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Resources

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Public Tools

There are a number of tools tailored specifically to hospitals and healthcare facilities that should provide a strong resource foundation to begin implementing sustainable practices without compromising your institution’s strict regulatory and safety requirements.

We’ve compiled a comprehensive list of these tools, categorized according to the Planning Process Step where they will be most useful to you and your team.

Welcome to The New York Healthcare Decarbonization Guide.This guide is the primary resource of the New York Healthcare Protocol (NYHP), an ongoing public/private collaboration by more than 80 organizations, all of whom have contributed time, energy and expertise toward the development of this guide. The guide will aid hospitals in New York State and beyond with their decarbonization efforts. It provides first-steps assistance and technical guidance to hospitals preparing to meet climate goals as set forth in New York State’s Climate Leadership and Community Protection Act (CLCPA), also known as The Climate Act. That Act, which was passed into law in 2019, mandates that Greenhouse Gas (GHG) emissions in New York State be reduced to 40% below 1990 levels by 2030, and 85% below 1990 levels by 2050 1. In the wake of The Climate Act, other local legislation has been enacted, including New York City’s Local Law 97. Federal legislation is expected to follow in the near future 2. In anticipation of these new laws, an increasing number of hospitals around New York State are getting serious about strategically reducing their carbon emissions.This guide was created to support facility directors and other hospital staff in those decarbonization efforts. It contains tools and resources that will help hospital personnel to evaluate the current state of their facilities, develop an overall decarbonization strategy, identify and prioritize individual decarbonization projects, and secure the funding needed to cost-effectively complete them.This guide will help hospitals of all types and of all sizes, those with abundant resources and those without, to navigate the decarbonization process while also realizing their resiliency goals. It will be especially helpful to hospitals that are just beginning their decarbonization journey, however even hospitals in the midst of a decarbonization initiative may find it useful and informative.DISCLAIMER: The views and opinions expressed in this document are those of the authors and do not necessarily represent official policy or views of the Decarbonization with Resilience Steering Committee or any of its partner organizations or contributors. For more information on the laws and regulations governing your facility improvement projects, please refer to New York State and local government resources.1 State of New York Official Website, https://climate.ny.gov2 The White House Official Website, https://www.whitehouse.gov/climate/ Public Tools
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Considerations

Issues and obstacles are inevitabilities in any project, large or small. This section was created to provide an overview of many of the issues that other hospitals have encountered over the course of their decarbonization initiatives. Consider it less a problem-solution resource than a list of things to be aware of as your planning and implementation processes proceed.

Welcome to The New York Healthcare Decarbonization Guide.This guide is the primary resource of the New York Healthcare Protocol (NYHP), an ongoing public/private collaboration by more than 80 organizations, all of whom have contributed time, energy and expertise toward the development of this guide. The guide will aid hospitals in New York State and beyond with their decarbonization efforts. It provides first-steps assistance and technical guidance to hospitals preparing to meet climate goals as set forth in New York State’s Climate Leadership and Community Protection Act (CLCPA), also known as The Climate Act. That Act, which was passed into law in 2019, mandates that Greenhouse Gas (GHG) emissions in New York State be reduced to 40% below 1990 levels by 2030, and 85% below 1990 levels by 2050 1. In the wake of The Climate Act, other local legislation has been enacted, including New York City’s Local Law 97. Federal legislation is expected to follow in the near future 2. In anticipation of these new laws, an increasing number of hospitals around New York State are getting serious about strategically reducing their carbon emissions.This guide was created to support facility directors and other hospital staff in those decarbonization efforts. It contains tools and resources that will help hospital personnel to evaluate the current state of their facilities, develop an overall decarbonization strategy, identify and prioritize individual decarbonization projects, and secure the funding needed to cost-effectively complete them.This guide will help hospitals of all types and of all sizes, those with abundant resources and those without, to navigate the decarbonization process while also realizing their resiliency goals. It will be especially helpful to hospitals that are just beginning their decarbonization journey, however even hospitals in the midst of a decarbonization initiative may find it useful and informative.DISCLAIMER: The views and opinions expressed in this document are those of the authors and do not necessarily represent official policy or views of the Decarbonization with Resilience Steering Committee or any of its partner organizations or contributors. For more information on the laws and regulations governing your facility improvement projects, please refer to New York State and local government resources.1 State of New York Official Website, https://climate.ny.gov2 The White House Official Website, https://www.whitehouse.gov/climate/ Considerations
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Glossary

Part of your decarbonization journey is learning the language. We’ve complied a glossary, based upon the final published ASHE glossary.

Welcome to The New York Healthcare Decarbonization Guide.This guide is the primary resource of the New York Healthcare Protocol (NYHP), an ongoing public/private collaboration by more than 80 organizations, all of whom have contributed time, energy and expertise toward the development of this guide. The guide will aid hospitals in New York State and beyond with their decarbonization efforts. It provides first-steps assistance and technical guidance to hospitals preparing to meet climate goals as set forth in New York State’s Climate Leadership and Community Protection Act (CLCPA), also known as The Climate Act. That Act, which was passed into law in 2019, mandates that Greenhouse Gas (GHG) emissions in New York State be reduced to 40% below 1990 levels by 2030, and 85% below 1990 levels by 2050 1. In the wake of The Climate Act, other local legislation has been enacted, including New York City’s Local Law 97. Federal legislation is expected to follow in the near future 2. In anticipation of these new laws, an increasing number of hospitals around New York State are getting serious about strategically reducing their carbon emissions.This guide was created to support facility directors and other hospital staff in those decarbonization efforts. It contains tools and resources that will help hospital personnel to evaluate the current state of their facilities, develop an overall decarbonization strategy, identify and prioritize individual decarbonization projects, and secure the funding needed to cost-effectively complete them.This guide will help hospitals of all types and of all sizes, those with abundant resources and those without, to navigate the decarbonization process while also realizing their resiliency goals. It will be especially helpful to hospitals that are just beginning their decarbonization journey, however even hospitals in the midst of a decarbonization initiative may find it useful and informative.DISCLAIMER: The views and opinions expressed in this document are those of the authors and do not necessarily represent official policy or views of the Decarbonization with Resilience Steering Committee or any of its partner organizations or contributors. For more information on the laws and regulations governing your facility improvement projects, please refer to New York State and local government resources.1 State of New York Official Website, https://climate.ny.gov2 The White House Official Website, https://www.whitehouse.gov/climate/ Glossary

Interested in learning more about the guide? Check out our launch presentation and webinar here

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Public Tools

The New York Healthcare Protocol has compiled a robust list of online and publicly available resources to support your decarbonization efforts, especially when it comes to measuring and modeling your facility’s energy/emissions profile and broader environmental impacts. Keep in mind, however, that most in-depth analysis tools require a one-time purchase or yearly subscription. That said there are various free resources and tools available (most notably Energy Star Portfolio Manager) that can assist you in modeling energy efficiency ratings and usage trends.
Step1

Designate an Initiative Leader

Step2

Understand the Regulatory Landscape

Step3

Establish Your Baselines

GHC Inventory Development Process and Guidance

The EPA provides a thorough and highly useful protocol for inventorying greenhouse gas emissions through the Center for Corporate Client Leadership.  The tool is based on a four-step process that covers standards and methods, data collection, mitigation plan development, and reporting. The EPA GHG Inventory Development Process Guidance can be found here.

The Energy to Care Dashboard Tool

A popular tool for hospitals, ASHE’s Energy to Care Dashboard Tool is an easy-to-use benchmarking and monitoring tool that provides an at-a-glance view of your facility’s energy use.  Designed to deliver comprehensive monitoring with a time investments of roughly 15 minutes a day, the Energy to Care Dashboard Tool combines a clean and simple interface with powerful features including ENERGY STAR® data options, energy and cost date widgets, and utility bill fault detection.

Ashe Dashboard

The Practice Greenhealth Network Benchmark Tool

This tool is available to users of the Practice Greenhealth Network and those of Healthcare Without Harm. It allows users to enter information about their electricity use, thermal energy use, and emissions.  The calculator then converts the information into impact estimates on community health and wellness.  The estimates cover factors ranging from illness and early mortality to missed workdays and other effects.  The calculator will estimate using regionally appropriate factors if the user enters their geographic information.

Calculator

ECO-III Energy Conservation in Hospitals

These guidelines, which resulted from a joint initiative by the US Government and the Government of India, provide benchmarking tools for energy systems as well as tools to help builders estimate the efficiency gains from more efficient building designs. Learn More or Read The Publication.

Design Schematics

All HVAC systems in current use fall into one of four categories.  Those categories are Air-to-Air, Air-to-Water, Water-to-Water, and Water-to-Air. Each has its own unique architecture and set of system components.

Step4

Gather Your Team

RACI Matrix

A RACI matric is a tool to help clarify roles, responsibilities, and relationships and ensure clear communication as well as smooth and streamlined workflows.  It is designed to help ensure that the right individuals/teams are connected to and consulted during the appropriate times throughout the strategy implementation process.

Step5

Set Vision & Map Strategy Tools

Decision-Making Matrix

This multi-page spreadsheet will allow you to enter your list of potential projects, weight their importance, score them according to various criteria, assess their financial impact, and even create preliminary budgets for them. In short, it contains everything you need to create a realistic and actionable strategic plan.

The Advanced Energy Design Guide for Large Hospitals, Achieving 50% Energy Savings toward a Net Zero Energy Building

This publication series is designed to help larger hospitals achieve energy savings that exceed minimum code requirements of ANSI/ASHRAE/IES Standard 90.1. For hospitals seeking to achieve a net-zero building (a building that annually draws an equal or lesser amount of energy from outside sources than it consumes) this guide is an excellent first step.

Reducing Healthcare Carbon Emissions A Primer on Measures and Actions for Healthcare Organizations to Mitigate Climate Change

This publication is intended as a starting point, a precursor to a larger and more comprehensive clean energy strategy. For hospitals who are interested in issues such as integrating environmental concerns into the definition of healthcare value, moving to a circular economy, and expanding preventive models of care, it is an excellent primer.

The ASHE Energy To Care Tool Kit

This publication contains resources designed to help organizations cut energy consumption and get more out of the Energy to Care program.

The ASHE Sustainability Tool Kit

For hospitals looking for a step-by-step guide to creating and implementing a sustainability program – either a new program or one that may already be underway – this guide is a helpful resource.

US Department of Health and Human Services Resources Page

Health and Human Services as a national hub for information on climate change and health policy. On this page you’ll find a range of federal resources designed to help organizations reduce climate change and its impact on the health of the American people.

Large Hospital 50% Energy Savings: Technical Support Document

This document was created by the Commercial Buildings Group at the National Renewable Energy Laboratory (NREL). It is a technical document that provides guidance and modeling methods for hospitals seeking to achieve whole-building energy reductions of 50% or more over existing standards (ANSI/ASHRAE/IESNA Standard 90.1-2004).

The Healthcare Without Harm Website

A resource repository of materials created to advance the goal of transforming healthcare worldwide, this web page contains a wealth of information on reducing carbon footprints, and environmental health and justice.

Healthcare Environmental Resource Center (HERC)

HERC is an organization devoted to pollution prevention and the reduction of hospital waste. This website is a comprehensive resource for compliance information, both federal and state, for hospitals, dental practices, and assisted living and nursing care facilities.

The Advanced Energy Retrofit Guide for Healthcare Facilities

This publication is part of a series of retrofit guides that have been published by the Department of Energy.  For those seeking guidance on performance improvement, project planning, financial payback metrics, and energy efficiency measures (EEMs), this guide is an invaluable resource.

US Environmental Protection Agency – E3 Energy Efficiency Tools

E3 is a technical assistance resource that spans six different agencies of the federal government. It was originally formed in 2009 for the purpose of advancing sustainability goals while also revitalizing the economy.  The site contains at least 8 different tools and resources, all designed to help stakeholders and assessment teams to improve in different areas.

Step6

Secure Funding

Safety Net Hospitals

New York Power Authority (NYPA)

Energy Efficiency (HVAC, LED Lighting, GSHP, etc.)

Improve your building’s energy efficiency through HCAC, building envelope, LED lighting, wastewater upgrades and more. NYPA helps you meet State guidelines and manages projects, ranging from simple improvements to complex clean energy retrofits across hundreds of buildings.  We can help achieve your goals with low-cost financing and no upfront investment.

Advisory Services (Audits, RCx, Energy Master Planning)

NYPA acts as a true partner to help you implement the right clean energy solution.  We provide strategic guidance and payback analysis to inform your decision.  We can plan and manage short- and long-term projects – resulting in the best implementation plan that meets your cost and energy needs.

EV Charging Infrastructure

We can lead you through the complex process of electrifying your fleet.  We offer an end-to-end approach – starting with assessment cost-benefit analysis, route planning, contracting and procurement – through to the implementation and management of electrical systems and charging stations.

Solar Advisory

NYPA helps you implement the best solar energy solution for you.  We offer a full range of options and are experts in all areas – including on-site solar, community solar and storage.  We act as your partner, and start with a free consultation and a true cost-benefit analysis to help you decide if solar is right for you.  If you decide to implement, we can plan, develop and install a solar solution at your site.

Market+ Power Supply

Economic Development Hydropower Supply

NYPA Programs

Step7

Implement

LEED Certification: Applying LEED to Healthcare Projects

Not an energy benchmarking tool per se, this site contains checklists/guidelines to help you achieve higher building energy efficiency and reduce carbon emissions in alignment with the LEED Rating System.  By incorporating the recommended sustainability measures and meeting the certification criteria, healthcare facilities an significantly conserve energy and water, minimize waste, and actively contribute to emission reductions through special guidelines that adhere to the unique operational requirements for healthcare facilities.

Step8

Measure & Verify

M&V Guidelines: Measurement and Verification for Performance-Based Contracts Version 4.0

This document contains procedures and guidelines to help organizations quantify the savings that result from the installation of energy efficient equipment, water conversation efforts, operations and maintenance improvements, renewable energy initiatives, and cogeneration projects conducted under performance-based contracts.

Guidebook for Energy Efficiency Evaluation, Measurement and Verification

Developed by the EPA’s State and Local Energy and Environment Program, this guide helps homeowners, businesses, and other organizations confirm that their energy efficiency programs are resulting in the expected levels of energy savings, and ensure their quantification and verification approaches are well-documented, rigorous, and consistently applied.

Evaluation, Measurement & Verification Guidance

This document was created to provide guidance to utilities, the New York State Energy Research and Development Authority (NYSERDA), and other evaluators on the proper way to conduct evaluation, measurement and verification (EM&V) activities associated with ratepayer-funded clean energy programs.

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Considerations

Issues and obstacles are inevitabilities in any project, large or small. This section was created to provide an overview of many of the issues that other hospitals have encountered over the course of their decarbonization initiatives.  Consider it less a problem-solution resource than a list of things to be aware of as your planning and implementation processes proceed.

General

Each building sector experiences its own unique set of challenges when it comes to implementing decarbonization projects. This short list, however, comprises a set of high-level considerations that are common to all. In your planning phase, it’s wise to be aware of:

  • Capital constraints and difficult return-on-investment evaluations.
  • Utility electrical grid decarbonization timelines and coordination.
  • Electrical grid reliability concerns as the utility electrical grid decarbonizes with zero-emission generation solutions.
  • Workforce training to operate and maintain new low-carbon HVAC system solutions.
  • Technology gaps to achieve replace-in-kind HVAC solutions with existing HVAC system infrastructure.
  • Building infrastructure limitations for electrification solutions for HVAC systems.

Building Code Conflicts

Resilience

Resilience is a consideration will be referenced often over the course of this guide. Particularly for healthcare facilities, maintaining rigorous, dependable 24/7 energy will always be a top priority.  The following considerations will be foremost in the minds of every healthcare facility that undertakes decarbonization:

  • Uninterrupted patient care throughout implementation and operation of new low-carbon HVAC system solutions.
  • Building code requirements associated with maintaining safe indoor environments.
  • Operational safety factors associated with back-up equipment and energy sources to maintain resiliency.

HVAC

Every HVAC infrastructure upgrade plan should start with a holistic evaluation of your facility to ensure your team has explored every opportunity to increase efficiency, recover heat, and electrify. Consider the following structure as a high-level blueprint for your HVAC decarbonization strategy. It can be useful no matter where you are in the carbon reduction planning process:

  • Tier 1 – Optimize controls to reduce and conserve energy in your existing HVAC system(s).
  • Their 2 – Replace equipment and systems that have reached the limit of their useful life.
  • Tier 3 – Install new low-carbon HVAC solutions
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Glossary

The final list of definitions is contingent upon the final guide. All definitions will be developed using ASHE’s glossary.

ASHRAE
The American Society of Heating, Refrigerating and Air-Conditioning Engineers is an American professional association seeking to advance heating, ventilation, air conditioning and refrigeration systems design and construction.  ASHRAE has over 50,000 members in more than 130 countries worldwide.

Decarbonization

  • The process to phase out carbon dioxide equivalent emissions, in the form of both operational and embodied carbon.
  • Encompasses removing carbon from the process chain as well as carbon released from producing building materials.

GHG
Greenhgouse Gas

GHG Protocol
A widely accepted metric for accounting and reporting emissions.  The protocol classifies emissions as scope 1, 2 or 3:

  • Scope 1: Direct emissions. Emissions emanating directly from health care facilities and health care-owned vehicles.
  • Scope 3: Indirect emissions.  Indirect emissions from purchased energy sources such as electricity, steam, cooling and heating.
  • Scope 3: The lion’s share of emissions derived from the health care supply chain through the production, transport and disposal of goods and services, such as pharmaceuticals and other chemicals, food and agricultural products, medical devices, hospital equipment and instruments.

MVP
Minimum Viable Product

Operational Carbon
The greenhouse gas emissions associated with daily operations. Includes direct and indirect emissions.  For example:

  • Building energy consumption.
  • Anesthetic gases.
  • Refrigerants on-site.
  • Staff commuting.
  • Business travel.

Resiliency (Healthcare Specific)
The capacity of a system to maintain function in the face of complex hazards that challenge accepted baseline assumptions for infrastructure capabilities, redundancies and disaster preparedness and response.

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