Policy: Environmentally Preferred Purchasing I. PURPOSE

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1 [Healthcare System] Site/Location: Systemwide Policy Number: Policy Title: Environmentally Preferred Purchasing Originated by: Supply Chain Management Approved by: Vice President, Supply Chain Management Policy: Environmentally Preferred Purchasing I. PURPOSE Protection of the earth s environment is essential for healthy communities. [Healthcare System] is committed to avoiding harms to human and environmental health, and to improving environmental quality by enhancing policies, programs, and practices for all of its business activities. Toward this end, [Healthcare System] has identified environmental stewardship as one of the tenets of its definition of corporate citizenship. The purpose of environmental stewardship is to minimize waste, prevent pollution, conserve natural resources, reduce costs, and model environmental protection practices within the health care industry. We will seek to purchase of environmentally preferable products whenever they perform satisfactorily and are available at a reasonably competitive price. Environmentally Preferred Purchasing (EPP) principles are intended to support purchasing decisions that evaluate products environmental impact (e.g., waste, toxicity), and to assure that purchased products and services are healthful, safe, and environmentally sound. The policy objectives are to: 1. Encourage waste prevention, recycling and use of recycled/recyclable materials through purchasing practices with vendors. 2. Identify environmentally preferable alternatives; 3. Generate less waste material by reviewing how supplies and equipment are purchased and delivered. II. DEFINITIONS Environmentally Preferred Purchasing is the purchase of products and services whose environmental impacts have been considered and found to be less damaging to the environment and human health when compared to competing products and services

2 DEHP (di-2-ethylhexyl phthalate) is a plasticizer (softener) used to increase the flexibility of polymers like polyvinyl chloride (PVC). DEHP is the plasticizer for most PVC medical devices such as IV bags and tubing. DEHP can leach out of the flexible PVC medical devices into the solution or medication it contains and subsequently into the patient. Animal studies indicate that DEHP is a potentially reproductive and development toxicant that potentially affects organismic development and reproductive systems. Green Buildings is the practice of creating healthier and more resource-efficient models of design, construction, renovation, operation, maintenance and demolition. Elements of green building include, but are not limited to, designing and operating buildings to use energy efficiently and to use renewable sources of energy, including solar and wind; use water efficiently; use building materials that, in comparison to competing brands, have a reduced negative effect on the environment throughout their life cycle (e.g. recycled content, low toxicity, energy efficiency, biodegradability, and/or durability); reducing the waste from construction, remodeling, and demolition; designing and operating buildings that are healthy for their occupants. Reference [Healthcare System] Sustainable Design Guidelines/Standards. Persistent bioaccumulative toxic compounds: Chemicals that do not break down readily in the environment and therefore persist in their toxic state for a long time. These compounds build up (accumulate) in living things and their build-up may case an adverse effect or effects in biological systems. Polyvinyl Chloride (PVC) is a chlorinated plastic polymer adapted for many different uses by adding fillers, stabilizers, lubricants, plasticizers (DEHP), pigments and flame retardant, depending upon the intended application. It is used in gloves, tubing, IV bags, medical trays etc. Dioxins are formed during the production and incineration of PVC products, which accumulate in the environment. Dioxins are developmental toxicants and animal studies indicate dioxins cause cancer in multiple organ systems. Recycling means the process of collecting, sorting, cleansing, treating and reconstituting materials that would otherwise become solid waste, and returning them to the economic mainstream in the form of raw material for new, reused, or reconstituted products. Take Back Provisions encompass the ability to return items for credit, reuse and disposal such as the return of mercury sphygmomanometers, fluorescent lights, shipping containers and packaging etc. Total Cost of Ownership consists of the costs, direct and indirect, incurred throughout the life cycle of an asset, including acquisition, deployment, operation, support and retirement.

3 III. PROCEDURE [Healthcare System] will use environmental criteria in its selection of suppliers, products and services. Vendors and/or manufacturers are encouraged, as a condition of doing business with [Healthcare System], to provide detailed information about how they have mitigated their organization s impact on the environment, and to consider value-added services that support [Healthcare System s] commitment to environmental protection. [Healthcare System] will incorporate the following environmental criteria for all purchasing/contracting decisions: A. Avoid Contracting and/or Purchasing Products Containing: 1. Persistent bioaccumulative toxic compounds as defined in the Supplier Environmental Disclosure form, addendum to this policy 2. Bisphenol-A 3. Carcinogens, mutagens and reproductive toxic chemicals as defined in the Supplier Environmental Disclosure form, addendum to this policy 4. Halogenated flame retardants 5. Mercury 6. Phthalates (e.g. plasticizer DEHP (di-2-ethylhexyl phthalate) 7. Polyvinyl chloride (PVC) B. General Utilization and Selection Strategy for Contracting Staff and Hospital Site/Department Purchases: 1. Preferring products that cause the least environmental harm during manufacturing, transport, use and disposal. 2. Partnering with suppliers who demonstrate a commitment to environmental quality through their business practices 3. Collaborating with distributors, manufacturers, and suppliers in designing/refining products to minimize environmental impact while maintaining quality and cost effectiveness in the following areas: Packaging reduction Purchasing recycled products with high post-consumer content, recyclable, and reusable products Conserving energy and water use in the manufacturing process Enhancing awareness among staff, members, and the public about resource conservation, and the linkage to public health

4 ADDENDUM SUPPLIER'S ENVIRONMENTAL AND SOCIAL ISSUES DISCLOSURES A. Mercury Reduction. [Healthcare System] is committed to minimizing the amount of mercury used in operations and desires to avoid the acquisition of Products that contain mercury whenever feasible alternatives exist that do not compromise patient care. Supplier must provide information in relation to those Products that contain mercury. The Products do not contain mercury. The Products that contain mercury are identified in Exhibit A to this Agreement, which specifies the amount of mercury contained in each product that contains mercury and indicates if a feasible mercury-free alternative is available. Supplier must specify the alternative component that is replacing mercury. B. Polyvinyl Chloride Plastic Reduction. [Healthcare System] is committed to minimizing the amount of polyvinyl chloride plastic (PVC) used in their operation and desires to avoid the acquisition of Products that contain PVC whenever feasible alternatives exist that do not compromise patient care. Supplier must provide information in relation to those Products that contain PVC. The Products do not contain PVC. The Products that contain PVC are identified in Exhibit A to this Agreement, which specifies the amount of PVC in each product that contains PVC and indicates if a feasible PVC-free alternative is available. Supplier must specify the alternative component that is replacing PVC. C. Phthalate Reduction. [Healthcare System] is committed to minimizing the amount of phthalates, including di-ethylhexyl phthalate (DEHP), used in their operation and desires to avoid the acquisition of Products that contain phthalates whenever feasible alternatives exist that do not compromise patient care. Supplier must provide information in relation to those Products that contain phthalates. Chemicals considered phthalates include but are not limited to bis (2-ethylhexyl) phthalate (DEHP) (CAS ); dibutyl phthalate (DBP) ; benzyl butyl phthalate (BBP) (CAS ); di-isononyl phthalate (DINP) (CAS and ); di-isodecyl phthalate (DIDP) (CAS and ); dioctyl phthalate (DNOP) (CAS The Products do not contain phthalates The Products that contain phthalates are identified in Exhibit A to this Agreement, which specifies the chemical name of the phthalate and the amount of phthalates

5 contained in each product that contains phthalates and indicates if a feasible phthalate-free alternative is available. Supplier must specify the alternative component that is replacing DEHP. D. Halogenated Flame Retardants and other halogenated organic chemicals. [Healthcare System] is committed to minimizing the amount of halogenated organic chemicals (HOCs) used in their operation and desires to avoid the acquisition of Products that contain HOCs whenever feasible alternatives exist that do not compromise patient care. HOCs are defined as chemicals containing a carbon-halogen bond. Halogens include fluorine, chlorine, bromine, and iodine. Supplier must provide information in relation to those Products that contain HFRs and HOCs. The Products do not contain HOCs The Products that contain HOCs are identified in Exhibit A to this Agreement, which specifies the amount of HOCs contained in each product that contains HOCs and indicates if a feasible HOC-free alternative is available. Supplier must specify the alternative component that is replacing halogenated flame retardants and alternative HOC-free product choices. E. Persistent, Bioaccumulative and Toxic Compounds Reduction. [Healthcare System] is committed to minimizing the amount of persistent, accumulative and toxic compounds (PBTs) designated as an EPA Waste Minimization Priority Chemical at and the Great Lakes Binational Toxics Strategy- at used in their operation and desires to avoid the acquisition of Products that contain PBTs whenever feasible alternatives exist that do not compromise patient care. Supplier must provide information in relation to those Products that contain PBTs. The Products do not contain PBTs. The Products that contain PBTs are identified in Exhibit A to this Agreement, which specifies the amount of the PBTs contained in each product that contains PBTs and indicates if a feasible PBT-free alternative is available. Supplier must specify the alternative component that is replacing the PBTs. G. Renewable Materials. [Healthcare System] is committed to conserving natural resources and purchasing products made from renewable resources. Supplier will notify Health Care System if the product or packaging is made from renewable materials. If so, what percentage of the product and packaging contain renewable materials. Renewable materials are defined as those made from resources that are not depleted by human use, such as corn and soybeans. All Products use 100% renewable materials

6 The Products that contain renewable materials are identified in Exhibit A to this Agreement, which specifies the name and source of the renewable material, and the amount of the renewable material contained in each product. H. Hazardous Waste. [Healthcare System] is committed to reducing its generation of hazardous waste. Supplier will indicate any products which qualify as hazardous waste as delivered or which generally qualify as hazardous waste after use as defined by the Resource Conservation and Recovery Act (RCRA). No products qualify as RCRA hazardous waste as delivered or after use. The Products that qualify as RCRA hazardous waste as delivered or after use are indicated in Exhibit A to this Agreement. I. Comprehensive Screening. [Healthcare System] is committed to using products where all ingredients have been fully evaluated for toxicity and environmental impact. Can supplier deliver to [Healthcare System] an estimate of the percentage of the chemical components of your product and packaging for which basic toxicity testing has been done? Basic toxicity testing is defined as sufficient to qualify under the Organization for Economic Cooperation and Development (OECD) s Screening Information Dataset (SIDS) for High Volume Production (HPV) Chemicals. Information on what tests are needed is referenced in the Manual for Investigation of HPV Chemicals Chapter 2: SIDS, The SIDS Plan and the SIDS Dossier found at Yes, percentage of chemical components and packaging for which basic toxicity testing has been done is: % No, at this time the supplier cannot deliver an estimate of the percentage of the chemical components of your product and packaging for which basic toxicity testing has been done. J. Packaging: [Healthcare System] is committed to reducing packaging waste. Supplier must indicate in Exhibit B the percentage of packaging that contains recycled content, is recyclable, and is compostable for each product. K. End of Life: [Healthcare System] is committed to reducing its costs and liability related to product disposal and to reducing its contribution to solid waste. Supplier must indicate in Exhibit B whether the product is recyclable, compostable, or has a manufacturer- or supplier-operated take-back program. L. Recycled Content: [Healthcare System] is committed to supporting markets for recycled content products. Supplier must indicate on Exhibit B what percentage of the product contains post-consumer recycled content.