SAN FRANCISCO (KRON) — Three Bay Area district attorneys and Attorney General Rob Bonta announced a settlement with Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals to resolve allegations that the healthcare provider unlawfully tossed hazardous waste, medical waste, and confidential health information into dumpsters.

The $49-million settlement is the result of undercover inspections conducted by Alameda, San Francisco, and San Mateo district attorneys’ offices focused on dumpsters located at Kaiser facilities. 

During the undercover inspections, district attorney investigators dug into unsecured dumpsters destined for disposal at publicly accessible landfills. They found hundreds of items of hazardous and medical waste — syringes, medical tubing with body fluids, aerosols, sanitizers, batteries, electronic wastes, and pharmaceuticals — and over 10,000 paper records containing the information of over 7,700 patients, according to Bonta’s office.

“As the largest healthcare provider in the state, Kaiser has an extraordinary responsibility to the public and to its own patients to ensure that hazardous waste, potentially infectious human waste materials, and highly sensitive patient health information are handled according to state laws and not sent to municipal landfills not equipped to handle those wastes,” said San Mateo County District Attorney Stephen Wagstaffe. 

The California Department of Justice subsequently joined the district attorneys and expanded the investigation statewide. 

Kaiser is headquartered in Oakland and operates over 700 facilities, making it the largest healthcare provider in California. Kaiser provides healthcare to approximately 8.8 million Californians.

“As a major corporation in Alameda County, Kaiser Permanente has a special obligation to treat its communities with the same bedside manner as its patients,” said Alameda County District Attorney Pamela Price. “Dumping medical waste and private information are wrong, which they have acknowledged. This action will hold them accountable in such a way that we hope means it doesn’t happen again.”

Kaiser hired a third-party consultant and conducted over 1,100 trash audits at its facilities in an effort to improve compliance, according to Bonta’s office. Kaiser also modified its operating procedures to improve its handling, storage, and disposal of waste.

Kaiser Permanente wrote in a statement to KRON4 Friday, “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.”

Kaiser Permanente’s statement continued, “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. 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.”

Kaiser’s unlawful disposals allegedly violated California’s Hazardous Waste Control Law, Medical Waste Management Act, and Confidentiality of Medical Information Act, as well as the federal Health Insurance Portability and Accountability Act, known as HIPAA.

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 Permanente said it is also taking additional steps, including:

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.
3. Training, which every employee and physician in California is required to participate in annually, on proper waste disposal processes.