Kaiser Permanente has been making a concerted effort to “build green.” That is a significant statement, because the organization is of a size that can make a big difference in the progress of this idea.

Kaiser Permanente is America's largest integrated healthcare organization. Founded in 1945, it is a nonprofit, prepaid group-practice program. The company serves the healthcare needs of 8.4 million members in nine states and the District of Columbia. It employs approximately 90,000 technical, administrative, and clerical employees and approximately 11,000 physicians, representing all specialties, nationwide. Kaiser Permanente has 960 buildings covering 54 million square feet, with another 10 million square feet and 90 buildings currently in design or under construction. During the next ten years, the company will construct as many as 20 hospitals.

Today, Kaiser Permanente extends its commitment from caring for the health of its members to caring for the environment. Leading the effort is Kaiser Perma- nente's Environmental Stewardship Council, which is charged with achieving the company's vision for environmental performance: “We aspire to provide healthcare services in a manner that protects and enhances the environment and health of communities now and for future generations.” The council's Green Buildings Committee leads in evaluating sustainability considerations for design and construction projects.

Kaiser Permanente's National Facilities Services division manages the design, construction, and operation of all the company's buildings. Under the division's aegis, the company operates a robust standards program to control quality, facilitate design, ensure operational efficiency, and promote a green building program. The division also administers the organization's National Purchasing Agreement (NPA) program, which was established in 1991 and is integral to this effort.

The NPA includes 25 national contracts with manufacturers of contractor, furnished, and installed systems and materials. This program covers a wide variety of items—from signage and elevators, to lighting and HVAC equipment. The intent of the program is to partner with these manufacturers to realize the goals of the standards program while reducing initial and life-cycle costs. Compliance with the NPA is mandatory for manufacturers; the result is a strategic alliance that allows Kaiser Permanente to help develop products and systems that meet the company's specific needs.

In 1993, Kaiser Permanente negotiated the first NPA for carpet. The company included a requirement in the Request for Proposal (RFP) prior to this process that bidders state what they were doing to reduce waste and support recycling. As it turned out, bidders either didn't respond or responded by referring to programs that sent carpet to road construction contractors for curing concrete. Only one company was actually recycling carpet; the rest seemed unable to comprehend why Kaiser Permanente was even asking the question. That company engaged in recycling was successful in becoming part of the NPA, along with two other companies less far along in their recycling endeavors. During the next nine years, Kaiser Permanente dropped one of the three companies, continued to partner with the company that was actually recycling, and tried to work with the third company to enhance its recycling and landfill-diversion programs.

Kaiser Permanente's standards at the time covered both broadloom and six-foot vinyl-backed carpet, and about 15 carpets met the company's performance and aesthetic criteria. In 2001 and 2002, Kaiser Permanente, with the assistance of NPA carpet manufacturers, conducted a thorough evaluation of the carpet in almost all its buildings. The company took note of the carpet type, age, type of traffic, maintenance practices, and condition. Based on that assessment, Kaiser Permanente determined that, due to performance issues, broadloom carpet was not appropriate for the company's facilities.

In 2002, when the NPA contracts for carpet came up for renewal, Kaiser Permanente decided to focus on sustainability in looking at current and potential partners. The negotiating team included a couple of interior designers, a representative from Environmental Services, and the organization's director of Environmental Stewardship, as well as two other members of Kaiser Permanente's Green Buildings Committee (an outside architect and a representative from the Healthy Building Network, a national network of green-building professionals). The team was charged with focusing on three main criteria in evaluating current and potential bidders for carpet: sustainability, product performance, and their healthcare line of products.

The negotiating team conducted research into the carpet industry to identify which companies were truly leading the charge to sustainability. Kaiser Permanente also met with fiber manufacturers to try to better understand the environmental impact of carpet fiber. After sorting out the facts from this “greenwashing,” the team decided to consider five carpet companies, including the two already under contract. The three other mills were included based on their industry leadership in sustainable practices.

The negotiating team prepared an RFP to be sent to all five companies. Tom Lent of the Healthy Building Network developed a detailed questionnaire, entitled “Key Questions for Environmentally Preferable Flooring Selection,” that looked at the environmental impact of carpet from manufacturing to the end of its life and beyond. The RFP contained an extensive product-performance questionnaire that included a requirement for impact test results for the backing—other than the British Spill Test, a timed test that measures how long it takes for a liquid to penetrate carpet. Kaiser Permanente needed to determine whether the manufacturers’ carpet backing was truly impermeable. Manufacturers also were required to submit samples of the carpet products that they proposed would comply with Kaiser Permanente standards. Each company was then invited to make a presentation to the team, focusing on its sustainable practices, specific healthcare product line, and product performance.

The team scored each company based on the selection criteria. The Kaiser Permanente members of the team met separately and divided the scoring grid into three categories, with each one assigned a weight: Sustainable issues were weighted at 45%, product evaluation at 45%, and green innovation at 10% of the total score.

Meanwhile, a major issue for Kaiser Permanente has been the elimination of PVC (vinyl) from products because of its contribution to pollution in the form of dioxin, a potent carcinogen. This was a difficult challenge because, based on the company's assessment of carpet in its facilities, there is no question that vinyl-backed carpet outperforms broadloom on many criteria, and it has the added advantage of potentially being recycled into new carpet at the end of use. Kaiser Permanente's hope was to find non-PVC-backed carpet that would have similar performance characteristics to the vinyl-backed products the company was using. However, none of the non-PVC-backed products passed the organization's required impact tests. As a result, the team focused on companies’ research and development efforts to create alternatives to vinyl and how likely they were to partner with Kaiser Permanente in that quest.

Based on the above analysis of the five companies, Kaiser Permanente did not renew its contract with one of the original two companies and added a new one. The current standards include either highly or 100% recycled, vinyl-backed, six-foot carpet. All carpet removed from Kaiser Permanente sites is now recycled or “downcycled” to meet that standard, reducing the need for manufacture of vinyl-based carpet. In the past year, the company has been working closely with both manufacturers to develop and bring to market a non-PVC-backed carpet. Today, the company is beta-site testing some exciting new nonvinyl products from both companies, and next year expects to have them included as part of Kaiser Permanente standards.

Kaiser Permanente's goal is to help transform the carpet industry as a whole so that it will manufacture nontoxic, fully recyclable products that meet sound performance criteria for healthcare. Indeed, this is a priority in Kaiser Permanente's continuing efforts to provide healthcare facilities that enhance the health status of Kaiser Perma-nente members, staff, communities, and the overall environment. HD