Educational Webinar: Ensuring Proper Compliance for Healthcare Practices

Good afternoon. Thank you for joining us today. My name is Brandon Martin here at mckesson Medical Surgical and I'm so excited to welcome you to today's presentation, ensuring proper compliance for health care practices featuring medro disposal. Before we get started, I'd like to direct your attention to our disclaimer while you are reviewing that information. I will remind you that today's presentation is being recorded and within a day or two, you can expect to receive a link to download a copy of the presentation. You can also download the slides by following the link under presentation materials to the left of your screen. If you have a question, feel free to enter it into the Q and A panel at the bottom left corner of your webinar window at any time and we will do our best to answer it at the end of the presentation. Our speaker today is John Cus. John is an enterprise account executive with med pro disposal and has seen the company go through massive growth over the past 11 years. He is a proven leader with a track record in developing and executing strategy that drives growth. John is skilled at building relationships with customers and passionate about helping businesses succeed. John. Thank you so much for being here today. I'm gonna go ahead and bring it over to you. Yes, Brandon, thank you for that introduction. Um Yes. Uh My name is John Cuss. Uh I am a national account executive here at Med Pro Disposal and have been with the company now 11 years and going. So as Brandon had mentioned, uh I have uh seen a lot of massive growth in our industry, which has also allowed me a unique opportunity uh to really have uh a very broad base of knowledge across compliance and different topics uh in our industry. Um So looking forward to presenting this to everybody today. Thank you again, everybody for taking some time out of your day uh to do this here with us. And with that, we'll go ahead and get started, but first a few housekeeping items that we want to ensure. So one if you will save all your questions for the end, um we will go ahead and read those aloud and, and answer those for you. And then lastly, if you do have specific questions that may require us to chat offline, we can certainly do that as well. So with that being said, uh we will go ahead and we'll jump in um to a quick over overview about what we'll be discussing today. Uh So, first of all, uh Med Pro, we are a Health Care Solutions focused company. We, we, so we focus on a few different aspects to help health care offices like yourself. Uh We'll be talking about trash. Uh So medical waste removal, whether it's biohazard waste, pharmaceutical waste or even hazardous waste as well. Uh What we found over the years in our industry is that, you know, close to 80% of the health care practices have been over paying for this service for various amounts of reasons. So, throughout the webinar, we'll also be uh trying to identify a few places for all of you to really focus in on, help reduce some of your overhead and your spend all, all in on these services. So how do we know these things? Well, we've been around for a long time but medical waste really didn't become something until the 19 eighties when the law was put in place. Um So there have been some changes over the years. Uh If you think about it from 1980 to today, roughly 40 years um is fairly new. So there have been some changes and updates along the way that we hope to bring you that information and help you make the best decisions for your organization. So first, we're gonna go through some of what the common waste streams are throughout the industry. First and foremost, we have sharps disposal. Uh So these are, you'll see here, sharps containers, um really anything inside your office, um whether they're glass slides to the actual syringes themselves should be placed in a sharps container. Uh Those sharps containers are then disposed of through a company like Med pro uh they're put into your biohazard container and the entire sharps container is disposable. Uh So those that entire container is then disposed of at our facility. Now, they come in various, you know, shapes and sizes, anything from a five quart or a wall mounted two gallon all the way up to an 18 gallon sharps container that may look, you know, similar to a kitchen garbage can, uh, doesn't matter the size. Uh, um, you know, those are still disposed of as biohazard packaging may be different. Um, but this is one of the areas where, you know, we may be able to help you reduce your cost and in maximizing the amount of space uh, inside of your biohazard box. So all Sharps except those that still contain medications in them, um, can be placed in these containers. Uh, if there are still remnants of a drug of any kind specifically, you know, maybe a chemotherapy drug that cannot go into a regular Red Sharps container that will need to be, um, first of all identified what type of medication is remaining in the drug and how much is remaining in that syringe. And then we would help you, uh, identify what that is. Is it hazardous? Is it controlled, is it noncontrolled and then place in their appropriate container from there. So, as we talked about, you know, some other common waste streams in health care. Uh, we get asked a lot. So, what is biohazard waste? What is it exactly? So, the definition that the EPA typically goes with is anything soaked or dripping. Uh, they would call it saturated in blood or bodily fluid. So, um, you know, should you squeeze it and it's saturated and something would leak out. It would be biohazard waste 100%. However, um, think about yourself at home, if you have a band aid with some dried blood on it, technically, that wouldn't be considered biohazard waste. It could be disposed of in the regular trash. Now, that being said, I would say that 95 plus percent of all of our customers and clients that we've spoken to and dealt with would certainly put that in the biohazard bin. Um, even if it was dried or, or just had remnants of it, uh, even though it's not technically classified as biohazard waste, that, um, that safety precaution per se would go directly. They would prefer to put you put that in your biohazard service. So you have the service in place. Um, it's always easier to err on the side of caution versus, uh, taking that risk and putting it in the regular trash. Now, that being said there are, you have identified several customers over the years that were putting items in the biohazard container that were not biohazard. So two common examples I could think of is, you know, something as simple as table paper, um, or gloves, you know, you know, the, the nitro gloves that are used in an office typically get thrown into the biohazard bag. That service is not, that is actually not necessarily required. Uh, you could save some space in your biohazard bag, maybe have less pick ups if you identify exactly what is biohazard or what isn't, if you have specific questions about items that you're putting in your biohazard bin or maybe not putting in your biohazard bin that you think you should be. Um, certainly pop those down on the chat and those questions we can talk about them here, you know, more towards the end. So some other things that we find that end up in the biohazard waste stream or IV bags or, you know, tubing with the residual medic medication. This is certainly something we can dispose of. However, it needs to be disposed of a little bit differently. So, as we'll talk about later in this webinar, different types of waste are disposed of differently. So, take a, um, a cancer center, for example, that would be administering chemotherapy drugs to the patient. They would, uh, in some cases, either do that via syringe or through an IV drip. Now, once the medication has passed through, uh, they're empty, however, there's still remnants of that medication inside those IV bags and that tubing therefore, that would not be able to go into your regular biohazard waste stream that would need to get segregated and would be determined that that's trace chemotherapy. OK. So that's one, um the other things that we see a lot of our customers that reach out to us that have expired or unused medications. Now, based on what type of medications though those are, uh there are different ways that we can dispose of those for you and the EPA the FDA, um, also have some specific regulations around um certain categories of waste. So we will get into that. However, um, just know that, you know, here at med Pro, we certainly can handle anything from hazardous, controlled noncontrolled uh medications. Uh But overall, if these are going into your biohazard stream, uh, then you are just was improperly and likely putting the company at risk of some type of ocean violation. So we just talked about trace chemotherapy here in this picture here in the webinar. You'll see yellow containers. So this is always a good moment for us to, to discuss colors of containers and what, what do they actually mean and why? So red is the most common you've seen, right? Biohazard bags, sharps containers, mostly red. There are yellow containers as well that would signify trace amounts of hazardous waste. So two of the most common examples. Again, cancer centers to trace chemotherapy, but there's also compounding pharmacies that have very trace amounts. Uh whether it's on the gloves or on the gowns that they're using. Um that also get placed into this. The reason we asked this to be segregated is because this type of waste is incinerated versus autoclave. Um So that is the main reason that we ask for that to be separated. If you were using syringes that had trace amounts of hazardous drugs, we would ask you to have yellow sharps containers to help us identify that there's also yellow bags as well that look very similar to biohazard bags. So that is some of the the difference in color and and why you see that really just helps us identify and segregate the waste and ensure proper disposal for, for all parties involved. So again, um now we're talking about bulk hazardous waste. So we just talked about trace and, and the EPA actually has a definition. So if we have a customer that says, you know, we have these quote unquote empty vials or there's very little remaining. And we ask, well, how much the reason we ask is because the EPA is actually defined what quote unquote re empty means. And that's anything 3% or less remaining solution in the vial or syringe. Um anything more than 3% would be classified as hazardous waste. So as you'll see in this picture here, there are black containers, black containers like this, they range anywhere from two gallons up to 18 gallons are signified for hazardous drugs. Uh the epa uh highly, very closely regulates che bulk chemotherapy or hazardous waste. So there's uh significantly more paperwork involved in this disposal if you have these containers and, or you have these drugs and you're having them dispose of and you're not really sure, you know what type of uh manifests and disposal and waste formulary should be created and they have on file again, that is something our team could certainly help you with. Um, or answer any questions. Uh If you're unsure of what to do. So, hazardous waste, we talked about the bulk chemotherapy side of things and, and some of the, the more common drugs. However, we also service liquid chemical waste as well, which is also hazardous and there's a difference between small and large quantity generators. Every state has a little bit of a different guideline. I would say most states, probably 80% of the states in the country simply adopt the federal guidelines. But there are some states like California and Florida that are a little bit more strict around depending on the amount of hazardous waste you produce in a calendar month or an entire year. That would determine this, what you, you would qualify either as a small or large quantity generator, regardless you would need an EPA ID number to have that disposed of, that's typically registered through the state. Again, we can help with that if that is something you haven't done or need some guidance on. Now, some of the more common streams you'll see below. I won't read them all out, but we do get quite a bit of whether it's Xylene or Formalin and things like that from laboratories that need to be disposed of. We can certainly handle that. Uh We handle, you know, whether you have a bunch of small car boys that are filled with those liquids, anywhere up to a 55 gallon steel drum. Um and anywhere in between, we can certainly help you identify what it is, the solution that you have and ensure the proper disposal for it. So, as I mentioned earlier, right, where does it all go? How is it disposed of? And at the very beginning of this webinar, I mentioned, there may be some tips and tricks to help you reduce cost overall. So first what happens to your medical waste? 80% of the medical waste that the biohazard waste that you have today and all across the country is auto clad. So what happens is um the best way to describe it is the medical waste gets put into these large stainless steel carts, they're rolled into the autoclave itself and then at an extreme high heat and pressure, they are sterilized. So it is RN I so rendered non infectious is the actual term that the disposal facility would use. That waste is then shredded, compacted down and taken to a dedicated landfill. That is how that waste is disposed of. I mentioned earlier in the slide that some waste needs to be segregated because it is still incinerated. There are only a handful of operational incinerators for specific types of uh waste all across the country. Uh So your cost for that type of waste would naturally be a little bit more expensive than the autoclave. The autoclave is believe it or not the most environmentally friendly and green solution there is uh which is why it was about, I think right around 2007 or 2008 where the EPA had some very large sweeping changes that really shut down a lot of the incinerators all across the country now, just because of the types of waste that we have here, uh Some of it does still need to get incinerated so that that is still an option in most states. And then lastly, we do have chemical treatment available. This is predominantly used in our hazardous waste side. Uh So things like Xylene or over the year, um I would say in the last 18 months, post COVID, we have gotten more calls regarding bulk hand sanitizer disposal. So during COVID, uh that production was ramped up significantly and it's left a lot of organizations uh with all of the this additional hand sanitizer that is actually a chemical treatment process because hand sanitizer is so highly flammable that it needs to be treated in a completely different sentiment. So, waste classification um medical waste. Yeah, it can be, it can be expensive. Right. So there are things that you can do here and at your own facility to try to reduce your overhead and cost. Number one is make sure you're classifying it correctly. Right. You're not over using materials or over buying medications to where you're going to have, uh, an access where you need to get rid of. Also, as we talked about earlier ensuring that things that are actually biohazard go in the biohazard, but more importantly, things that are not, do not end up in there. Um We have posters and guides that we can provide our customers and or not, right? Even if you're with someone else and you wanna use our resources, we're more than happy to share that with you. Uh We have waste classification posters that you can put up. We have a dos and don't poster that we can provide, which is, you know, what does go in which bin and what does not so simply doing that and training your staff. And as you can see on the bottom, right, posting those guidelines near your bins. Um You may be surprised how much waste you can simply remove from going in that waste stream and maybe going into your regular trash. Therefore, you'd be filling up your biohazard box less, getting picked up less and overall producing less waste in that stream. Uh And, and really eliminating uh some cost there. So service frequency. This I would say is a big one in terms of how can you reduce your cost over the years? So, let's start here. Most of your facilities are likely on a set, pick up schedule. So your current vendor will come out whether it's once a week, once every two weeks, once a month, maybe you're a small office and they come once a quarter either way. Um What you wanna make sure is that you're maximizing your space. And here's what I mean by that, when your vendor comes out to pick up, what exactly are they picking up? So, mostly everywhere in the country, you're probably provided a large cardboard box lined with a red biohazard bag. If you're in the state like California, you're likely being provided a large plastic bin. When your vendor comes, how many of those bins or boxes are they actually picking up? Is it just one, if it is just one, do you have space to store too? So for example, if you were getting a weekly pick up of one box, it would be much more cost effective for us to come every two weeks and pick up two boxes. And furthermore even more cost effective to come once a month and pick up four boxes. So, uh whether it's Med Pro or Company ABC, all of our cost is really involved in getting to your facility. Once the truck leaves, we wanna make sure it comes back as full as possible. We wanna make sure that we're maximizing route efficiency, whether, like I said, whether it's us or any company really. So all of our cost is getting to your facility, the fuel, the driver, right. The labor, the insurance. Now, once we're there, there's a, a much more minimal increased cost in picking up additional boxes because we're already at your facility. So if you can store, waste a little bit longer and have a little bit more picked up at one time, you would be surprised how much money you can save. Now, that being said, there are a few states, like, like I had just mentioned, Florida and California where you may not be able to do that in Florida, you're required to have a pick up at least once a month. And in California, there are some regulations at state that you may even be required to have a pick up once a week depending on the pounds that you produce of biohazard in a given month. But those are some smart ways that you can simply do that. And then lastly, we're a national company. You may have locations that are positioned throughout the country or, you know, in multiple states. And instead of uh piecing that together or maybe working with a vendor who you had thought was maybe the only vendor that could perform that type of service across multiple states, uh we can help you save money in that aspect as well. So we just talked about service volume, right? How flexibility matters. Um One of the things um I would say here at the bottom is take a look at your invoice. So we are a flat fee company here at med pro disposal. The price you sign for on our agreement is the price that you get on the invoice, not a dollar or more. However, our industry is notorious for energy fees, fuel service charges or invoices that just don't seem clear. Uh I have customers all the time that say, you know, I'm looking at my invoice today and I don't understand, I seem to be signed up for this OSHA program, but we don't really use it and I can't really identify what I'm paying for medical waste or for my pharmaceutical waste or even for uh you know, this the ocean training platform. I don't understand. So take a close look at your invoices. If you see any of those things, it's also a red flag that you're likely being overcharged and there's probably uh a better option for you in the market. Uh But in terms of service volume, like I mentioned, um we we wanna make sure that we're picking you up at the right times to maximize your space. But also know that we're extremely flexible. So we have several customers that call us quite often whether they need to increase or decrease their service frequency. Um Hey John, for example, I know we wanted to go monthly and pick up 223 boxes at a time. Our patient volume has increased. Therefore, our waste has increased and we don't have the storage. Can we move to every two weeks? Absolutely. You can always move up or down in terms of your frequency of service with Medro very easily. It's something we do all the time. So just keep that in mind nothing's ever set in stone or, you know, you know, etched in concrete as they might say. But uh we certainly are flexible with that as well. So we mentioned overall how you can create efficiency. So high level, make sure that the waste is going into the proper bins and things that are supposed to go in those bins go in and the ones that do not do not and then frequency and volume. Are you really maximizing your efficiency there? Again, if you're unsure, feel free to reach out, we, we do something um that's called the cost savings analysis. We can always take a look and provide you that information. So how is waste regulated? We've talked about a few regulations, we've talked about, you know, the EPA, what do they enforce and how do they work? So the Department of Environmental Protection, every state follows a very specific guideline. However, like I said, most states do adopt the federal guidelines. Um The most important piece here is that every state does say that the title to the waste um is uh the customer is responsible from cradle to grave. So the generator of the waste is responsible from cradle to grave. So what I mean by that is if you are a biohazard producer or a hazardous waste producer, once you generate that waste inside your facility, you are, then the state makes you the the generator responsible of that waste all the way until it ends up completely disposed, whether that's uh in an autoclave, incinerated or chemical treatment all the way until your destruction manifest is given to you. You, the customer are responsible for that. Now, there are a few companies in our industry that actually help you by removing that liability. Medro is one of them. So what Medro will do is in our agreement, it clearly states that title to the waste transfers and vests to Medro upon pick up. So right there in your parking lot, you're absolved of that liability. Should something go wrong. So that is a protection that Med Pro provides all of its customers. I can mention, I think there's one or two other companies out there that also provide that they're very few and far between though the the amount of money needed to provide an insurance policy, uh to be able to put that in agreement is, is fairly large. Uh So there's only a few companies that do provide that Med Pro is one of them. So it's something to keep in mind, you know, as you're thinking a, am I being compliant, are we doing things? Right. Well, you know, everybody wants to ensure that that is the case and everybody operates in good faith. However, if your current vendor doesn't have that and something does go wrong, there is a high likelihood that you could be held liable for, for an instance that, um, you know, if there was a needle stick per se or a truck gets into an accident and waste bills who's responsible for that at the end of the day. Well, in the, according to the EPA would be the generator of the waste. So we mentioned a little here state by state regulations, storage limitations, um labeling and packaging. So I would say that the biggest thing to know is that Florida and California are the two strictest states in the country when it comes to the regulation of biohazard waste. There are states though. However, a few that I can name off the top of my head, South Carolina, the state of New York, um do have some other regulations as well. I think Pennsylvania has a minimum quarterly service. So there are a few other states that do have those types of regulations. Um If you have questions about your state uh in particular, or would like to know if you're following and doing the appropriate things. Again, reach out to us. We'd be more than happy to have that discussion. And provide you that information. So, staying compliant, we've talked about the biohazard side of things and the waste side of things. But obviously there is a whole other side of this conversation, which is your OSHA and Hi, a, uh, regulations. So, hi aa, as everybody knows here and is probably well aware that this is something that, um, unfortunately you hear a lot about and you only hear the bad news, right? You hear the the companies with the hipaa breaches and the violations and you see it on the news and you, you find out that you know, this company uh had their customers information stolen and millions of individuals were impacted. So the training around this specific to patient privacy is extremely high. So we help here at Med Pro, as I mentioned in the beginning of this webinar, we're a health care solutions focused company. We are more than just your medical waste company. We want to find every avenue we can to help you stay compliant. And one of them is around OSHA and Hipaa training. We have an online platform that will help remove all of this burden from you. We have a trained team that not only this isn't necessarily something where we sign, you know, you sign up for it and then we lob it over the fence to you per se. We have a team dedicated to make sure that not only are you using it properly but also staying up to date and making sure that everybody inside of your office that requires this type of service and requires this type of training is getting that training. Now, when it comes to who needs it, we would say everybody from the receptionist to the doctor, to the janitorial staff, right? If they're employed by your organization, why? Because that there is always a risk that should the receptionist go back into a room to drop something off for the doctor that they see some confidential files. So everybody should have that OSHA training and that Hipaa training. So staying protected, we were just talking about patient uh protected health information. So um as many people are moving to digital documents, which is great and uh is certainly reducing the amount of paper, waste. Paper is inevitable, printing things out charts typically that there is still paper in every office. Now, uh we do talk to some customers that say, well, I bought uh a shredder on Amazon for the office unless that shredder is up to hi a compliance standards which I would say if you're spending anything less than three or $400 on a shredder likely very likely is not the case. Uh that is not HIPAA compliant. It all comes with how the documents are cross shredded here at Med Pro. This is another service we do provide, we provide shredding services. Now, one of the great things about med pros document destruction for our customers is over 80% of all of our customers are provided on site shredding. So when our truck shows up to your facility, we, you know, we provide a large 36 inch console, a locked console. It's got a cardboard box on the inside. And then on the top of this, the console, there's that opening for you to put your paper in the cardboard box inside, collects that paper. Now, when a driver comes to your facility to empty that cardboard box, he's going to bring it down to the truck, that truck will actually shred those documents right there in your parking lot. So therefore you are at zero risk of any type of breach because those documents do not travel anywhere. They leave your office and they get shredded and you get printed that receipt right there in your parking lot. I would say that pretty much any other company that I've ever dealt with or spoken to 90% of them do off site shredding. So they're going to your location, then they're making 25 other stops and then it's going to the warehouse and that doesn't mean that those documents are being shredded that day, they're likely being off loaded, then put into a queue. And then, you know, hopefully in the next few days they get shredded, but there's no guarantee or timeline around when that will happen here at Med Pro. We don't take that lightly and we shred that right in your parking lot outside of some very rural areas, I would say um pretty much anywhere else in the country we provide on site shredding for your facilities. So OSHA training now, OSHA can be a very uh big word. Uh When I talk to people, I always tell them uh I am not the OSHA police. I am just here to help you understand what you've been doing and help you fill in the gaps. Uh We have a comprehensive online OS A and H A training platform, thousands of our customers use it and we get rave reviews around it. This platform does a lot more than just training, but let's start there first what we do. Uh We provide things like bloodborne pathogen training. Hi A training GHS hazard communication training. Uh and dot Training. So dot Training is a good one to just focus on real fast. Anybody that signs the manifest for destruction during a biohazard pick up is technically supposed to be dot Certified. That certification is basically a training that ensures the person signing the manifest understands how to properly package the waste. So those trainings and then there are even more. There's fire prevention, there's P pe training, there are tons of trainings on our course, but those are the four main ones, the bloodborne pathogen which is required annually for everybody in the office. Then hi, a training I believe is required every three years. However, OSHA recommends that it's done annually. Now, outside of those trainings, we provide uh several other services. Um The program includes a customized HC uh HCP compliance specialist. So, like I mentioned, uh we will make sure that you're using this and, and using it appropriately. It also helps you with all of your safety plans that are required for your office. So things like exposure control, emergency preparedness, hazard, communication, and fire prevention. Those are the four main plans that need to not only be created but also updated annually as well. So if you don't have those, don't worry, it's very simple to do. Uh our program essentially outlines the entire plan for you and provide it to you is a really just a fill in the blank questionnaire. So you go through the plan, fill in the blanks with the information that's specific to your organization. It also provides you your safety data sheets. So all your sds S um you know, some companies still have the, the binder where they print it out and they put it in there, which is great. But how often do you keeping up with that here? It's all online. So we have an online search feature for sds. I tell everybody just having access to our portal makes you compliant in this space because it's basically Google for sds. There's gonna be a little field, it's gonna say you could type in a manufacturer or a product click search and you'll get a list, get a list of all those products or of that manufactured that product that they have created. You click it and the ST Ss opens. It's so simple. And the best part is there's a little button that says click to save to my sds and the system creates a little folder for you. So you don't have to keep saving it. So outside of just the trainings, uh there, there is a lot more that is involved here. Um, we'll keep you up to date with any type of regula regulatory or compliance changes. If you wanted to make custom policies for your facility, you know, we can do that for you as well. Um, so it's very much us working with you to ensure you're compliant from top to bottom. So all of those trainings, you're gonna get a certification at the end of it, um, where you can reference that the trainings that need to be done on an annual basis. Uh, there is a dashboard on our annual, uh, on our portal. I'm sorry. And, um, it'll tell you exactly who has taken it when they've taken it and when they need to do it again. So you don't need to manage where, um, you know, we've had some people say, well, we do it once a year and someone comes into the office. Ok. That's probably great. But is it that convenient for you? 12, what do you do if there's turnover or you hire a new employee. How do you fill in those gaps? Right. So people tend to get trained at different times. This program is super simple. The employee simply gets a link in their email inbox that says that they've been assigned this training. They click the link, takes them right to their page and they complete the videos with a short little quiz at the end of each one is real simple. And then that certification saves automatically on your portal when they're complete. Don't have to print it out, don't have to keep it in a binder. Um You know, you don't have to keep something on file that says, hey, we had, you know, Sally come December 3rd and then this person got trained, you know, when we hired him in February that we take all the guests out of that for you. So it's um it really helps you not only get compliant but then stay compliant as your organization, you know, grows or, or continues to operate. So I appreciate everybody uh for attending this webinar here today. Um It looks like we've got about 20 minutes or so. So um if there were any questions down in the chat here, um we can go ahead and get that um get those going. Excellent. Thank you so much John. Uh uh we did just have a question come in. Um Does the training include a lesson plan? It does. Yes, it does include a lesson plan um for that as well. X one. Uh And I actually have a question um going back to some of the uh earlier slides there, I was gonna ask you about the um color codes for the various containers. Are those established by the EPA or is that like, is that a global sort of thing or is that um decided by individual states or organizations? No, that is determined by the EPA. Uh If, um, so that is a good question, Brandon. Uh Should you place something in the wrong bin? Uh The only bin that is trouble, should you play something wrong into, would be the black hazardous bin? Because as a customer or as a, as an organization, you are actually responsible at the end of the day for classifying the waste is not your current vendors responsibility uh to ensure that proper things are in the proper containers. It's up to the, the organization of the company itself and that individual, which is why that dot Training is so important. Um So if something gets put into a black bin that isn't hazardous, unfortunately, it's gonna be classified as hazardous. Uh So unless the customer wants to repackage it, which is certainly always an option, um, it's going to be half it's going to be disposed of in that manner. Uh We've had a few more questions come in. Um Let's see. Uh, someone asked about uh uh pricing. Uh How, how, how do we get pricing. Absolutely. Uh So I just reach out to myself, my emails here on the screen. Um So you can always reach out to me to get pricing. Now, in order for me to provide you pricing, all I would need to know is your, where your location is, right? Uh Geographically speaking. Um I pull up the route and then your volume and frequency. So how often are you getting serviced? And how many of those boxes are being picked up each time? Are you interested in taking advantage of our os a training program? Uh Phar uh Do you have any pharmaceutical disposal that you're in need of? And then lastly the shredding. So, you know, I can certainly walk through those types of, uh, services and what those prices are usually within about, you know, should you call me and we're, we're on a call within about five or 10 minutes. I can put together a quote. Um, unless there's some hazardous waste that takes a little bit longer, but 90% plus of the time, uh I can do it right on the phone or live uh, with anybody that's interested in getting some pricing. Excellent. Excellent. Um, let's see, just looking through the list here. Uh, here's one, gloves were discussed, it not being biohazard. What about gloves used to mix chemotherapy that did not have chemo spilled on them closed systems are used. Where would those be disposed? Good question. Uh those are typically still disposed of in the yellow containers or in the yellow bags. Those gloves being used to mix the chemotherapy medications, even if it wasn't spilled on, um, more from a safety precaution. If it was, if it wasn't that, if it was, you know, I, hey, I used these gloves to examine a patient. I, I put them on when I went in the room and it never really came into contact with any bodily fluids or, or, or blood, then that would be fine to go in the regular trash. But the uh typically any of the the gowns or the gloves when that individual is using them to mix those drugs are almost always put into the tra into the uh yellow bags for disposal. Excellent. And um I think that you may have already answered this one in the presentation, but just in case uh we had some late arrivals, uh specific rules on throwing syringes in the trash, uh says yes, they have had drugs in them. Uh So if the, so if the syringe still has medication in it there, depending on what it is, there's a few different ways to have it disposed of. Uh typically we find that this is true it for controlled substances. So we do have customers that have uh different types of systems. We have different types of systems as well. Uh There is uh a regulation that allows a customer or allows an organization to, uh, if there's a little bit of remnant of that drug left to waste it into gauze, then that gauze is placed in our bio hazard bin and the syringe that is placed into a red Sharps container. Now, if it's, uh, it's all gonna depend on the medication. So I don't wanna give one sweeping answer. That, that's the right answer for all the instances. Um, I would say, and, you know, if you have some real questions about what is left in the syringe and can it go into the sharps container, reach out to us directly? Um Let's have that conversation. I wanna make sure I'm giving you the right answer and um, if, uh because it's gonna depend on what type of the medication it is. Sure. Sure. And, um, and yes, I would invite any of our audiences had a couple of questions about specific medications, but just, you know, as time allows, I feel like it, it'd be best to just direct them to you offline, um, which would be happy to uh Yeah, excellent. Um And uh this is a good question you wanna ask, uh, how do we request posters for our facility mentioned for biohazard sharp, etcetera? Yeah, you should actually even be able to print those out on our website. If you go to Med Pro disposal.com, there's a resources tab and there's the do s and don't post I believe is on there as is the waste classification guide. If you have trouble finding it, simply reach out to myself. Um you know, and we'll, we can get those to you like fun. Um And then I just have one question. We've uh had some recent webinars about the uh updated us P 800 standards. Can you speak just a little bit about um about that uh with as, as it relates to waste disposal and uh and maybe how that has impacted your customer base. Just kind of some thoughts on, on that. Yeah, so that um that is actually some information that I would have our Director of operations answer. Um He is the one from a compliance standpoint that is way is much more well versed in that aspect than I would be. So, unfortunately, brand I, I, I'd love to give you a little bit more information, but I don't wanna speak out of turn there. Um So if you have something, yeah, if, if you have something specific or any of anybody does, um you know, if you reach out to myself, I would get Mark Wolf. He's our director of operations and we can get that answered. Excellent, excellent. Oh, and I do have just one other uh question regarding prices are the, are the prices separated for the waste pick up and the training on the invoices? Yes, they are. So we have the option to we, we prefer to separate those charges so that you can see them. We do have the ability to roll in that charge. So for example, if it was 100 and $50 a month for your medical waste removal and $50 a month for your training, uh we would certainly send you an invoice that detailed that medical waste removal. 100 and 50 it would show the service say, you know, monthly every other week, whatever that might be for 100 and $50. Then underneath, there'd be a separate line item for the OSHA training. Um, but we do have, uh, you know, the option to kind of bundle that in. If you prefer to have it bundled in, we can do that too, but we do break it out as well. Excellent. Well, as we near the end of the hour. Oh, actually, oh, I was just about to say we, we actually just have one more question coming in. Um, uh, what is, what is the rule on? Uh, yeah, uh, what is the rule on wasting meds into the sharps container? So I bel oh, go ahead, go ahead, go ahead. No, that's ok. So, um, it's going to depend again what type of medications you have. So, and, and that you're discussing. So I would, uh, I would highly suggest to reach out to us directly and to discuss that off line. There is no, you know, one sweeping rule that I could give you right now. That would say yes for Xy and Z you can do that. Um, it's really gonna depend on the medication. So, uh, I would, I would prefer to take that offline and, and let's talk about it and make sure, you know, you guys are doing it appropriately. And actually I just had one other question too. Um, the, uh, going back to the different containers and things and the ones that are, um, incinerated, uh, that I, I would imagine the container is incinerated as well. Is there, are there any that are, um, that are reusable or uh is so depending on the types of ways. And so, correct. So the um the entire container is incinerated. So, in um other than there are, so there's reusable tubs. So the reusable tubs are, I always say they like large for an analogy, they look like a large rubber made tote that you'd buy it. You know, Home Depot or your Christmas decorations in, for example, except it's red and it's got a biohazard sign, you know, they're 30 gallon bins. So in the state of California, you know, there's 28 38 43 gallon, there's bunch of different sizes. We have them, all those of themselves are reusable. So if there was incineration waste because the State of California requires everybody to have plastic bins versus the cardboard boxes. Then when that waste gets back to the facility, that was a segregated to the side for incineration, but that plastic bin doesn't get incinerated, it goes through a wash and sterilization process to be reused, the actual sharps containers themselves. Those are all disposable. Those would get incinerated. Those are not reused. Excellent. Excellent. Ok. Well, one more time as we near the end of the hour, I definitely want to thank you all for uh taking the time to join us today. Uh And John, thank you so much for your expertise and uh your presentation uh very uh informative and uh really enjoyed it. Yeah, I appreciate everybody taking some time if we did not get to your question or if you have additional questions, we certainly invite you to uh reach out to John. Uh you can expect in the next day or so. Uh some additional information uh including a recording of this presentation. Uh one more time. I'll let you uh review our disclaimer here and some contact information for mckesson and for a full list of our upcoming events. I invite you to visit us at M ms.mckesson.com/educational dash webinars. You can register for a future webinar share with your colleagues. Uh There are some on demand webinars uh from previous dates and you can also sign up to receive regular updates on our webinar schedule. John, thank you so much uh one more time for joining us today and sharing your time and expertise. Absolutely. It was a pleasure. Thank you for having me. Excellent. Well, have a great day, everyone. You too as well.