California

California AG announces $49M settlement with Kaiser over hazardous, medical waste

Attorney General Rob Bonta was joined by six DAs in massive probe of state's largest health care provider

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Kaiser has agreed to pay more than $49 million for alleged illegal dumping of hazardous and medical waste in unsecure dumpsters outside its hospitals, California Attorney General Rob Bonta announced Friday.

Bonta, in partnership with six district attorneys, announced the settlement, saying the health care provider unlawfully disposed of hazardous waste, medical waste and protected health information at Kaiser facilities statewide.

In addition to the money, Kaiser will be required to take significant steps to prevent future unlawful disposals, Bonta said.

"The illegal disposal of hazardous and medical waste puts the environment, workers and the public at risk," Bonta said. "It also violates numerous federal and state laws. As a health care provider, Kaiser should know that it has specific legal obligations to properly dispose of medical waste and safeguard patients’ medical information."

The settlement is the result of DA offices conducting undercover inspections of dumpsters at 16 Kaiser facilities, Bonta said. Those inspections revealed unsecured dumpsters that were headed to public landfills. They found hundreds of items, including aerosols, cleansers, sanitizers, batteries, electronic wastes, syringes, medical tubing with body fluids and pharmaceuticals, as well as more than 10,000 paper records containing the personal and medical data of over 7,700 patients.

Bonta's office subsequently expanded the Kaiser probe further across the state, and in response to the joint investigation, Kaiser hired a third-party consultant to conduct trash audits at its facilities. Kaiser also changed how it handled, stored and disposed of waste, Bonta said.

Kaiser released a statement Friday (full statement below), saying in part: "About six years ago we became aware of occasions when, contrary to our rigorous policies and procedures, some facilities’ landfill-bound dumpsters included items that should have been disposed of differently. Upon learning of this issue, we immediately completed an extensive auditing effort of the waste stream at our facilities and established mandatory and ongoing training to address the findings. All Kaiser Permanente staff and physicians in California take this required annual training.

"We take this matter extremely seriously and have taken full responsibility to acknowledge and, in cooperation with the California Attorney General and county district attorneys, correct our performance regarding landfill-bound trash where it may have fallen short of our standards."

Kaiser has agreed to pay more than $49 million for alleged illegal dumping of hazardous and medical waste in unsecure dumpsters outside its hospitals, California Attorney General Rob Bonta announced Friday.

Kaiser is headquartered in Oakland and operates over 700 facilities statewide, making it the largest health care provider in California.

The district attorneys of Alameda, San Bernardino, San Francisco, San Joaquin, San Mateo and Yolo counties joined Bonta in the settlement announcement.

"My office takes patient privacy and the protection of the environment very seriously," San Francisco DA Brooke Jenkins said. "Hazardous waste, medical waste, and confidential patient information must be disposed of properly. When it is not, we will not hesitate to take action. Protecting patient privacy and the environment is just as important as protecting public safety."

According to a news release, as part of the settlement, Kaiser:

  • Will pay $47.250 million. That amount includes $37,513,000 in civil penalties; $4,832,000 in attorneys’ fees and costs; and $4,905,000 for supplemental environmental projects, primarily environmental prosecutor training.
  • Must pay an additional $1.75 million in civil penalties if, within 5 years of the entry of the final judgment, Kaiser has not spent $3.5 million at its California facilities to implement enhanced environmental compliance measures to ensure compliance with relevant provisions of the law that are alleged to have been violated.
  • Must retain an independent third-party auditor — approved by the Attorney General’s Office and the district attorneys — who will: perform no less than 520 trash compactor audits at Kaiser’s California facilities to help ensure that regulated wastes (including items containing protected health information) are not unlawfully disposed of; and conduct at least 40 programmatic field audits each year, for a period of five years after entry of the final judgment, to evaluate Kaiser’s compliance with policies and procedures designed to ensure compliance with applicable laws related to hazardous waste, medical waste, and protected health information.

Kaiser's full statement:

"Kaiser Permanente is committed to the health and well-being of our members, patients, employees, physicians, and the communities we serve, which includes proper waste disposal and protecting the confidentiality of member and patient information. Millions of people receive care and support in our hundreds of medical facilities across California each year and we have well-established policies and procedures for disposing of the different kinds of resulting waste items.

"About six years ago we became aware of occasions when, contrary to our rigorous policies and procedures, some facilities’ landfill-bound dumpsters included items that should have been disposed of differently. Upon learning of this issue, we immediately completed an extensive auditing effort of the waste stream at our facilities and established mandatory and ongoing training to address the findings. All Kaiser Permanente staff and physicians in California take this required annual training. We also introduced specialized equipment, instructions, and receptacles placed closest to where waste is generated to ensure all types of waste are disposed of properly, and we introduced more environmentally friendly products to enhance our long-standing environmental compliance measures.

"We take this matter extremely seriously and have taken full responsibility to acknowledge and, in cooperation with the California Attorney General and county district attorneys, correct our performance regarding landfill-bound trash where it may have fallen short of our standards. We dedicated many hours to identifying and closing gaps to strengthen our regulated waste disposal program and are confident in our ability not only to meet the monitoring and reporting requirements of this settlement, but to comply with the numerous requirements that apply to the different kinds of waste that result from caring for millions of Californians.

"In order to address this issue, Kaiser Permanente developed a three-step approach that includes:

  1. Assessment of hospitals, medical office buildings, and other facilities to identify the types of waste generated and to provide the right receptacles so that it is as easy and convenient as possible for our staff and physicians to dispose of waste in the appropriate receptacles;
  2. Worksite rounding to observe disposal techniques and to provide just-in-time training to ensure compliance with proper practices; and
  3. Training, which every employee and physician in California is required to participate in annually, on proper waste disposal processes.

"We are not aware of any body part being found at any time during this investigation."

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