Regulatory and Enforcement Update Janet Bowen, EPA Region

Regulatory and Enforcement Update Janet Bowen, EPA Region

Regulatory and Enforcement Update Janet Bowen, EPA Region I 617-918-1795, [email protected] www.epa.gov/region1/healthcare July 27, 2005 Adapted from Region 2 May 2005 pr esentation 1 Region I Approach Mercury Challenge Program (1999-2001) National Award:Making Medicine Mercury Free http://www.h2e-online.org/programs/award/appls/

mmmfChallenge.htm Regional Hospital email group Promote H2E (2001 present) National: 1,038 partners representing 4,366 facilities (as of July 13, 2005) Region I: 127 partners in New England 2 Region 1 Approach (Cont.) Increased Compliance Assistance - Compliance workshop 2001 - SPPC Conference 2002 - Compliance workshop: May 20, 2004

- RCRA half day trainings * One in each state * June 2004- December 2004 3 Region 1 Approach (Cont.) Increase Enforcement Presence in Healthcare EPA sent letter to hospital CEOs (April 2004) - Increase enforcement presence - Information about EPA Audit policy - Information about Region II

enforcement cases 4 Results: Compliance Monitoring & Incentives Programs Hospitals Universe 480 Inspections 44 Enforcement Actions

24 Formal Enforcement Actions 10 ($1,289, 913) Settlements 8 ($557,612) Audit Agreements 37 Voluntary Disclosures

128 covering 478 facilities ($10,417,113 for 59 resolved) Violations Corrected 1100+ Adapted from Region 2 July 2005 5 Healthcare Violations 679 Violations from 128 Facilities Breakout of Violations from Hospital Disclosures CW A Violations 17%

EPCRA Violations 12% CAA Violations 7% TSCA Violations 4% SDW A Violations 1% RCRA Violations 60% Adapted from Region 2, July 2005

6 Top 15 Healthcare Violations From 59 Resolved Voluntary Disclosures Ran k 1 2 3 4 5 Violation Statut e

ID of HW RCRA Universal Waste RCRA Chemical EPCRA Inventory SIP CAA Requirements Frequency SPCC 44 CWA

Adapted from Region 2, July 2005 92 66 48 48 7 Top 15 Healthcare Violations From 59 Resolved Voluntary Disclosures Ran k 6 7

8 Violation Labeling CFC Leak Detection Records MSDS Records Statut e RCRA CAA Frequency 35

32 EPCRA 30 9 Manifests RCRA 30 10 CESQG RCRA 25 Adapted from Region 2, July 2005 Requirements 8 Top 15 Healthcare Violations From 59 Resolved Voluntary Disclosures Ran Violation

Statut k e 11 Personnel RCRA Training 12 Empty RCRA Containers 13 CFCs Use CAA Certified Technicians 14 Lead Paint TSCA Disclosure Adapted from Region 2, July 2005

Frequency 25 23 23 23 9 Healthcare RCRA Violations 409 Violations Breakout of RCRA Violations from Hospital Disclosures Container Management 16% UST 1%

Ge nera tor Require ments 18% Ge ne ral Facility Standards 16% ID of HW 23% Accumulation Time 2% Manife st 7% Unive rsal W aste 16% Adapted from Region , July 2005

10 Hazardous Waste (HW) Issues Lack of HW management training of employees Treating HW without a permit Lack of RCRA contingency plan Spill control equipment not readily accessible Failure to make HW determinations Adapted from Region 2 May 2005 pr esentation 11

Hazardous Waste (HW) Issues Failure to ensure that HW meets Land Disposal Restrictions Failure to upgrade/close underground storage tanks (USTs) by 12/22/98 Malfunctioning leak detection systems on USTs Adapted from Region 2 May 2005 pr esentation 12 Hazardous Waste Environmental Compliance

Audit Protocols Hazardous Waste Generators Used Oil and Universal Waste Generators Underground Storage Tanks Hazardous Waste Treatment, Storage, and Disposal Facilities Facilities Regulated under Subtitle D of RCRA www.epa.gov/compliance/incentives/auditing/ protocol.html Adapted from Region 2 May 2005 pr esentation 13 Hazardous Waste Environmental Assistance

Resources Hazardous Waste General Resources http://www.hercenter.org/regsandstandards/RCRA.html Understanding the Hazardous Waste Rules: A Handbook for Small Businesses http://www.epa.gov/region02/waste/public/sqg_pdf.pdf Hazardous Waste Requirements for Large Quantity Generators http://www.epa.gov/region02/waste/public/lqgpdf.pdf EPAs Office of Underground Storage Tanks http://www.epa.gov/swerust1/index.htm

Adapted from Region 2 May 2005 pr esentation 14 Healthcare CWA Violations 49 Violations Breakout of CWA Violations from Hospital Disclosures NPDES 10% SPCC/OIL Spill 90% Adapted from Region 2, July 2005

15 Water Compliance Issues No permit for wastewater discharges Not complying with permit conditions No/inadequate secondary containment of storage tanks/containers No SPCC plan Floor drains Adapted from Region 2 May 2005 pr esentation 16 Water Regulations (40 CFR Parts 100-136,

403, 460) (http://www.epa.gov/region02/ff/ca.htm) Wastewater Discharges NPDES: http://www.epa.gov/npdes Pretreatment: http://cfpub.epa.gov/npdes/home.cfm? program_id=3 UIC: http://www.epa.gov/ogwdw/uic.html Stormwater Discharges http://cfpub.epa.gov/npdes/home.cfm?program_id=6 Oil above ground and underground tanks http://www.epa.gov/oilspill/index.htm

Other (e.g. filtration plants) Adapted from Region 2 May 2005 pr esentation 17 Healthcare CAA Violations 113 Reported Violations Breakout of CAA Violations from Hospital Disclosures Asbestos 8% SIP (including MACT, NESHAPS, & Title V) 43% CFCs 49%

Adapted from Region 2, July 2005 18 Air Compliance Issues Failure to use properly trained and accredited asbestos personnel. Failure to notify EPA of asbestos removal projects and keep required documentation/recordkeeping. Failure to properly dispose of asbestos debris. Failure to close lids on parts washers when not in use. Failure to properly handle CFCs and records. Failure to include ETO sterilizer, spray paint

booth, and parts degreaser in air permit. Adapted from Region 2 May 2005 pr esentation 19 Air (40 CFR 50-99) Clean Air Act General Resources http://www.hercenter.org/regsandstandards/CAA.html Air Conditioning/Refrigeration Asbestos http://www.epa.gov/asbestos

Boilers/Emergency Generators Medical Waste Incinerators http://www.epa.gov/ttn/atw/129/hmiwi/rihmiwi.html Other (e.g., degreasers, ETO sterilizers, spray booths) Adapted from Region 2 May 2005 pr esentation 20 Healthcare EPCRA Violations 79 Violations Breakout of EPCRA Violations from Hospital Disclosures MSDS 38% Chemical

Inventory 62% Adapted from Region 2, July 2005 21 Other Requirements (http://www.epa.gov/region02/ff/ca.ht m) Emergency Planning and Community Right to Know (40 CFR 302, 355, 370, 372) http://yosemite.epa.gov/oswer/CeppoWeb.nsf/content/epcraOvervi ew.htm

Pesticides (40 CFR 150-189) http://www.epa.gov/pesticides/ PCBs (40 CFR Part 761) http://www.epa.gov/opptintr/pcb/ www.epa.gov/compliance/incentives/auditing/ protocol.html Adapted from Region 2 May 2005 pr esentation 22 Healthcare TSCA Violations 24 Violations Breakout of TSCA Violations from Hospital Disclosures

PCBs 4% Le ad Paint 96% Adapted from Region 2, July 2005 23 EPAs Audit Policy National Audit policy www.epa.gov/compliance/incentives/auditing/ auditpolicy.html Press releases New England May 25, 2005 Caritas Christi Health Care http://www.epa.gov/region1/pr/2005/may/sraw050501.html

February 14, 2005 Portsmouth Regional Hospital http://www.epa.gov/region1/pr/2005/feb/sr050203.html 24 National Tools Profile of the Healthcare Industry (2/05) Document Number: 310R05002 - plain language environmental profile http://www.hercenter.org/links/ Or call 1-800-490-9198 Compliance Assistance Center Healthcare still under construction -

on-line compliance assistance Formal launch mid-April 2005 Website www.hercenter.org 25 26 National Tools Cont. Environmental Compliance and Improvement Guide To improve compliance with JCAHO Environmental of Care Standard Available

www.hercenter.org/regsandstandard s/jcahointro.html 27 28 Choose a Standard. 29 Clip Board Versions 30 National Tools Cont. H2E Waste Management System Excel spreadsheet to assist hospitals

track waste data solid, hazardous, recyclable, regulated medical Currently being piloted with hospitals Register for this FREE tool at http://www.hercenter.org/wms.html 31 H2E Waste Management Tool 32 National Tools Cont. Mercury Assessment Tool Based on CA Excel speadsheet (2002) Use to help inventory mercury items Use to calculate the amount of mercury

http://www.h2e-online.org/tools/merc-man.htm Scroll down and click Mercury Assessment Worksheet. To access the manual open the spreadsheet and click on INSTRUCTIONS at the bottom 33 National Tools Cont. Healthcare Guide to Pollution Prevention Implementation through Environmental Management Systems, second edition Revised draft second edition: May 2005 Available: Kentucky Pollution Prevention Center URL: www.kppc.org, under Now Available 34

Regional Projects OECA Hospital Assessment Project - UNH interns collected data from 25 hospitals in RI, CT and NH - Summer 2003 - Federal Template online - Project data available online http://www.epa.gov/region1/healthcare/compliance.html 35 Hospital for Healthy Environment: Goals Virtually eliminate mercury waste by year 2005 Reduce total waste volume by 33% by year 2005, by 50% by 2010 Identify and reduce PBT chemicals and other

hazardous substances in hospitals through pollution prevention and waste reduction Our key to success is your involvement! 36 H2E Tools H2E Listserve H2E Self Assessment Guide and other Guides Comprehensive Website Mercury, Waste Reduction, Green Buildings, Green Purchasing, Energy Efficiency, Chemical /Pollution Prevention, Water Conservation, Universal Waste Monthly Teleconferences for

Partners Technical Resources 37 How to Become a H2E Partner Partner Registration Form online http://www.h2e-online.org/programs/ partner/p_reg.htm 38 H2E Program Contacts Toll Free Hotline: 800-7274179 E-mail: [email protected]

www.h2e-online.org Laura Brannen, Director Kelly Heekin, Communications [email protected] 603-795-9966 Chen Wen, Director [email protected] 202-564-8849 Janet Brown, Partner Coordinator [email protected] cell 347-393-3809

Sarah OBrien, Champion Coor. [email protected] (802) 479-0317 [email protected] Liza Nanni, Program Assoc. [email protected] 603-795-9966 Jolie Patterson-Rosst, Awards Coordinator [email protected] 703-243-0056 Cecilia DeLoach, State Partnership Programs Coordinator [email protected]

800-727-4179 39 39 General Resources Sustainable Hospital Project http://www.sustainablehospitals.org/cgi-bin/ DB_Index.cgi Healthcare Without Harm http://www.noharm.org/ RCRA Online http://www.epa.gov/rcraonline/ 40 ENERGY STAR is A voluntary partnership with EPA

A strategic approach to energy management Recognized by 60% of U.S. Households 41 EnergyStar Resources Healthcare Benchmarking - Evaluate your hospitals energy perf - Healthcare benchmarking starter kit www.energystar.gov/healthcare Portfolio Manager to benchmark energy performance available for: - Acute care and children hospitals - Medical offices (new in 2004) 42 EnergyStar Resources

Cont. Building Upgrade Manual http://www.energystar.gov/index.cfm? c=business.bus_upgrade_manual New Building Guidance http://www.energystar.gov/index.cfm? c=new_bldg_design.new_bldg_design Free EnergyStar Internet training http://es.netspoke.com/attendee/default.asp Toll Free EnergyStar Hotline: 1-888-STAR-YES (1-888-782-7937) 43

Contact Us Bill White EPA Region 1, ENERGY STAR Boston, MA 617-918-1333 [email protected] Clark Reed National Healthcare Manager, ENERGY STAR Washington, D.C. [email protected] www.energystar.gov/healthcare 44

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