NR 526.18(2) (2) Waste types. The waste audit shall identify the types of waste that are generated within each source area. It is not necessary to determine how much of each waste type is generated in each source area. The waste types are: medical waste, including infectious waste items listed in s. NR 526.05 and items which are either being mixed with infectious waste or handled as infectious waste; hazardous waste, including but not limited to hazardous chemotherapy waste; radioactive waste; trace chemotherapy waste; recyclable materials; wastes which may have to be managed separately because they are any combination of infectious, hazardous or radioactive waste; and other solid waste.

NR 526.18 Note Note: Infectious waste which is also hazardous may also be regulated by the department under hazardous waste rules. See chs. NR 660 to 670 and s. NR 526.11 (2) (f). Infectious waste which is also radioactive is regulated by the department of health services under ch. DHS 157 and the federal government under Title 10 CFR until no longer regulated as radioactive material, as provided in s. NR 526.02 (6).

NR 526.18(3) (3) Quantity of medical waste. The waste audit shall identify how many pounds of medical waste the medical facility, as a whole, generated during the previous 12 months.

NR 526.18(4) (4) Medical waste generation rate. The waste audit shall identify the rate at which the medical facility generated medical waste during the 12 months covered by the audit. The waste generation rate shall be calculated according to the appropriate formula in s. NR 526.21 (1).

NR 526.18(5) (5) Waste management practices. The waste audit shall identify how medical waste is collected, stored, transported and treated from the point of generation to the point of final disposal, including any medical waste discharged to a publicly-owned wastewater treatment system. The audit shall identify how non-infectious waste is prevented from being mixed with infectious waste. The audit shall include any waste types that are currently mixed with or may be mixed with infectious waste. The audit may also identify waste management practices for waste types that are not mixed with medical waste.

NR 526.18 History History: Cr. Register, October, 1994, No. 466, eff. 11-1-94; CR 05-020: am. (2) Register January 2006 No. 601, eff. 2-1-06.

NR 526.19 NR 526.19 Medical waste reduction plan.

NR 526.19(1) (1) General provisions. Unless exempt under s. NR 526.16 (2), each director or director’s designee shall prepare a medical waste reduction plan for separating, reducing and managing the medical waste generated, for evaluating alternatives to disposable products and for maintaining waste reduction efforts. The director or director’s designee shall do all of the following when preparing the medical waste reduction plan:

NR 526.19(1)(a) (a) Include all of the information required in subs. (3) to (10) in the medical waste reduction plan.

NR 526.19(1)(b) (b) Assess the medical waste reduction plan and its results annually and update the plan at least every 5 years.

NR 526.19(1)(c) (c) Keep a copy of the most recent medical waste reduction plan and make it available for the department to review upon request according to s. NR 526.22 (2). The department may require the director to submit a copy of the plan and related materials to the department for its review and approval. The department may approve the plan with conditions, including but not limited to specifying goals, objectives and schedules.

NR 526.19(1)(d) (d) Consider the following priorities in developing the medical waste reduction plan:

NR 526.19(1)(d)1. 1. Waste reduction, including but not limited to: reducing the amount of packaging and the use of disposable items, substituting other products and materials, changing or modifying equipment, changing purchasing policies or procedures, changing housekeeping practices, providing more effective ways to separate infectious wastes from all other waste types, and selling or donating unused items and equipment to others.

NR 526.19(1)(d)2. 2. Reuse by appropriate reprocessing, including but not limited to: sterilizing, disinfecting, decontaminating, laundering, recharging, exchanging waste or equipment with others, and selling or donating reprocessed items or equipment to others.

NR 526.19(1)(d)3. 3. Recycling of recyclable materials.

NR 526.19(1)(e) (e) Consider all of the following factors when evaluating waste management strategies and alternatives to disposables:

NR 526.19(1)(e)1. 1. Costs, including benefits, savings and reduced liabilities.

NR 526.19(1)(e)2. 2. Probable adverse effects on patient care and worker safety posed by the alternatives.

NR 526.19(1)(e)3. 3. Probable effects of transferring waste disposal to other media, including land, air and water.

NR 526.19(1)(e)4. 4. State recycling laws and rules and local recycling ordinances.

NR 526.19(1)(e)5. 5. Recycling options available in the area.

NR 526.19(1)(e)6. 6. Compliance with other rules and regulations that apply to or within the medical facility, such as occupational health and safety regulations, state and federal air management regulations, state and federal wastewater regulations and state and federal hazardous waste regulations.

NR 526.19(1)(e)7. 7. Availability of products or equipment needed to implement an alternative.

NR 526.19(1)(e)8. 8. Other considerations specific to the medical facility.

NR 526.19(2) (2) Optional provisions.

NR 526.19(2)(a) (a) The director or director’s designee may also address the waste types listed in s. NR 526.18 (2) in the medical waste reduction plan, or incorporate the medical waste reduction plan within a comprehensive waste management plan for the medical facility.

NR 526.19(2)(b) (b) The medical waste reduction plan may describe, incorporate or refer to waste reduction policies or waste minimization plans adopted prior to November 1, 1994 or to applicable waste handling and management policies or plans developed under other rules, such as s. NR 662.041, or under the requirements of other agencies such as OSHA or the joint commission on accreditation of healthcare organizations.

NR 526.19(2)(c) (c) If the medical facility manages its infectious waste with other infectious waste generators, the director or director’s designee may work together with those generators to develop a single medical waste reduction plan.

NR 526.19(2)(d) (d) The medical waste reduction plan may describe incentives which are offered to encourage staff to participate actively in implementing, evaluating and improving the plan.