[Pharmwaste] Collection and destruction of the LTC facility patient generated pharmaceutical waste for Virginia

Smith, Charlotte csmith at pharmecology.com
Mon Apr 4 14:32:36 EDT 2011


Hi Deborah,

I took a closer look at the statement included below and have some concerns:
Those pharmaceuticals that are under the control of the patient or resident of the long-term care facility, when discarded, would be subject to RCRA's household hazardous waste exclusion (40 CFR 261.4(b)(1)).

In the majority of long term care facilities, the pharmaceuticals are NOT under the control of the patient or resident and are managed entirely by professional staff. The only instances in which that is not the case are independent living and some assisted living facilities, depending on the competence of the resident. I am concerned that managing these as non-RCRA is not allowed under the law. Have you discussed this in Virginia with this in mind? The Wisconsin DNR specifically does not exempt long term care facilities due to the business-like nature of the facility, as compared to an actual residence.

Best regards,

Charlotte A. Smith, R. Ph., M.S.
Director, PharmEcology Services
WM Healthcare Solutions
Tel 713-725-6363
877-247-7430

Waste Management
1001 Fannin
Houston, TX 77002

From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of DeBiasi, Deborah (DEQ)
Sent: Thursday, March 24, 2011 3:56 PM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] Collection and destruction of the LTC facility patient generated pharmaceutical waste for Virginia


There has been a great deal of discussion on the list about the feasibility of handling the pharmaceutical waste from LTC facilities in the same manner as household generated pharmaceutical waste.

The Virginia DEQ considers the pharmaceutical waste from the patients and residents to be excluded from hazardous waste regulation, and it can be collected and destroyed along with the other DEA collected residential pharmaceuticals at the Covanta WTE incinerator in Virginia.  The LTC facilities must still comply with the record keeping requirements of the Board of Pharmacy and maintain a list of the medications that are given to the DEA for disposal.

I am appreciative that the DEA included LTCs with their collection event, since much of the LTC residentially generated medications are disposed of through flushing.   My focus now is to get as many of them as possible to participate in the DEA sponsored Drug Take-Back Initiative as I can, in addition to the 80 collection sites we have registered for the April 30th collection event to date.  (Note that the Virginia DEA agents will be collecting the pharmaceuticals from the LTC facility in the week leading up to April 30th.  LTC staff will not be transporting them.)

Excerpts from the EPA waste preamble and regulation that Virginia adopted by reference are provided below:

*******

In the preamble of the UWR proposal, EPA wrote the following:

Tuesday, December 2, 2008 Federal Register Volume 73, Number 232, page 73525 explains the following:

c. Long-Term Care Facilities

     Nursing homes, assisted living centers, and other long-term care facilities also may be subject to the RCRA hazardous waste generator regulations. However, many long-term care facilities may be unaware of the applicability of the RCRA hazardous waste regulations to their hazardous pharmaceutical waste.


     Most long-term care facilities generate two types of hazardous pharmaceutical waste. First, the facility itself may generate hazardous wastes as a result of its central management of pharmaceuticals in its pharmacy or pharmacy-like area. These hazardous pharmaceutical wastes would be subject to the RCRA hazardous waste generator regulations since the pharmaceuticals are under the control of the facility, and, thus, the resulting wastes are generated by that facility (see 40 CFR part 262). The long-term care facilities, like other generators, are responsible for determining whether the wastes it generates are hazardous wastes subject to regulation under RCRA subtitle C. If so, the facility must then manage the wastes accordingly. Long-term care facilities face many of the same issues that health care facilities and pharmacies do in managing hazardous pharmaceutical waste, as discussed above.

     Secondly, patients and residents in long-term care facilities may generate hazardous wastes. Those pharmaceuticals that are under the control of the patient or resident of the long-term care facility, when discarded, would be subject to RCRA's household hazardous waste exclusion (40 CFR 261.4(b)(1)). Hazardous pharmaceutical wastes generated by the resident are excluded from regulation because they are considered to be derived from a household.

********

Regarding the facility receiving such waste, the relevant regulatory language also appears at 40 CFR 261.4(B)(1) which also states that "A resource recovery facility managing municipal solid waste shall not be deemed to be treating, storing, disposing of, or otherwise managing hazardous wastes for the purposes of regulation under this subtitle, if such facility:

(i) Receives and burns only

(A) Household waste (from single and multiple dwellings, hotels, motels, and other residential sources) and

(B) Solid waste from commercial or industrial sources that does not contain hazardous waste; and

(ii) Such facility does not accept hazardous wastes and the owner or operator of such facility has established contractual requirements or other appropriate notification or inspection procedures to assure that hazardous wastes are not received at or burned in such facility."

Deborah L. DeBiasi
Email:   Deborah.DeBiasi at deq.virginia.gov (NEW!)
WEB site address:  www.deq.virginia.gov
Virginia Department of Environmental Quality
Office of Water Permit and Compliance Assistance Programs
Industrial Pretreatment/Whole Effluent Toxicity (WET) Program
PPCPs, EDCs, and Microconstituents
www.deq.virginia.gov/vpdes/microconstituents.html
Mail:          P.O. Box 1105, Richmond, VA  23218
Location:  629 E. Main Street, Richmond, VA  23219
PH:         804-698-4028
FAX:      804-698-4032

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