Framework environmental management plan

4.3Operational phase

4.3.1 Operating permits

All of the permits which the developer was required to obtain so as to be granted the urbanization permit will need to be kept up-to-date and any re-application made before the relevant permit expires.
All conditions upon which the permit was granted must be complied with.

4.3.2 Waste Issues

It is assumed that the majority of emergency departments, intensive care units, operating rooms, burn units, which are under the scope of the Health Sector Reform - Improving Health System Quality and Efficiency Project, will form part of a larger hospital. This means that the hospital will already have a plan for how to handle its waste, and the waste streams generated by the unit will quite simply be handled in accordance with this existing plan (MO no. 1126/2012).

However, if the unit under the scope of the project is a self-contained unit, not attached to a larger hospital, before the unit starts to operate, a plan on the management of all waste produced must be put in place.
Whether the waste plan already exists in the hospital or has been newly created for the renovated unit, in order to comply with EU environmental law, certain standards on waste management must be followed at all of the rehabilitated units.
Firstly, there are general standards applying to all waste as described in section 2.1.2 above (Waste Framework Directive and Hazardous Waste Directive). There are also standards pertaining to specific sorts of waste such as asbestos, PCBs/PCTs, packaging waste and waste electronic and electrical equipment, batteries and accumulators.
Finally, there are the extremely important standards on regulating how waste can be safely disposed of, particularly on the landfill of waste and on waste incineration. Generally speaking, waste from the units must be disposed of either in an incinerator or a landfill that is compliant with the Incineration of Waste Directive or Landfill Directive respectively.
An important category of waste generated by the units will be that of medical waste. There are two very important EU requirements concerning medical waste that must be followed, namely:

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  Hospital and other clinical waste which is infectious may not be landfilled;
  
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  Infectious clinical waste must not mixed with other categories of waste and must not be handled directly, it must be placed straight into the incinerating furnace.
  

In addition to the EU law requirements on medical waste, there are Romanian standards, in Ministerial Order no 1226/2012. These must also be followed at each of the renovated units. A summary of MO 1226/2012 is presented at section 2.4 and guidelines on how to handle medical waste are given in Annex 1, section 13.

4.3.3 Water Issues

There are two key issues regarding water which must be dealt with during the operation of the units.

Firstly, the drinking water which is provided to the operating units, intensive care units, ambulatory care units and emergency care units (or to the larger hospital to which these units are attached) must meet the quality requirements laid down in the Water for human consumption Directive (see section 2.1.3) and in the Romanian transposing legislation.
Secondly, all discharges of used water from the hospital must be collected and treated in accordance with the Urban Waste Water Treatment Directive (see section 2.1.3) and in the Romanian transposing legislation. Romanian legislation on the collection, treatment and discharge of waste waters is found in GD 188/2002, amended and supplemented by GD 352/2005. There is a specific mention in the Romanian legislation that discharges of waste water from sanitary establishments (e.g. hospitals) shall be subjected to prior treatment if it does not comply with the requirements of microbiological standards before it is discharged into the public sewage system.

5Monitoring

A crucial part in ensuring that this Environmental Management Plan is put into practice is the description of those persons who are responsible for “policing” it, and ensuring that it is in place. Section 5 describes how this EMP will be enforced – by the PMU and also by State environmental officials.

PMU
The PMU will disseminate this EMP to all contractors when they are appointed, as well as to the site supervisors. The PMU will ensure that all contracts with builders, designers, decorators and others involved in implementation of the renovation/rehabilitation aspects of the project will include requirements to respect this EMP and the legal provision concerning the environment.
In addition, the PMU will engage technical specialists who will ensure that all contractual obligations, including conformity with this EMP, are being fulfilled. The technical specialist will act as the representative of the beneficiary and will report to the beneficiary and to the investor, through the PMU.
This technical specialist and the PMU will, so far as within their responsibilities, co-ordinate their activities with the environmental authorities.
The PMU will ensure that the designers and developers of the individual projects will work closely with the relevant agencies to ensure compliance with all relevant legislation, procedures and requirements. The main agencies are the LEPAs, the Environment Guard and the County Public Health Directorates, and their roles and responsibilities are summarized below.
Local Environmental Protection Agencies (LEPAs)

In accordance with the Framework Regulation on the Organization of the Local Environmental Protection Agencies, adopted on the basis of the Governmental Decision 1000/2012 on the Reorganization of the National Environmental Protection Agency, the LEPAs have responsibilities in the fields of authorization and monitoring of the activities with environmental impact, such as:

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  issues agreements /authorizations for the activities with significant impact on the environment, based on the current legal provisions;
  
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  authorizes the projects and activities with environmental impact at local level;
  
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  monitors at local level the enforcement of the EIA legislation; and
  
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  monitors the implementation of the County Waste Management Plans.
  

The National Environmental Guard

The main responsibilities of the Environmental Guard are:

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  controls the activities with environmental impact and enforces the sanctions provided in the environmental legislation;
  
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  controls if the environmental legislation and the measures established by the compliance programs, as well as the legal procedures, are properly enforced;
  
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  controls the activities with major/significant impact on the environment, in order to prevent and eliminate the pollution risks;
  
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  where there is a breach of a law or regulation, enforces sanctions (administrative or fines) or collaborates with the judicial authorities (environmental crimes).
  

County Public Health Directorates

The County Public Health Directorates, among others, are in charge of the sanitary inspections of local level and with the sanitary authorization for the hospitals. In particular, they are responsible for supervision of the collection of medical and contaminated waste.