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California Prosecutors Aggressively Pursue Compliance With Medical and Hazardous Waste Disposal Requirements

Health care facilities' compliance with medical and hazardous waste disposal laws comes under scrutiny in recent—and costly—investigations in California.

Prosecutors across California are taking interest in hospitals' and health systems' compliance with the state's complex regulatory landscape for the storage, transportation, and disposal of regulated waste. According to public reports, since 2023, California Attorney General Rob Bonta and district attorneys in at least 15 different counties have investigated allegations of improper disposal of hazardous and medical waste by hospitals, health systems, and other entities, resulting in lengthy investigations with the potential for costly settlements and expensive ongoing mitigation efforts.

Most notably, in September 2023, Kaiser reached a $49 million settlement with the State of California to resolve allegations that it unlawfully disposed of hazardous waste, medical waste, and protected health information at its facilities statewide. In addition to the stipulated fine, Kaiser also agreed to hire a third-party auditor to conduct hundreds of audits over a five-year period and to implement various ongoing compliance measures, including a local oversight officer and a compliance hotline, among others.

More recently, in December 2024, the Santa Clara District Attorney's Office announced findings from ongoing and recent investigations into the waste disposal practices of three county-owned hospitals and another privately owned facility, which similarly found evidence of improperly disposed medical and hazardous waste.

These investigations highlight the importance of compliance with applicable waste management laws for all generators of medical and hazardous waste in the state. California law imposes strict liability for violations, with civil penalties of up to $70,000 per disposal of hazardous waste and up to $10,000 per disposal of medical waste. Hospitals and health systems are not the only target of recent investigations; according to Attorney General Bonta, the California Department of Justice "will continue to hold any entity accountable" for violation of California's waste disposal laws.

Given this ongoing scrutiny, hospitals and other entities handling medical and hazardous waste may benefit from reevaluating and updating their policies, trainings, and communications for effective waste management to promote compliance with applicable California law.

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