Clark Reed, US EPA Hospitals for a Healthy Environment Conference December 6, 2007

1. Clark Reed, US EPAHospitals for a Healthy Environment Conference December 6, 2007 Improve Performance with ENERGY STAR Best Practices Lessons learned from top performing hospitals

2. Goals • Identify low-cost, high-return strategies to reduce energy consumption and save money • Top 10 Best Practices of Energy Star Hospitals

3. ENERGY STAR is… • A voluntary partnership • with EPA A strategic approach to energy management Recognized by 65% of Americans

4. ENERGY STAR is… Products Homes Businesses

5. ENERGY STAR Partners 14% of Healthcare organizations have partnered with ENERGY STAR Houston

6. “Only hospitals with modern high-tech equipment can be considered energy efficient.”

7. “New facilities that are poorly operated will always outperform older facilities that are well-run.”

8. “Large capital budgets are required in order to increase energy performance.”

9. “In-house energy management is so difficult that you need to hire outside energy experts.”

10. “Re-negotiating energy contracts is the most significant means to energy cost savings.”

11. Myths!

12. Benchmark Score 1 25 50 75 100 U.S. EPA Energy Performance Rating System The rating system overlays a 1 to 100 scale over national data, which gives relative meaning to energy use. Number of Buildings Highest Building Energy Use Lowest

13. U.S. EPA Energy Performance Rating System Number of Buildings Sample Acute care 177 bed facility 280,000 square feet 1 25 50 75 100 Benchmark Score 550 1052 KBtu/ft2/year 183 443 353 Highest Building Energy Use Lowest

14. Audit again Audit +5% 0 -5% Costs -10% Easy Actions Undertaken (obvious energy waste) Program Falters Savings lost due to lack of systems -15% -20% -25% 0 5 10 Years Typical EM Roller Coaster

15. +5% EM Program Initiated Cut energy waste 0 -5% Costs -10% Extra savings from operations and process improvements -15% -20% New Plant Technical Development -25% 0 10 5 Years A Systematic EM Process

16. Continuous Energy Management Requires… Management Framework (Policies and Procedures) Energy Management Strategy

17. Management Framework Management infrastructure needed to continuously improve

18. Assess Your Hospital’s Energy Management Program

19. Top 10 Best Practices

20. ENERGY STAR Labeled Buildings • Rating of 75 or higher on EPA 1 – 100 scale • Over 3,700 commercial buildings have earned the ENERGY STAR

21. ENERGY STAR Buildings = Low Carbon Buildings Use 35% less carbon dioxide (and less energy) than their peers,onaverage The Trust Mark of a Low Carbon Building

22. Commit to Continuous Improvement St. Francis Hospital and Medical Center (CT) • President and VP involved in all energy management issues • Energy Team includes diversity of staff • Follows “Master Plan for Energy”

23. 9. Assess Performance Shriners Hospital for Children – Houston, TX • Cut electricity use 18% • Reduced chilled water consumption 30% • Reduced steam demand 37% Avoided Costs over $1 million 94 92 88 75 42 ’96 ’03 ’04/’05 ’06 ‘07

24. 9. Assess Performance (cont’d) Shriners’ Improvements • LED lighting • Occupancy Sensors • Balanced air & water systems • Installed energy efficient motors • Installed variable frequency drives • New energy efficient motors and 2 new chilled water pumps in HVAC

25. 8. Set Goals Providence Health & Services Non-profit healthcare system of 26 hospitals in Pacific Northwest • 2-3% energy savings per year, system wide • 20% rate of return • Long-term goal of achieving Energy Star for all buildings within portfolio Selected Energy Star qualified facilities

26. Energy Management Strategy • Recommissioning • Lighting • Load Reductions • Fan Systems • Heating & Cooling

27. 7. Upgrade Equipment Sacred Heart Medical Center Spokane, WA • $750,000 investment in efficient lighting • T-8 lamps with electronic ballasts • LED exit signs • CFLs

28. 6. Address Central Plant New York-Presbyterian Hospital New York, New York • Delta T differential • VFD fans & pumps • Upgrade to efficient 4400-ton chiller • 1st hospital w/ CHP in New York City

29. 5. Recommission St. Francis Hospital & Health Services Marysville, MO • Cut gas bill by 50% • Reduced electricity bill by 17% • Increased rating 40 points in one year Avoided Costs over $800,000 92 88 85 91 51 ’02 ’03 ’04 ’05 ‘06

30. St Francis’ Improvements • Evaluated building equipment • Reduced operating time of boilers • Water temperature controls • Replaced boiler burners • Correctly installed heat exchanger • Installed T8s

31. Save 75% energy in “off” mode $10/year Life 10x $90/year $600/year $50/year 4. Purchase ENERGY STAR Qualified Products Calculate Savings

32. 3. Train Employees Albuquerque Indian Hospital • Training is a major focus of energy efficiency efforts • Attend 3 training courses each year • Trained to use controls systems • Routine (daily & monthly) preventative • maintenance checks

33. 2. Communicate (Internally) • Demonstrate social responsibility • Spread the word • Empower employees • Work with PR department

34. 2. Communicate (Externally) Public Service Announcement publicizing Partners of the Year Money Magazine US News & World Report Forbes Magazine Inside ASHE Shriners Hospital for Children – Houston named Partner of the Year for 2007

35. 1. Make the Business Case Non-profit $1 saved in energy is equivalent to generating new revenues of: $20 in hospitals $10 in medical offices For-profit A 5% reduction in energy costs is equivalent to increasing earnings per share by one cent

36. Get Started • Register for free online benchmarking training – held monthly, free of charge • All tools and resources in this presentation can be found free-of-charge at www.energystar.gov/healthcare • Join ENERGY STAR www.energystar.gov/join

37. Questions?

38. Clark Reed reed.clark@epa.gov Director of Healthcare Facilities Division ENERGY STAR, U.S. EPA www.energystar.gov/healthcare