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Coordinate Waste Contracts to Maximize Waste Program Performance

All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.


Integrated waste contracts (or at least coordination of waste-related contracts) will help a hospital minimize costs, maximize waste vendor resources and hold vendors accountable for all contracted aspects of waste management.

  • Project Talking Points

    • Integrated waste contracts work to ensure that the myriad different waste streams are integrated. Coordination between vendors is critical to ensure that vendors are minimizing waste streams in the best interest of you, the customer. Moreover, because waste is regulated and there are safety concerns, integrated contracts maximize the value of vendor consult, training, and education.
    • Complexity and regulations in healthcare waste streams cost up to ten times that of regular trash. Recycling, on the whole, aims to be less costly than disposal in a landfill, thereby saving money. If the facility is large enough, some recyclables will generate a revenue stream.
    • Regulated medical waste and hazardous waste contracts tend to be the most complex. Contracting agents must be informed about how to minimize costs, maximize contract value, and meet regulatory requirements – and even go beyond them.
    • The waste program’s overall goal is the reduction of waste generated from the hospital environment into local landfill and other disposal sites.
    • Contracts must specify that proper data and reporting requiremenet be included not only on all invoices but where regulated waste is concerned, in manifest and other billing/tracking documents.
    • The contracts should specify performance requirements including data collection, reporting, environmental impacts, training, and education.
    • One of the comprehensive goals of waste stream management program is to reduce waste. Ask your integrated waste contractor their can help with source reduction project such as maximizing the recycling of paper products, package reduction, and the use of refurbished and reusable items.
    • Well-managed waste contracts hold waste and recycling vendors accountable for all contracted aspects of waste management.
  • Triple Bottom Line Benefits

    • Cost benefits: In order to maximize resources, facilities should target at least 20% of its waste stream. Identifying sources of unopened and unused supplies going into the waste stream is a good place to start reducing waste. By setting up a process for waste management systems offers opportunities for cost saving and the investments required are typically minimal.
    • Environmental benefits: The recycling of paper, cardboard, metals, plastic, and glass minimizes the amount of waste going to landfills or being incinerated. The recycling of furniture, equipment, and supplies also reduces the waste going to landfills.
    • Social benefits: Having staff trained and following all the procedures ensure the proper disposal of items and leads to a healthier and safer environment. Studies show that staff, particularly younger staff, expect and will be happier in an environment that is more environmentally responsible.
  • Purchasing Considerations

    The How-To section below address contracting specifications for each waste stream.  Below are general contracting issues regarding your overall waste program.

    • Attach your company’s environmental or sustainability statement or policy that establishes a commitment to environmentally preferable purchasing and sustainability as a pre-requisite in your operations.
    • Work with your Group Purchasing Organization (GPO) as they may be able to help with suggested contract language.
    • Require your vendor to track and report all your waste data and provide monthly reports and dashboards. All waste/recycling must be included in the reporting as you will not have a total view of your data unless you are tracking everything that is leaving your facility.
    • Ask vendors to specify training, education, signage, and all other support provided as part of the service.
    • Specify all equipment provided as part of service.
    • Specify all fees including tipping fees, pick up fees, equipment, environmental surcharges, etc.
    • Specify any end-of-life product take-back programs, including electronics. List all items and outline the process for participation.
    • Specify provision of all credentials, licensing and permits for transportation, receiving facility, training/education certifications of all workers.  Note: national and credible waste haulers should provide detailed documentation as a matter of course but if you are using local haulers, ensure you are provided copies of all documents.
    • Specify any certifications for recycling, waste disposal e.g. certified e-Stewards.
  • How-To

    NOTE: This PIM does not provide specific or detailed contractual language for all aspects of every waste contract, particularly for aspects of regulatory compliance, permits, or licenses. The purpose of this PIM is to ask your hauler about considerations to help you improve your overall sustainability performance.

    1. Determine the stakeholders during the contracting process. Likely candidates include your Green Team, EVS Director, Safety/compliance officer, and supply chain representatives.  Staff from areas/departments who may be impacted by potential changes in waste operations should be included.  Make sure that all stakeholders know that you are assessing your waste contracts to maximize value, reduce costs, and improve compliance/safety considerations and your sustainability performance.
    2. Understand your waste streams.  This task should not be trivialized as understanding the regulated waste streams is complex, as is knowing how the marketplace works.  For example, universal wastes should be a separate RFP then hazardous waste as while some hazardous waste haulers manage universal wastes, the same is not true in reverse. 
    3. Develop your goals and objectives for the waste program generally and for each waste stream individually.  If recycling and waste minimization is an imperative, then ensuring your prospective vendors can help you meet your goals is critical. 
    4. Bring the stakeholders together and during your first meeting, make sure the group is in alignment in both definitions of waste and your organizational goals for each.
    5. Determine your performance goals, again, for the program in total but for each waste stream.  Waste management needs to be looked at  in the whole because you can’t impact one stream without impacting the other.  Its one pie, which is divided differently depending upon your program goals.  Ultimately, you’d also like to see the whole pie size decrease, but that’s also connected to patient volume and staffing levels.  Define what you will be measuring, how your vendor will be expected to help you get that data, and how you will report it on a regular basis.
    6. For each waste stream below, gather the following information:
    • Responsible person/department for tracking and managing
    • Current vendor name and all contracts (some are bundled)
    • Twelve (12) months of invoices

    Review the following waste categories

    Solid Waste

    • Check your current contract and compare it to your current invoices. Do the invoices include the information you need like container weights, tipping fees, environmental fees, surcharges, etc.? Make sure the contract reflects the reality for all charges and vice versa.  Even if you go with a new vendor, this process will inform what you expect from any vendor.
    • Before establishing a new contract, understand how often waste is picked up. Are the containers full? Is there a pressure gauge on the compactor? Is it used?  How will the vendor work with you to maximize equipment utilization?
    • Will the current vendor give you feedback if they see, for example, loads with lots of cardboard or other recyclables mixed in with your waste?  How can they help you with your waste minimization goals?
    • How does the vendor ensure the waste is secure when being transported?
    • Visit the landfill or waste destination.  How far is it away and what are the impacts or minimizing trips to the destination?  How is waste tipped?  On a “floor” or directly into the landfill.  Is the landfill secure?  Take pictures to use for training purposes. 
    • How does the vendor manage surges in waste volume?
    • How does the vendor manage equipment?  Leases, lease to own, equipment maintenance, cleanliness, etc.
    • How will the vendor manage pick-ups?  Swap and drop or total turn around.  Understand the implications on operations of each.
    • How are loads tracked and reflected in your monthly invoices?  Do the invoices give you the data you need to track and report your performance indicators?

    Construction, Demolition Debris, and Bulky Waste

    • For large construction projects, the contractor is often responsible for the C&D contract. You might not be getting the best value in that case. If recycling and waste minimization is your objective, take those contracts back in-house.
    • C&D/bulky waste collection – This is often a contract that doesn’t get much attention. Check the contract terms, but also audit the container every week. You are likely to find cardboard and other donate-able goods that are not C&D. Aim to reduce costs, minimize your waste, and get this contract under the facility’s control.
    • Bulky waste – When you audit the C&D trailer, you are likely to see items that have a high potential for beneficial reuse. Most facilities do not have space for equipment, furniture or bulky items at the dock so they are thrown away in the open trash container. Consider designating a particular day of the month to arrange for local charities to pick up unwanted materials. Make sure to pre-screen so you do not give away valuable goods. Contact your C&D hauler and express your interest in this program and ask them what they can do to help!
    • Does the hauler recycle the C&D waste and can they give you a certificate of recycling? 
    • Does your hauler provide LEED documentation, training, and education for C&D management, including recycling? Always ask and take advantage of free resources.
    • Is your hauler committed to waste reduction?  And what does that look like?  This is an open ended question but ask your C&D hauler how they can help, what programs they might offer to help with special pickups.
    • How are loads tracked and reflected in your monthly invoices?  Do the invoices give you the data you need to track and report your performance indicators?

    Regulated Medical Waste

    NOTE: Regulated Medical Waste (RMW) management is a huge topic so this section is strictly related to contracting for RMW minimization.

    • Within an RMW contract, there are several sub-categories that are collected, treated and managed separately. Ensure your invoices give you the information you need to track waste disposition, weights, and costs to track your regulatory obligations and your performance for each sub-category. Periodically review your costs against your contract terms for consistency.
    • Specify what costs are included in the contract including bags, boxes, and labels.  List all costs including cost per pound, hauling costs, environmental fees, or any additional fees.  Review with your hauler that they will provide signage, training and education, waste audits, and feedback on your waste.
    • Sharps -- Consider a reusable sharps container program to reduce your costs and volume of waste being landfilled or incinerated. SEE related PIM on the Roadmap.
    • General Infectious: Visit the treatment location for a review of safety and compliance related issues.  Does the vendor provide feedback on opportunities to reduce the volume?
    • Pathological Waste and Special Waste: Ensure you know where your waste is going. Check invoices to be sure waste designated for incineration is being routed to the proper facilities.
    • How will pickup be tracked and reflected in your monthly invoices?  Do the invoices give you the data you need to track and report your performance indicators?

    Hazardous Waste

    • Like all other waste related contracts, it’s important to understand what services your hauler provides. Hazardous waste paper work and manifest tracking is paramount. You are legally responsible for your waste from cradle to grave. It is very important to understand where your waste is going.
    • What hazardous waste minimization programs does your hauler provide?
    • Does the hauler provide training and educational opportunities? Safety Officers and/or waste handlers should be properly trained with at least an 8-hour hazwhopper class.  Waste technicians at the dock should also be trained.

    Universal Waste

    • Batteries and light Bulbs: First, ensure that your waste is being recycled. Get tracking documents to confirm end-of-life disposition. With all waste and recycling services, ensure that your invoices include the weight of the bulbs or lamp feet and you can convert to pounds. Include the recycling numbers in with your other recycling.
    • Some vendors that sell bulbs may also provide recycling services. Confirm the proper collection and disposal containers and check the contract to make sure they are either included in the contract price or not.
    • Finally, before you consider a bulb crusher, check with your state’s regulations as many states have banned them, and some require a treatment permit. For more information visit:
    • Electronics: Ensue an integrated waste contract includes the safe handling and proper recycling of electronics waste. Ask where the materials are recycled and get a certificate of recycling.
    • Does your vendor export any universal waste?
    • Does the vendor provide data destruction services and can they provide a certificate of destruction?

    Paper: Confidential and non-confidential

    • HIPAA requires the safe and secure management of patient information.  That may or may not mean that shredding is required.  IF your vendor can manage your paper securely --assessed by detailed risk audit - without shredding, you might be able to save money.  Many facilities are simplifying the process by taking a “universal approach” to confidential paper management and including ALL paper in that category thereby boosting capture rates significantly.  Paper recycling markets fluctuate but are often strong.  Negotiate including all paper in this category. 
    • Some facilities are bringing the shredding operation back in-house if space is available.  Consider your total confidential paper shredding spend and assess whether you have options to reduce costs and maximize paper collection but doing it in-house.
    • Ensure that weight and costs/rebates are collected and included in your recycling data.  If your HIPAA vendor does not weigh the paper, ask them provide # containers and estimated weights.


    • Cardboard: The objective in cardboard recycling contracts is to balance the need to maximize revenue with ease of handling that will maximize collection rates. Cardboard typically generates the largest revenue when it is baled onsite, but that is often difficult. Cardboard collected commingled in single stream will often not generate any revenue but ease of use might make that the most cost effective option. Cardboard should be contracted by the ton and the contract should specify the equipment (baler, compactor, dumpster, etc.), the rebate and any charges/fees. Ensure all data is provided on the invoices.
    • Beverage containers (glass, #1 and #2 plastics, aluminum cans, tin (food) cans):  Work with the vendor to maximize collection.  Some vendors are providing “single-stream” recycling where all recyclables, mixing paper and containers, from areas that otherwise resemble recycling from a  hotel/restaurant are included.  Single-stream requires MORE training as users tend to get lazy.  Ask your vendor for sample training materials and recycling container labels.
    • Plastics: Most recyclers will take standard plastics. Others will find markets for “non-traditional” plastics like blue wrap, shrink wrap, rigid trays, etc.  Some vendors will take all plastics mixed. Work with your vendor to determine the best way to collect and transport plastics. As with all other materials, ensure your invoices contain all the data required by the contract.
    • Pallets – plastic and wooden: Facilities that generate a lot of pallets that must be disposed of can determine if a contract is necessary or if one of their current vendors that delivers product to them, such as a distributor, would be willing to pick these up and use them again.  Otherwise, there may be a local pallet rebuilder in town that will purchase pallets from the facility.  Contracts should be written that discuss pallet grade and conditions and how much will be paid for each type.  Most vendors will park a tractor trailer at the facility or pick up on a regular basis depending on the number generated. See the Roadmap PIM in implementing a pallet program in you facility.
    • Toner Cartridges: Often the vendor awarded the contract for providing the toner to the facility is contracted to pick up used toner cartridges for reuse or proper disposal.  The “revenue” can either be realized in the contract price (unit price reduction per unit recycled) or the receipt of cash revenue stream that can be easily reported. The contract should specify pick up, timing, invoicing, and reporting.


    • How often is the composting picked up?
    • How are containers washed?
    • Are biodegradable bags provided or encouraged?
    • Visit the compost facility to ensure it meets appropriate standards.  Are there any community complaints?
    • Can you buy soil amendment back from the compost facility?
    • How will pickups be tracked and reflected in your monthly invoices?  Do the invoices give you the data you need to track and report your performance indicators?
  • Tools

    Understanding your total waste volume will help you contract for the appropriate amounts of waste. If you do not know your waste data, either include that as one of the first tasks that your vendor will help you with, or take the time to do that work prior to contract negotiations. Ensure that the contract allow a six (6) month check in to renegotiate if vast volumes change significantly.

    Many waste haulers have waste data programs as part of their service.  The limitations of those however is that they typically only track what they manage.  A comprehensive program should capture all waste data.  Waste data management tools in the marketplace:

    If you have an ROI tool, calculator, or similar resources to share, please contact us or participate in the discussion below.

  • Case Studies

    Providence Health & Services: Reducing Waste and Pollution - Providence tracks all waste streams, energy use, and purchasing and scrutinizes those areas for opportunities to reduce environmental impact.

    Waste Management Partners with GM: WM was asked to assist in a need to improve the way GM’s pressed cardboard packing containers were managed. 

    New York-Presbyterian Hospital & Sustainability: NYP Green incorporates team work to encourage recycling, composting, and healthy environment.

  • Regulations, Codes and Standards, Policies

    • Federal facilities are required to use EPP criteria. EPP involves considerations of “products and services that have a lesser or reduced effect on human health and the environment when compared with competing products or services for the same purpose.” See Executive Order 13101: Greening the Government through Waste Prevention, Recycling, and Federal Acquisition.
    • Waste related contracts for “regulated” or “compliance-related” waste must follow a specific list of regulations that should be included in the contract specifications.
    • Non-hazardous Waste Regulations EPA: The Code of Federal Regulations Parts 239 through 259 contains the regulations for solid waste.
  • Cross References: LEED

    LEED 2009 For Existing Buildings: Operations & Maintenance, Materials & Resources Credit 6: Solid Waste Management: Waste Stream Audit 

    LEED for Healthcare 2009:  Materials and Resources Prerequisite 1: Storage & Collection of Recyclables

    LEED for Healthcare 2009:  Materials and Resources Credit 2.1: Construction Waste Management: Divert 50% From Disposal

    LEED for Healthcare 2009:  Materials and Resources Credit 2.2: Construction Waste Management: Divert 75% From Disposal

  • PIM Synergies

  • More Resources

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  • PIM Descriptors

    Supply Chain, Waste

    Level: Beginner

    Category List:

    • C&D
    • Composting
    • Contracted Services
    • Hazardous Waste
    • Medical Products
    • Operational Strategies
    • Operations
    • Policy
    • Recycling
    • Regulated Medical Waste
    • Reuse
    • Solid Waste
    • Source Reduction
    • Strategic Operations
    • Waste and Recycling

    PIM Attributes:

    • Chemicals
    • Optimize Operations
    • Waste Reduction

    Improvement Type:


    • Environmental Services
    • Purchasing/Materials Management/Supply Chain
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