Creating a Chemicals Policy April 29, 2005 John Strong President and CEO

1. Creating a Chemicals PolicyApril 29, 2005John StrongPresident and CEO

2. Who is Consorta? • Founded May, 1998 • Illinois Business Corporation--Cooperative • Owned by 13 Catholic Health Care Systems • 60% of all U. S. Catholic Hospitals are Members • 527 Acute Care Sites; 54,600 Beds • 1,776 Non-Acute Care Sites • 4 of the 5 Largest Catholic Health Systems in the U. S. are Owners • Purchase Volume: Approximately $4.1 Billion Annually • 708 Group Purchasing Contracts Awarded by the Members • Mission: Remove Cost from Owner’s Supply Chain Consorta Shareholders Work as a Group to Bring Better Value and Meaningful Change to Selected Product Categories Purchase as a Group Provide Supply Chain Management Tools • Aggregate Volume to Obtain Price Discounts • Commit Volume to One or More Suppliers • Obtain Administrative Fee from Suppliers, • Deduct Operating Expenses and Return • Balance to Owners • Conduct Product Evaluations • Provide Information and Reporting • Furnish Technology Assessment and • Value Analysis Tools • Product Conversion Assistance

3. WA ME MT ND MN OR VT NH ID WI NY MA SD RI MI CT WY PA IA NJ NE OH MD NV DC DE IN UT IL CA CO WV VA KS MO KY NC TN OK AZ NM AR SC GA AL MS TX LA AK FL HI PR Consorta is One of the Five Leading GPOs in the U.S.Membership Profile Owners • Ascension Health – St. Louis, MO • Caritas Christi Health Care – Boston, MA • Catholic Health East – Newtown Square, PA • Catholic Health Initiatives – Denver, CO • Hospital Sisters Health System – Springfield, IL • Ministry Health Care – Milwaukee, WI • Provena Health – Mokena, IL • Sisters of St. Francis Health Services – Mishawaka, IN • St. Clare’s Health Services – Denville, NJ • St. John Health System – Tulsa, OK • Trinity Health – Novi, MI • Via Christi Health System – Wichita, KS • Wheaton Franciscan Services – Wheaton, IL

4. Environmental Stewardship Consorta is committed to conduct business in a socially responsible and ethical manner that protects the safety of its employees, and its Shareholders' patients and employees, as well as the environment.

5. Consorta’s Position Statement Our Shareholders Want a Leadership Role • Improve Impact on Environmental • Quality • Reduce Costs • Healthier Environment • Pooling Hospital Product Experience • Feedback to Suppliers • Hold Suppliers Accountable for • Performance Expectations Shareholder Direction

6. Shareholders’ Objectives • Enhance work place safety • Reduce waste and waste disposal costs • Become better environmental stewards and neighbors • Educate about pollution prevention opportunities • Provide tools to minimize waste volume • Reduce the use of persistent, bio-accumulative toxic chemicals • Eliminate the use of mercury • Lead by example

7. Purpose of Chemicals Policy • Shift responsibility to chemicals manufacturers to provide safety data • Leverage additional disclosure of material content and safety • Signal market to greener/safer product innovation • Improve healthcare financial margins • Build momentum using healthcare’s opinion leader status

8. Response to emerging public concern Research hazards Research alternatives Test alternatives Make decisions in uncertainty Continue to use potentially hazardous materials Face potential liability from the use of hazardous materials Face an unpredictable regulatory climate Operate in uncertainty Lack of a Chemicals Policy…Creates a Burden for Users Policy change at the national level will relieve this burden on healthcare organizations

9. Consorta’s Approach Consorta and its Shareholders are adopting a chemicals policy shaped by guiding principles shared with others working to protect people and the environment and to honor healthcare’s dictum to First, Do No Harm.

10. Guiding Principles Precaution: Act when credible evidence of harm is established. Substitution: Evaluate and seek to replace hazardous substances with less hazardous alternatives. Extended Producer Responsibility: Physical/financial responsibility through post-consumer product life-cycle.

11. Guiding Principles Hazard Analysis vs. Risk Assessment: Use hazard analysis to assess safety instead of risk-based approach. Life Cycle Impact: Consider chemical hazards throughout product life time. Materials-Based Approach: Whenever possible, influence product design.

12. Guiding Principles Disclosure: Seek greater disclosure of material content of products from suppliers. Accountability: Establish goals and publicly report on progress. Manufacturing and Retail Healthcare Product “Specifiers” Product “Takers”

13. Goals Minimize  Eliminate PVC & DEHP IV Bags & Tubing Other plastics in direct contact with patient’s blood or body fluid Find Alternatives to PVC and Chlorinated Substances Identify and Contract for EPP Products Cleaning products Building products Furnishings Activities Work with Select Manufacturers to eliminate DEHP Use methods similar to latex Support Work of Advocates to Require DEHP Labeling H2E HCWH Educational Programs Online resources Contract for Alternative Products whenever available Meet with senior executives whenever possible “Vote with our dollars” Objectives and StrategiesEliminate/Improve Management of Hazardous Products Hazardous Chemicals Persistent, Bio-Accumulative, Toxic Pollutants

14. Policy Implementation • Integrate core guiding principles in contracting process • Disclosure during the RFP process • List and prioritize chemicals of concern • Dynamic process starting with, • Mercury • DEHP • PVC • Brominated flame retardants • Communicate with suppliers • Educate, report • Advocate

15. Creating a Chemicals Policy…we’ve only taken the first step.