On
June
24,
1998,
a
landmark
agreement
was
put
together
by
the
American
Hospital
Association
(
AHA)
and
the
United
States
Environmental
Protection
Agency
(
EPA).
The
Memorandum
of
Understanding
(
MOU)
set
new
goals
for
hospital
pollution
prevention
over
the
next
five
years,
and
brought
together
a
stakeholders
council
to
enforce
the
provisions
of
the
MOU.
Health
Care
Without
Harm
(
HCWH)
was
an
active
participant
in
the
preparation
of
the
agreement,
and
sat
on
the
AHA
Leadership
Council.

The
MOU
set
10
action
steps
for
the
council
to
focus
on
over
a
five­
year
period.
Two
of
the
top
priorities
are
the
virtual
elimination
of
mercury­
containing
waste
from
the
hospital
waste
stream
by
the
year
2005,
and
the
goal
of
achieving
a
thirty­
three
percent
(
33%)
reduction
in
total
waste
volume
in
all
hospitals
by
2005
and
an
overall
goal
of
achieving
a
fifty
percent
(
50%)
reduction
by
2010.

The
ten
points
of
the
plan
are
as
follows:

1.
Virtual
Elimination
of
Mercury
Waste.

2.
Total
Waste
Volume
Reduction.

3.
Seminars.

4.
Software
Distribution.

5.
Industry
P2
Information.

6.
Review
of
Industry
P2
Information.

7.
Chemical
Waste
Minimization.

8.
Ethylene
Oxide
and
PBT
Pollutant
Information.

9.
Industry
Input
on
U.
S.
EPA
Guidance.

10.
AHA
Environmental
Leadership
Council.

11.
Awards/
Recognition.

Hospitals
for
a
Healthy
Environment
(
H2E)
was
adopted
as
the
title
for
this
effort.
In
September
2001,
H2E
became
a
partnership
of
the
AHA,
EPA,
HCWH
and
the
American
Nurses
Association
(
ANA).
An
H2E
listserve
has
been
developed.
Join
the
H2E
listserv
to
share
and
learn
technical
information,
find
educational
tools
and
identify
practical
strategies
for
mercury
elimination
and
discuss
other
pollution
prevention
and
waste
minimization
issues.
For
information
on
how
to
become
an
active
participant
in
the
H2E
process,
see
their
website
at
www.
h2e­
online.
org.

The
Memorandum
1.0
INTRODUCTION.
This
Memorandum
of
Understanding
("
MOU")
is
made
between
the
United
States
Environmental
Protection
Agency
("
U.
S.
EPA")
Office
of
Prevention,
Pesticides
and
Toxic
substances
("
OPPT"),
U.
S.
EPA
Region
5
and
the
American
Hospital
Association
("
AHA").
Throughout
this
MOU,
any
reference
to
"
U.
S.
EPA"
shall
include
both
OPPT
and
Region
5
and
any
reference
to
"
AHA"
shall
refer
to
AHA
and
its
Personal
Membership
Groups
("
PMGs").
U.
S.
EPA
and
AHA
are
referred
to
herein
as
"
the
Parties"
to
this
MOU.

1.1
The
Parties
intend
by
this
MOU
to
establish
a
mutually
beneficial
public/
private
partnership.

1.2
This
MOU
will
address
the
basic
relationship,
roles
and
responsibilities
of
the
Parties
but
leaves
for
later
agreement
the
more
precise
terms
that
will
constitute
the
substance
of
the
partnership

2.0
PURPOSE.
The
AHA
consists
primarily
of
health
care
provider
organizations
across
the
United
States.
The
Parties
enter
into
this
MOU
for
the
primary
purpose
of
transferring
to
AHA
institutional
members,
PMG
personal
members
and
other
health
care
professionals
technical
information
on
Pollution
Prevention
("
P2")
opportunities
that
exist
with
respect
to
waste
generated
Memorandum
of
Understanding
between
the
American
Hospital
Association
&
the
U.
S.
Environmental
Protection
Agency
Pub
1­
03
This
publication
is
part
of
Going
Green:
A
Resource
Kit
for
Pollution
Prevention
in
Health
Care.

For
additional
copies
of
this
or
other
publications
included
in
the
kit,
or
to
find
out
how
to
get
a
complete
kit,
visit
Health
Care
Without
Harm
on
the
Web
at
www.
noharm.
org.

This
version:
October
15,
2001
by
the
health
care
industry.
The
Parties'
believe
that
this
information
transfer
will
provide
the
health
care
industry
with
enhanced
tools
for
minimizing
the
production
of
persistent,
bioaccumulative
and
toxic
("
PBT")
pollutants
and
reducing
the
volumes
of
waste
generated.
Such
reductions
are
beneficial
to
the
environment
and
will
reduce
the
waste
disposal
costs
incurred
by
the
health
care
industry.
The
Parties
to
this
MOU
hereby
affirm
the
Congressional
goals
and
principles
set
forth
in
the
Pollution
Prevention
Act
("
PPA"),
42
U.
S.
C.
13101
through
13109,
particularly
the
goal
of
reducing
the
generation
of
pollution
at
its
source,
preferentially
to
the
recycling,
treatment
and/
or
disposal
of
such
waste.

3.0
AUTHORITY.
Section
6604(
b)(
5)
of
the
PPA,
42
U.
S.
C.
13103(
b)(
5),
directs
U.
S.
EPA,
among
other
things,
to
facilitate
the
adoption
of
source
reduction
techniques
by
businesses,
including
the
distribution
of
source
reduction
information
to
businesses.

4.0
ROLES
AND
RESPONSIBILITIES
OF
THE
PARTIES.
The
Parties
intend
to
undertake
the
following
activities
pursuant
to
this
MOU:

1.
Virtual
Elimination
of
Mercury
Waste.
The
Parties
intend
to
work
together
to
develop
a
Mercury
Waste
Virtual
Elimination
Plan
that
will
set
forth
a
strategy
for
achieving
the
goal
of
virtually
eliminating
mercury­
containing
waste
from
the
health
care
industry
waste
stream
by
the
year
2005.

2.
Total
Waste
Volume
Reduction.
The
Parties
intend
to
work
together
to
develop
a
Model
Waste
Volume
Reduction
Plan
that
will
assist
in
reducing
the
total
volume
of
all
wastes
(
including
both
regulated
and
non­
regulated
waste)
generated
by
the
health
care
industry,
with
an
initial
goal
of
achieving
a
thirty­
three
percent
(
33%)
reduction
in
all
hospitals
by
2005
and
an
overall
goal
of
achieving
a
fifty
percent
(
50%)
reduction
by
2010.
3.
Seminars.
The
Parties
intend
to
cosponsor
a
series
of
Health
Care
Industry
Waste
Management
Seminars
("
Seminars")
to
be
held
at
various
locations
across
the
United
States.
The
Seminars
will
be
the
primary
vehicle
by
which
technical
information
on
P2
opportunities
will
be
transferred
to
the
health
care
professionals,
and
will
focus
upon
transferring
technical
information
related
to
decreasing
health
care
industry
waste
volume,
minimizing
the
production
of
PBT
pollutants,
improving
waste
stream
segregation,
reducing
waste
management
costs
and
ensuring
regulatory
compliance
for
regulated
waste
streams.

4.
Software
Distribution.
In
order
to
facilitate
the
successful
completion
of
the
Seminars
and
the
virtual
elimination
of
mercury­
containing
waste,
U.
S.
EPA
intends
to
provide
for
distribution
at
the
various
Seminars
up
to
300
copies
of
the
software
program
entitled
"
Mercury
In
Medical
Facilities"
that
has
been
developed
by
Purdue
University
with
assistance
from
the
Region
5
Software
Development
Unit
("
SDU").
Purdue
University
maintains
a
copyright
on
this
software
program,
but,
insofar
as
the
software
was
developed
with
Federal
Government
assistance
the
software
may
be
freely
copied
and
disseminated.
The
Parties
will
mutually
decide
how
the
up
to
300
total
software
copies
will
be
distributed
among
the
various
Seminars.

5.
Industry
P2
Information.
AHA
intends
to
develop
baseline
information
on
the
P2
activities
of
the
health
care
industry
and
to
monitor
P2
progress
over
time.
To
obtain
this
information,
AHA
will
develop,
with
review
and
comment
by
U.
S.
EPA,
an
information
questionnaire
to
be
distributed
to
health
care
professionals
by
AHA
at
various
times
in
the
future.
The
first
distribution
will
be
used
to
determine
the
baseline
P2
information
and
subsequent
distributions
will
be
used
to
monitor
industry
P2
progress.
AHA
will
gather
all
responses
to
the
questionnaires.
Insofar
as
U.
S.
EPA
will
not
be
sponsoring
the
distribution
of
the
questionnaire,
the
distribution
of
the
questionnaire
is
not
subject
to
the
requirements
of
the
Paperwork
Reduction
Act
("
PRA"),
44
U.
S.
C.
3501
through
3520.

6.
Review
of
Industry
P2
Information.
Throughout
the
duration
of
this
MOU,
the
Parties
intend
to
work
together
to
review
and
compile
the
information
obtained
from
the
baseline
and
progress
questionnaires
(
Item
#
5).
U.
S.
EPA
agrees
that,
unless
required
by
law,
the
identity
of
any
survey
participant
need
not
be
revealed
by
AHA
to
U.
S.
EPA.
From
this
information,
the
Parties
will
be
able
to
disseminate
more
effectively
P2
information
and
to
monitor
the
success
of
the
Mercury
Waste
Virtual
Elimination
Plan
(
Item
#
1)
and
the
Model
Waste
Volume
Reduction
Plan
(
Item
#
2).

7.
Chemical
Waste
Minimization.
The
Parties
intend
to
work
together
to
develop,
for
various
kinds
of
chemical
waste,
a
Model
Chemical
Waste
Minimization
Plan
("
Model
Plan").
The
first
Model
Plan
will
pertain
to
mercury­
containing
waste
("
Model
Plan
For
Mercury").
The
Model
Plan
For
Mercury
is
presently
being
developed
by
the
State
of
Illinois
with
assistance
from
U.
S.
EPA.
When
that
plan
is
completed,
U.
S.
EPA,
with
comments
from
AHA,
will
make
such
modifications
to
the
Model
Plan
For
Mercury
as
are
necessary
to
reflect
current
knowledge,
best
management
practices
and
any
other
circumstances
experienced
by
the
health
care
industry
Other
chemical
wastes
will
be
addressed
by
future
Model
Plans.
AHA
intends
to
disseminate
each
Model
Plan
to
as
wide
an
audience
in
the
health
care
industry
as
is
reasonably
possible.
Both
AHA
and
U.
S.
EPA
intend
to
make
each
Model
Plan
available
to
the
public
on
their
respective
Internet
home
pages.
Each
such
Internet
presentation
shall
properly
reflect
the
relative
contributions
of
the
Parties
and
any
third
party
(
such
as
the
State
of
Illinois
with
respect
to
the
Model
Plan
For
Mercury)
to
the
development
of
the
particular
Model
Plan.
8.
Ethylene
Oxide
and
PBT
Pollutant
Information.
The
Parties
intend
to
M
E
M
O
R
A
N
D
U
M
O
F
U
N
D
E
R
S
T
A
N
D
I
N
G
B
E
T
W
E
E
N
T
H
E
A
M
E
R
I
C
A
N
H
O
S
P
I
T
A
L
A
S
S
O
C
I
A
T
I
O
N
&
U
.
S
.
E
N
V
I
R
O
N
M
E
N
T
A
L
P
R
O
T
E
C
T
I
O
N
A
G
E
N
C
Y
2
work
together
to
investigate
P2
opportunities
with
respect
to
ethylene
oxide
and
PBT
pollutants.

9.
Industry
Input
on
U.
S.
EPA
Guidance.
To
the
extent
feasible
and
practical,
U.
S.
EPA
will
solicit
comments
by
AHA
and
the
AHA
Environmental
Leadership
Council
(
as
established
pursuant
to
this
MOU)
on
U.
S.
EPA's
policies
and
technical
guidance
specifically
affecting
the
health
care
industry's
waste
streams.
AHA's
comments
will
be
limited
to
the
practicality
and
feasibility
of
the
matters
set
forth
in
the
policies
and
technical
guidance
Such
input
shall
not
be
sought
with
respect
to
any
adjudication
or
any
rulemaking
that
is
subject
to
the
notice
and
comment
requirements
set
forth
in
the
Administrative
Procedure
Act
("
APA")
at
5
U.
S.
C.
553(
b).

10.
AHA
Environmental
Leadership
Council.
AHA
will
develop
an
AHA
Environmental
Leadership
Council
("
the
Council")
that
will
be
responsible
for
making
recommendations
to
the
AHA
on
educational
and
outreach
activities,
recommending
content
experts
to
participate
in
programs
and/
or
the
development
of
products
such
as
the
Model
Plans,
monitoring
progress
toward
established
environmental
goals,
selecting
the
award
recipients
for
national
recognition
programs,
and
assisting
in
the
publication
of
an
annual
report
documenting
the
hospital
industry's
progress
toward
P2.

11.
Awards/
Recognition.
The
Parties
intend
to
work
together
to
determine
national
"
success
stories"
of
the
implementation
of
P2
activities
toward
health
care
industry
waste
generation.
Successful
P2
activities
shall
be
recognized
by
awards
or
other
recognition
by
U.
S.
EPA,
AHA
and/
or
the
Parties
acting
jointly.

4.1
The
Parties
understand
that
other
organizations
and/
or
coalitions
who
promote
environmentally
responsible
practices
have
a
vested
interest
in
the
goals
described
in
this
MOU.
Furthermore,
the
Parties
recognize
that
these
stakeholders
play
an
important
role
in
the
partnership
to
advance
P2
in
the
health
care
industry.
In
recognition
of
this
fact,
the
Parties
will
allow
for
the
participation
of
stakeholders
in
the
manner
set
forth
in
Attachment
#
1
to
this
MOU.

5.0
FUNDING.
The
Parties
shall
attempt
to
secure
reasonable
funding
to
allow
for
the
successful
completion
of
the
activities
described
herein.
Both
Parties,
however,
expressly
acknowledge
that
the
activities
under
this
MOU
shall
be
subject
to
the
availability
of
appropriated
funds
and
personnel
of
each
Party,
or
the
approval
of
other
sources
of
funding.
Nothing
in
this
MOU
or
elsewhere
shall
be
construed
as
establishing
a
contract
(
or
other
legally
binding
commitment)
obligating
U.
S.
EPA
or
AHA
to
provide
money,
goods
or
services
of
any
kind
to
any
legal
entity.

6.0
AGREEMENTS.
In
order
to
foster
the
successful
completion
of
this
MOU,
the
Parties
agree
to
the
following
terms
and
conditions:

1.
Each
Party
pledges
in
good
faith
to
go
forward
with
this
MOU
and
to
further
the
goals
and
purposes
of
this
MOU,
subject
to
the
terms
and
conditions
of
this
MOU.
The
Parties
shall
attempt
to
resolve
disputes
through
good
faith
discussions.

2.
Either
Party
may
unilaterally
withdraw
at
any
time
from
this
MOU
by
transmitting
a
signed
writing
to
that
effect
to
the
other
Party.
This
MOU
and
the
public/
private
partnership
created
thereby
shall
be
considered
terminated
sixty
(
60)
days
from
the
date
the
non­
withdrawing
Party
actually
receives
the
notice
of
withdrawal
from
the
withdrawing
Party.

3.
By
mutual
agreement,
which
may
be
either
formal
or
informal,
the
Parties
may
modify
the
list
of
intended
activities
set
forth
in
Paragraph
4.0
above
and/
or
determine
the
practical
manner
by
which
the
goals,
purposes
and
activities
of
this
MOU
will
be
accomplished
However,
any
modification
to
any
other
written
part
of
this
MOU
must
be
made
in
writing
and
signed
by
both
Parties
or
their
designees.

4.
Nothing
in
this
MOU
shall
be
construed
to
authorize
or
permit
any
violation
of
any
Federal,
State
or
local
law
imposed
upon
the
Parties,
including
but
not
limited
to,
the
PRA,
APA,
or
the
Anti­
Deficiency
Act,
31
U.
S.
C.
1342.

5.
Nothing
in
this
MOU
shall
be
construed
to
authorize
or
permit
any
violation
of
any
Federal,
State
or
local
law,
including,
but
not
limited
to,
any
environmental
law
administered
and/
or
enforced
by
U.
S.
EPA,
by
any
person,
including,
but
not
limited
to,
any
health
care
provider
organization.

6.
AHA
agrees
that
it
does
not
expect,
nor
will
it
ever
seek
to
compel
from
U.
S.
EPA
in
any
judicial
forum,
the
payment
of
money,
services
or
other
thing
of
value
from
U.
S.
EPA
based
upon
the
terms
of
this
MOU.
The
foregoing
provision
does
not
in
any
way
affect
any
legal
rights
accruing
to
AHA
by
virtue
of
any
other
law,
contract
and/
or
assistance
agreement.

7.
AHA
understands
and
acknowledges
that,
as
an
institution
of
the
Federal
Government,
U.
S.
EPA
has
a
duty
to
refrain
from
providing
any
commercial
entity
an
exclusive
privilege
without
receiving
payment
therefore
and,
as
a
consequence,
that
U.
S.
EPA's
relationship
with
AHA
in
no
way
affects,
alters
or
otherwise
constrains
U.
S.
EPA's
right
to
provide
similar
(
or
identical)
services
to,
or
establish
similar
(
or
identical)
relationships
with,
any
other
entity.

8.
AHA
understands
that
U.
S.
EPA's
participation
in
this
MOU
does
not
constitute
an
endorsement,
express
or
implied
of
(
a)
any
policy
advocated
by
AHA,
the
Council
or
any
stakeholder;
or
(
b)
any
good
or
service
offered
or
sold
by
AHA,
the
Council
or
any
stakeholder.

9.
Insofar
as
U.
S.
EPA's
participation
in
this
MOU
consists
of
rendering
tech­
M
E
M
O
R
A
N
D
U
M
O
F
U
N
D
E
R
S
T
A
N
D
I
N
G
B
E
T
W
E
E
N
T
H
E
A
M
E
R
I
C
A
N
H
O
S
P
I
T
A
L
A
S
S
O
C
I
A
T
I
O
N
&

U
.

S
.

E
N
V
I
R
O
N
M
E
N
T
A
L
P
R
O
T
E
C
T
I
O
N
A
G
E
N
C
Y
3
nical
assistance
to
accomplish
the
goals
of
the
MOU,
U.
S.
EPA
expressly
reserves
the
right
to
abstain
from
expressing
a
position,
either
formal
or
informal,
on
any
matter
of
law,
policy
or
science
related
in
any
way
to
the
subject
matter
of
this
MOU,
including,
but
not
limited
to,
any
matter
of
law,
policy
or
science
related
to
any
PBT
pollutant.
Nothing
in
this
MOU
shall
constitute
any
commitment
by
U.
S.
EPA
to
investigate
or
reinvestigate
any
position,
either
formal
or
informal
on
any
matter
of
law,
policy
or
science.

10.
AHA
shall
maintain
full
right,
title
and
interest
in
any
intellectual
property
right,
including
a
copyright,
in
any
work
product
developed
solely
by
AHA
under
this
MOU.
Intellectual
property
developed
by
AHA
with
financial
assistance
from
U.
S.
EPA
shall
be
subject
to
theconditions
set
forth
in
U.
S.
EPA's
applicable
assistance
regulations
(
e.
g.,
40
C.
F.
R.
30.36).
Any
intellectual
property
developed
collaboratively
by
the
Parties
will
also
be
governed
by
the
Federal
Copyright
Statute
at
Title
17
of
the
United
States
Code
or
by
the
Federal
Patent
Statute
at
Title
35
of
the
United
States
Code.

11.
Information
on
source
reduction
received
by
U.
S.
EPA
pursuant
to
this
MOU
shall
be
made
available
to
the
public
pursuant
to
Section
6606(
b)
of
the
PPA,
42
U.
S.
C.
13105(
b).

7.0
PRIMARY
CONTACTS.
The
Parties
intend
that
the
work
under
this
MOU
shall
be
carried
out
in
the
most
efficient
manner
possible.
To
that
end,
the
Parties
intend
to
designate
individuals
that
will
serve
as
primary
contacts
between
the
Parties.
The
Parties
intend
that,
to
the
maximum
extent
possible
and
unless
otherwise
approved
by
the
other
Party,
all
significant
communications
between
the
Parties
shall
be
made
through
the
primary
contacts.
The
designated
primary
contacts
for
the
Parties
are
listed
in
Attachment
#
2
to
this
MOU.
8.0
TERMINATION.
Unless
extended
by
a
written
agreement
executed
by
both
Parties,
this
MOU
shall
terminate
exactly
five
(
5)
years
from
the
date
upon
which
this
MOU
becomes
fully
executed
by
all
signatories
listed
below.

The
Parties,
on
this
24th
day
of
June,
1998,
hereby
agree
to
the
foregoing
MOU,
which
shall
be
effective
immediately
upon
full
execution
by
the
signatories
listed
below.

For
the
United
States
Environmental
Protection
Agency:

Dr.
William
H.
Sanders,
III,
Director
Office
of
Pollution
Prevention
and
Toxics
Office
of
Prevention,
Pesticides
and
Toxic
Substances
U.
S.
EPA
David
A.
Ullrich
Acting
Regional
Administrator
U.
S.
EPA,
Region
5
For
the
American
Hospital
Association:

Jonathan
T.
Lord,
M.
D.
Chief
Operating
Officer
American
Hospital
Association
This
publication
is
part
of
Going
Green:
A
Resource
Kit
for
Pollution
Prevention
in
Health
Care.
For
additional
copies
of
this
or
other
publications
included
in
the
kit,
or
to
find
out
how
to
get
a
complete
kit,
visit
Health
Care
Without
Harm
on
the
Web
at
www.
noharm.
org.
1755
S
Street,
NW
Suite
6B
Washington,
DC
20009
Phone:
202.234.0091
Fax:
202.234.9121
www.
noharm.
org
info@
hcwh.
org
The
PCF
certification
mark
and
term
are
the
sole
property
of
the
Chlorine
Free
Products
Association
and
are
only
used
by
authorized
and
certified
users.
