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

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)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(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.

NR 526.19(2)(e)(e) When setting goals in sub. (3), the director or director’s designee may recognize and maintain past accomplishments in reducing medical waste. The plan may list other goals, including other numerical goals, which encourage continuous improvement in medical waste reduction. Numerical goals may be modified over time to reflect changing conditions.

NR 526.19(3)(3) Goals and objectives. The medical waste reduction plan shall list the medical facility’s internal goals, objectives and a timetable for reducing the amount of medical waste generated by the medical facility. Goals shall include, but are not limited to, all of the following:

NR 526.19(3)(a)(a) Meeting a specific numerical goal expressed in terms of a medical waste generation rate calculated according to s. NR 526.21 (1). If a medical facility has already significantly reduced its medical waste generation rate and has implemented policies which meet all of the goals in pars. (b) to (d), the numerical goal may be to maintain the current medical waste generation rate.

NR 526.19(3)(b)(b) Preventing the mixing of non-infectious waste with infectious waste by separating waste at the source according to s. NR 526.06 and by implementing the waste management procedures developed under sub. (5).

NR 526.19(3)(c)(c) Reducing the use of disposable items when it is practical to do so, by implementing the procedures for evaluating alternatives to disposables developed under sub. (6).