1. HealthPartners Recycling Program
Friday, April 6, 2018

2. Who We Are Health Insurance Care
1.5 million members in Minnesota and surrounding states
Care
More than 1 million patients
Not-for-profit, consumer-governed, Integrated care and financing health care system
Based in the Twin Cities and Metro area in Minnesota, plan side of the business reaches into Iowa
A team of over 22,000 people
Health Plan services 1.4 million health and dental members
Provide care to more than 1 million patients at our 55 Medical Clinics, 22 Dental Clinics, and 7 hospitals
Additional notes:
1,700 physicians
HealthPartners Medical Group
Park Nicollet Health Services
Stillwater Medical Group
TRIA
55 medical and surgical specialties
55 primary care clinics
Dental Clinics - 600,000 dental patients and 70 dentists
Specialties: oral surgery, orthodontics, pediatric dentistry, periodontics, prosthodontics
Seven Hospitals
Regions: 454 bed Level 1 trauma
Methodist: 426 bed acute care hospital, featuring the Jane Brattain Breast Center
Lakeview: 97 bed acute care hospital, national leader in orthopaedic care
Hudson: 25 bed critical access hospital, award winning healing arts program
Westfields: 25 bed critical access hospital, regional cancer care center
Amery: 25 bed critical access hospital, including four clinics and an assisted living facility
St. Francis: 86 bed community hospital (partial owner)
55 Medical Clinics
22 Dental Clinics
8 Hospitals
34 Pharmacies
22,500 Employees
Research and Education Institute

3. Who we are: Head + Heart, Together
Mission To improve health and well-being in partnership with our members, patients and community.
Vision Health as it could be, affordability as it must be, through relationships built on trust.
Values
EXCELLENCE
We strive for the best results and always look for ways to improve.
COMPASSION
We care and show empathy and respect for each person.
PARTNERSHIP
We are strongest when we work together and with those we serve.
INTEGRITY
We are open and honest and we keep our commitments
We are a very mission driven organization.

4. New Waste Stations

5. New Decals

6. Recycling Recycling Umpire at 8170
In 2017, recycled 2,300 tons (37%) of materials at hospitals and larger facilities
Single-stream, comingled recycling program
Accepts all plastics, rigid or soft
Bottles, cans, glass, aluminum, cardboard
Blue Wrap
Shrink Wrap
Batteries
Salvaged Metals
Food waste, organics, and fryer oil
E-waste
Confidential Paper
X-rays
Ink Jet Toner Cartridges
In 2016, we at HealthPartners recycled 2,213 tons of materials at our larger facilities and six hospitals
Three of the hospitals in fact were recognized with the Top 25 Award this year
Hudson Hospital and Clinic, Hudson WI
Regions Hospital in St. Paul, MN
Park Nicollet Methodist Hospital, St. Louis Park, MN – also received a Top 10, Circle of Excellence Award under the waste category
2,213 tons of materials, puts us at an overall recycling rate of about 37%
Weight and recycling rate is in reference Practice Greenhealth’s definition of recycling includes all of the waste streams listed and more
Each bullet point represents a different collection system
Photo is of our recently update recycling decals
Place these on all recycling containers
Started enlarging this image and placing these on the walls of cafeterias above recycling containers
Recycling Umpire at 8170

7. Plastics Recycling
Single-stream, comingled recycling program through Republic Services
Accepts all plastics, rigid, soft
#1 PETE
#2 HDPE
#3 PVC
#4 LDPE
#5 PP
#6 PS
#7 Others
Packaging, grocery bags, Ziploc bags
Merrick Inc. recycles
Blue Wrap
Shrink wrap
Top Left: Single-stream, commingled recycling containers from Emergency Department. Top Right: Shrink wrap recycling container on receiving dock.
Today we are specifically talking about plastics recycling, which is one of the main types of waste that is generated at all of our healthcare facilities
Two vendors that service our plastics recycling programs
Our single-stream, co-mingled recycling program is through Republic Services
In addition to bottles, cans, cardboard, glass
Collect all plastics, rigid or soft, #1 - #7 in the same recycling container
Photo of the left, shows our standard recycling container, which is blue, overflowing with comingled recyclables
Recycle blue wrap at all 6 of our hospitals and one of our same day surgery centers
Most recently started collecting and recycling shrink wrap in the receiving area at Regions Hospital in St. Paul, MN picture on the right
These programs are through Merrick Inc.

8. Plastics Recycling: Pick-up and Removal
Right: Plastics and blue wrap collected in separate recycling containers. Containers are located inside the OR.
Left: Full containers are brought to centrally located utility room or soiled linen closet.
In order to collect as much material as possible, we have a standard blue recycling container that have been strategically placed throughout all of our facilities to capture that co-mingled recyclable material
Cafeterias, kitchens, breakrooms, copy rooms, staff lounges, nurses work stations, labs, supply areas, in some cases patient rooms
Inside/just outside operating rooms
Pre-op/post op areas
Recycling and waste containers in lobbies, waiting rooms, entrances, elevator bays
Our model is to centrally place in a high traffic area, with multiple employees collocated blue recycling and grey/tan trash containers
Every time someone goes to discard an item they have the option to either trash it or place it in the recycling
Also label recycling and trash containers with decals that we created in house. Contain photos of items that we specifically generate in our facilities. For example our trash decal has a photo of a plastic glove on it.
In relation to medical plastics, all of our surgery areas at our hospitals, same day surgery, and ambulatory centers have recycling containers either inside the operating/procedure rooms or right outside of the rooms
Photos: in the surgery departments, collect blue wrap separately from the comingled recyclables. Put labels right on the containers and sometimes on the wall above containers to clearly indicate which container is for which type of recyclable
One containers are full, OR staff bring them to a centrally located utility room or soiled linen closet located on the same floor
LH process:
Covered recycling container for plastics that stays in OR throughout the whole case; once it is full, OR staff bring to larger container in the hallway; once that is full OR staff bring to utility room; Houskeeping grabs bags to bring to recycling compactor
Blue wrap is removed from OR right after the kit is unwrapped and brought to a container in the hallway; once that is full OR staff bring to utility room; Housekeeping grabs bags and places them in staging location near dock; wait for Merrick to pick it up
Do recycling suction canisters; use a different type of fluid management system that requires the plastic, disposable canisters a couples times/week; OR staff brings canisters and instrument processing disinfects them and then they are recycled with the rest of the plastics.
MH process:
Plastics recycling containers in OR as well as another plastics container outside of the OR by the blue wrap organics recycling container (photo above). Plastics container stays in OR throughout the duration of the case, empty after each case. OR staff take plastics recycling containers and blue wrap to a storage closet by the waste management dock area
Plastics recycling containers in OR are not covered. Staff use judgment to determine if recyclable material has been contaminated or not. For isolation cases all plastics are taken out of the room to be recycled before the patient arrives or nothing is recycled
RH process:
The recycling containers for anesthesia are in the OR all the time.
Only clean materials from setting up, such as syringe covers, packaging etc. go in there. 
We do not empty after each case. 
Anesthesia aides empty when they are full or at end of day. 

9. Plastics Recycling: Pick-up and Removal
Materials are brought to the waste management area
Plastics in Republic Services Container/Compactor
Blue wrap in separate staging area
Partnership Resources, Inc (PRI) employees collecting recycling through out Methodist Hospital
Blue wrap staged for pick-up
Recycling is then taken to the waste management area where it is either placed into the Republic Services exterior dumpster or compactor
Or, in the case of Blue wrap, it is placed in a staging area for Merrick to pick-up
Photo on the right is from Hudson Hospital, blue wrap awaiting pick-up in the maintenance building
Typically this material is transported by housekeeping or environmental services staff
However, at Park Nicollet Methodist Hospital and the Park Nicollet Clinic campus we have a rock star recycling team from Partnership Resources, Inc or (PRI) - Photo
Provides day training and habilitation services and is currently serving approximately 235 adults with developmental disabilities with varying functioning levels. PRI believes that each person with developmental disabilities has unique talents and gifts to contribute to the community. In keeping with our mission, PRI works to provide appropriate opportunities for individuals with disabilities to play a respected and valued role in community life.
Link to their website to learn more
Additional cost to the hospital, but it is money well spent supporting 7 individuals that help us achieve our waste diversion and recycling goals at two of our major facilities within the HealthPartners family of care
Additional notes:
Additional cost; $30K for Methodist Hospital and a near by XX sq. foot clinic campus. Helps support 7 individuals. At MH Tuesdays and Thursdays; housekeeping services any recycling on the days PRI is not there if necessary.

10. Blue wrap and Shrink wrap bales at Merrick, Inc. facilities
Collects shrink and blue wrap from locations
Baled the materials separately
Shrink wrapped sold to Trex
Composite decking
Blue wrap sold to Poly Wrap Recycling, LLC or a vendor that makes plastic shelving
All materials stay in USA
Merrick, Inc. employees
Another great partner that plays an instrumental role in helping HealthPartners achieve our waste reduction and recycling goals is Merrick Inc.
Merrick Inc is a private, nonprofit 501(c)(3) corporation that offers a variety of meaningful work options and life enrichment activities to over 375 adults with intellectual or developmental disabilities at their energy efficient facility in Vadnais Heights or their newly renovated space in North St. Paul.
Merrick Inc is dedicated to empowering adults with disabilities through vocational and social opportunities and guiding them toward realizing their goals and dreams
Photo of one of their teams
One of many ways Merrick Inc supports their mission is by offering a blue wrap recycling service to the numerous health care facilities in the twin cities area.
They own and operate trucks that collect the materials from all six of our hospitals and other hospitals in the area for the past two, plus years
Bring them back to their facility in North St. Paul and unload it
Crew on the receiving end that sorts through all of the material and remove anything that isn’t acceptable, such as tape
It is then bailed into approximately 1200 pound bales – Photo
Store the bales until they have 30 or so to fill up a semi-truck trailer
The shrink wrap is shipped out to a company called “Trex” where it is then made into composting decking
The blue wrap is shipped out through a company called Ploy Wrap recycling
The middle man, but the end user will pelletize it and sell it on the open reuse market
Another vendor that blends the blue wrap pellets with other plastics pellets to make shelving
Regardless, all of the materials stay in the United States
Title bar is linked to their website to learn more

11. Republic Services Material Recovery Facility (MRF)
Two Material Recovery Facilities in the area
8% residual rate; lowest rate throughout the whole company
Optical Sorters:
#1 PETE
#2 HDPE
#5 PP
Hand sorting/Pick line:
#3 PVC
#4 LDPE
#6 PS
#7 Others
Soft plastics; packaging, grocery bags, Ziploc bags
Materials stay in USA
Second plastics recycling vendor is Republic Services
Two Material Recovery Facilities (MRFs) in the area
Minneapolis
Inver Grove Heights
The state of Minnesota requires recycling service providers to a 85% of the materials they collect allowing a 15% residual rate
Republic Services overall has on average a 10% residual rate or lower; well below the mandated 15% rate by the state
In fact, their Minneapolis MRF has an astonishing 8% residual rate which is the lowest in the whole company
When determining acceptance criteria and which items to recycle; Republic takes into consideration the following four things:
Volume: the total amount of a particular material that will come through the MRF
Capture Mechanism: does the MRF have the capability to separate that material out?
Long-term end market: Will there be a viable, ethical market available in the future?
Value: Is the material valuable and have a desirable ROI?
Highly mechanized process, very interesting if you haven’t been to a MRF I would recommend touring one
I was able to tour the Republic Services facility in Inver Grove Heights and I learn a lot about the industry
Specifically plastics get recycled depending on the type
Optical sorter which captures
#1 – PETE
#2 – HDPE
#5 – PP
The Plastic film gets capture and recycled in one of two ways
Some plastic film/soft plastics get capture by the air knives
Some plastic film/soft plastics are hand picked off of the conveyer belt
All materials stay in the United States and the end product, markets/uses include:
Composite decking; natural gas piping (#2 HDPE)
Carpeting (#1 PETE)
Plastic signage (#5 PP)
#6 paper grade – paper mill (soft plastics; air knives)
Grade C film plastic
Materials stay in the US

12. What is going well Relationship with Vendors/Partners
Blue Bags Project
Relationship with Vendors/Partners
Ongoing employee education
Well established donation program
Innovative uses for blue wrap in Western, WI
Park Nicollet Clinic Waste Sort Volunteers
As you can see from my previous slides, we have a sell established, working relationship with our recycling vendors
They provide us monthly reports indicated the total weight of material recycled or trashed
Respond to questions and requests in a timely manner
Open communication goes both ways
Ongoing employee education on recycling programs as well as our many other sustainability initiatives
9 Green teams and additional sustainability work groups; one of which is with representatives from our Communications Department
Meet monthly to get messages about our program communicated throughout the organization in a variety of different ways
Each of our Green Teams have at least one representative from the OR
Another work group is our Supply Chain; we meet quarterly and work on annual sustainability goals
Recycling and sustainability information in our New Employee Orientation
A multitude of resources and educational documents on our internal webpage that anyone can access, download, and use in whatever way works best in there department
Our department frequently visits all staff and department meetings to give updates
Complete waste sorts with our Green Teams and other volunteers to help education staff and what can/can’t be recycled
Just to name a few examples
Well established donation program
Donated 54 tons of unused medical supplies, medical equipment, and office furniture through our nonprofit partners
Innovative uses for blue wrap in Western, WI
Before Merrick Inc. was able to create a route to collect blue wrap from our Western, WI facilities we had quite the innovative reuse program
Partnered with local schools, churches, non-profits to find unique ways to reuse the materials.
Using blue wrap for table clothes at employee picnics/BBQs, community events, farmers market – Photo
This eventually developed into the Blue Bags Project in partnerships with the local high school, 2 local church sewing groups, a local printing company, and a local girl scout troop to make 1100 reusable tote bags
The bags were donated to Empty Bowls, a local annual charity event
During these event, the bags were sold and the proceeds benefited the Hungry Child’s Backpack Program
A program through the local food shelf that addresses food insecurity in the New Richmond Community by sending food in backpacks with children for their family
In all this our blue bags project raised $6,000
Learn more about this project and other community based sustainability projects at a CleanMed breakout session on Wednesday afternoon that our three Green team leaders from our three facilities there will be giving along with the a teacher from New Richmond High School

13. Issues Uncertain commodity markets Outlet for materials
PVC tubing
Issues
Smaller plastic items
Uncertain commodity markets
Outlet for materials
Local ordinances
Items with two or more types of materials
Smaller plastic items
Black plastics
Plastic nitrile gloves
Overwrap bags from supplies
While we have been greatly successful in the area of plastics recycling, there are some issues
Uncertain commodity markets; low crude oil prices, global competition
Outlet for materials
Local ordinances
City of St. Louis Park – Park Nicollet Methodist Hospital
Issues with recycling
Items made up of two or more different types of plastics
Items that are too small and will fall through the cracks/machinery at the recovery facility
Black plastic items – feedback we got from one of our haulers

14. Other Diverted Items Total: 4,600 Tons Organics: 227 Tons
C&D: 1,500 Tons
Donations: 50 Tons
Archive Destruction: 408 Tons
GOR: 172 Tons
Total: 4,600 Tons

15. The Bottomline! Total: $1.5 MM Tax on Trash Recycling: $79K
17-70%
None on R3 or Organics
Recycling: $79K
Grants: $42K
Solvent Stills: $80K
GOR: $1.1 MM
Total: $1.5 MM

16. Questions