Title: Volume 28—Health Care Delivery
Category: Part B—Industry-based Guidance for IFRS S2
Source: IFRS Foundation (https://www.ifrs.org)
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Year: 2023
Type: Industry
Industry-based Guidance on implementing
Climate-related Disclosures
Volume 28—Health Care Delivery
June 2023
IFRS S2
IFRS
® Sustainability Disclosure Standard
International Sustainability Standards Board
This Industry-based Guidance accompanies IFRS S2 Climate related Disclosures (published
June 2023; see separate booklet) and is issued by the International Sustainability
Standards Board (ISSB).
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© IFRS Foundation 2023
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IFRS S2 CLIMATE-RELATED DISCLOSURES–JUNE 2023
© IFRS Foundation
1
Introduction
This volume is part of the Industry-based Guidance on Implementing IFRS S2 Climate-related
Disclosures. This guidance suggests possible ways to apply some of the disclosure requirements in
IFRS S2 but does not create additional requirements.
This volume suggests possible ways to identify, measure and disclose information about
climate-related risks and opportunities that are associated with particular business
climate-related risks and opportunities that are associated with particular business
models, economic activities and other common features that characterise participation in
this industry.
This industry-based guidance has been derived from Sustainability Accounting Standards
Board (SASB) Standards, which are maintained by the International Sustainability
Standards Board (ISSB). The metric codes used in SASB Standards have been included for
Standards Board (ISSB). The metric codes used in SASB Standards have been included for
ease of reference. For additional context regarding the industry-based guidance contained
in this volume, including structure and terminology, application and illustrative
examples, refer to Section III of the Accompanying Guidance to IFRS S2.
IFRS S2 INDUSTRY-BASED GUIDANCE
2
© IFRS Foundation
Volume 28—Health Care Delivery
Industry Description
The Health Care Delivery industry owns and manages hospitals, clinics and other health
care related facilities. Entities provide a range of services, including inpatient and
outpatient care, surgery, mental health, rehabilitation and clinical laboratory services.
Demand for health care delivery services is driven largely by insurance coverage rates,
demographics, illness and injury rates. The industry is characterised by high fixed labour
demographics, illness and injury rates. The industry is characterised by high fixed labour
and facilities costs, and an increased regulatory focus on reduced costs of care and
improved outcomes. Health care delivery entities also face significant competition for
patients and resources from private, non-profit and religious health care systems.
Sustainability Disclosure Topics & Metrics
Table 1. Sustainability Disclosure Topics & Metrics
TOPIC
METRIC
CATEGORY
UNIT OF
MEASURE
CODE
Energy
TOPIC
METRIC
CATEGORY
UNIT OF
MEASURE
CODE
Energy
Management
(1) Total energy consumed,
(2) percentage grid electricity and
(3) percentage renewable Quantitative Gigajoules (GJ),Percentage (%) HC-DY-130a.1 Waste Management Total amount of medical waste:percentage (a) incinerated, (b) recycled or treated and (c) landfilled Quantitative Metric tons (t) HC-DY-150a.1 Total amount of: (1) hazardous and
(2) non-hazardous pharmaceutical waste, percentage (a) incinerated, (b)
(2) non-hazardous pharmaceutical waste, percentage (a) incinerated, (b) recycled or treated and (c) landfilled Quantitative Metric tons (t),Percentage (%) HC-DY-150a.2 Climate Change Impacts on Human Health&Infrastructure Description of policies and practices to address: (1) the physical risks because of an increased frequency and intensity of extreme weather events, (2) changes in the morbidity and mortality rates of illnesses and diseases associated with climate change and (3) emergency
illnesses and diseases associated with climate change and (3) emergency preparedness and response Discussion and Analysis n/a HC-DY-450a.1 Table 2. Activity Metrics
ACTIVITY METRIC
CATEGORY
UNIT OF
MEASURE
CODE
Number of (1) facilities and (2) beds, by type Quantitative Number HC-DY-000.A Number of (1) inpatient admissions and (2) outpatient visits Quantitative Number HC-DY-000.B IFRS S2 CLIMATE-RELATED DISCLOSURES–JUNE 2023© IFRS Foundation 3
Energy Management Topic Summary Health Care Delivery entities operate energy-intensive facilities and rely on both purchased electricity and fuel. The consumption of both can contribute to environmental impacts, including climate change and pollution. Legislative attempts to limit these impacts and to incentivise energy efficiency and renewable energy may result in price volatility associated with fossil fuels and conventional electricity. Entities that improve
volatility associated with fossil fuels and conventional electricity. Entities that improve energy efficiency may decrease costs and limit exposure to energy price fluctuations.
Metrics HC-DY-130a.1. (1) Total energy consumed, (2) percentage grid electricity and
(3) percentage renewable 1 The entity shall disclose (1) the total amount of energy it consumed as an aggregate figure, in gigajoules (GJ).
1.1
The scope of energy consumption includes energy from all sources,
1.1
The scope of energy consumption includes energy from all sources,
including energy purchased from external sources and energy produced by the entity itself (self-generated). For example, direct fuel usage, purchased electricity, and heating, cooling and steam energy are all included within the scope of energy consumption.
1.2
The scope of energy consumption includes only energy directly consumed by the entity during the reporting period.
1.3
by the entity during the reporting period.
1.3
In calculating energy consumption from fuels and biofuels, the entity shall use higher heating values (HHV), also known as gross calorific values (GCV), which are measured directly or taken from the Intergovernmental Panel on Climate Change (IPCC).
2 The entity shall disclose (2) the percentage of energy it consumed that was supplied from grid electricity.
2.1
The percentage shall be calculated as purchased grid electricity
2.1
The percentage shall be calculated as purchased grid electricity consumption divided by total energy consumption.
3 The entity shall disclose (3) the percentage of energy it consumed that was renewable energy.
3.1
Renewable energy is defined as energy from sources that are replenished at a rate greater than or equal to their rate of depletion, such as geothermal, wind, solar, hydro and biomass.
3.2
The percentage shall be calculated as renewable energy consumption
3.2
The percentage shall be calculated as renewable energy consumption divided by total energy consumption.
3.3
The scope of renewable energy includes renewable fuel the entity consumed, renewable energy the entity directly produced and renewable energy the entity purchased, if purchased through a renewable power purchase agreement (PPA) that explicitly includes renewable energy certificates (RECs) or Guarantees of Origin (GOs), a Green‐e Energy
certificates (RECs) or Guarantees of Origin (GOs), a Green‐e Energy Certified utility or supplier programme, or other green power products IFRS S2 INDUSTRY-BASED GUIDANCE 4© IFRS Foundation
that explicitly include RECs or GOs, or for which Green‐e Energy Certified RECs are paired with grid electricity.
3.3.1
For any renewable electricity generated on-site, any RECs and GOs shall be retained (not sold) and retired or cancelled on behalf of the entity for the entity to claim them as renewable energy.
3.3.2
For renewable PPAs and green power products, the agreement shall explicitly include and convey that RECs and GOs be retained or
explicitly include and convey that RECs and GOs be retained or replaced and retired or cancelled on behalf of the entity for the entity to claim them as renewable energy.
3.3.3
The renewable portion of the electricity grid mix that is outside of the control or influence of the entity is excluded from the scope of renewable energy.
3.4
For the purposes of this disclosure, the scope of renewable energy from biomass sources is limited to materials certified to a third-party standard
biomass sources is limited to materials certified to a third-party standard (for example, Forest Stewardship Council, Sustainable Forest Initiative,
Programme for the Endorsement of Forest Certification, or American Tree Farm System), materials considered eligible sources of supply according to the Green-e Framework for Renewable Energy Certification, Version 1.0 (2017) or Green-e regional standards, and/or materials that are eligible for an applicable state renewable portfolio standard.
4
applicable state renewable portfolio standard.
4 The entity shall apply conversion factors consistently for all data reported under this disclosure, such as the use of HHVs for fuel usage (including biofuels) and conversion of kilowatt hours (kWh) to GJ (for energy data including electricity from solar or wind energy).
Waste Management Topic Summary Health Care Delivery entities generate a significant amount of regulated medical and
Topic Summary Health Care Delivery entities generate a significant amount of regulated medical and pharmaceutical waste. Disposal fees for these types of waste are typically higher than that of conventional waste and may present a significant cost for the industry. Entities that reduce the amount of waste generated by enhanced waste segregation strategies,
recycling and reuse may limit their exposure to these costs.
Metrics
recycling and reuse may limit their exposure to these costs.
Metrics HC-DY-150a.1. Total amount of medical waste: percentage (a) incinerated, (b) recycled or treated and (c) landfilled 1 The entity shall disclose the total amount of medical waste generated, in metric tons, aggregated for all facilities it owns and operates, and the percentage (a) incinerated, (b) recycled or treated and (c) landfilled.
2 Medical waste (also known as regulated medical waste, infectious waste,
2 Medical waste (also known as regulated medical waste, infectious waste,
biomedical waste or biohazardous waste) that may be subject to applicable jurisdictional laws or regulations includes:IFRS S2 CLIMATE-RELATED DISCLOSURES–JUNE 2023© IFRS Foundation 5
2.1
Cultures and stocks—cultures and stocks of infection agents and associated biological cultures, including cultures from medical and pathological laboratories, and stocks of infectious agents from research and industrial laboratories, waste from the production of biological,
discarded, live and attenuated vaccines, and culture dishes and devices used to transfer, inoculate and mix cultures.
2.2
Pathological wastes—human pathological wastes, including tissues,
2.2
Pathological wastes—human pathological wastes, including tissues,
organs, body parts and body fluids removed during surgery and autopsy,
or other medical procedures, and specimens of body fluids and their containers.
2.3
Human blood and blood products—(1) liquid waste human blood; (2) blood products; (3) items saturated or dripping with human blood; or (4) items saturated or dripping with human blood now caked with dried human
saturated or dripping with human blood now caked with dried human blood, including serum, plasma and other blood components, and their containers used or intended for use in patient care, testing and laboratory analysis, or the development of pharmaceuticals. Intravenous bags also are included in this category.
2.4
Sharps—sharps used in animal or human patient care or treatment, or in medical research or industrial laboratories, including hypodermic needles,
medical research or industrial laboratories, including hypodermic needles,
syringes (with or without the attached needle), Pasteur pipettes, scalpel blades, blood vials, needles with attached tubing and culture dishes (regardless of presence of infectious agents). Also included are other types of broken or unbroken glassware that were in contact with infectious agents, such as used slide and cover slips.
2.5
Animal waste—contaminated animal carcasses, body parts and bedding of
2.5
Animal waste—contaminated animal carcasses, body parts and bedding of animals known to have been exposed to infectious agents during research (including research in veterinary hospitals), production of biologicals or testing of pharmaceuticals.
2.6
Isolation wastes—biological waste and discarded materials contaminated with blood, excretion, exudates or secretions from humans who are isolated to protect others from specific highly communicable diseases, or
isolated to protect others from specific highly communicable diseases, or isolated animals known to be infected with highly communicable diseases.
2.7
Unused sharps—unused, discarded sharps including hypodermic needles,
suture needles, syringes and scalpel blades.
3 The entity shall calculate the percentages of medical waste by their final disposition method as the total weight of medical waste generated that was (a)
disposition method as the total weight of medical waste generated that was (a) incinerated, (b) recycled or treated and (c) landfilled, divided by the total weight of medical waste generated.
3.1
Recycling or treatment shall include disposal via recycling facility,
treatment facility or other (for example, return to a supplier or commercial composting).
4 If the entity uses a waste transport service, broker or intermediary to handle its
4 If the entity uses a waste transport service, broker or intermediary to handle its medical waste, the entity shall make a good faith effort to determine the final disposition method.
IFRS S2 INDUSTRY-BASED GUIDANCE 6© IFRS Foundation
HC-DY-150a.2. Total amount of: (1) hazardous and (2) non-hazardous pharmaceutical waste, percentage (a) incinerated, (b) recycled or treated and (c) landfilled 1 The entity shall disclose (1) the total amount of hazardous pharmaceutical waste generated, in metric tons, aggregated for all facilities it owns and operates, and the percentage (a) incinerated, (b) recycled or treated and (c) landfilled.
1.1
Hazardous pharmaceutical waste is defined in accordance with applicable
1.1
Hazardous pharmaceutical waste is defined in accordance with applicable jurisdictional legal or regulatory framework(s) where the waste was generated.
1.2
Hazardous pharmaceutical waste generally displays these characteristics:ignitibility, corrosivity, reactivity or toxicity.
1.3
The entity shall calculate the percentage of hazardous pharmaceutical waste by the final disposition method as the total weight of hazardous
waste by the final disposition method as the total weight of hazardous pharmaceutical waste generated that was (a) incinerated, (b) recycled or treated and (c) landfilled, divided by the total weight of hazardous pharmaceutical waste generated.
1.3.1
Recycling or treatment shall include disposal via recycling facility,
treatment facility or other (for example, return to a supplier or commercial composting).
1.4
The entity may use the United Nations Environmental Programme (UNEP)
commercial composting).
1.4
The entity may use the United Nations Environmental Programme (UNEP) Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal for the purposes of defining hazardous pharmaceutical waste for operations located in jurisdictions that lack applicable legal or regulatory definitions.
1.5
The entity shall disclose the applicable jurisdictional standard or regulation used to define hazardous pharmaceutical waste.
2
regulation used to define hazardous pharmaceutical waste.
2 The entity shall disclose (2) the total amount of non-hazardous pharmaceutical waste generated, in metric tons, aggregated for all facilities it owns and operates,
and the percentage (a) incinerated, (b) recycled or treated and (c) landfilled.
2.1
Non-hazardous (solid) waste is defined as any garbage or refuse, sludge from a wastewater treatment plant, water supply treatment plant, or air
from a wastewater treatment plant, water supply treatment plant, or air pollution control facility and other discarded material, including solid,
liquid, semi-solid, or contained gaseous material resulting from industrial,
commercial, mining and agricultural operations, and from community activities. It may require special handling because it is a controlled substance or poses an environmental or human health threat.
2.2
The entity shall calculate the percentages of non-hazardous
2.2
The entity shall calculate the percentages of non-hazardous pharmaceutical waste by their final disposition method as the total weight of non-hazardous pharmaceutical waste generated that was (a) incinerated,
(b) recycled or treated and (c) landfilled, divided by the total weight of non-
hazardous pharmaceutical waste generated.
2.2.1
Recycling or treatment shall include disposal via recycling facility,
treatment facility or other (for example, return to a supplier or
treatment facility or other (for example, return to a supplier or commercial composting).
IFRS S2 CLIMATE-RELATED DISCLOSURES–JUNE 2023© IFRS Foundation 7
3 If other disposition methods for hazardous or non-hazardous pharmaceutical waste exist (for example, composting or permanent long-term storage), then the entity should disclose these.
4 If the entity uses a waste transport service, broker or intermediary to handle its pharmaceutical waste, the entity shall make a good faith effort to determine the final disposition method.
Climate Change Impacts on Human Health & Infrastructure Topic Summary
final disposition method.
Climate Change Impacts on Human Health & Infrastructure Topic Summary An increase in extreme weather events associated with climate change may present physical threats to health care delivery facilities and create challenges in serving affected populations. Coupled with the potential spread of infectious diseases and food and water scarcity, these events may present material implications for the Health Care Delivery industry.
Metrics
industry.
Metrics HC-DY-450a.1. Description of policies and practices to address: (1) the physical risks because of an increased frequency and intensity of extreme weather events,
(2) changes in the morbidity and mortality rates of illnesses and diseases associated with climate change and (3) emergency preparedness and response 1 The entity shall describe the nature, scope and implementation of its policies and practices related to addressing the risks to physical infrastructure and assets
practices related to addressing the risks to physical infrastructure and assets presented by changes in the frequency, severity, type and geographical location of extreme weather events such as:
1.1
Risks to physical infrastructure located in flood prone low-lying or hurricane-prone areas
1.2
Risks to physical infrastructure based on facility design, such as having important medical equipment in basements or the availability of backup power 2
important medical equipment in basements or the availability of backup power 2 The entity shall describe the nature, scope and implementation of its policies and practices related to addressing the risks presented by the changes in prevalence,
geography and severity of some diseases likely to be impacted by climate change,such as:
2.1
The need for added or flexible capacity because of an influx of patients suffering from heat-related illness
2.2
suffering from heat-related illness
2.2
Obtaining the necessary facilities and expertise to identify and treat changing disease profiles in patients, including:
2.2.1
Malaria, dengue fever and other vector borne diseases that affect tropical populations, but, because of climate change, may target non-tropical regions in the future
2.2.2
Heat-related diseases (for example, lung diseases such as asthma caused by increases in ground level ozone) IFRS S2 INDUSTRY-BASED GUIDANCE 8© IFRS Foundation
2.2.3
Waterborne diseases (for example, cholera because of increased flooding incidence)
2.2.4
Human developmental disorders (for example, malnutrition because of decreased food availability) 3 The entity shall describe the nature, scope and implementation of its policies and practices related to emergency preparedness and response.
3.1
The discussion shall include the regulatory environment in which the entity operates and whether it requires specific emergency preparedness
entity operates and whether it requires specific emergency preparedness and response plans.
3.2
The entity may disclose whether it has implemented external policies or best practices voluntarily, such as those outlined in the World Health Organization’s Hospital Emergency Response Checklist.
IFRS S2 CLIMATE-RELATED DISCLOSURES–JUNE 2023© IFRS Foundation 9
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