S02_-_Exhibit_4___Medical_Center_and_VCC_History.pdf

Altoona

Regulated Medical Waste (RMW) Summary

• Altoona VA Medical Center (AVAMC) currently utilizes the VISN contract (VISN VA244-14-C-0179

– Expires March 31, 2019) contract for RMW (sharps and red bag) disposal.

• AVAMC staff collects and replaces the sharps containers throughout all facilities. The sharps containers are not reusable/re-used; they are disposed with the red bag waste.

• RMW (red bag & sharps waste) is collected, boxed and consolidated by VA staff awaiting vendor pick-up and disposal.

• Refer to remainder of document for Altoona’s RMW history

Regulated Medical Waste History

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? Yes

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? If yes, complete Table A and proceed to number 3. If no, proceed to number 3. Yes

TABLE A – Disposable Sharps Containers Purchased Sharps container size

Quantity purchased FY2015 Quantity purchased

FY2016

Quantity purchased

FY2017

Quantity purchased

FY2018

IMF# 21651 – 1

QUART (60 PER

CASE)

5 cases 8 cases 7 cases 6 cases

IMF# 21652—

5.4 QUART (12

PER CASE)

63 cases 68 cases 56 cases 70 cases

IMF# 21653—9

GALLON (8 PER

CASE)

34 cases 31 cases 32 cases 30 cases

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-up locations Location Street Address City State Zip VAMC Altoona 2907 Pleasant Valley Blvd Altoona PA 16602 State College CBOC 2581 Clyde Ave State College PA 16801

Johnstown CBOC 598 Galleria Drive Johnstown PA 15904 DuBois CBOC 5690 Shaffer Rd DuBois PA 15801

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History

Exhibit 4 – Medical Center and VCC History

Altoona

Pick-up location RMW (including sharps) weight in lbs. FY2015

RMW (including sharps) weight in lbs. FY2016

RMW

(including sharps) weight in lbs.

FY2017

RMW

(including sharps) weight in lbs.

FY2018

Frequency of pick-up (daily, weekly, etc.)

Altoona VAMC 20,615 18,379 15,587 17,288 Bi-weekly (every 2 weeks)

State College

CBOC

302 282 279 292 Monthly

Johnstown CBOC 353 386 387 375 Monthly DuBois CBOC 427 431 409 431 Monthly

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History Pick-up location Trace chemo weight

FY2015

Trace chemo weight

FY2016

Trace chemo weight

FY2017

Trace chemo weight in lbs. FY2018

Altoona VAMC N/A N/A N/A 535**

**Please note that Altoona VAMC implemented Chemotherapy in FY2018 and will have trace chemo moving forward.

8) Please provide a list to the best of your knowledge of VA, Federal, State, and Local directives, standards, ordinances, laws and regulations applicable to RMW.

PA Code, ARTICLE VII. HAZARDOUS WASTE MANAGEMENT, Chap. Sec. 260- 270a PA Code, Article IX, Residual Waste Management, Chapter 287-291, 293,295, 297-299 40 CFR 260-279, Protection of Environment DOT Rule 49 CFR 25 PA, Pennsylvania’s Protection of the Environment 067 PA Code, Chapter 403, Hazardous Material Transportation Covered Device Recycling Act #108 of 2010 Waste Transportation Safety Act, Act 90 of 2002

Butler

• Butler VA Medical Center (BVAMC) currently utilizes the VISN contract (VISN VA244-14-C-0179 – Expires March 31, 2019) contract for RMW (sharps and red bag) disposal.

• BVAMC staff collects and replaces the sharps containers throughout all facilities. The sharps containers are not reusable/reused; they are disposed with the red bag waste.

• RMW (red bag & sharps waste) is collected, boxed and consolidated by VA staff awaiting vendor pick-up and disposal.

• Refer to remainder of document for Butler’s RMW history

Regulated Medical Waste History

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? Yes.

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? Yes. If yes, complete Table A and proceed to number

3. If no, proceed to number 3.

TABLE A – Disposable Sharps Containers Purchased Sharps container size

Quantity purchased FY2015 Quantity purchased FY2016 Quantity purchased

FY2017

Quantity purchased

FY2018

1 quart 60 60 60 70 2 gallon 35 5gal 48 48 48 0

5.4 quart 420 19gal 100 100 100 72

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-up Locations Location Street Address City State Zip Butler VA 325 New Castle Road Butler PA 16001 Butler HCC 353 North Duffy Road Butler PA 16001

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History (add rows as required) Pick-up location RMW (including sharps) weight in lbs. FY2015

RMW (including sharps) weight in lbs. FY2016

RMW

(including sharps) weight in lbs.

FY2017

RMW

(including sharps) weight in lbs.

FY2018

Frequency of pick-up (daily, weekly, etc.)

Butler

Butler VA 8,477 8,507 9,711 1,276 Weekly Butler HCC N/A N/A N/A 8,695 Weekly

5) If you answered no to number 2, the conclusion is your facility deploys reusable sharps containers. Circle the below statement that describes your facility and then proceed to number

6. Not Applicable

a) VA staff collects and replaces reusable sharps containers throughout the facility and consolidates them at one location for pick-up by RMW Contractor.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location (add rows as required)

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

325 New Castle Road 1 quart 50 BG or AMD all 353 North Duffy Road 5 gallon 10

19 gallon 8

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

Not Applicable

Coatesville

• Coatesville currently utilizes two contracts for RMW disposal:

o VISN VA244-14-C-0179 – Expires March 31, 2019. Provides RMW (red bag) disposal for

Coatesville Main Facility o 36C24419P0217 – Expires March 31, 2019. Provides RMW (sharps) disposal for Main

Facility and two community clinics.

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout all facilities.

• Red bag and sharps waste is collected at the Coatesville VAMC every two weeks. Yellow waste is being added in FY2019.

• The two community clinics do not require red bag waste service.

• Refer to remainder of document for Coatesville’s RMW history

Regulated Medical Waste History

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW

(including sharps) disposal? Yes for RMW, but no for sharps . If not, record below the applicable contract number and expiration date currently in use.

RMW: 36C24419P0217

Sharps RMW: 36C24418P1505

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? If yes, complete Table A and proceed to number 3. If no, proceed to number 3. NO

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-Up Locations

Location Street Address City State Zip

Coatesville VAMC 1400 Black Horse Hill Road Coatesville PA 19320

Spring City 11 Independence Drive Spring City PA 19475

Delaware County 4883 West Chester Pike Newtown Square

PA 19073

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History

Pick-up location RMW (including sharps) weight

FY2015

RMW (including sharps) weight

FY2016

RMW (including sharps) weight

FY2017

Frequency of pick-up (daily, weekly, etc.)

Coatesville VAMC 4.29 tons 3.01 tons 3.09 tons Every 2 weeks

5) If you answered no to number 2, the conclusion is your facility deploys Reusable sharps containers. Circle the below statement that describes your facility and then proceed to number

6.

a) VA staff collects and replaces reusable sharps containers throughout the facility and consolidates them at one location for pick-up by RMW Contractor.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected

5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location: Total 205

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

Coatesville 4 gallon 100 Stericycle

Coatesville 2 gallon 45 Stericycle

Coatesville 8 gallon 15 Stericycle

Coatesville 17 gallon 10 Stericycle

Delaware County 4 gallon 13 Stericycle

Extra Mixture 12 Stericycle

Spring City 4 gallon 10 Stericycle

TABLE F — RMW History with Reusable Containers (with distribution)

Pick-up

Location

(Facility, CBOC, Satellite, etc.)

RMW

weight

(no sharps)

FY2015

RMW

weight

(no sharps)

FY2016

RMW

weight

(no sharps)

FY2017

RMW

weight

(no sharps)

FY2018

RMW

frequency of Pick-up

(daily, weekly, etc.)

Sharps weight

FY2015

Sharps weight

FY2016

Sharps weight

FY2017

Sharps weight

FY2018

Sharps frequency of Pick-up

(daily, weekly, etc.)

Coatesville 1.5 tons .72 tons .18 tons 96 LBS Bi-weekly 2.48 tons

2.12 tons

2.29 tons

6,242 LBS Bi-weekly

Delaware

County

N/A N/A N/A Estimated

20 LBS

As needed

(Once every 3 months)

Included in total above

Included in total above

Included in total above

Estimated

100 LBS

As needed

(Once every 3 months)

Spring City N/A N/A N/A Estimated

20 LBS

As needed

(Once every 3 months)

Included in total above

Included in total above

Included in total above

Estimated

100 LBS

As needed

(Once every 3 months)

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table

G.

**All three locations will begin collecting chemo waste with this contract.

TABLE G – Trace Chemo Waste History

Pick-up location Trace chemo weight

FY2015

Trace chemo weight

FY2016

Trace chemo weight

FY2017

None reported None reported None reported

8) Please provide a list to the best of your knowledge of VA, Federal, State, and Local directives, standards, ordinances, laws and regulations applicable to RMW.

PA Title 25, Chapter 284

Erie

• Erie currently utilizes two contracts for RMW disposal:

o VISN VA244-14-C-0179 – Expires March 31, 2019. Provides RMW (red bag) disposal for

Erie Main Facility o VA244-17-P-1053 –Expires March 31, 2019. Provides RMW (sharps) disposal for Main

Facility and four community clinics (one in Ohio and three in Pennsylvania).

McKean County CBOC Sharps removal service provided as part of the Lease.

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout all facilities.

• VA244-17-P-1053 indicates the number of re-usable sharps containers throughout all locations is: 236 two gallon, 20 seventeen gallon and 8 cart mount.

• Refer to remainder of document for Erie’s RMW history

Regulated Medical Waste History

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? NO. If not, record below the applicable contract number and expiration date currently in use.

RMW: VA244-14-C-0179

Sharps RMW: VA244-17-P-1053

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? If yes, complete Table A and proceed to number 3. If no, proceed to number 3. NO

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-Up Locations Location Street Address City State Zip

Erie VAMC 135 East 38th Street Erie PA 16504 Ashtabula County 2044 Lambros Lane Ashtabula OH 44004

Crawford County 16954 Conneaut Lake Road Meadville PA 16335 Venango County 464 Allegheny Boulevard Franklin PA 16323 Warren 3 Farm Colony Drive Warren PA 16365

5) If you answered no to number 2, the conclusion is your facility deploys reusable sharps containers. Circle the below statement that describes your facility and then proceed to number 6.

Erie

a) VA staff collects and replaces reusable sharps containers throughout the facility and consolidates them at one location for pick-up by RMW Contractor.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

Erie VAMC 17 gal, 3 gal, and 2 gal Varies Stericycle Ashtabula CBOC 8 gal, and 2 gal Varies Stericycle Crawford CBOC 8 gal and 2 gal Varies Stericycle Warren CBOC 8 gal and 2 gal Varies Stericycle Venango CBOC 8 gal and 2 gal Varies Stericycle

TABLE F – RMW History with Reusable Containers (with distribution) Pick-up Location (Facility, CBOC, Satellite, etc.)

RMW

weight (no sharps)

FY2015

RMW

weight (no sharps)

FY2016

RMW

weight (no sharps)

FY2017

RMW

weight (no sharps)

FY2018

RMW

frequency of Pick-up (daily, weekly, etc.)

Sharps weight

FY2015

Sharps weight

FY2016

Sharps weight

FY2017

Sharps weight

FY2018

Sharps frequency of Pick-up (daily, weekly, etc.)

Erie

VAMC

810 lbs 389 lbs 657 lbs 590 lbs Weekly 5,049 lbs

4,986 lbs

5,120 lbs

4,926 lbs

Weekly

Ashtabula

CBOC

N/A N/A N/A N/A N/A 98 lbs 110 lbs 108 lbs 472 lbs Monthly

Crawford

CBOC

N/A N/A N/A N/A N/A 153 lbs 139 lbs 145 lbs 300 lbs Monthly

Warren

CBOC

N/A N/A N/A N/A N/A 102 lbs 105 lbs 113 lbs 180 lbs Monthly

Venango

CBOC

N/A N/A N/A N/A N/A 34 lbs 39 lbs 35 lbs 42 lbs Monthly

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History Pick-up location

Trace chemo weight FY2016

Trace chemo weight FY2017

Trace chemo weight FY2018

Erie VAMC 8,842 lbs 8,970 lbs 16,178 lbs

Lebanon

Regulated Medical Waste (RMW) Summary:

• Lebanon VA Medical Center (LVAMC) currently utilizes the VISN contract (VA244-14-C-0179 – Expires March 31, 2019) for RMW (sharps and red bag) disposal.

• LVAMC staff collects and replaces the sharps containers throughout all facilities. The sharps containers are not reusable/reused; they are disposed with the red bag waste.

• RMW (red bag & sharps waste) is collected, boxed and consolidated by VA staff awaiting vendor pick-up and disposal.

• Refer to remainder of document for Lebanon’s RMW history

Regulated Medical Waste History:

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? Yes.

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? Yes If yes, complete Table A and proceed to number 3.

If no, proceed to number 3.

Sharps Container Size Quantity

Purchased

FY2017

Quantity Purchased

FY2018

8 GL Pharmasafety 79 145

3 GL Pharmaceutical Funnel Top 2 6

19 GL Toxic Hazardous Waste 29 34

1 QT Sharp Container 111 176

5.4 QT Sharp Container 731 3397

2 GL Sharp Container 497 554

3 GL Chemo Sharp Container 41 44

9 GL Sharp Container 859 919

19 GL Sharp Container 126 129

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-Up Locations

Location Street Address City State Zip

Lebanon VAMC 1700 South Lincoln Ave Lebanon PA 17042

York Clinic 2251 Eastern Blvd. York PA 17402

Berks Clinic 2762 Century Blvd. Wyomissing PA 19610

Cumberland 5070 Ritter Road Mechanicsburg PA 17055

Lancaster Clinic 212 Willow Valley Lakes Drive Willow Street PA 17584

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History

Pick-up location RMW (including sharps) weight

FY2015

RMW (including sharps) weight

FY2016

RMW

(including sharps) weight

FY2017

RMW

(including sharps) weight

FY2018

Frequency of pick-up (daily, weekly, etc.)

Lebanon VAMC 227,906 lbs 219,137 lbs 221,726 lbs

218,749 lbs

Twice Weekly

Cumberland 3,378 lbs 2,940 lbs 2,953 lbs 2,895 lbs Monthly

Lancaster Clinic 1,785 lbs 1,781 lbs 1,797 lbs 1,740 lbs Monthly

York Clinic 2,684 lbs 2,725 lbs 2,448 lbs 517 lbs Monthly

Berks Clinic N/A 1,823 lbs 1718 lbs 377 lbs Monthly

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History

Pick-up location

Trace chemo weight FY2015

Trace chemo weight FY2016

Trace chemo weight FY2017

Trace chemo weight FY2018

Lebanon

VAMC

Not Tracked Separately

Not Tracked Separately

Not Tracked Separately

7,380 lbs

8) Please provide a list to the best of your knowledge of VA, Federal, State, and Local directives, standards, ordinances, laws and regulations applicable to RMW.

It is not federally managed:

https://www.epa.gov/rcra/medical-waste

So, we follow state laws:

http://www.dep.pa.gov/Business/Land/Waste/SolidWaste/MunicipalWaste/Regulated-Medical- Chemotherapeutic-Waste/Pages/default.aspx

There is an OSHA chapter on blood borne pathogens – but this is about preventing employee exposure, not too much about the actual waste end of things.

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

Exhibit 4 – Medical Center and VCC History https://www.epa.gov/rcra/medical-waste http://www.dep.pa.gov/Business/Land/Waste/SolidWaste/MunicipalWaste/Regulated-Medical-Chemotherapeutic-Waste/Pages/default.aspx http://www.dep.pa.gov/Business/Land/Waste/SolidWaste/MunicipalWaste/Regulated-Medical-Chemotherapeutic-Waste/Pages/default.aspx https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

Philadelphia

• Philadelphia currently utilizes two contracts for RMW disposal.

o VISN VA244-14-C-0179 – Expires March 31, 2019. Provides RMW (red bag) disposal for all facilities.

o VA244-16-D-0413 – Expires March 31, 2019. Provides RMW (sharps) disposal for all facilities.

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout all facilities.

• Refer to remainder of document for Philadelphia’s RMW history

Regulated Medical Waste History:

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? Yes. If not, record below the applicable contract number and expiration date currently in use.

RMW: VA244-14-C-0179

Sharps RMW: VA244-16-D-0413

2) Does your facility currently deploy disposable (not recycled) sharps containers and combine them with non-sharps RMW for pick-up? YES**. If yes, complete Table A and proceed to number 3. If no, proceed to number 3.

TABLE A – Disposable Sharps Containers Purchased Sharps container size

Quantity purchased FY2015 Quantity purchased FY2016 Quantity purchased FY2017

19 gal N/A 350 50 **For use in Lab only

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-Up Locations Location Street Address City State Zip Philadelphia VA 3900 Woodland Ave Philadelphia PA 19104 Horsham CBOC 433 Caredean Drive Horsham PA 19044

Gloucester CBOC 211 County House Road Sewell NJ 80802 Philadelphia VA Nursing Home

3461 Civic Center Blvd. Philadelphia PA 19104

Camden CBOC 300 S Broadway Camden NJ 81031 Philadelphia Dialysis Center

4219 Chestnut Street Philadelphia PA 19104

West Philadelphia Clinic

6332 Market Street, Suite 100 Philadelphia PA 19139

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History Pick-up location RMW (including sharps) weight in

LBS FY2016

RMW (including sharps) weight in

LBS FY2017

RMW (including sharps) weight in

LBS FY2018

Frequency of pick-up (daily, weekly, etc.)

Philadelphia VA 87,984 138,565 118,789 1x weekly Horsham 479 426 340 1x monthly Gloucester 796 526 414 1x monthly Camden 192 173 140 1x monthly Philadelphia VA Nursing (CLC)

126 173 432 1x weekly

Philadelphia Dialysis

12,791 12,598 11,600 1x weekly

West Philadelphia Clinic

N/A N/A N/A – Pickup starting in 2019 – Estimated 400 LBS

1x weekly

5) If you answered no to number 2, the conclusion is your facility deploys reusable sharps containers. Circle the below statement that describes your facility and then proceed to number 6.

a) VA staff collects and replaces recycled sharps containers throughout the facility and consolidates them at one location for pick-up by RMW Contractor.

b) The RMW Contractor collects and replaces recycled sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps Container Size Number in Use

Brand of Sharps Container Utilized

Philadelphia VAMC 4gl 677 Biosystems Philadelphia VS Nursing 4gl 160 Biosystems Snyder House 4gl 2 Biosystems Philadelphia Dialysis 4gl 8 Biosystems CMCVAMC- Laboratory 17gal 25 Snyder IND.

(Stericycle) CMCVAMC - Research 17gal 20 Snyder IND.

(Stericycle) CMCVAMC- OPERATING 17gal 10 Snyder IND

(Stericycle)

TABLE F – RMW History with Reusable Containers (with distribution) Pick-up Location (Facility, CBOC, Satellite, etc.)

RMW

weight (no sharps)

FY2016

RMW

weight (no sharps)

FY2017

RMW

weight (no sharps)

FY2018

RMW

frequency of Pick-up (daily, weekly, etc.)

Sharps weight

FY2016

Sharps weight

FY2017

Sharps weight

FY2018

Sharps frequency of Pick-up (daily, weekly, etc.)

Philadelphia

VA

87,984 138,565 118,789 1x Week 39,858 15,562 13,241 Weekly

Horsham 479 426 340 1x mth In number above

In number above

In number above

1x mth

Gloucester 796 526 414 1x mth In number above

In number above

In number above

1x mth

Camden 192 173 140 1x mth In number above

In number above

In number above

1x mth

Philadelphia VA Nursing

(CLC)

126 173 432 Weekly In number above

In number above

In number above

Weekly

Philadelphia Dialysis

12,791 12,598 11,600 Weekly In number above

In number above

In number above

Weekly

West Philadelphia Clinic

N/A N/A N/A – service to begin in 2019.

Estimated

400 LBS

Weekly N/A N/A N/A – service to begin in 2019.

Weekly

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History Pick-up location Trace chemo weight

FY2016

Trace chemo weight

FY2017

Trace chemo weight

FY2018

Philadelphia VA 16,319 9,550 9,366

8) Please provide a list to the best of your knowledge of VA, Federal, State, and Local directives, standards, ordinances, laws and regulations applicable to RMW.

Medical waste differs from hazardous waste. Hazardous waste is regulated by the US EPA (and related state rules) under the Resource Conservation and Recovery Act. Medical waste is not covered federal environmental laws or US EPA regulations (with the exception of a medical waste that also meets the definition of hazardous waste). Rather, medical waste is mostly controlled by state law and associated regulations. In addition to state environmental agency laws/rules, aspects of medical waste management are also controlled by the Occupational Safety & Health Administration (federal and/or state) and Department of Transportation (federal and state).

Each of our 50 states have developed rules and implemented regulations for medical waste. The state rules vary to some extent, including terminology. Depending on which state you live in, you may hear the terms regulated medical waste, biohazardous waste or infectious medical waste. In most cases, these terms all refer to the same thing: that portion of the medical waste stream that may be contaminated by blood, body fluids or other potentially infectious materials, thus posing a significant risk of transmitting infection.

Most states have regulations covering packaging, storage, and transportation of medical waste. Some states require health care facilities to register and/or obtain a permit. State rules may also cover the development of contingency plans, on-site treatment, training, waste tracking, recordkeeping, and reporting.

In most states, the environmental protection agency is primarily responsible for developing and enforcing regulations for medical waste management and disposal. Although in some states, the department of health may play an important role or even serve as the primary regulatory agency.

Where both agencies are involved, typically the department of health is responsible for on-site management and the environmental agency is responsible for transportation and disposal.

OSHA, whether it is the U.S. Department of Labor Occupational Safety & Health Administration or an OSHA state program (24 states operate their own program), regulates several aspects of medical waste, including management of sharps, requirements for containers that hold or store medical waste, labeling of medical waste bags/containers, and employee training. These standards are designed to protect healthcare workers from the risk of exposure to blood borne pathogens. However, they also help to systematically manage wastes, which benefit the public and environment.

Regulated medical waste is defined by the US Department of Transportation as a hazardous material.

DOT rules mostly apply to transporters rather than healthcare facilities; although, knowledge of these rules is important because of the liability associated with shipping waste off-site.

Definition of Regulated Medical Waste (RMW)

A solid waste is considered a RMW if it is capable of producing an infectious disease in humans or if it is not excluded under the regulations. RMW includes:

• Cultures and stock of microorganisms and biologicals;

• Human blood and human body fluids;

• Tissues and other anatomical wastes;

• Sharps. (Needles, syringes, etc.);

• Animal carcasses, body parts, bedding and related wastes that are known to be infected with human pathogens;

Exhibit 1 – Medical Center and VCC History http://www.hercenter.org/hazmat/hazdeterm.cfm

• Any residue or contaminated soil, water, or other debris resulting from the cleanup of a spill of any RMW; and

• Any solid waste contaminated by or mixed with RMW.

Managing Regulated Medical Waste (RMW)

Permit Requirements

If you treat, store, or dispose of RMW, you are required to have a permit for the management of RMW, unless exempt under the regulations.

Permit-by-Rule

Facilities that meet the following conditions may be qualified to operate under a permit for RMW management activities and their owners or operators are not required to comply with permit issuance procedures:

• The facility and all RMW activities are in compliance with all state and local requirements;

• More than 75% (by weight, in a calendar year) of all RMW that is stored, treated or disposed of by the facility is generated on-site;

• No RMW is transported from or received by the facility without being properly packaged and labeled. Facilities storing RMW will indicate the first date that the waste was placed in storage date on the outer packaging of the RMW;

• The activities at the facility do not involve the placing of RMW directly into or on the land;

• The owner or operator of the facility has notified the director in writing that the facility is operating under an on-site permit by rule;

• The owner or operator of the facility has submitted to the director a certification from the local governing body, without qualifications, conditions, or reservations, that the location and operation of the facility are consistent with all applicable ordinances;

• The owner or operator of the facility has submitted to the director appropriate Key Personnel Disclosure Statements; and

• A person certified by the Board of Waste Management Facility Operators will operate the facility.

Packaging and Labeling

Generators of RMW are responsible for the packaging and labeling of the wastes. Once a bag or container becomes full, it must be sealed, labeled and managed in accordance with the regulations.

Contractors or other agents may provide services to the generator, including packaging and labeling of RMW, if the packaging or repackaging is performed on-site where the RMW was generated and no transportation, storage, treatment or disposal occurs prior to the packaging or repackaging.

All RMW shall be packaged as follows:

• When RMWs are discarded, they shall be placed in containers that meet the requirements of the standards for occupational exposure to blood borne pathogens. The general industry standard requires the packaging to be closable, constructed to prevent leakage, labeled with the

Exhibit 1 – Medical Center and VCC History biohazard symbol, and closed to prevent spillage during handling. Upon being placed in storage, red bags shall be used for the packaging of all RMW. Packaging shall be labeled as required;

• Contaminated sharps shall be placed directly in containers as required by the general industry standards. The containers shall be labeled as required;

• As bags and containers become full, they shall be sealed such that no waste materials can leak;

• Prior to transporting RMW, waste will be packaged for transportation in accordance with the standards of 49 CFR Part 173 or packaged in accordance with an exemption approved by the United States Department of Transportation;

• Waste shall be labeled. The label shall be securely attached to or printed on packaging. The label may be a tag securely affixed to the package. Indelible ink shall be used to complete the information on the label. The label and the information provided on the label must be clearly legible. The following information shall be included:

o The name, address and business telephone number of the generator;

o "RMW" in large print; and o The Biological Hazard Symbol.

• All etiological agents that are transported must be packaged and labeled in accordance with federal and other applicable regulations;

• Sharps must be placed directly into puncture resistant containers as required by the general industry standards in 16VAC25-90-1910.1030(d)(4)(iii)(A); and

• Persons packaging RMW shall wear appropriate items of personal protective equipment

Reusable Containers

RMW may be conveyed in reusable carts or containers under the following conditions:

• The waste in the cart or container is packaged and labeled fully in accordance with state regulations;

• Immediately following each time a reusable cart or container is emptied and prior to being reused it is thoroughly cleaned with detergent or general purpose disinfectant; and

• When reusable carts or containers containing RMW are used for off-site transport, all aspects of the cart or container management shall comply with all applicable federal Department of Transportation Hazardous Material Regulations.

Spill Containment and Cleanup Kit

All RMW management facilities are required to keep a spill containment and cleanup kit within the vicinity of any area where RMW is managed. The kit location shall provide for rapid and efficient cleanup of spills anywhere within the area. All vehicles transporting RMWs are required to carry spill containment and clean up kit whenever RMWs are conveyed.

Containment and Cleanup Procedures

If there is a RMW spill, the following procedures shall be implemented:

• Take appropriate precautions to ensure personnel do not come into contact with any contaminants by wearing appropriate personal protective equipment;

• Repackage spilled waste in accordance with required packaging requirements;

• Transport any regulated medical waste by a registered transporter;

• Clean and disinfect any areas having been contacted by RMW.

• Materials used to decontaminate the area will be disinfectants effective against mycobacteria;

and

• Take necessary steps to replenish containment and cleanup kit.

Treatment and Disposal

• All regulated medical waste must be incinerated, sterilized by steam, or treated by a method as described in the RMW regulations.

• No RMW shall be disposed of in a solid waste landfill or other solid waste management facility.

Upon authorized treatment and management, the solid waste or its ash is not RMW and may be disposed of at any permitted landfill or other permitted solid waste management facility.

• Regulated medical waste in closed bags or containers shall not be compacted or subjected to violent mechanical stress; however, after it is fully treated and it is no longer regulated medical waste, it may be compacted in a closed container.

Closure Requirements

When a facility that has been used for RMW management is to cease operations involving regulated medical wastes, it shall be thoroughly cleaned and disinfected. All RMW shall be disposed of, and all equipment decontaminated.

Recordkeeping Requirements

Unless a generator is exempt from recordkeeping requirements, generators and RMW management facilities shall maintain the following accurate records for three years:

• A list of the members of any committee for the management of infection control for the facility, their address, their phone numbers and the period of their membership;

• The date, persons involved and short description of events in each spill of more than 32 gallons of regulated medical waste or one quart of regulated medical waste consisting of free liquid;

• A notebook or file containing the adopted policies and procedures of the facility for dealing with regulated medical wastes;

• A log of all special training received by persons involved in regulated medical waste management; and

• A log of regulated medical waste received from off-site, the generator, the amount and its storage and receipt dates. Records shall be maintained for a period of three years and be available for review.

All RMW management facilities shall maintain the following accurate records:

• A signed certificate for each load received in which the generator affirms that the load does not contain hazardous waste or radioactive materials; and

• Signed and effective contract, inclusive of all loads received from a generator, in which the generator affirms that all loads will not contain hazardous waste radioactive materials, except as provided under the regulations.

Transporting Regulated Medical Waste

• All transporters must be registered with the DEQ prior to transporting any RMW and been issued a registration number.

• RMW stored for more than seven days must be refrigerated and kept at an ambient temperature between 35 and 45 degrees Fahrenheit. A vehicle that is parked for more than 24 hours during transport will be considered a storage facility.

• A covered loading area is not required if RMW are in a container that is resistant to the elements

• Transporters must keep transport vehicles sanitized and decontaminated.

OSHA Regulations

In addition to the state medical waste environmental regulations there are some Occupational Safety and Health Administration (OSHA) rules that apply to medical/infectious waste. Virginia is one of 21 states operating an approved occupational safety and health program. This program is operated by the Virginia Department of Labor and Industry. OSHA rules (Occupational Exposure to Blood borne Pathogens Standards) impact various aspects of medical/infectious waste, including management of sharps, requirements for containers that hold or store medical/infectious waste, labeling of medical/infectious waste bags/containers, and employee training. These requirements can be found in the HERC section entitled OSHA Standards for Regulated Waste.

Exhibit 1 – Medical Center and VCC History http://www.envcap.org/rmw/osha-bps.cfm

Pittsburgh

• Pittsburgh currently utilizes two contracts for RMW disposal.

o VISN VA244-14-C-0179 – Expires March 31, 2019. Provides RMW (red bag) disposal for both facilities.

o 36C24418P0602 – Expires March 31, 2019. Provides RMW (sharps) disposal for both facilities.

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout all facilities.

• The community clinics do not require RMW service; it is provided with the lease.

• RMW and/or Sharps Pickups may be required at the Green Tree Annex upon the request of the

FCOR, but routine pickup is not required at this site.

• In near future a new facility will be added near current HJH Campus. Expected RMW generation to equal that of a CBOC.

• Pittsburgh incorporates re-usable red bag waste containers.

• Refer to remainder of document for Pittsburgh’s RMW history

Regulated Medical Waste History:

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? No, see below. If not, record below the applicable contract number and expiration date currently in use.

RMW: VA244-14-C-0179

Sharps RMW: 36C24418P0602

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? NO. If yes, complete Table A and proceed to number

3. If no, proceed to number 3.

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-up Locations

Location Street Address City State Zip

UD campus University Drive West Dock Pittsburgh PA 15240

HJH campus 1010 Delafield Road B50 Pittsburgh PA 15215

** RMW and/or Sharps Pickups may be required at the Green Tree Annex upon the request of the FCOR, but routine pickup is not required at this site.

* A new facility close to HJH campus will be generating waste in near future. It will require RMW service.

Note: CBOC’s RMW disposal is provided by lease

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History

Pick-up location RMW (including sharps) weight

FY2015

RMW (including sharps) weight

FY2016

RMW

(including sharps) weight

FY2017

RMW

(including sharps) weight

FY2018

Frequency of pick-up (daily, weekly, etc.)

UD/HJH-

Combined

283.77 Tons 280.58 Tons 247.46 Tons 270 Tons Weekly-1X HJH

2X p/week UD

5) If you answered no to number 2, the conclusion is your facility deploys Reusable sharps containers. Circle the below statement that describes your facility and then proceed to number 6.

Both A & B apply to VAPHS. For this report, the EMS staff collected bagged/containerized regulated medical waste from point of generation to processing room where the waste is boxed in re-usable RMW boxes. It is noted that EMS has eliminated the use of card board boxes limited to just emergency or when reusable containers have run out.

Sharps service is furnished by contractor. The relationship of the contractor can be defined as contractor employs a sub contractor to furnish the containers, transport and final processing. The contractor performs the day to day operations such as container replacement, containers full replaced with empty, installs of new containers, collection from point of generation.

a) VA staff collects and replaces reusable sharps containers throughout the facility and consolidates them at one location for pick-up by RMW Contractor.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

See below All sizes. See below See below Stericycle

SHARPS BOX SIZES TOTAL INVENTORY NUMBER

GENERAL LOCATION (CRASH CART, FLOOR or BLDG#)

SMALL MEDIUM LARGE XLARGE

CAPACITY

UD CAMPUS BASEMENT FLOOR 0 10 0 0

UD CAMPUS GROUND FLOOR 0 6 24 10

UD CAMPUS 1st FLOOR 48 102 31 16 UD CAMPUS 2nd FLOOR 4 21 65 43 UD CAMPUS 3rd FLOOR 0 83 8 2 UD CAMPUS 3rd Floor Operating Rooms 0 28 17 0 UD CAMPUS 3rd Floor Operating Rooms A-Carts 52 0 0 0 UD CAMPUS 4th FLOOR 12 38 0 0

UD CAMPUS CARDIO CATH OPERATING ROOMS 4 17 0 0

UD CAMPUS 5TH FLOOR 0 62 0 0

UD CAMPUS 6th FLOOR 0 51 0 0 UD CAMPUS 7th FLOOR 0 25 6 4 UD CAMPUS 8th FLOOR 0 30 0 0 UD CAMPUS 9th FLOOR 0 37 0 0 UD CAMPUS 10th FLOOR 13 31 0 0 UD CAMPUS 11th FLOOR 0 0 0 0

UD CRASH CART COUNT (SMALL S14) 69 0 0 0

UD BUILDING 29 GROUND FLOOR 0 0 0 0

UD BUILDING 29 1st FLOOR 0 0 23 2 UD BUILDING 29 2nd FLOOR 0 0 5 0 UD BUILDING 29 3RD, 4th & 5th FLOOR 6 12 0 0 HJH BUILDING 50 (all wards, clinics, exam rooms) 21 96 0 0 HJH BUILDING 50 Crash Carts 24 0 0 0 HJH BUILDING 51 (all wards, clinics, exam rooms) 10 140 6 2 HJH BUILDING 51 Crash Carts 36 0 0 0

HJH BUILDING 71 ( all clinics) 27 50 4 6

HJH BUILDING 70 (RESTROOMS) 8 0 0 0

HJH BUILDING 69 (EXAM ROOMS) 6 0 0 0

OTHER buildings 30, 49, Fisher House, etc 0 0 0 0 CBOCs ( small purchase requests) 0 0 0 0 GREEN TREE HEALTH ( Small purchase requests) 0 0 0 0 Renovations (HJH) ward needed 0 36 0 0

TOTAL ESTIMATED 340 875 189 85

TABLE F – RMW History with Reusable Containers (with distribution)

Pick-up Location (Facility, CBOC, Satellite, etc.)

RMW

weight (no sharps)

FY2015

RMW

weight (no sharps)

FY2016

RMW

weight (no sharps)

FY2017

RMW

weight (no sharps)

FY2018

RMW

frequency of Pick-up (daily, weekly, etc.)

Sharps weight

FY2015

Sharps weight

FY2016

Sharps weight

FY2017

Sharps weight

FY2018

Sharps frequency of Pick-up (daily, weekly, etc.)

UD/HJH 278.77

tons

276.64 tons

244.52 tons

UD:

396,808

LBS

HJH:

3,724

LBS

Weekly-

1X HJH

2X p/week

UD

5.0 tons

3.94 tons

2.94 tons

UD:

45,638

LBS

HJH:

4,142

LBS

Weekly-

1X HJH

2X p/week

UD

Note green tracker does not have line item for re-usable

RMW

boxes

Started using

RMW

re-usable boxes

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History

Pick-up Location Trace chemo Weight FY2017

Trace Chemo Weight FY2018

UD campus 1.14 tons 11,458 LBS

8) Please provide a list to the best of your knowledge of VA, Federal, State, and Local directives, standards, ordinances, laws and regulations applicable to RMW.

VHA Directive 1850.06

Wilkes Barre

• Wilkes Barre currently utilizes three contracts for RMW disposal.

o VA244-14-C-0179 – Expires March 31, 2019. Provides RMW and Trace Chemo disposal for Wilkes Barre VAMC** (See note below), Allentown Outpatient Clinic (AOPC), and Sayre CBOC.

o 36C24419P0251 – Expires March 31, 2019. Provides RMW (sharps) disposal for Wilkes Barre VAMC and the AOPC.

o VA244-14-C-0143 – Expires January 31, 2019. Provides Municipal Solid Waste (MSW) and RMW disposal for Wilkes Barre VAMC

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout the Wilkes Barre VAMC and AOPC.

• RMW (sharps and red bag) generated by the remaining clinics is managed by the landlord. The fees are incorporated into the applicable lease.

• **RMW (red bag waste) generated at the main facility is divided into two groups. The waste generated in surgery, the laboratory and trace chemotherapeutic waste is collected by VA staff and disposed using contract VA244-14-C-0179. The RMW generated in the examination rooms is collected by WBVAMC staff, autoclaved and combined with MSW disposed under contract

VA244-14-C-0143.

• Refer to remainder of document for Wilkes Barre’s RMW history

RMW History:

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? RMW only. If not, record below the applicable contract number and expiration date currently in use.

RMW: VA244-14-C-0179

Sharps RMW: VA244-14-C-0072

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? Yes If yes, complete Table A and proceed to number 3. If no, proceed to number 3.

TABLE A – Disposable Sharps Containers Purchased

Sharps container size

Quantity purchased FY2015 Quantity purchased FY2016 Quantity purchased

FY2017

Quantity purchased

FY2018

5 quart 90 90 90 120

3 gallon 30 30 30 0

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-up locations

Location Street Address City State Zip

Wilkes-Barre 1111 E End Blvd. Wilkes-Barre PA 18711

AOPC 3110 Hamilton Blvd. Allentown PA 18103

Sayre CBOC 1537 Elmira St. Sayre PA 18840

4) If you answered yes to number 2, complete Table C and proceed to number 7.

TABLE C – RMW History

Pick-up location RMW (including sharps) weight

FY2016

RMW

(including sharps) weight

FY2017

RMW

(including sharps) weight

FY2018

Frequency of pick-up (daily, weekly, etc.)

Wilkes-Barre 600 600 58,437 Weekly

5) If you answered no to number 2, the conclusion is your facility deploys Reusable sharps containers. Circle the below statement that describes your facility and then proceed to number 6.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

Wilkes-Barre 2-4-8-17 350 Stericycle

AOPC 2-4 57 Stericycle

TABLE F – RMW History with Reusable Containers

Pick-up Location (Facility, CBOC, Satellite, etc.)

RMW

weight

(LBS)

(no sharps)

FY2016

RMW

weight

(LBS)

(no sharps)

FY2017

RMW

weight

(LBS)

(no sharps)

FY2018

RMW

frequency of Pick-up (daily, weekly, etc.)

Sharps weight

(LBS)

FY2016

Sharps weight

(LBS)

FY2017

Sharps weight

(LBS)

FY2018

Sharps frequency of Pick-up (daily, weekly, etc.)

Wilkes- Barre

27,845 20,620 33,848 Weekly 25,540 26,185 24,589 Weekly

AOPC 912 1,436 457 Biweekly 608 584 (included in Wilkes- Barre

VAMC

Sharps Volume above)

Biweekly

Sayre

CBOC

392 382 363 Monthly N/A N/A N/A N/A

7) If you generated and tracked Trace Chemo Waste independently of other RMW, complete Table G.

TABLE G – Trace Chemo Waste History

Pick-up location Trace chemo weight

FY2016

Trace chemo weight

FY2017

Trace chemo weight

FY2018

Wilkes Barre VAMC 600 600 4,117

Wilmington

• Wilmington currently utilizes three contracts for RMW disposal.

o VISN VA244-14-C-0179 – Expires March 31, 2019. Provides RMW (red bag) disposal for

Wilmington VAMC o VA244-14-C-0449 –Expires September 30, 2019. Provides RMW (red bag) disposal for all

CBOC’s.

o VA244-14-C-0450 –Expires September 30, 2019. Provides RMW (sharps) disposal for all facilities.

• The Sharps disposal vendor provides the labor to collect full containers and replace with empty containers throughout all facilities.

• VA staff will replace full sharps containers with empty ones in the event the vendor misses some or if the container becomes full prior to next scheduled pick-up.

• RMW (red bag waste) is collected, boxed and consolidated by VA staff awaiting vendor pick-up and disposal.

• Sharps weight history is referred to as “tare weight”. The Sharps weight is weight of waste (net weight) not including the re-usable sharps container weight.

• Refer to remainder of document for Wilmington’s RMW history

RMW History:

1) Does your facility currently use the VISN contract VA244-14-C-0179 for its RMW (including sharps) disposal? Yes, red bag only for Wilmington VAMC. If not, record below the applicable contract number and expiration date currently in use.

RMW (Red Bag): VA244-14-C0449 - all CBOCs; VA244-14-C-0179 – Wilmington VAMC

RMW (Sharps): VA244-14-C-0450 covers Wilmington VAMC and all CBOCs

2) Does your facility currently deploy disposable (not reusable) sharps containers and combine them with non-sharps RMW for pick-up? If yes, complete Table A and proceed to number 3. If no, proceed to number 3. No

3) Which location(s) (CBOC, Satellite locations, etc.) does the RMW Contractor pick-up RMW -complete Table B.

TABLE B – RMW Pick-up locations

Location Street address City State Zip

Wilmington

VAMC*

1601 Kirkwood Hwy Wilmington DE 19805

CBOCs**

Kent County

CBOC

1198 S Governors Ave # 201 Dover DE 19904

Sussex County

CBOC

(“Georgetown”)

21748 Roth Ave Georgetown DE 19947

Cumberland County CBOC (“Vineland”)

79 West Landis Avenue Vineland NJ 08360

Atlantic County

CBOC

(“Northfield”)

1909 New Rd Northfield NJ 08225

Cape May County

CBOC

1 Monroe Avenue Cape May NJ 08203

* Main facility

**the main facility in Wilmington and all CBOCs are currently covered by two separate contracts with different option years; see responses to item 1 above.

5) If you answered no to number 2, the conclusion is your facility deploys reusable sharps containers. Circle the below statement that describes your facility and then proceed to number 6.

b) The RMW Contractor collects and replaces reusable sharps containers throughout the facility. Comment: Red bags are collected and boxed by the facility’s EMS crews for vendor to pick up and dispose.

6) If you selected 5(a) above, complete Table D and E and proceed to number 7. If you selected 5(b) above, complete Table E and F and proceed to number 7.

TABLE E – Reusable Sharps Containers In Use at Each Pick-up Location

Pick-up location (Facility, CBOC, Satellite, etc.)

Sharps container size Number in use

Brand of sharps container utilized

Wilmington VAMC (DE) Mixed- see container size above

428 Sharpsmart (Daniels)

Kent County CBOC (DE) S22 (4 gal) 14 Sharpsmart (Daniels)

Sussex County CBOC (DE) S22 and S32 (8 gal) 30 Sharpsmart (Daniels)

Cumberland County CBOC

(NJ)

S22 and S32 23 Sharpsmart (Daniels)

Atlantic County CBOC (NJ) S22 and S32 19 Sharpsmart (Daniels)

Cape May County CBOC (NJ) S22 8 Sharpsmart (Daniels)

*numbers can be subject to around 15% adjustment; vendor provides container holders (floor) and brackets (wall) as needed as part of contract with no additional charge.

TABLE F – RMW History with Reusable Containers (with distribution)

Pick-up Location (Facility, CBOC, Satellite, etc.)

RMW

weight (no sharps)

FY2015

RMW

weight (no sharps)

FY2016

RMW

weight (no sharps)

FY2017

RMW

weight (no sharps)

FY2018

RMW

frequency of Pick-up (daily, weekly, etc.)

Sharps weight

FY2015

Sharps weight

FY2016

Sharps weight

FY2017

Sharps weight

FY2018

Sharps frequency of Pick-up (daily, weekly, etc.)

Wilmington

VAMC (DE)

48,400 48,270 52,933 45,857 Weekly** 12,400 13,000 12,200 11,101 Weekly

Kent County

CBOC (DE)

0 0 40 233 Monthly 235 193 242 233 Monthly

Sussex County

CBOC (DE)

40 0 0 329 Monthly 187 149 272 329 Monthly

Cumberland County

CBOC (NJ)

0 0 0 137 Monthly 81 101 137 137…