?42?99018
                 MEMORANDUM of UNDERSTANDING


Between the United States Environmental Protect/on Agency and the American
Hospital Association

1.0   INTRODUCTION.  This Memorandum of Understanding ("MOD") is made
      between the United States Environmental Protection Agency ("U.S. EPA")
      Office of Prevention,  Pesticides and Toxics ("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 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.

-------
Memorandum of Understanding
U.S. EPA and AHA
Page 2 of 8


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  co-sponsor 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
            ("SOU").  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.

-------
Memorandum of Understanding
U.S. EPA and AHA
Page 3 of 8
            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.

            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).

            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

-------
Memorandum of Understanding
U.S. EPA and AHA
Page 4 of 8
            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
            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 potice-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

-------
Memorandum of Understanding
U.S. EPA and AHA
Page 5 of 8

      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.

-------
Memorandum of Understanding
U.S. EPA and AHA
Page 6 of 8


      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 ah exclusive privilege without receiving payment
            therefor 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
            technical 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  re-investigate 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 the

-------
Memorandum of Understanding
U.S. EPA and AHA                  .
Page 7 of 8

            conditions 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  1 7 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.
 [MOU continues on next page]

-------
Memorandum of Understanding
U.S. EPA and" AHA
Page 8 of 8

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, 1 998, hereby agree to the foregoing MOU,
which shall be effective immediately upon full execution  by the signatories listed
bejow.


For the United States Environmental Protection Agency:
Dr. William H. Sanders, III, Director
Office of Pollution Prevention and Toxics
Office of Prevention, Pesticides and Toxics
 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

-------
Memorandum of Understanding
U.S. EPA and AHA
Attachment #1                                               Pa9e 1  of 2


               ROLES OF THE PARTIES AND THE STAKEHOLDERS


In addition to those roles expressly stated in the body of the MOU, this  attachment
sets forth the respective roles  of the Parties and the stakeholders as they relate to
fulfilling the goals of the MOU.

The term "stakeholders" refers to organizations representing both  public and private
sectors who have a vested interest in the outcome of the efforts and goals
described in the MOU. Stakeholders would include, but not necessarily be limited
to,  the Health Care Without Harm Coalition, the Healthcare Resource Conservation
Coalition, allied state and metropolitan healthcare  associations, state, local and
governmental environmental agencies and other health care organizations.

As  set forth below, the Parties and the stakeholders will have representation on the
AHA Environmental Leadership Council established by Paragraph 4.0(10) of the
MOU.. In creating  and facilitating the activities of  the Council, AHA  will  develop a
process by  which the Council  will conduct its activities. That process will  provide
each Party and stakeholder with each of the following: (1) full opportunity to
participate in Council discussions on matters coming before the Council; (2) full
opportunity to voice opinions, ideas and/or  suggestions on the matters coming
before the Council; (3) the right to recommend matters for consideration by the
Council; and (4) the opportunity to propose modifications to the process by which
the Council operates. The AHA .will also endeavor to provide the  Parties and
stakeholders with  (1) the information needed to foster open and honest  discussions
of  matters coming before the  Council; and  (2)  an  explanation  of how the
participants' input was, or was not, utilized by AHA.

 Role of the AHA:

       [1]    The AHA shall be responsible  for managing AHA's human and financial
             resources necessary to achieve the goals of the MOU.

       [2]    The AHA will develop the AHA Environmental Leadership Council
             established pursuant to the MOU.

       [3]    The AHA shall manage and implement the initiatives identified in this
             MOU in partnership with U.S.  EPA and the stakeholders. These
             initiatives shall include the development of educational and outreach
             activities, the creation of products such as the Model Plans, the

-------
           1'"!!!!' •' 
-------
Memorandum of Understanding
U.S. EPA and AHA
Attachment #2
                       Page 1  of 1
                 LIST OF DESIGNATED PRIMARY CONTACTS
For the AHA:.

Katherine Svedman
Executive Director
American Society, for Healthcare
  Environmental Services
American Hospital Association
One North Franklin
Chicago, Illinois 60606
Phone: (31 2) "422-3860
FAX: (3.12) 422-4571
E-Mail: ksvedma1@aha.org
For Media Issues:
Alicia Mitchell
Media Relations Office
American Hospital Association
325  Seventh Street, N.W.
Washington, D.C.  20004
Phone: (202) 626-2339
FAX: (202) 626-2345
E-mail: amitche1@aha.org
For the U.S. EPA:

Chen Wen
Hospitals for a Healthy Environment National Coordination Team
Pollution Prevention Division
Office of Pollution Prevention and Toxics
USEPA - MC7409
401 M St. S.W.
Washington, D.C. 20460
PH: (202) 260-4109               .  .
FX: (202) 260-0178
email: wen.chen@epa.gov

-------

-------