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Kaiser Permanente Case Study Alternatives Assessment Meeting December 2, 2004 Lynn Garske Environmental Stewardship Manager
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2 Overview Kaiser Permanente is the nation’s largest nonprofit health plan 8.2 million members30 medical centers431 medical office buildings $25 billion annual revenue 136,500 employees 12,300 physicians 9 states and Wash DC
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3 Environmental Stewardship at KP Environmental Stewardship Vision: We aspire to provide health care services in a manner that protects and enhances the environment and health of communities now and for future generations. Focus areas: Green Buildings, Environmentally Responsible Purchasing, Sustainable Operations
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4 Why Sustainability Alignment with corporate mission: improve the health of the communities we serve. Industry practices generate waste, pollution and consume natural resources Recognized link between building design and health outcomes Impact of building materials on indoor air quality and environmental health Planned growth 2004-2013: 25 new hospitals, replacements or significant additions 100 new medical office buildings (MOBs)
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5 Alternatives Assessments Medical Products: PVC/DEHP-free products for neonatal units; latex-free and PVC-free exam gloves; mercury-free measurement devices Safer chemicals: Replacing mercury-based fixatives; selecting greener cleaners; recyclable solvents Green Buildings: carpet hard surface/resilient flooring casework
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6 Evolution of Effort Clinical (with formal protocols) to non- clinical (we invented protocols) Initial work on building materials required consultants; today we’re able to conduct most of the activities internally Key component is objective, independent, transparent verification of vendor claims and test results
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7 Framework for Assessing Building Materials Sourcing Mfg Use Post-Use Sourcing (product content) free of PVC; free of PBTs and carcinogens; post consumer; security of supply Sustainable manufacturing waste; energy; water; TRI Use CHPS 1350; Green Seal; our own air sampling performance; aesthetics Post use recyclability; reuse; take back
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8 Overview – Casework Project Project context Results Details – limited LCA – 7 vendors Sourcing Manufacturing Use Post-Use
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9 Project Context Goal: To improve indoor air quality of the built environment by reducing harmful emissions. Scope: Particleboard (PB) and Medium-Density Fiberboard (MDF) that are the foundations of finishings and furnishings. Project: To identify alternative materials to traditional PB and MDF bound with urea formaldehyde binders using LCA criteria.
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10 Review Team Environmental Stewardship – Research, vendor contact Cabinet Shops – Performance testing, expertise Contracting – Pricing and acquisition NFS Green Buildings Liaison
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11 Early Research Results – PB/MDF Binders Urea Formaldehyde – traditional Lignin – not yet viable for desired applications Phenol Formaldehyde – not subject to Form. Reg. due to low emissions Polymeric diphenylmethane diisocyanate - pMDI – low exposure limits for raw product, no detectable emissions after curing Content Recovered/recycled wood Forest Certified Wood – recovered/not Wheat residuals Rice residuals – local plants don’t mfg. product Sugarcane bagasse – not in production Paper – Mfg. out of business
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12 Vendors Did not undergo LCA Enviroboard - rice, wrong product – thick board Weyerhauser – recovered wood, no response Temple-Inland, FSC – formaldehyde binder Acadiaboard Duracane, sugarcane bagasse – out of business CanFibre – AllGreen, recovered wood, unable to contact DuraGreen, sugarcane bagasse, out of business Underwent LCA Sonoco – paper/lignin, out of business Phenix Bioply – newspaper, pMDI SierraPine Medite – recovered wood, pMDI Collins Companies – FSC wood, urea form. Dow BioProducts Woodstalk – wheat, pMDI Rodman Industries Resincore – recovered wood, phenol formaldehyde Sorm, Inc. – wheat, pMDI
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13 Life Cycle Analysis - Sourcing PBT’s, carcinogens – binders, pesticides Rapidly renewable – wheat, rec. wood Security of supply – capacity available Packaging – minimal, strapping Transportation – rail, truck FSC, SCS certified – recovered wood/not Free of added formaldehyde - binder Sustainable agricultural practices - wheat
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14 LCA – Sustainable Manufacturing Waste minimization Water minimization Non-renewable energy minimization Reduced emissions during manufacturing Environmental data: US EPA - Toxics Release Inventory - http://www.epa.gov/triexplorer/ Scorecard - http://www.scorecard.org/ Environment Canada - http://www.ec.gc.ca/pdb/npri/npri_home_e.cfm Worker injury data
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15 LCA – Use: IAQ and Performance Indoor Air Quality California High Performance School (CHPS) 1350 emissions – whole unit testing – http://www.chps.net/ CHPS Carcinogen standards Green Seal http://www.greenseal.org /recommendations.htm Building Green Inc. http://www.buildinggreen. com/menus/subtopics.cfm ?TopicID=5 Performance Machinability Aesthetics Durability Strength Water resistance Maintenance/IAQ Cabinet Shop findings Wheat PB Recovered wood MDF Finishes
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16 LCA – Post Use Closed loop recyclable Readily down-cycled Supplier facilitates end of life disposition
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17 LCA – General Criteria Environmental Statement, Mission Facility locations Dimensions Quality assurance
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18 Resources – Fiberboard, Isocyanates Green Seal Choose Green Report http://www.greenseal.org/cgrs /CGR_PB&MDF.pdf ISOCYANATES by Eric LeBreton http://www.tc.gc.ca/canutec/e n/articles/documents/isocy.htm Isocyanates - Risk Assessment and Preventive measures, Nordic supervisory authorities, - Copenhagen 2000 http://www.arbeidstilsynet.no/ publikasjoner/rapporter/rappor t1eng.html OSHA info - http://www.osha.gov/SLTC/iso cyanates/ Preventing Asthma and Death from Diisocyanate Exposure NIOSH ALERT: 1996 DHHS (NIOSH) Publication No. 96-111 http://www.cdc.gov/niosh/ast hma.html report on particleboard/mdf http://www.fiberfutures.org/p ages/fiberlinks.html
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19 KP Decision on Casework Pursuing RFP on 3 most promising products all are free of added formaldehyde 2 wheat-based products 1 post industrial wood product all are less expensive than current product! For contracted casework, develop specs and pursue through our GPO Overall effort considered big win by the KP Green Building Committee
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