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

[DeBiasi, Deborah (DEQ)]

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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