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E-M:/ Fwd: Legislative Update - 11-2-01

Enviro-Mich message from "Rita Jack" <rita.jack@prodigy.net>

Here's more information about the medical waste incineration bill.

-----Original Message-----
From: Senator Gary Peters [mailto:SenGPeters@senate.state.mi.us] 
Sent: Friday, November 02, 2001 4:23 PM
To: Andy Schor
Subject: Legislative Update - 11-2-01


November 2, 2001

- Medical Waste Incineration

- Budget Cuts / Rainy Day Fund

- Teachers Prescribing Ritalin

- Pain Management

This Week's Capitol Quote

"You can put lipstick on a pig all you want, but it's still no beauty

- Senate Minority Leader John Cherry, commenting that the bill being
considered by the Senate regarding payday lending does not go far enough
in protecting consumers from predatory practices.

The Senate Natural Resources and Environmental Affairs Committee this
week took testimony on SB 11, a bill that will create model state
regulations for Medical Waste Incinerators based on recommendations by
Health Care Without Harm.  The bill, sponsored by Senator Gary Peters
(D-Bloomfield) would also require the Department of Environmental
Quality to determine if there are better ways to dispose of medical
waste.  If alternatives to incineration are found, the Department would
stop issuing permits for medical waste incineration facilities.

The issue with incineration is that incinerators emit exhausts with
contaminants like dioxin which has been linked to cancer, birth defects,
asthma, and diabetes.  Many hospitals and incinerators are located in
residential areas, and are causing these health and environmental
problems in neighborhood communities.  Lead, mercury, particulate, and
acid gases are also linked to the emissions from medical waste
The bill arose as a result of the conditions at the state's last medical
waste incinerator in Hamtramck.  Citizens from the area and
environmental groups have claimed that it is emitting mercury and dioxin
into the air, and negatively affecting the population.  The incinerator
and its operators were also accused of not meeting requirements of
consent decrees and of misleading local residents who claimed they were
told it would emit no harmful substances.

In addition to this incinerator, testimony was given that many hospitals
have shut down their own incinerators.  Many communities have protested
the incineration of medical waste in their neighborhoods, and this has
led to many of the closures.  Claims were made that because Hamtramck is
a poorer community, it cannot afford to put public pressure on the
medical waste incinerator.  Some of the hospitals now send the waste to
Hamtramck, and some ship it out of state.  Others use alternative
methods to deal with the medical waste.  The main alternative to
incineration is autoclaving.  This is a process of steam sterilization,
and is safer for health and the environment.  Residue from autoclaving,
which is used by more than 1,000 facilities across the country, reduces
waste volume by 60 to 80%.  Another option is microwaving, which also
employs steam to disinfect waste and has been used by hospitals and
commercial facilities for years. Other options involve irradiative and
biological procedures.
The Department of Environmental Quality said state standards on medical
waste match federal standards, and exceed them regarding mercury.  They
said that since these standards were created, the state has gone from
150 medical waste incinerators to just the one corporate facility in
Hamtramck.   They also said that incineration is a valid method of
eliminating medical waste.

The committee will take up this bill for a vote if opposition is not
heard within ten days from the committee hearing.

 The Senate and House this week approved of a five percent cut to the
legislative and judicial budgets, as well as a transfer of up to $550
million from the Budget Stabilization Fund (Rainy Day Fund) by passing
SB 671.  The bill now goes to the Governor for his signature.

 There was concern that the measure may be unconstitutional because the
bill originally only amended the Management and Budget Act to keep the
state's K-12 school aid system in balance for 2001-02.  Because the
House changed this to create a negative appropriation, it was argued
that it is unconstitutional.  The constitution states that bills cannot
amend law by reference, and legislation cannot contain more than one
subject.  By adding the Legislature and Judiciary (which are not
controlled by the Management and Budget Act), the bill violated the
state constitution.  Others countered this by saying that the state has
enacted negative appropriations many times before.

 The bill transfers up to $350 million from the Budget Stabilization
Fund (BSF) to keep the state's school aid fund in balance during the
2001-02 fiscal year.   It also allows for a transfer of up to $200
million from the BSF to keep the 2000-01 budget (that ended September
30) in balance.  The part dealing with the Legislature and Judiciary
requires 5% cuts from both the Legislature and Judiciary budgets.
According to the Senate Fiscal Agency, the 5 percent cut in the
legislative budget means a reduction of $5.1 million.   Out of the
Judiciary, the cuts would mean a reduction of nearly $4.8 million.

 The House this week passed a series of bills dealing with teachers
prescribing Ritalin.  The main bill, HB 5085, would require school
districts to adopt and implement a policy prohibiting any school
employee or official from recommending the use of psychotropic drugs for
any child.  The measure allows teachers to discuss behavior problems
with parents and refer a child to appropriate education evaluators to
determine if the child has a learning disability or emotional
impairment.  The bill also allows teachers to recommend that a child be
evaluated by an appropriate health care provider, and refer parents to
appropriate health professionals affiliated with the school district.
HB 5083 creates a 15-member Psychotropic Drug Use Advisory Council
within the Department of Community Health (DCH). Membership of the
Council would include a regular teacher, and one of the members must be
a special education teacher.  HB 5086 would require DCH to consult with
appropriate professional organizations, and to develop and distribute to
each school district an informational pamphlet to describe psychotropic
drugs that are frequently prescribed to minors in Michigan.  In
addition, other bills in the package would prohibit parents from being
charged with neglect for refusing to put their children on Ritalin and
create a state Web page discussing the harmful side effects of the drug.

 Supporters of the main bill said that teachers are overzealously urging
that children take Ritalin because of suspected attention
deficit/hyperactivity disorder.  These supporters have also said that
health professionals should have the sole responsibility in diagnosing
the disorder and advising whether children should take Ritalin.   They
said that this legislation will set clear guidelines for teachers.  They
also said that this is only necessary for the few teachers who have
acted unscrupulously in recommending Ritalin.  Opponents said that the
HB 5085 is not necessary.  They said that children are not compaining
about this, and teachers and school administration are not hearing of
problems with Ritalin recommendations by teachers.

 HB 5085 passed the full House on an 88-16 vote.  The legislation now
goes to the Senate for consideration.

This week, the Senate unanimously passed Senate Bills 660, 661, 662,
664, 781 and 782.  SB. 781 and 782 change language in pain management
law from "terminally ill patients" to "patients with reduced life
expectancy due to advanced illness." SB 781 also directs the Department
of Community Health by July 1, 2002, to update the written summary
physicians must give to those dying regarding what rights they have. SB
782 says the update must inform patients that they can choose "adequate
and appropriate pain and symptom management as a basic and essential
element of medical treatment. The legislation also encourages doctors to
discuss new and advanced treatments with their patients.  SB 660 strips
reference to "intractable pain" in the Public Health Code, and requires
that members of the state's advisory committee on pain and symptom
management would have to have training in pain and symptom management.
SB 661 and SB 662 delete references to "intractable pain" in both the
enabling statute for Blue Cross/Blue Shield of Michigan and the
Insurance Code.  SB 664 adds language to the state's Patient Bill of
Rights saying patients or nursing home residents should be entitled to
adequate and appropriate pain and symptom management.

These bills were proposed to improve pain management and improve the
quality of life of extremely ill and terminally ill patients by
encouraging physicians to treat a patient's pain more aggressively.
Physicians have been barred from certain treatments because patients'
may not be "terminally ill".  The new language allows for more
flexibility in treatment.

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