Long-Term Care Turns Energy Dollars into Health Care Dollars

Effective energy management in long-term care (LTC) facilities can go a long way to assisting in the redirection of utility dollars back into client care dollars, without negatively impacting either client comfort or service delivery. Dozens of Canadian LTC facilities, such as Winnipeg’s Fred Douglas Lodge, Markdale’s Grey Gables Home for the Aged, Saint Luke’s Place (Cambridge, ON) and the Kenneth E. Spencer Memorial Home (Moncton, NB), have embraced energy efficiency.

In so doing they are taking advantage of a long list of benefits not the least of which are reduced energy consumption and energy costs, a reduction in hazardous greenhouse gas (GHG) emissions and more comfortable client-care and staff working environment. Facilities committed to improved energy efficiency also can benefit from access to federal funding of up to $250,000 to assist with planned energy retrofit projects, under Natural Resources Canada’s Energy Innovators Initiative.

Size Doesn’t Matter

Energy retrofit projects range in complexity from simple light bulb replacements to major heating, ventilation and air conditioning (HVAC) installations but, regardless of the size and character of a site, there is something every department can do to help reduce utility consumption and it needn’t cause undue hardship. It is generally accepted that 10% savings in energy use can be readily achieved simply through operational changes brought about by increased awareness.

Most LTC facilities are pretty straightforward buildings with straightforward mechanical and electrical systems… even casual management of the operation of heating, ventilation and airconditioning systems can provide huge savings compared to simply letting them run without control or care. This equipment is responsible for more than half the energy costs in most LTC facilities, and saving at least 10% is usually something that takes virtually no investment other than a few hours of time.Dale Robertson, P.Eng. Enerscan Engineering, Halifax

Effective energy efficiency training is essential in getting the energy savings/conservation message out to staff, patients, volunteers, clients and third-party tradespeople who frequent your facility. So too is training of staff to properly operate and maintain your many electronic and mechanical systems.

This people-based science of energy efficiency must be woven into an effective overall energy management strategy that often starts with a basic utility consumption tracking system sometimes referred to as a “Monitoring & Tracking” system.

Findings released from a 1999 survey of Canadian health care facilities revealed that annual energy cost intensity is directly related to the frequency of data collection. The more frequent the data collection, the lower the energy cost intensity. Facilities assembling data on a daily basis reported a mean energy cost of 14.6 percent lower than other facilities. Once you are in a position to quantify your actual utility consumption patterns, you are better prepared to set about developing a plan to reduce consumption. At this juncture you may want to consider an energy audit and study the feasibility of various initiatives you and your staff identify as worthy of consideration.

Figure 1 lists some of the more common energy retrofit projects and the associated benefits. You may notice that ‘energy savings’ accrue from each. The listing also parallels the projects that have been successfully implemented in numerous Canadian LTC homes and for which federal funding has been received under the Energy Innovators Initiative (EII).

Energy Efficiency in Action

The Kenneth E. Spencer Memorial Home is a 200-bed, LTC facility in New Brunswick and many of the initiatives listed above formed part of their energy retrofit programme. According to Executive Director, Steven Campbell, the project was relatively straight forward: “Conceive an idea, garner support, get the idea financed, hire the right people to manage it and then take action. Lastly, and most importantly, reap the benefits!”

Energy retrofit projects have also been high on the agendas for many other homes including Saint Luke’s Place Home for the Aged (Cambridge, ON) and Grey Gables Home for the Aged (Markdale, ON). Both have recently completed projects, funded in part through EII. Grey Gables is anticipating its DDC (Direct Digital Control) retrofit project will bring about $19,000 in annual energy savings. Saint Luke’s replaced over fifteen hundred outdated T12 fluorescent light fixtures with new energy efficient T8 fluorescent tubes and electronic ballasts. Annual energy savings are anticipated to be in excess of $29,000. Combined, the actions of these two facilities represent yearly savings of approximately 3,000 Gigajoules of energy or about $48,000.

“Lighting has improved tremendously throughout the entire facility.” says Pieter Vos, Director of Maintenance at Saint Luke’s Place. “It is brighter and more reliable and now that the minimum energy savings criteria has been lifted from the Energy Innovator funding, we look forward to moving ahead with the next phase of our energy retrofit work and taking advantage of additional financial incentives. I encourage all homes … to investigate the prospects of Energy Innovator funding … “

Renewable Energy as an Energy Efficiency Option

According to Natural Resources Canada’s Jeff Knapp, LTC facilities have energy use patterns that are very compatible with renewable energy (RE) technologies. Installing RE technologies permits facilities to reduce their reliance upon traditional fuel sources while saving energy dollars and reducing GHG emissions. Since LTC facilities use large volumes of hot water, they are perfect candidates to employ solar water preheating. The higher the hot water load, the greater the savings can be with solar. Solar can also be used economically to preheat ventilation air.

Rockwood Terrace Home for the Aged (Durham, ON) recently installed thirty solar collector panels and two 400-gallon storage tanks to assist them in reducing their utility bills. Building Services Manager, Brian Manser, claims “The solar initiative is expected to produce the equivalent of 75,000 kilowatt hours per year and result in significant energy savings for the facility.” Based upon current subsidized electricity rates, the savings are expected to be approximately $4,500. Utilizing renewable energy such as solar can help to cushion against the uncertainty of rising electricity charges.

“RE technologies also come with peace of mind. They give control of energy price back to the facility, since they are not vulnerable to the large and unpredictable price increases associated with fossil fuels.”Jeff Knapp, NRCan - Renewable Energy Deployment Initiative

Moving Beyond – A Case Study

Winnipeg’s Fred Douglas Lodge (FDL), a 136-bed long-term care and assisted living residence, has taken its involvement in energy efficiency far beyond upgrades to building envelope and mechanical systems.

FDL was built in the mid-1960’s with several additions having been added since then. From the mid-1990’s until 2001, utility costs had increased by 35% with no corresponding increase in funding. While the senior management team was exploring various ways to contain rising costs they became aware the Energy Innovators Initiative (EII).

Energy Innovators Initiative (EII) Provides Incentives to Move Forward

The EII is a voluntary federal programme of NRCan’s Office of Energy Efficiency (OEE) designed to help institutions explore energy efficiency options and strategies. Member organizations pledge to work towards the reduction of GHG through more prudent energy consumption practices. In exchange, EII (www.oee.nrcan.gc.ca/eii) offers access to tools, services and energy retrofit incentives of up to $250,000 delivered through Energy Innovators Officers who work with members as they pursue energy management planning and retrofits.

In 1999, the Canadian College of Health Service Executives (CCHSE), on behalf of their energy efficiency partner, NRCan, provided FDL with EII programme documentation and invited their Executive Director to enroll. The materials incited FDL to complete their Energy Management Action Plan (EMAP) and in so doing define their long-term energy management strategy.

As a smaller facility with an aging infrastructure, the energy efficiency challenges at FDL were many. They lacked both the necessary funds to implement the required retrofit initiatives that would generate energy savings and their energy bill and projected savings were far below the minimum level that at the time qualified them for assistance. Management was, however, cognizant that by initiating a low cost in-house employee awareness campaign they could begin to realize energy savings almost immediately.

Initiatives on the Move

The Director of Support Services, Mark Nore, assumed the role of ‘Energy Champion’ and has been integral to the success of the initiative. Through the Environmental Services Team, FDL embarked upon a major campaign engaging staff to consider the daily actions they could take to reduce energy consumption such as turning off lights when leaving a room, reporting dripping taps, etc. Displays were set up in the main entrance area providing information on what can be done at home to save energy and the organization’s in-house newsletter was used to provide tips on how to ‘Think Green’.

Thanks to the assistance of FDL’s facility management company, Aramark Canada, FDL was able to work with an Aramark consultant who prepared an energy audit. Many energy saving opportunities such as boiler replacement and lighting projects were identified and the process of tackling each inefficiency one step at a time soon began.

Two of FDL’s four 1970’s vintage boilers were replaced with new energy efficient ‘heat on demand’ boilers. This $75,000 project is expected to generate utility savings of about $6,000 per year. The remaining two boilers are currently being replaced.

A full lighting audit has also just been completed and FDL is moving to replace all incandescent ‘EXIT’ signs with new energy efficient LED models. The local utility company, Manitoba Hydro, provided an incentive to purchase the new hardware and FDL is covering the installation cost. Existing T-12 fluorescent lighting fixtures are also being replaced with T- 8 fluorescent fixtures containing energy efficient electronic ballasts.

Staff is further studying the merit of upgrading to compact fluorescent wall sconce lighting and installing motion sensors in public washrooms and meeting rooms. Utility savings in excess of $11,000 per annum are expected to result from these upgrades. In many jurisdictions across Canada there is assistance available for such projects from local utility companies.

"We are planning to use Energy Innovator funding for our next project which will involve switching from T12 to T8 lighting and changing all EXIT lights to LED. This move alone will add thousands of dollars back into our operating budget."Mark Nore, Director of Support Services, Fred Douglas Society

SECTOR CHAMPIONS – Sharing Enthusiasm and Expertise

Not only is staff at FDL making a significant impact on GHG emissions reduction and redirecting operational savings back into client care through their initiatives but they are taking time to share their project successes and lessons learned with colleagues from other organizations. Staff at FDL believes that energy efficiency should be a concern for everyone and to that end they have undertaken to participate in a number of workshops, clinics and conferences sponsored by NRCan, CCHSE and other professional associations.

"Addressing energy efficiency is a very proactive approach to take particularly in light of ever-increasing utility costs. It helps us get the most out of our funding." Mark Nore, Director of Support Services, Fred Douglas Society (Winnipeg)

For the past three years the Manitoba Provincial Health Conference has provided an energy efficiency awareness booth as part of its yearly event to showcase the energy efficiency accomplishments of provincial health care facilities. Each year staff from FDL have joined with other energy champions from facilities such as Brandon Regional Health Authority, Winnipeg Health Sciences Centre and Seven Oaks General Hospital to promote their energy savings initiatives. This helped to raise the profile of the value of effective energy management programs within the long-term care sector and has served to galvanize others within the sector to embrace energy efficiency as a basic operating principle.

In the fall of 2003, FDL continued their outreach activities by hosting an energy awareness workshop for local LTC facilities. Manitoba Hydro and representatives from the regional health authority were invited to learn more about recent funding changes that make it more attractive for smaller facilities to access federal incentive monies. A local lighting company was also on hand to answer questions and demonstrate new energy efficient lighting solutions. As a result, many in attendance have now become members of the EII program and energy efficiency is now an integral part of monthly meetings among the region’s LTC maintenance managers.

Fred Douglas Lodge staff is encouraged by their successes and is pleased to set an example of healthy energy stewardship for others to follow. According to Mark Nore, “Fred Douglas Lodge will continue to share our energy efficiency knowledge and expertise with our colleagues. It is a win-win scenario for us all”.

What Next?

Increasingly, LTC providers are acknowledging the many benefits to adopting energy efficiency into their operating plans. Energy efficiency initiatives can help to reduce GHG emissions and generate significant dollar savings that can be reallocated to other critical needs within the organization at a time when little new money is available from funders to address the growing needs of our aging population.

The scope of energy awareness and retrofit opportunities is immense taking into account both people-based awareness and training and the many technological systems and subsystems. Facilities across the country continue to learn about the virtually unlimited potential to get involved and have a positive impact on the health of their residents, staff and the communities they serve.

The initiatives outlined above represent just a few of the thousands of energy efficiency projects that have been carried out within LTC homes in the recent past. These and similar projects within the Canadian health care sector as a whole have precipitated the conversion of approximately $40M in utility dollars back into client care and client services. NRCan has assisted with many of these projects by placing in excess of $5.5M in EII incentives into the sector.

If you are preparing to implement an energy efficiency retrofit project or need financial assistance with your feasibility study and/or energy audit, you are encouraged to consider EII. To date, over eighty-five LTC organizations have made a public pledge to reduce their GHG emissions and help foster a better understanding of our environment. Is your facility next?

EII members must own, manage or lease a Canadian building or buildings, in sectors such as health care, education or non-profit. Projects with signed contracts or where work has already commenced are NOT eligible. See Programme documents for complete details on eligibility or speak with an EII officer.