adapted from region 2 may 2005 presentation 1 regulatory and enforcement update janet bowen, epa...

Adapted from Region 2 May 2005 prAdapted from Region 2 May 2005 presentationesentation

11

Regulatory and Regulatory and Enforcement UpdateEnforcement Update

Janet Bowen, EPA Region IJanet Bowen, EPA Region I

617-918-1795, 617-918-1795, [email protected]@epa.govwww.epa.gov/region1/healthcarewww.epa.gov/region1/healthcare

July 27, 2005July 27, 2005

mailto:[email protected]

http://www.epa.gov/region1/healthcare

22

Region I ApproachRegion I Approach• Mercury Challenge ProgramMercury Challenge Program (1999-2001)(1999-2001) National Award:National Award:Making Medicine Mercury FreeMaking Medicine Mercury Freehttp://www.h2e-online.org/programs/award/appls/http://www.h2e-online.org/programs/award/appls/

mmmfChallenge.htmmmmfChallenge.htm

• Regional Hospital email groupRegional Hospital email group

• Promote H2EPromote H2E (2001 – present)(2001 – present)National: 1,038 partners representing 4,366 National: 1,038 partners representing 4,366 facilities facilities (as of July 13, 2005)(as of July 13, 2005)

Region I: 127 partners in New EnglandRegion I: 127 partners in New England

33

Region 1 ApproachRegion 1 Approach (Cont.)(Cont.)Increased Compliance AssistanceIncreased Compliance Assistance

- Compliance workshop 2001- Compliance workshop 2001 - SPPC Conference 2002- SPPC Conference 2002 - Compliance workshop: May 20, - Compliance workshop: May 20,

20042004 - RCRA half day trainings - RCRA half day trainings * One in each state* One in each state * June 2004- December 2004* June 2004- December 2004

44

Region 1 ApproachRegion 1 Approach (Cont.)(Cont.) Increase Enforcement Increase Enforcement Presence in HealthcarePresence in Healthcare• EPA sent letter to hospital CEOs EPA sent letter to hospital CEOs (April (April

2004)2004)

- Increase enforcement presence- Increase enforcement presence

- Information about EPA Audit - Information about EPA Audit policypolicy

- Information about Region II- Information about Region II

enforcement casesenforcement cases

Adapted from Region 2 July 2005Adapted from Region 2 July 2005 55

Results:Results:Compliance Monitoring & Incentives Compliance Monitoring & Incentives

ProgramsPrograms Hospitals

Universe480

Inspections44

Enforcement Actions 24

Formal Enforcement Actions 10 ($1,289, 913)

Settlements 8 ($557,612)

Audit Agreements 37

Voluntary Disclosures128 covering 478 facilities

($10,417,113 for 59 resolved)

Violations Corrected 1100+

Adapted from Region 2, July 2005Adapted from Region 2, July 2005 66

Healthcare ViolationsHealthcare Violations679 Violations from 128 679 Violations from 128

FacilitiesFacilitiesBreakout of Violations from Hospital Disclosures

SDWA Violations1%

EPCRA Violations12%

CWA Violations17%

CAA Violations7%

TSCA Violations4%

RCRA Violations60%


Top 15 Healthcare ViolationsTop 15 Healthcare ViolationsFrom 59 Resolved Voluntary From 59 Resolved Voluntary DisclosuresDisclosuresRanRankk

ViolationViolation StatutStatutee

FrequencyFrequency

11 ID of HWID of HW RCRARCRA 9292

22 Universal WasteUniversal Waste RCRARCRA 6666

33 Chemical Chemical InventoryInventory

EPCRAEPCRA 4848

44 SIP SIP RequirementsRequirements

CAACAA 4848

55 SPCCSPCC CWACWA 4444




FrequencyFrequency

66 LabelingLabeling RCRARCRA 3535

77 CFC Leak CFC Leak Detection Detection RecordsRecords

CAACAA 3232

88 MSDS RecordsMSDS Records EPCRAEPCRA 3030

99 ManifestsManifests RCRARCRA 3030

1010 CESQG CESQG RequirementsRequirements

RCRARCRA 2525




FrequencyFrequency

1111 Personnel Personnel TrainingTraining

RCRARCRA 2525

1212 Empty Empty ContainersContainers

RCRARCRA 2323

1313 CFCs – Use CFCs – Use Certified Certified TechniciansTechnicians

CAACAA 2323

1414 Lead Paint Lead Paint DisclosureDisclosure

TSCATSCA 2323

1515 Container Container ManagementManagement

RCRARCRA 2121

Adapted from Region , July 2005Adapted from Region , July 2005 1010

Healthcare RCRA ViolationsHealthcare RCRA Violations409 Violations409 Violations

Breakout of RCRA Violations from Hospital Disclosures

Generator Requirements18%

ID of HW 23%

Universal Waste16%

General Facility Standards16%

Container Management16%

UST 1%

Accumulation Time2%

Manifest 7%


1111

Hazardous Waste (HW) Hazardous Waste (HW) IssuesIssues

• Lack of HW management training of Lack of HW management training of employeesemployees

• Treating HW without a permitTreating HW without a permit

• Lack of RCRA contingency planLack of RCRA contingency plan

• Spill control equipment not readily Spill control equipment not readily accessibleaccessible

• Failure to make HW determinationsFailure to make HW determinations


1212

Hazardous Waste (HW) Hazardous Waste (HW) IssuesIssues

• Failure to ensure that HW meets Failure to ensure that HW meets Land Disposal Restrictions Land Disposal Restrictions

• Failure to upgrade/close underground Failure to upgrade/close underground storage tanks (USTs) by 12/22/98storage tanks (USTs) by 12/22/98

• Malfunctioning leak detection Malfunctioning leak detection systems on USTssystems on USTs


1313

Hazardous Waste Hazardous Waste Environmental Compliance Environmental Compliance Audit ProtocolsAudit Protocols

• Hazardous Waste GeneratorsHazardous Waste Generators

• Used Oil and Universal Waste GeneratorsUsed Oil and Universal Waste Generators

• Underground Storage TanksUnderground Storage Tanks

• Hazardous Waste Treatment, Storage, and Hazardous Waste Treatment, Storage, and Disposal FacilitiesDisposal Facilities

• Facilities Regulated under Subtitle D of RCRAFacilities Regulated under Subtitle D of RCRA

www.epa.gov/compliance/incentives/auditing/www.epa.gov/compliance/incentives/auditing/protocol.htmlprotocol.html


1414

Hazardous Waste Hazardous Waste Environmental Assistance Environmental Assistance ResourcesResources• Hazardous Waste General ResourcesHazardous Waste General Resources

http://www.hercenter.org/regsandstandards/RCRA.htmlhttp://www.hercenter.org/regsandstandards/RCRA.html

• Understanding the Hazardous Waste Rules: A Understanding the Hazardous Waste Rules: A Handbook for Small BusinessesHandbook for Small Businesseshttp://www.epa.gov/region02/waste/public/sqg_pdf.pdfhttp://www.epa.gov/region02/waste/public/sqg_pdf.pdf

• Hazardous Waste Requirements for Large Quantity Hazardous Waste Requirements for Large Quantity GeneratorsGeneratorshttp://www.epa.gov/region02/waste/public/lqgpdf.pdfhttp://www.epa.gov/region02/waste/public/lqgpdf.pdf

• EPA’s Office of Underground Storage TanksEPA’s Office of Underground Storage Tankshttp://www.epa.gov/swerust1/index.htmhttp://www.epa.gov/swerust1/index.htm


Healthcare CWA ViolationsHealthcare CWA Violations49 Violations49 Violations

Breakout of CWA Violations from Hospital Disclosures

NPDES 10%

SPCC/OIL Spill90%


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Water Compliance IssuesWater Compliance Issues

• No permit for wastewater dischargesNo permit for wastewater discharges

• Not complying with permit conditionsNot complying with permit conditions

• No/inadequate secondary No/inadequate secondary containment of storage containment of storage tanks/containerstanks/containers

• No SPCC planNo SPCC plan

• Floor drainsFloor drains


1717

Water Regulations (40 CFR Parts 100-136, Water Regulations (40 CFR Parts 100-136, 403, 460)403, 460)

((http://www.epa.gov/region02/ff/ca.htm)http://www.epa.gov/region02/ff/ca.htm)• Wastewater DischargesWastewater Discharges

NPDES: http://www.epa.gov/npdesNPDES: http://www.epa.gov/npdesPretreatment: http://cfpub.epa.gov/npdes/home.cfm?Pretreatment: http://cfpub.epa.gov/npdes/home.cfm?program_id=3program_id=3

UICUIC: : http://www.epa.gov/ogwdw/uic.htmlhttp://www.epa.gov/ogwdw/uic.html

• Stormwater DischargesStormwater Dischargeshttp://cfpub.epa.gov/npdes/home.cfm?program_id=6http://cfpub.epa.gov/npdes/home.cfm?program_id=6

• Oil above ground and underground tanksOil above ground and underground tankshttp://www.epa.gov/oilspill/index.htmhttp://www.epa.gov/oilspill/index.htm

• Other (e.g. filtration plants)Other (e.g. filtration plants)


Healthcare CAA ViolationsHealthcare CAA Violations113 Reported Violations113 Reported Violations

Breakout of CAA Violations from Hospital Disclosures

SIP (including MACT, NESHAPS,

& Title V) 43%

CFCs 49%

Asbestos 8%


1919

Air Compliance IssuesAir Compliance Issues• Failure to use properly trained and accredited Failure to use properly trained and accredited

asbestos personnel.asbestos personnel.• Failure to notify EPA of asbestos removal Failure to notify EPA of asbestos removal

projects and keep required projects and keep required documentation/recordkeeping.documentation/recordkeeping.

• Failure to properly dispose of asbestos debris.Failure to properly dispose of asbestos debris.• Failure to close lids on parts washers when Failure to close lids on parts washers when

not in use.not in use.• Failure to properly handle CFCs and records.Failure to properly handle CFCs and records.• Failure to include ETO sterilizer, spray paint Failure to include ETO sterilizer, spray paint

booth, and parts degreaser in air permit.booth, and parts degreaser in air permit.


2020

Air (40 CFR 50-99)Air (40 CFR 50-99)

• Clean Air Act General ResourcesClean Air Act General Resources

http://www.hercenter.org/regsandstandards/CAA.hthttp://www.hercenter.org/regsandstandards/CAA.htmlml

• Air Conditioning/RefrigerationAir Conditioning/Refrigeration• AsbestosAsbestos

http://www.epa.gov/asbestoshttp://www.epa.gov/asbestos• Boilers/Emergency Generators Boilers/Emergency Generators • Medical Waste IncineratorsMedical Waste Incinerators

http://www.epa.gov/ttn/atw/129/hmiwi/rihmiwi.htmlhttp://www.epa.gov/ttn/atw/129/hmiwi/rihmiwi.html

• Other (e.g., degreasers, ETO sterilizers, spray Other (e.g., degreasers, ETO sterilizers, spray booths)booths)

http://www.hercenter.org/regsandstandards/CAA.html

http://www.hercenter.org/regsandstandards/CAA.html


Healthcare EPCRA ViolationsHealthcare EPCRA Violations79 Violations79 Violations

Breakout of EPCRA Violations from Hospital Disclosures

Chemical Inventory62%

MSDS 38%


2222

Other RequirementsOther Requirements(http://www.epa.gov/region02/ff/ca.ht(http://www.epa.gov/region02/ff/ca.htm)m)• Emergency Planning and Community Right Emergency Planning and Community Right

to Know (40 CFR 302, 355, 370, 372)to Know (40 CFR 302, 355, 370, 372)http://yosemite.epa.gov/oswer/CeppoWeb.nsf/content/epcraOvervihttp://yosemite.epa.gov/oswer/CeppoWeb.nsf/content/epcraOverview.htmew.htm

• Pesticides (40 CFR 150-189)Pesticides (40 CFR 150-189)http://www.epa.gov/pesticides/http://www.epa.gov/pesticides/

• PCBs (40 CFR Part 761)PCBs (40 CFR Part 761)http://www.epa.gov/opptintr/pcb/http://www.epa.gov/opptintr/pcb/

www.epa.gov/compliance/incentives/auditing/www.epa.gov/compliance/incentives/auditing/protocol.htmlprotocol.html


Healthcare TSCA ViolationsHealthcare TSCA Violations24 Violations24 Violations

Breakout of TSCA Violations from Hospital Disclosures

Lead Paint 96%

PCBs 4%

2424

EPA’s Audit PolicyEPA’s Audit Policy

National Audit policyNational Audit policywww.epa.gov/compliance/incentives/auditing/auditpolicy.htwww.epa.gov/compliance/incentives/auditing/auditpolicy.htmlml

Press releases – New England Press releases – New England May 25, 2005 Caritas Christi Health CareMay 25, 2005 Caritas Christi Health Carehttp://www.epa.gov/region1/pr/2005/may/sraw050501.htmlhttp://www.epa.gov/region1/pr/2005/may/sraw050501.html

February 14, 2005 Portsmouth Regional HospitalFebruary 14, 2005 Portsmouth Regional Hospitalhttp://www.epa.gov/region1/pr/2005/feb/sr050203.htmlhttp://www.epa.gov/region1/pr/2005/feb/sr050203.html

http://www.epa.gov/compliance/incentives/auditing/auditpolicy.html

http://www.epa.gov/compliance/incentives/auditing/auditpolicy.html

2525

National ToolsNational Tools

Profile of the Healthcare Industry (2/05) Profile of the Healthcare Industry (2/05) Document Number: 310R05002Document Number: 310R05002

- plain language environmental profile- plain language environmental profilehttp://www.hercenter.org/links/http://www.hercenter.org/links/ Or call 1-800-490-9198Or call 1-800-490-9198

Compliance Assistance Center – Healthcare Compliance Assistance Center – Healthcare still still under constructionunder construction

- on-line compliance assistance- on-line compliance assistance - Formal launch mid-April 2005 - Formal launch mid-April 2005 - Website - Website www.hercenter.orgwww.hercenter.org

http://www.hercenter.org/links/

2727

National Tools – Cont.National Tools – Cont.• Environmental Compliance and Environmental Compliance and

Improvement GuideImprovement Guide – – To improve To improve compliance with JCAHO compliance with JCAHO Environmental of Care StandardEnvironmental of Care Standard

• Available Available www.hercenter.org/regsandstandardwww.hercenter.org/regsandstandards/jcahointro.htmls/jcahointro.html

2929

Choose a Standard.

3030

““Clip Board” VersionsClip Board” Versions

3131

National Tools – Cont.National Tools – Cont.

H2E Waste Management SystemH2E Waste Management System

• Excel spreadsheet to assist hospitals Excel spreadsheet to assist hospitals track waste data – solid, hazardous, track waste data – solid, hazardous, recyclable, regulated medicalrecyclable, regulated medical

• Currently being piloted with hospitalsCurrently being piloted with hospitals

• Register for this FREE tool at Register for this FREE tool at

http://www.hercenter.org/wms.htmlhttp://www.hercenter.org/wms.html

http://www.hercenter.org/wms.html

3232

H2E Waste Management H2E Waste Management ToolTool

3333


Mercury Assessment ToolMercury Assessment Tool• Based on CA Excel speadsheet (2002)Based on CA Excel speadsheet (2002)• Use to help inventory mercury itemsUse to help inventory mercury items• Use to calculate the amount of Use to calculate the amount of

mercury mercury

http://www.h2e-online.org/tools/merc-man.htmhttp://www.h2e-online.org/tools/merc-man.htm Scroll down and click Mercury Assessment Worksheet. To Scroll down and click Mercury Assessment Worksheet. To

access the manual open the spreadsheet and click on access the manual open the spreadsheet and click on INSTRUCTIONS at the bottomINSTRUCTIONS at the bottom

3434


Healthcare Guide to Pollution Prevention Healthcare Guide to Pollution Prevention Implementation through Environmental Implementation through Environmental Management Systems, second editionManagement Systems, second edition

Revised draft second edition: May 2005Revised draft second edition: May 2005

Available: Available: Kentucky Pollution Prevention CenterKentucky Pollution Prevention CenterURL: URL: www.kppc.orgwww.kppc.org, under “Now Available” , under “Now Available”

http://www.kppc.org/

3535

Regional ProjectsRegional Projects

• OECA Hospital Assessment ProjectOECA Hospital Assessment Project - UNH interns collected data from 25 - UNH interns collected data from 25 hospitals in RI, CT and NH hospitals in RI, CT and NH - Summer 2003- Summer 2003 - Federal Template online - Federal Template online - Project data available online- Project data available online

http://www.epa.gov/region1/healthcare/compliance.htmlhttp://www.epa.gov/region1/healthcare/compliance.html

3636

Hospital for Healthy Hospital for Healthy Environment: GoalsEnvironment: Goals

– Virtually eliminate mercury waste by year 2005Virtually eliminate mercury waste by year 2005– Reduce total waste volume by 33% by year Reduce total waste volume by 33% by year

2005, by 50% by 20102005, by 50% by 2010– Identify and reduce PBT chemicals and other Identify and reduce PBT chemicals and other

hazardous substances in hospitals through hazardous substances in hospitals through pollution prevention and waste reductionpollution prevention and waste reduction

Our key to success is your involvement!Our key to success is your involvement!

3737

H2E ToolsH2E Tools

H2E ListserveH2E Listserve H2E Self Assessment Guide and H2E Self Assessment Guide and

other Guidesother Guides Comprehensive WebsiteComprehensive Website Mercury, Waste Reduction, Green Buildings, Green Mercury, Waste Reduction, Green Buildings, Green

Purchasing, Energy Efficiency, Chemical /Pollution Purchasing, Energy Efficiency, Chemical /Pollution Prevention, Water Conservation, Universal WastePrevention, Water Conservation, Universal Waste

Monthly Teleconferences for Monthly Teleconferences for PartnersPartners

Technical ResourcesTechnical Resources

3838

How to Become a H2E How to Become a H2E PartnerPartner

Partner Registration Form onlinePartner Registration Form online

http://www.h2e-online.org/programs/http://www.h2e-online.org/programs/partner/p_reg.htmpartner/p_reg.htm

3939

Toll Free Hotline: 800-727-Toll Free Hotline: 800-727-41794179E-mail: E-mail: [email protected]@h2e-online.orgwww.h2e-online.orgwww.h2e-online.org

• Kelly HeekinKelly Heekin, Communications , Communications [email protected]@H2E-online.org

• Liza NanniLiza Nanni, Program Assoc., Program [email protected]@H2E-online.org– 603-795-9966603-795-9966

• Jolie Patterson-RosstJolie Patterson-Rosst, Awards , Awards [email protected]@H2E-online.org– 703-243-0056703-243-0056

• Cecilia DeLoachCecilia DeLoach, State , State Partnership Programs CoordinatorPartnership Programs [email protected]@H2E-online.org–800-727-4179800-727-4179

• Laura BrannenLaura Brannen, Director, [email protected]@H2E-online.org

– 603-795-9966603-795-9966• Chen WenChen Wen, Director, Director

[email protected]@H2E-online.org– 202-564-8849 202-564-8849

• Janet BrownJanet Brown, Partner Coordinator, Partner [email protected]@H2E-online.org

– cell 347-393-3809 cell 347-393-3809 • Sarah O’BrienSarah O’Brien, Champion Coor. , Champion Coor.

[email protected]@h2e-online.org– (802) 479-0317(802) 479-0317

H2E Program ContactsH2E Program Contacts










4040

General ResourcesGeneral Resources

Sustainable Hospital ProjectSustainable Hospital Projecthttp://www.sustainablehospitals.org/cgi-http://www.sustainablehospitals.org/cgi-

bin/DB_Index.cgibin/DB_Index.cgi

Healthcare Without HarmHealthcare Without Harmhttp://www.noharm.org/http://www.noharm.org/

RCRA OnlineRCRA Onlinehttp://www.epa.gov/rcraonline/http://www.epa.gov/rcraonline/

http://www.epa.gov/rcraonline/

4141

A voluntary partnership with EPA

ENERGY STAR is…ENERGY STAR is…

A strategic approach to energy management

Recognized by 60% of U.S. Households

4242

EnergyStar ResourcesEnergyStar Resources

Healthcare Benchmarking Healthcare Benchmarking - Evaluate your hospital’s energy perf- Evaluate your hospital’s energy perf - Healthcare benchmarking starter kit- Healthcare benchmarking starter kitwww.energystar.gov/healthcarewww.energystar.gov/healthcare

Portfolio Manager to benchmark energy Portfolio Manager to benchmark energy performance available for:performance available for:

- Acute care and children hospitals- Acute care and children hospitals - Medical offices - Medical offices (new in 2004)(new in 2004)

4343

EnergyStar Resources – EnergyStar Resources – Cont.Cont.• Building Upgrade ManualBuilding Upgrade Manualhttp://www.energystar.gov/index.cfm?http://www.energystar.gov/index.cfm?

c=business.bus_upgrade_manualc=business.bus_upgrade_manual

• New Building GuidanceNew Building Guidancehttp://www.energystar.gov/index.cfm?http://www.energystar.gov/index.cfm?

c=new_bldg_design.new_bldg_designc=new_bldg_design.new_bldg_design

• Free EnergyStar Internet trainingFree EnergyStar Internet traininghttp://es.netspoke.com/attendee/default.asphttp://es.netspoke.com/attendee/default.asp

• Toll Free EnergyStar Hotline: Toll Free EnergyStar Hotline: 1-888-STAR-YES (1-888-782-7937)1-888-STAR-YES (1-888-782-7937)

4444

Contact UsContact Us

Bill WhiteEPA Region 1, ENERGY STARBoston, [email protected]

Clark ReedNational Healthcare Manager, ENERGY STARWashington, [email protected]

www.energystar.gov/healthcare

adapted from region 2 may 2005 presentation 1 regulatory and enforcement update janet bowen, epa...

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