by trauma that is not

 


known to be or is not highly likely to be contaminated with an

 

infectious agent and that is requested by an individual to be

 

returned for religious, ethnic, or personal reasons is not trauma

 

waste.

 

     (17) "Trauma waste management practitioner" or "practitioner"

 

means a person who undertakes as a commercial activity the cleanup,

 

handling, and transport of trauma waste from a trauma scene in this

 

state.

 

     (18) "USDOT" means the United States department of

 

transportation.

 

     Sec. 13809. A producing facility that does not incinerate

 

decontaminate medical waste on site shall do ensure that all of the

 

following are done to contain medical waste:

 

     (a) Package, contain, and locate medical waste in a manner

 

that protects and prevents the medical waste from release at the

 

producing facility or at any time before ultimate disposal.

 

     (b) Separate the categories of At the point of origin, sort

 

and separate medical waste at the point of origin by type as listed

 

in section 13805(15) into appropriate containers. that are labelled

 

as required under subdivision (c).

 

     (c) Label or mark the containers required under subdivision

 

(b) with a biohazard symbol or the words "medical waste" or

 

"pathological waste" in letters not less than 1 inch high before

 

transport in accordance with USDOT regulations as specified in 49

 

CFR part 172, subparts D and E.

 

     (d) Not compact or mix medical waste with other waste

 

materials before decontamination, incineration, and disposal.

 


     (e) If decontaminated medical waste is mixed with other solid

 

waste, clearly label the container to indicate that it contains

 

decontaminated medical waste.

 

     (d) Segregate medical waste that is being packaged for final

 

decontamination or disposal from other waste materials.

 

     (e) (f) Store medical waste in such a manner that prevents

 

putrefaction and also prevents infectious agents from coming in

 

contact with the air or with individuals.

 

     (f) (g) If medical waste is stored outside of the producing

 

facility or at the business location of a trauma waste management

 

practitioner, store the medical waste in a secured area or locked

 

in a container that weighs more than 500 pounds and prevent access

 

to the area or container by vermin or unauthorized individuals.

 

     (g) (h) Not store medical waste on the premises of the

 

producing facility for more than 90 days. The storage period begins

 

when the use of the storage container is initiated. However, if a

 

producing facility generates only sharps as medical waste and

 

generates 1 liter or less of sharps waste in a 90-day period, the

 

90-day storage period begins when the sharps container becomes

 

full, except that a partially full sharps container shall be

 

disposed of within 1 year after sharps are first placed in the

 

container. If a producing facility generates only sharps as medical

 

waste, the producing facility shall record on the sharps waste

 

container the following dates, when those dates occur:

 

     (i) The date when sharps waste is first placed in the storage

 

container.

 

     (ii) The date when the container becomes full.

 


     (h) Not store transfer station storage containers for more

 

than 7 days or as otherwise approved by the department.

 

     (i) Store trauma waste being transported in a vehicle so it is

 

physically separated by partition or compartments and does not

 

present a cross-contamination hazard to the decontamination

 

equipment and supplies stored and transported in the same vehicle.

 

     (j) Transport medical waste in accordance with USDOT shipping

 

regulations.

 

     (k) Retain USDOT medical waste shipping paper records for a

 

minimum of 3 years.

 

     Sec. 13810. A producing facility that incinerates

 

decontaminates medical waste on site shall do ensure that all of

 

the following are done to contain medical waste:

 

     (a) Package, contain, and locate medical waste in a matter

 

manner that protects and prevents the medical waste from release at

 

the producing facility or at any time before ultimate disposal.

 

     (b) Sort and separate medical waste by type as listed in

 

section 13805(15) into appropriate containers that are labeled in

 

accordance with subdivision (d).

 

     (c) (b) Separate and dispose of sharps in the manner described

 

in section 13811(d) 13811(1)(d).

 

     (d) (c) Label the containers required under subdivision (a) or

 

(b) with a biohazard symbol or the words "medical waste" or

 

"pathological waste" in letters not less than 1 inch high.

 

     (e) (d) Not store medical waste on premises of the producing

 

facility for more than 90 days.

 

     Sec. 13811. (1) A producing facility shall store,

 


decontaminate, and dispose of ensure that medical waste is

 

decontaminated and disposed of pursuant to all of the following

 

requirements:

 

     (a) Cultures and stocks of material contaminated with an

 

infectious agent shall be stored in closed, puncture-resistant

 

containers, decontaminated by autoclaving or incineration use of an

 

autoclave or incinerator, and disposed of in a sanitary landfill,

 

or shall be subjected to a decontamination and disposal process

 

approved by the department.

 

     (b) Blood, and blood products, and body fluids shall be

 

disposed of by 1 or more of the following methods:

 

     (i) Flushing Flushed down a sanitary sewer.

 

     (ii) Decontaminating by autoclaving or incineration.

 

     (iii) Solidifying.

 

     (iv) If not in liquid form, transferring to a sanitary

 

landfill.

 

     (ii) Decontaminated by use of an autoclave or incinerator and

 

disposed of in a landfill.

 

     (iii) Solidified then decontaminated by use of an autoclave or

 

incinerator and disposed of in a landfill.

 

     (iv) (v) A decontamination and disposal process approved by the

 

department.

 

     (c) Pathological waste and trauma waste shall be disposed of

 

by 1 or more of the following methods:

 

     (i) Incineration or cremation.

 

     (i) Incinerated and disposed of in a landfill.

 

     (ii) Cremated.

 


     (iii) (ii) Grinding and flushing Ground and flushed into a

 

sanitary sewer.

 

     (iv) (iii) Burial Buried in a cemetery , if packaged and

 

transported in leakproof containers of sufficient integrity to

 

prevent rupture accordance with USDOT requirements.

 

     (iv) Grinding until rendered unrecognizable, stored in closed,

 

puncture-resistant, properly labeled containers, and, if not in

 

liquid form, disposed of in a sanitary landfill.

 

     (v) A decontamination and disposal process approved by the

 

department.

 

     (d) Sharps shall be disposed of by 1 of the following methods:

 

     (i) Placement in rigid, puncture-resistant containers that are

 

appropriately labeled and transported to a sanitary landfill in a

 

manner that retains the integrity of the container.

 

     (ii) Incineration or decontamination and grinding that renders

 

the objects unrecognizable. Ground sharps shall be placed in a

 

sealed, rupture-resistant container and transported to a sanitary

 

landfill.

 

     (i) Disposed of in a landfill if packaged and transported in

 

accordance with USDOT requirements.

 

     (ii) Decontaminated by use of an autoclave or incinerator and

 

disposed of in a landfill.

 

     (iii) A decontamination and disposal process approved by the

 

department.

 

     (e) Animal waste contaminated with organisms infectious to

 

humans a pathogen shall be disposed of by incineration or by burial

 

in a sanitary landfill in properly labeled, double containers that

 


are leakproof and puncture-resistant and are tightly sealed to

 

prevent escape of fluids or material. Contaminated animal organs

 

disposed of separately shall be rendered unrecognizable. 1 of the

 

following methods:

 

     (i) Decontaminated by use of an autoclave or incinerator and

 

disposed of in a landfill.

 

     (ii) Disposed of in a landfill if packaged and transported in

 

accordance with USDOT requirements.

 

     (iii) A decontamination and disposal process approved by the

 

department.

 

     (2) A medical waste treatment technology shall attain during

 

operation a minimum level of decontamination to protect human

 

health, safety, welfare, and the environment as established by

 

rules promulgated by the department.

 

     Sec. 13812. (1) A medical waste treatment technology shall not

 

be installed or used unless the technology has been reviewed and

 

approved by the department. The department shall review the

 

technology for compliance with this act and rules promulgated under

 

this act.

 

     (2) An application for evaluation and review of the medical

 

waste treatment technology shall be submitted to the department,

 

with supportive documentation, on a form provided by the

 

department. The department shall review the application and

 

supportive documentation and shall approve or deny the application.

 

If the application is denied, the department shall specify the

 

reasons for the denial issued and what additional information is

 

needed to approve an application.

 


     (3) An evaluation fee of $500.00 shall be submitted with each

 

application under this section. The collected fee shall be

 

forwarded to the state treasury and deposited in the fund.

 

     (4) The manufacturer shall provide to the department the name

 

and address of each producing facility where installation of the

 

approved technology is to occur. The equipment shall not be used

 

until on-site efficacy and validation testing are successfully

 

completed. Approval of a treatment technology by the department

 

under this part is for the use of the technology as a medical waste

 

treatment method only. The producing facility is responsible for

 

securing any other permits or required approvals needed for the

 

technology from other agencies or department programs.

 

     Sec. 13813. (1) Each A producing facility shall register with

 

the department on a form prescribed by the department. A producing

 

facility shall have a written medical waste management plan that

 

contains information required in section 13817 on file on the

 

premises within 90 days after registration.

 

     (2) A producing facility shall submit the following

 

registration fee with the registration form:

 

     (a) For a producing facility that is a private practice office

 

with fewer than 4 licensees under article 15 who are physicians,

 

physician assistants, dentists, podiatrists, certified nurse

 

practitioners, certified nurse midwives, acupuncturists, or

 

veterinarians employed by, under contract to, or working at the

 

producing facility, a registration fee of $50.00 before October 1,

 

2009 or $80.00 on or after October 1, 2009.

 

     (b) For a producing facility that is a private practice office

 


with 4 or more licensees under article 15 who are physicians,

 

physician assistants, dentists, podiatrists, certified nurse

 

practitioners, certified nurse midwives, acupuncturists, or

 

veterinarians employed by, under contract to, or working at the

 

producing facility, a registration fee of $20.00 for each licensee,

 

up to a maximum total registration fee of $80.00 before October 1,

 

2009 or $100.00 on or after October 1, 2009.

 

     (c) For a producing facility that is a health facility or

 

agency, including a hospital with fewer than 150 beds and a home

 

health care agency, a registration fee of $75.00 before October 1,

 

2009 or $100.00 on or after October 1, 2009.

 

     (d) For a producing facility that is a health facility or

 

agency that is a hospital with 150 or more licensed beds or a

 

laboratory, a registration fee of $150.00.

 

     (e) For a producing facility that is not a health facility or

 

agency, including, but not limited to, a body art facility, blood

 

draw station, blood or blood product collection facility, funeral

 

home, animal control shelter, pharmacy, school district, nursing

 

home, hospice, and ambulance operation, a registration fee of

 

$75.00 before October 1, 2009 or $80.00 on or after October 1,

 

2009.

 

     (f) For a producing facility that is a trauma waste management

 

practitioner, a medical waste treatment facility, or a medical

 

waste collection and transport company, a registration fee of

 

$150.00.

 

     (3) A mobile health care unit, such as a bloodmobile, that is

 

owned and operated by a registered producing facility in a fixed

 


location shall be included under the registration of the registered

 

facility.

 

     (4) (3) Upon receipt of a complete registration form and

 

registration fee under this section, or section 13815, the

 

department shall issue a certificate of registration to the

 

producing facility unless the department determines that the

 

producing facility is not in compliance with this part or the rules

 

promulgated under this part. A certificate of registration issued

 

under this section is valid for 3 years from its date of issuance.

 

The department shall investigate each complaint received and may

 

inspect a producing facility registered under this section pursuant

 

to the receipt of a complaint.

 

     (5) (4) Registration fees collected pursuant to this section

 

and section 13815 shall be forwarded to the state treasury and

 

deposited pursuant to section 13829 in the fund.

 

     (6) A public sharps collection program shall register as a

 

medical waste producing facility but is exempt from payment of any

 

registration fee under this section.

 

     (7) Notwithstanding section 13807(6), all funeral homes shall

 

manage used body bags as medical waste pursuant to this part.

 

     Sec. 13815. A producing facility shall submit the following

 

registration fee with the registration form required under section

 

13813:

 

     (a) For a producing facility that is a health facility or

 

agency other than a hospital described in subdivision (b) and for a

 

producing facility that is not a health facility or agency, a

 

registration fee of $75.00.

 


     (b) For a producing facility that is a health facility or

 

agency that is a hospital with 150 or more licensed beds or a

 

clinical laboratory, a registration fee of $150.00.

 

     (1) Subject to subsection (2), a person shall not engage in

 

the cleanup, handling, and transport of trauma waste from a trauma

 

scene in this state unless the person is registered and has been

 

issued a trauma waste transport permit under this section. Except

 

as otherwise provided in this subsection, before a person engages

 

in the cleanup, handling, and transport of trauma waste from a

 

trauma scene in this state, the person shall apply for registration

 

and to receive a trauma waste transport permit on forms and in the

 

manner prescribed by the department.

 

     (2) A person who engaged in the cleanup, handling, and

 

transport of trauma waste from a trauma scene in this state on the

 

day before the effective date of the amendatory act that added this

 

subsection may continue to engage in the cleanup, handling, and

 

transport of trauma waste from a trauma scene on and after that

 

date, subject to the following:

 

     (a) Within 30 days of the effective date of the amendatory act

 

that added this subsection, the person shall notify the department

 

that the person is engaging in the cleanup, handling, and transport

 

of trauma waste from a trauma scene and that the person intends to

 

continue to engage in that activity.

 

     (b) On or before the date and in the manner prescribed by the

 

department, the person shall submit an application for registration

 

and to receive a trauma waste transport permit.

 

     (c) Upon receipt of the application under subdivision (b), the

 


department shall proceed in the manner prescribed in subsection (4)

 

for acting upon a new application and either issue a certificate of

 

registration and a trauma waste transport permit or notify the

 

person that its application for registration and issuance of a

 

trauma waste transport permit has been denied under this section

 

and include the reasons for the denial. The person shall

 

immediately cease operation as a trauma waste management

 

practitioner upon receipt of a notice that its application for

 

registration and issuance of a trauma waste transport permit has

 

been denied under this section. A person who receives a notice that

 

its application for registration and issuance of a trauma waste

 

transport permit has been denied under this subdivision may reapply

 

as prescribed in subsection (3), and the department shall proceed

 

in the manner prescribed in subsection (4) on the application as if

 

it were a new application.

 

     (3) A person that submits an application for registration and

 

to receive a trauma waste transport permit under this section shall

 

submit all of the following with the application:

 

     (a) A registration fee of $150.00.

 

     (b) A written trauma waste management plan that meets the

 

requirements of subsection (7).

 

     (c) Proof of financial responsibility for bodily injury,

 

property damage, or environmental damage to third parties caused by

 

accidental occurrences arising from the trauma waste cleanup and

 

transport activities of the trauma waste management practitioner.

 

     (d) Subject to subsection (5), a fee prescribed by the

 

department to cover the expense of the background check required

 


under subsection (4).

 

     (4) Upon receipt of a complete application for registration

 

form under this section and subject to subsection (5), the

 

department shall cause to be conducted a background check of all

 

individuals listed in the application as being the owners,

 

officers, directors, partners, or other key employees of the trauma

 

waste management practitioner. The department shall determine

 

whether any information received as a result of the background

 

check makes the practitioner ineligible to be registered and issued

 

a trauma waste transport permit under this section and, if so,

 

shall not register or issue a permit to the person. The department

 

shall notify the person that its application for registration and

 

issuance of a trauma waste transport permit has been denied under

 

this section and include the reasons for the denial. A person who

 

receives a notice that its application for registration and a

 

trauma waste transport permit has been denied under this subsection

 

may reapply in the manner prescribed in subsection (3), and the

 

department shall proceed in the manner prescribed in this

 

subsection on the application as if it were a new application. If

 

the department determines that the applicant is able to engage in

 

the cleanup, handling, and transport of trauma waste in a manner

 

that will protect the public health, safety, welfare, and the

 

environment, the department shall issue a certification of

 

registration and a trauma waste transport permit to the applicant

 

under this section. If any of the information or documentation

 

required under subsection (3) is not yet available at the time of

 

application, the department may issue a permit on a conditional

 


basis, subject to receipt of that information or documentation as

 

soon as practical after issuance of the conditional permit. The

 

applicant shall comply with all deadlines and requirements for the

 

submission of the information or documentation in order to receive

 

an unconditional trauma waste transport permit under this section.

 

     (5) A certificate of registration and trauma waste transport

 

permit issued under this section is valid for 1 year from the date

 

of issuance. A trauma waste management practitioner shall comply

 

with subsection (2) and any rules or other guidance issued by the

 

department to obtain a renewal permit under this section. The

 

department shall act on a renewal application in the same manner as

 

a new application under subsection (4). However, the department is

 

not required to conduct a background check annually, but shall

 

conduct a background check of a trauma waste management

 

practitioner for a renewal application at least once every 3 years.

 

     (6) Within 90 days of the effective date of the amendatory act

 

that added this subsection and on a continuing basis, the

 

department, in consultation with the trauma waste management

 

industry and the health care industry, shall establish the

 

following standards:

 

     (a) Documentation of personal protection required to be

 

provided for and used by employees of trauma waste management

 

practitioners.

 

     (b) Technologies and chemicals appropriate to the task of

 

cleaning, handling, and disinfecting a trauma scene.

 

     (c) Other standards as necessary.

 

     (7) A trauma waste management practitioner shall develop a

 


trauma waste management plan that contains information relating to

 

the cleanup, handling, and transport of all trauma waste removed,

 

stored, transported, and disposed of by the practitioner. The

 

trauma waste management plan shall describe all of the following:

 

     (a) The personal protection to be provided to employees of the

 

practitioner to minimize exposure to infectious agents throughout

 

the process of handling and transporting trauma waste.

 

     (b) The technologies, chemicals, and procedures to be used in

 

the task of cleaning, handling, and disinfecting the trauma scene.

 

     (c) Any other information that the department determines is

 

necessary under subsection (6).

 

     (8) A trauma waste management practitioner shall update its

 

trauma waste management plan every year or within 30 days of a

 

change in any of the following:

 

     (a) A person or site named in the plan.

 

     (b) The types of trauma waste handled or the methods of

 

handling trauma waste.

 

     (9) Upon request, a trauma waste management practitioner shall

 

produce its current trauma waste management plan for an employee of

 

the department pursuant to a routine or unannounced inspection or

 

the investigation of a complaint. A practitioner shall maintain a

 

current version of its trauma management plan on file on the

 

premises at all times. Upon revision of any portion of its trauma

 

waste management plan, a practitioner shall promptly file the

 

revised plan with the department and shall comply with all

 

requirements of the department under section 13819.

 

     (10) A trauma waste management practitioner shall comply with

 


its trauma waste management plan and shall transport trauma waste

 

to a producing facility that decontaminates or incinerates medical

 

waste for treatment or disposal. A trauma waste management

 

practitioner shall not store trauma waste on its premises for more

 

than 14 days. A trauma waste management practitioner shall package

 

medical waste in the manner prescribed in section 13821 and as

 

otherwise prescribed by the department.

 

     (11) The department may inspect a trauma waste management

 

practitioner in either a routine or unannounced manner in order to

 

determine whether the practitioner should be registered and a new

 

or renewal permit should be issued to the practitioner under this

 

section or to investigate a complaint. The department may deny,

 

suspend, or revoke registration and the issuance of a permit if the

 

department determines that the practitioner is not able to engage

 

in the cleanup, handling, and transport of trauma waste in a manner

 

that will protect the public health, safety, and welfare and the

 

environment. A trauma waste management practitioner is entitled to

 

notice and a hearing in the manner prescribed in section 92 of the

 

administrative procedures act of 1969, 1969 PA 306, MCL 24.292, if

 

the department determines that it must suspend or revoke

 

registration and the issuance of a permit under this subsection.

 

     (12) The department shall develop, maintain, and post on its

 

website a current list of registered trauma waste management

 

practitioners. The department shall periodically submit a current

 

list of registered trauma waste management practitioners to local

 

health agencies, local health officers, local environmental health

 

administrators, and county sheriffs. Upon request, the department

 


shall submit a current list of registered trauma waste management

 

practitioners to other public agencies and to the general public.

 

     Sec. 13817. (1) Subject to subsection (7), a producing

 

facility shall have a written medical waste management plan on file

 

on the premises within 90 days after registration as a producing

 

facility. The medical waste management plan required in section

 

13813 shall contain information relating to the handling of all

 

medical waste generated, stored, or decontaminated , or incinerated

 

at each the producing facility or transported from the producing

 

facility for handling by another facility for storage , or

 

decontamination , incineration, or for disposal in a sanitary

 

landfill, cemetery, or other disposal site. A professional

 

corporation person may identify and prepare a common medical waste

 

management plan for all producing facilities owned and operated by

 

the corporation person. A copy of the common medical waste

 

management plan shall be kept available at each producing facility

 

site for inspection by the department.

 

     (2) The A medical waste management plan shall comply with this

 

act and describe each of the following, to the extent the

 

information is applicable to the producing facility:

 

     (a) The types of medical waste handled.

 

     (b) The segregation, packaging, labeling, and collection

 

procedures used.

 

     (c) The use and methods of on-site or off-site storage.

 

     (d) The use and methods of on-site or off-site

 

decontamination.

 

     (e) The use of on-site or off-site incineration.

 


     (f) The corporate or other legally recognized business name,

 

of solid waste haulers who transport address, and telephone number

 

of medical waste disposal service companies that transport or treat

 

medical waste for the producing facility.

 

     (g) The use name and address of sanitary landfills,

 

cemeteries, and other disposal sites to which medical waste is

 

directly taken by the producing facility.

 

     (h) The measures to minimize exposure of the producing

 

facility's employees to infectious agents throughout the process of

 

handling and disposing of the medical waste, including, where

 

applicable, the use of protocols, procedures and training, personal

 

protective devices and clothing, physical containment or isolation

 

devices or systems, and prevention or control of aerosols.

 

     (i) The name of the individual responsible for the management

 

of the medical waste.

 

     (j) Cleanup methods and procedures to be used in response to

 

spills of medical waste.

 

     (2) A medical waste management plan shall comply with the

 

requirements of this act.

 

     (3) A producing facility shall update a its medical waste

 

management plan each time there is every 3 years or within 30 days

 

of a change in either any of the following: , within 30 days after

 

the change occurs:

 

     (a) A person or site named in the plan.

 

     (b) The types of medical waste handled or the methods of

 

handling medical waste at the facility.

 

     (4) Upon request, a producing facility shall make its medical

 


waste management plan available to the department pursuant to a

 

routine or unannounced inspection or the investigation of a

 

complaint.

 

     (5) Upon receipt of 24 hours' advance notice, a producing

 

facility shall make its medical waste management plan available to

 

an employee of the producing facility for inspection on the

 

premises or provide a copy of the medical waste management plan to

 

the employee.

 

     (6) A producing facility shall comply with its medical waste

 

management plan.

 

     (7) This section does not apply to a trauma waste management

 

practitioner.

 

     Sec. 13819. (1) Upon review of a medical waste management plan

 

under section 13817(4) 13817 or a trauma waste management plan

 

under section 13815, the department may require a producing

 

facility or trauma waste management practitioner to modify the

 

medical waste management its plan at any time the department

 

determines that the plan is not adequate to protect the public

 

health, safety, and welfare and the environment or is inconsistent

 

with state or federal law. Upon determining that the plan is

 

inadequate or inconsistent under this section making such a

 

determination, the department shall notify the producing facility

 

or the trauma waste management practitioner in writing of its the

 

determination and the specific modifications necessary for

 

compliance. The producing facility or trauma waste management

 

practitioner shall modify the plan accordingly within 10 days after

 

receipt of the notice from the time period specified by the

 


department in its notice.

 

     (2) The department may issue a warning to a producing facility

 

or trauma waste management practitioner that fails to modify a plan

 

within the 10-day period.

 

     Sec. 13820. The department may enter at any reasonable time

 

upon private or public property upon which medical waste is

 

reasonably believed to be located to determine compliance with this

 

part or a rule promulgated under this part.

 

     Sec. 13821. (1) A producing facility that transports medical

 

waste or has medical waste transported off the premises of the

 

producing facility or a trauma scene shall package and transport

 

the medical waste in the following manner: accordance with the

 

applicable USDOT hazardous materials regulations specified under 49

 

CFR parts 171 to 180.

 

     (a) Sharps that are not ground or incinerated as described in

 

section 13811(d) shall be contained for disposal in individual

 

leakproof, rigid, puncture-resistant containers that are secured to

 

preclude loss of the contents. In addition, a container used to

 

store or transport a number of individual sharps containers shall

 

be leakproof. These containers shall be conspicuously labeled with

 

the word "sharps". Sharps that are contained pursuant to this

 

subdivision may be disposed of as solid waste pursuant to part 115

 

(solid waste management) of the natural resources and environmental

 

protection act, Act No. 451 of the Public Acts of 1994, being

 

sections 324.11501 to 324.11549 of the Michigan Compiled Laws.

 

However, sharps shall not be compacted or handled during transport

 

in a manner that will result in breakage of a sharps container.

 


     (b) Medical waste other than sharps shall be contained in bags

 

other than body pouches or other containers that are impervious to

 

moisture and have a strength sufficient to resist ripping, tearing,

 

breaking, or bursting under normal conditions of usage or handling.

 

The bags or containers shall be secured so as to prevent leakage

 

during storage, handling, or transport.

 

     (2) Medical waste that is decontaminated and packaged in

 

accordance with sections 13809, 13810, and 13811, as applicable,

 

may be disposed of as solid waste pursuant to part 115 of the

 

natural resources and environmental protection act, 1994 PA 451,

 

MCL 324.11501 to 324.11550.

 

     (3) Hazardous waste, as defined in part 111 of the natural

 

resources and environmental protection act, 1994 PA 451, MCL

 

324.11101 to 324.11153, shall not be disposed of as medical waste.

 

     Sec. 13823. (1) If A person who discovers suspected medical

 

waste is discovered on any land or water in the this state and

 

reported to the department of natural resources, the department of

 

public health, a local health department, the department of state

 

police, or any other state or local governmental agency, the agency

 

or department receiving the report shall promptly investigate to

 

confirm the existence of medical waste. If the existence of medical

 

waste is confirmed by a department or agency other than the

 

department of natural resources, a report shall be transmitted

 

immediately to the department of natural resources. shall report

 

the medical waste to the department. The department of natural

 

resources may if appropriate take measures to contain the medical

 

waste, to close off the area, to remove the medical waste from the

 


environment, and to do all things necessary to protect the public

 

health, safety, and welfare and the environment. The department of

 

natural resources may if appropriate conduct an investigation to

 

determine the source of the medical waste.

 

     (2) The department of natural resources may consult with the

 

department of public health, the appropriate local health

 

department, the department of state police, and the department of

 

attorney general on the actions taken by the department of natural

 

resources under this section.

 

     (3) After the department of natural resources confirms the

 

existence of medical waste under this section, the department of

 

natural resources shall inform the legislature, the governor, the

 

advisory council, and the public on the results of any

 

investigation conducted within 30 days after the investigation is

 

completed.

 

     Sec. 13825. (1) If there is a suspected violation of this part

 

on the premises of a health facility or agency or on the premises

 

of an incinerator owned and operated by a health facility or agency

 

producing facility, the department of public health shall promptly

 

conduct an investigation to confirm the violation. If the suspected

 

violation is reported to the department of natural resources, a

 

local health department, the department of state police, or any

 

other state or local governmental agency, the report immediately

 

shall be transmitted to the department of public health. If the

 

investigation confirms the existence of a violation of this part,

 

the department of public health may if appropriate take measures to

 

correct the violation and to do all things necessary to protect the

 


public health, safety, and welfare and the environment.

 

     (2) The department of public health may consult with the

 

department of natural resources, the appropriate local health

 

department, the department of state police, and the department of

 

attorney general on the actions taken by the department of public

 

health under this section. If the suspected violation of this part

 

is at an incinerator owned and operated by a health facility or

 

agency, the department of public health immediately shall notify

 

the department of natural resources and request the assistance of

 

the department of natural resources in conducting the

 

investigation.

 

     (3) If the department of public health confirms the existence

 

of a violation under this section, the department of public health

 

shall inform the legislature, the governor, the advisory council,

 

and the public on the results of the investigation conducted within

 

30 days after the investigation is completed.

 

     Sec. 13827. (1) The interdepartmental medical waste advisory

 

council is created in the department. The council shall consist of

 

the following members appointed as follows:

 

     (a) One individual appointed by the director of public health

 

representing the department.

 

     (b) One individual appointed by the director of the department

 

of natural resources representing the department of natural

 

resources.

 

     (c) One individual appointed by the director of the department

 

of state police representing the department of state police.

 

     (d) One individual appointed by the director of commerce

 


representing the department of commerce, who has knowledge of

 

tourism in the state.

 

     (e) One individual appointed by the attorney general

 

representing the department of the attorney general.

 

     (2) The representative of the department shall serve as

 

chairperson.

 

     (3) The advisory council The department shall do all of the

 

following:

 

     (a) Collect data pertaining to medical waste reports and

 

investigations under this part.

 

     (b) Annually report to the governor , and the standing

 

committees in the senate and house of representatives with

 

jurisdiction over public health matters , the department of public

 

health, and the department of natural resources on all of the

 

following:

 

     (i) The number of medical waste reports received and

 

investigations conducted under this part.

 

     (ii) The implementation and effectiveness of this part.

 

     (iii) Changes in the overall regulatory scheme pertaining to

 

medical waste, including, but not limited to, the enactment of

 

pertinent federal law.

 

     (iv) Recommendations, if any, that the advisory council

 

department has for changes to this part or any other state statute

 

or rule that pertains to medical waste.

 

     (v) Coordinate reports and investigations under this part

 

between the department of public health and the department of

 

natural resources.

 


     Sec. 13829. (1) The medical waste emergency response fund is

 

created in the state treasury.

 

     (2) The state treasurer shall deposit in the fund all money

 

fees received pursuant to this act part, revenue under section

 

13831(3), and all money received by the fund as otherwise provided

 

by law.

 

     (3) The state treasurer shall direct the investment of the

 

fund. Interest and earnings of the fund shall be credited to the

 

fund. Money in the fund at the close of the fiscal year shall

 

remain in the fund and shall not revert to the general fund.

 

     (4) The department shall be the administrator of the fund for

 

auditing purposes.

 

     (5) (4) Not The department shall expend money from the fund,

 

upon appropriation, only for the following purposes:

 

     (a) Not more than 80% of the total amount in the fund shall be

 

used by the department of public health for administrative expenses

 

related to the implementation of this part. , and the balance may

 

be used by the department of natural resources for

 

     (b) For response activities necessitated by addressing the

 

release of medical waste into the environment.

 

     (c) For programs relating to medical waste reduction,

 

management, and education.

 

     Sec. 13830. (1) The department shall promulgate rules to

 

prescribe training standards for both medical and nonmedical

 

personnel who handle medical waste in producing facilities

 

implement this part.

 

     (2) Each producing facility shall train its personnel who

 


handle medical waste pursuant to the rules promulgated under

 

subsection (1).

 

     Sec. 13831. (1) Except as provided in subsection (2), a person

 

who violates this part or a rule promulgated under this part is

 

subject to an administrative fine of not more than $2,500.00 for

 

each violation and an additional fine of not more than $1,000.00

 

for each day during which the violation continues. For a first

 

offense, the department of public health or the department of

 

natural resources may postpone the levying of a fine under this

 

subsection for not more than 45 days or until the violation is

 

corrected, whichever occurs first.

 

     (2) A person who fails to register with the department or have

 

a medical waste management plan available for inspection in

 

compliance with sections 13813 and 13817 is subject to an

 

administrative fine of $500.00.

 

     (3) A person who violates this act may be enjoined by a court

 

of competent jurisdiction from continuing the violation.

 

     (1) The department may request that the attorney general bring

 

an action in the name of the people of this state for any

 

appropriate relief, including injunctive relief, for a violation of

 

this part or rules promulgated under this part.

 

     (2) In addition to any other relief provided under this

 

section, the court may impose on any person in violation of this

 

part or rules promulgated under this part a civil fine as follows:

 

     (a) Except as provided in subdivision (b), a civil fine of not

 

more than $2,500.00 for each violation and an additional civil fine

 

of not more than $1,000.00 for each day during which the violation

 


continues.

 

     (b) A civil fine of $500.00 for failure to register with the

 

department under section 13813 or 13815 or to make a trauma waste

 

management plan or a medical waste management plan available to the

 

department under section 13815 or 13817, respectively.

 

     (3) In addition to any other relief provided by this section,

 

the court may order a person who violates this part or rules

 

promulgated under this part to pay to this state an amount equal to

 

all of the following:

 

     (a) The cost of containing and removing medical waste and

 

taking action necessary to protect public health, safety, and

 

welfare, and the environment.

 

     (b) The full value of damage done to the natural resources of

 

this state.

 

     (c) The costs of surveillance and enforcement incurred by this

 

state as a result of the violation.

 

     (4) Revenue collected under subsection (2) or (3) shall be

 

deposited in the fund.

 

     Sec. 13832. The department may issue a cease and desist order

 

to correct a violation of this part or a rule promulgated under

 

this part to a person who conducts, manages, maintains, or operates

 

a producing facility if the violation is causing an imminent public

 

health hazard or threat to the environment.

 

     Sec. 13833. (1) A person who violates this part, a rule

 

promulgated under this part, or a final order pursuant to this part

 

is guilty of a misdemeanor punishable by imprisonment for not more

 

than 6 months or a fine of not more than $1,000.00, or both, plus

 


any payment ordered under section 13831(3). Each day upon which a

 

violation described in this section occurs is a separate offense.

 

     (2) A payment ordered under section 13831(3) recovered in a

 

prosecution under this section shall be deposited in the fund.

 

However, if a law enforcement agency of a local unit of government

 

was primarily responsible for the enforcement of this part, the

 

payment shall instead be forwarded to that local unit of

 

government.