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Page Page 11
Energy $aving $olutions for Hospitals
How Combined Heat and Power Systems are saving hospitals millions of dollars in operations and capital while helping protect the environment and public health.
Texas Hospital Association AudiocastTexas Hospital Association AudiocastNovember 1, 2005November 1, 2005
Austin, TexasAustin, Texas
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Purpose of Today’s AudioCastPurpose of Today’s AudioCast
Describe CHP and its Value Proposition in Describe CHP and its Value Proposition in Hospital SettingsHospital Settings
Encourage Hospital Executives to Evaluate Encourage Hospital Executives to Evaluate CHP in their FacilitiesCHP in their Facilities
Provide Information on How to Move Provide Information on How to Move Forward with CHPForward with CHP
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
IntroductionsIntroductions Moderator Moderator
– Robert MorozRobert Moroz, AIA, LEED AP, President, AIA, LEED AP, PresidentHealthcare Facilities Consultation and Planning; Austin, TexasHealthcare Facilities Consultation and Planning; Austin, Texas
SpeakersSpeakers– Dan BullockDan Bullock, Director , Director
Gulf Coast CHP Applications Center; The Woodlands, TexasGulf Coast CHP Applications Center; The Woodlands, Texas– Ed MardiatEd Mardiat, DBIA, Principal and Director of CHP Development , DBIA, Principal and Director of CHP Development
Burns & McDonnell Engineering Company; Kansas City, MissouriBurns & McDonnell Engineering Company; Kansas City, Missouri– Kim ShinnKim Shinn, P.E., LEED AP, Director of Sustainable Design, P.E., LEED AP, Director of Sustainable Design
TLC Engineering for Architecture; Brentwood, TennesseeTLC Engineering for Architecture; Brentwood, Tennessee– Gail VittoriGail Vittori, LEED AP, Co-Director , LEED AP, Co-Director
Center for Maximum Potential Building Systems; Austin, TexasCenter for Maximum Potential Building Systems; Austin, Texas
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
What is Combined Heat and Power (CHP)?What is Combined Heat and Power (CHP)?
Combined Heat and Power Plants:Combined Heat and Power Plants:– ““Recycle” normally wasted energy into steam Recycle” normally wasted energy into steam
and/or chilled water for use by the hospitaland/or chilled water for use by the hospital– Generates Electricity for a hospital on siteGenerates Electricity for a hospital on site
Provides 100% Primary (Normal) PowerProvides 100% Primary (Normal) Power Provides 100% Emergency backup powerProvides 100% Emergency backup power
– Are up to 250% more efficient at turning input Are up to 250% more efficient at turning input energy into useful energy than are energy into useful energy than are conventional electric utility plantsconventional electric utility plants
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Why Hospitals?Why Hospitals?
CHP CHP “Best User” Profile“Best User” Profile is: is:– Coincident electrical and thermal loads Coincident electrical and thermal loads – 24 hour/day, 7 day/week, 365 day/year 24 hour/day, 7 day/week, 365 day/year
operationoperation– Low Seasonal Variation in loadsLow Seasonal Variation in loads– High Power Reliability NeedsHigh Power Reliability Needs
Hospitals fit the Hospitals fit the “Best User” Profile“Best User” Profile for for Combined Heat and Power applicationsCombined Heat and Power applications
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Conventional Power Plants convert about 35% of their Conventional Power Plants convert about 35% of their primary input fuel into electricity; the remainder is lost “up primary input fuel into electricity; the remainder is lost “up the stack”. An additional 6% efficiency drop occurs in the stack”. An additional 6% efficiency drop occurs in transmission to the site. Overall, at the Hospital’s meter, the transmission to the site. Overall, at the Hospital’s meter, the result is roughly a result is roughly a 33% efficient primary fuel conversion to 33% efficient primary fuel conversion to useful energyuseful energy..
.33 BTU In
Power Plant Distribution System Hospital
.02 BTU LossCentralized Generation Model
How Typical Power Delivery WorksHow Typical Power Delivery Works
.65 BTU Loss
.35 BTU In1 BTU In
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Combined Cooling, Heating and Power Plants can be Combined Cooling, Heating and Power Plants can be 75% 75% efficient at primary fuel conversion to useful energy and, efficient at primary fuel conversion to useful energy and, because they are located on site, have no transmission loss.because they are located on site, have no transmission loss.
This is a This is a 42% savings in primary energy utilization42% savings in primary energy utilization compared compared to the Typical Power Delivery Model.to the Typical Power Delivery Model.
CHP Plant Hospital
CHP Model
How CHP WorksHow CHP Works
1 BTU In
.25 BTU Loss
.75 BTU In
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
CHP Electric Generation EquipmentCHP Electric Generation Equipment
Reciprocating Engines Microturbines
Gas TurbinesGas Turbines
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
CHP Heat Recovery SystemsCHP Heat Recovery Systems
Steam and Hot WaterSteam and Hot WaterExhaust GasesExhaust Gases
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
CHP Thermally Activated TechnologyCHP Thermally Activated Technology
Absorption ChillersAbsorption Chillers
Desiccant DehumidificationDesiccant Dehumidification
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
CHP Technology is ProvenCHP Technology is Proven
Installed in > 200 Hospitals in the U.S. Installed in > 200 Hospitals in the U.S. todaytoday
Average System Size = 2 MWMedian System Size = 230 kW
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Texas Tech Health Science CenterTexas Tech Health Science Center LubbockLubbock 25 MW25 MW TurbineTurbineNatural Natural
GasGas 19901990
Lackland AFB HospitalLackland AFB Hospital San AntonioSan Antonio10.4 10.4 MWMW TurbineTurbine
Natural Natural GasGas 19981998
UT Health Science CenterUT Health Science Center DallasDallas 4.6 MW4.6 MW EngineEngineNatural Natural
GasGas 19781978
Dell Children’s Medical CenterDell Children’s Medical Center AustinAustin 4.3 MW4.3 MW TurbineTurbineNatural Natural
GasGas 20052005
Providence Memorial HospitalProvidence Memorial Hospital El PasoEl Paso 4.2 MW4.2 MW EngineEngineNatural Natural
GasGas 19871987
R.E. Thomason HospitalR.E. Thomason Hospital El PasoEl Paso 2.4 MW2.4 MW EngineEngineNatural Natural
GasGas 19961996
Austin State HospitalAustin State Hospital AustinAustin 2.2 MW2.2 MW TurbineTurbineNatural Natural
GasGas 19901990
RBJ Health CenterRBJ Health Center AustinAustin 200 kW200 kW Fuel CellFuel CellNatural Natural
GasGas 20022002
Vista Hills Medical CenterVista Hills Medical Center El PasoEl Paso 180 kW180 kW EngineEngineNatural Natural
GasGas 19861986
CHP installed in Hospitals in TexasCHP installed in Hospitals in Texas
Page Page 1313
Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Who Benefits?Who Benefits?
PatientsPatients HospitalsHospitals Capital PartnersCapital Partners Utility CompaniesUtility Companies The PublicThe Public Federal, State and Local GovernmentsFederal, State and Local Governments The EnvironmentThe Environment
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Benefits to PatientsBenefits to Patients In local and regional disasters, patient transfers and In local and regional disasters, patient transfers and
evacuations can be deadly. evacuations can be deadly. Loss of power puts patients currently undergoing Loss of power puts patients currently undergoing
critical procedures at risk.critical procedures at risk. ““Brown outs” and “Voltage Sags” can shut down Brown outs” and “Voltage Sags” can shut down
sensitive diagnostic equipment and interrupt non-sensitive diagnostic equipment and interrupt non-critical procedurescritical procedures
A facility that can remain A facility that can remain fully functional fully functional can avoid can avoid these risks to its patients.these risks to its patients.
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
More Reliable Normal Power: More Reliable Normal Power: It is bad It is bad enough now when a hospital has to go on enough now when a hospital has to go on emergency power, but when a hospital emergency power, but when a hospital converts to fully digital Medical Records, converts to fully digital Medical Records, RFID/Bar Code Scan Drug delivery, RFID/Bar Code Scan Drug delivery, Computerized Physician Order Entry, etc., Computerized Physician Order Entry, etc., Health care delivery stops if the “lights go Health care delivery stops if the “lights go out”. out”.
Benefits to HospitalsBenefits to Hospitals
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Higher Quality Normal Power:Higher Quality Normal Power: Local Local generation provides fewer sags and surges. generation provides fewer sags and surges. Moving from normal power to grid backup Moving from normal power to grid backup is measured in “cycles”, not “seconds”.is measured in “cycles”, not “seconds”.
““Island” Power:Island” Power: In the event of a grid In the event of a grid failure due to natural, technical, or terrorist failure due to natural, technical, or terrorist causes, your strategic community asset will causes, your strategic community asset will remain in operation when needed most.remain in operation when needed most.
Benefits to Hospitals (continued)Benefits to Hospitals (continued)
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
More Backup Power:More Backup Power: CHP supplies 100% of the CHP supplies 100% of the Hospital’s needs; not just Life Safety Hospital’s needs; not just Life Safety requirements. (FYI, Texas Licensing Code does requirements. (FYI, Texas Licensing Code does not require Chillers to be on Backup.)not require Chillers to be on Backup.)
More Reliable Backup Power:More Reliable Backup Power: Probability of Probability of failure of the traditional Hospital “grid plus failure of the traditional Hospital “grid plus backup” is 67% according to Primen backup” is 67% according to Primen Perspective’s Perspective’s R RXX for Health Care Power for Health Care Power
FailuresFailures, DE-PP-24, 11/2003 , DE-PP-24, 11/2003
Benefits to Hospitals (continued)Benefits to Hospitals (continued)
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Intangible Benefits to HospitalsIntangible Benefits to Hospitals
Sustainable Design: Sustainable Design: Green Guide for Green Guide for Health Care (GGHC) points and Leadership Health Care (GGHC) points and Leadership in Energy Environmental Design (LEED)in Energy Environmental Design (LEED)
Public Relations: Public Relations: – Positive Press CoveragePositive Press Coverage– Community SupportCommunity Support
Philanthropic “edge”: Philanthropic “edge”: Foundations are Foundations are becoming interested in “Green” Buildingsbecoming interested in “Green” Buildings
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Economic Benefits to HospitalsEconomic Benefits to Hospitals Initial Capital Savings: Initial Capital Savings: A CHP plant owned A CHP plant owned
by a capital partner allows a hospital to by a capital partner allows a hospital to redirect it’s own capital (that would redirect it’s own capital (that would otherwise have been spent on chillers, otherwise have been spent on chillers, emergency generators, switchgear, boilers, emergency generators, switchgear, boilers, pumps and the Physical Plant Building to pumps and the Physical Plant Building to contain this equipment) towards its core contain this equipment) towards its core healthcare mission thus potentially saving healthcare mission thus potentially saving millions of dollars in construction costs.millions of dollars in construction costs.
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Economic Benefits to Hospitals (continued)Economic Benefits to Hospitals (continued)
Operating Cost Savings:Operating Cost Savings: At the hospital’s At the hospital’s option, capital savings can be traded for long option, capital savings can be traded for long term operating cost savings by:term operating cost savings by:– Increasing hospital equity in return for lower Increasing hospital equity in return for lower
power and thermal ratespower and thermal rates– Using portions of capital savings to improve the Using portions of capital savings to improve the
energy performance of the hospital itself energy performance of the hospital itself through demand side energy conservation through demand side energy conservation improvementsimprovements
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
The The “Numbers Pencil”“Numbers Pencil” from the Investor’s from the Investor’s perspectiveperspective
Low Risk of investing in a Low Risk of investing in a “Utility-Like”“Utility-Like” ventureventure
Investors are comfortable with Investors are comfortable with “Longer “Longer Returns”Returns” on Investments on Investments
Investing in these types of energy projects is Investing in these types of energy projects is their their “Core Business”“Core Business”
Benefits to Capital PartnersBenefits to Capital Partners
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
““Demand Side Management”Demand Side Management” costs less than constructing costs less than constructing new conventional power plants. new conventional power plants.
Places Places “Velvet Handcuffs”“Velvet Handcuffs” on a large customer in on a large customer in deregulated utility marketsderegulated utility markets
Useful to Utilities for grid power managementUseful to Utilities for grid power management Avoids Utility Investment where the grid is insufficient due Avoids Utility Investment where the grid is insufficient due
to congestion or in rural areas where it is underdeveloped.to congestion or in rural areas where it is underdeveloped.
Benefits to Utility CompaniesBenefits to Utility Companies
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Benefits to the PublicBenefits to the Public
Helps reduce respiratory illnessesHelps reduce respiratory illnesses– Less NOx, SOx, and PM Less NOx, SOx, and PM
Reduces green house gas emissionsReduces green house gas emissions– Less than half CO2 emitted per kWhLess than half CO2 emitted per kWh
Improved trade balancesImproved trade balances– More domestic, less imported energyMore domestic, less imported energy
Energy efficiency is good public policy!Energy efficiency is good public policy!
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Benefits to Federal, State, & Local GovernmentBenefits to Federal, State, & Local Government
CHP AdoptersCHP Adopters– VA Hospitals, Prisons, Emergency RespondersVA Hospitals, Prisons, Emergency Responders
Disaster PreparednessDisaster Preparedness– Creates powered islands for sanctuary, medical Creates powered islands for sanctuary, medical
care, public safetycare, public safety Homeland SecurityHomeland Security
– Enhances communications, service delivery, and Enhances communications, service delivery, and recovery in affected areasrecovery in affected areas
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Benefits to the EnvironmentBenefits to the Environment
Because CHP plants are so efficient at Because CHP plants are so efficient at “recycling” waste energy, they produce 1/3 “recycling” waste energy, they produce 1/3 of the pollution just due to lower fuel usage of the pollution just due to lower fuel usage per unit of useful energy produced. per unit of useful energy produced.
CHP plants typically burn natural gas which, CHP plants typically burn natural gas which, while not a perfect fuel, is far preferable to while not a perfect fuel, is far preferable to coal, lignite or oil in terms of particulate and coal, lignite or oil in terms of particulate and green house gas pollution green house gas pollution
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
What is the Green Guide for Health Care?What is the Green Guide for Health Care?
A quantifiable sustainable design toolkit to help A quantifiable sustainable design toolkit to help hospitals plan facilities that are environmentally hospitals plan facilities that are environmentally friendly while enhancing patient and staff safety friendly while enhancing patient and staff safety and well being.and well being.
The GGHC supports the use of Combined Heat and The GGHC supports the use of Combined Heat and Power as a strategy for Hospitals for improving Power as a strategy for Hospitals for improving their emergency power systems and response their emergency power systems and response capabilities during disaster situations. capabilities during disaster situations.
Free download of the Free download of the “Guide” “Guide” at www.gghc.orgat www.gghc.org
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
A self-certifying guidance document for harnessing best practices in the health care industry.
GREEN GUIDE FOR HEALTH CARE
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Sponsors
Convener
sponsors
Center for Maximum Potential Building Systems, www.cmpbs.org
Hospitals for a Healthy Environment, www.h2e-online.org
NYS Research and Energy Development Authority, www.nyserda.org
Merck Family Fund, www.merckff.org
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
The Green Guide for Health Care seeks to reward those organizations that voluntarily steward the environment in the interests of human health. It also creates incentive for the healthcare and related industries to change their practices, build sustainable environments, and enhance their overall accountability and performance.
industrytool
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
The design and operation of health care buildings is highly regulated with intense economic and life safety oversight
Health care facilities are often multiple building campuses of varying ages, conditions, systems
24/7 operations with patients in place require intensive coordination and redundancy of all services at all times.
Long ownership mean owners realize life cycle implications of their construction choices.1
2
3
4
overviewdesign attributes
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Operational issues, such as mercury elimination, have defined industry’s environmental stewardship
5
operational attributesThe H2E is a voluntary program designed to help health care facilities enhance work place safety, reduce waste and waste disposal costs and become better environmental stewards and neighbors.
overview
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
6
7
8
Construction frequently occurs within or adjacent to occupied buildings (where health is fragile, or steadiness of hand required)
Infection Control Risk Assessment (ICRA) protocols to minimize the impacts of construction on occupants demonstrate leadership to the wider sustainable building industry
Healthcare construction managers can evolve a rigorous, sustainable set of practices for the healthcare industry that may inform wider construction practice
construction attributesoverview
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
constructionmanual
1 – Integrated Design2 – Sustainable Sites3 – Water Efficiency4 – Energy & Atmosphere5 – Materials & Resources6 – Indoor Environmental Quality
7 – Innovation
2 - 21 - 181 - 73 - 192 - 242 - 220 - 4
11 - 94
Section / Category Name Pre-Req. / Max. Total
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
operationsmanual
1 – Integrated Operation2 – Energy Conservation3 – Water Conservation4 – Chemical Management5 – Waste Management6 – Environmental Services7 – Environmental Purchasing8 – Innovation
4 - 83 - 181 - 81 - 51 - 60 - 90 - 110 - 7
10 - 72
Section / Category Name Pre-Req. / Max. Total
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Intent
Health Issues
Reference Standards
Credit Goals
Technologies & Strategies
organization
Documentation
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
registration growth
overviewregistration
0
1000
2000
3000
4000
5000
6000
Nov-0
3
Jan-
04
Mar
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May
-04
Jul-0
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Sep-0
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
geographic distributionGreen Guide for Health Care Pilot 2.0
As of July 2005
overviewregistration
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
profile
overviewregistration
35%13%22%3%9%2%16%
growth profession
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
pilot growth
overviewpilot
growth profession
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
pilot projects
overviewpilot
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Case StudiesCase Studies
Montefiore Medical Center, New York, NY Montefiore Medical Center, New York, NY Critical Access Hospital PrototypeCritical Access Hospital Prototype Dell Children’s Medical Center of Central Dell Children’s Medical Center of Central
Texas (DCMCCT); Austin, TexasTexas (DCMCCT); Austin, Texas Texas Tech Health Science CenterTexas Tech Health Science Center
(TTHSC); Lubbock, Texas(TTHSC); Lubbock, Texas
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Montefiore Medical Center, NYCMontefiore Medical Center, NYC
14 MW Combustion Turbine CHP plant, cost $23 14 MW Combustion Turbine CHP plant, cost $23 million and saves $3 million/yearmillion and saves $3 million/year
August 14 Blackout plunged 50 million people into August 14 Blackout plunged 50 million people into darkness in the Northeastern U.S.darkness in the Northeastern U.S.
Hospital had full HVAC, kitchen service, surgical Hospital had full HVAC, kitchen service, surgical and full diagnostic support, in all, 95 to 98 percent and full diagnostic support, in all, 95 to 98 percent of the hospital was unaffectedof the hospital was unaffected
““We were fully generating and really didn’t miss a We were fully generating and really didn’t miss a beat”beat” – – Steven M. Safyer, M.D. Senior Vice President and CMOSteven M. Safyer, M.D. Senior Vice President and CMO
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Critical Access Hospital ScenarioCritical Access Hospital Scenario
25 bed, Critical Access Hospital, 25 bed, Critical Access Hospital, Somewhere, TexasSomewhere, Texas
AssumptionsAssumptions– 62,500 sq. ft. 62,500 sq. ft. – 284 tons of cooling284 tons of cooling– 1.875 MMBtu of heating1.875 MMBtu of heating– 187 kW of electrical load187 kW of electrical load– Hot Day (ARI, 95Hot Day (ARI, 95º F)º F)
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Critical Access Hospital Prototype SolutionCritical Access Hospital Prototype Solution
UTC PureComfort Microturbine Packaged SystemUTC PureComfort Microturbine Packaged System– 139 Tons of “free” cooling output during hot days139 Tons of “free” cooling output during hot days
– 252 kW of on-site power generation252 kW of on-site power generation
– 175175º F hot water during cold daysº F hot water during cold days
Grid connect or dual modeGrid connect or dual mode Inlet silencers for noise reductionInlet silencers for noise reduction Ultra-low emissions at less than 9 ppm NOxUltra-low emissions at less than 9 ppm NOx Emergency stand-by generator versus on-site CHP Emergency stand-by generator versus on-site CHP
generation with heat recovery generation with heat recovery
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Dell Children’s Case Study – Project OverviewDell Children’s Case Study – Project Overview 32.2 acre brownfield site in the 709 acre Robert 32.2 acre brownfield site in the 709 acre Robert
Mueller Municipal Airport Redevelopment in Austin Mueller Municipal Airport Redevelopment in Austin 169 Bed Children’s Replacement Hospital169 Bed Children’s Replacement Hospital
– 470,000 Building Gross Square Foot (BGSF)470,000 Building Gross Square Foot (BGSF)
– $110M Construction Cost; $200M Capital Budget$110M Construction Cost; $200M Capital Budget
157,000 BGSF $21M Medical Professional Office 157,000 BGSF $21M Medical Professional Office Building with $9M, 900 Car GarageBuilding with $9M, 900 Car Garage
25,300 BGSF, $18M, CHP District Energy Plant 25,300 BGSF, $18M, CHP District Energy Plant
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Dell Children’s Case StudyDell Children’s Case Study
Local Power Utility, Austin Energy, provided Local Power Utility, Austin Energy, provided $18M in capital to construct the CHP Plant. $18M in capital to construct the CHP Plant.
$7M Capital Savings$7M Capital Savings accrued to the Hospital accrued to the Hospital from not building its own Central Plantfrom not building its own Central Plant
Hospital has long term contracts to purchase Hospital has long term contracts to purchase power, chilled water and steam from CHP Plantpower, chilled water and steam from CHP Plant
Plant expandable to for future growth of HospitalPlant expandable to for future growth of Hospital Plant will also serve the “Urban Campus” of the Plant will also serve the “Urban Campus” of the
709 Acre RMMA Development709 Acre RMMA Development
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Dell Children’s Case StudyDell Children’s Case Study
Power is generated on site by natural gas fired Power is generated on site by natural gas fired turbines which supply 100% of hospital’s energyturbines which supply 100% of hospital’s energy
Hospital has two, 100% redundant backups from Hospital has two, 100% redundant backups from two independent substation feeds off the Gridtwo independent substation feeds off the Grid
Life Safety Systems back up by diesel generatorLife Safety Systems back up by diesel generator Absorption Chillers produce Chilled WaterAbsorption Chillers produce Chilled Water Chilled Water Storage Tank allows peak shavingChilled Water Storage Tank allows peak shaving Heat Recovery Equipment produces SteamHeat Recovery Equipment produces Steam
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Texas Tech Medical School and Lubbock General Texas Tech Medical School and Lubbock General Hospital on the 1,839 acre Texas Tech Health Hospital on the 1,839 acre Texas Tech Health Science Center (TTHSC) campus in LubbockScience Center (TTHSC) campus in Lubbock
$14M, CHP Electrical Generating Plant $14M, CHP Electrical Generating Plant 47 MW gas turbine coupled with 22 MW steam 47 MW gas turbine coupled with 22 MW steam
turbine (with 2turbine (with 2ndnd steam turbine on standby), steam turbine on standby), produces up to 290 lb/sec of steamproduces up to 290 lb/sec of steam
Local Power Utility, Lubbock Power and light, Local Power Utility, Lubbock Power and light, provided the capital to construct the CHP Plant in provided the capital to construct the CHP Plant in 1990.1990.
Texas Tech Case Study – Project OverviewTexas Tech Case Study – Project Overview
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Texas Tech Case StudyTexas Tech Case Study TTU has long term contracts to purchase power TTU has long term contracts to purchase power
and steam from CHP Plantand steam from CHP Plant Originally constructed with a GE 21 MW Originally constructed with a GE 21 MW
LM2500 gas turbine, the plant has recently been LM2500 gas turbine, the plant has recently been upgradedupgraded
LP&L actually reduced LP&L actually reduced operations in response to operations in response to high gas prices, but was high gas prices, but was able to continue to provide able to continue to provide steam to the campussteam to the campus
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Texas Tech Case StudyTexas Tech Case Study
A combined cycle gas turbine steam generation A combined cycle gas turbine steam generation plantplant
Hospital and academic campuses get electricity Hospital and academic campuses get electricity from the gridfrom the grid
Two 2.5 MW diesel generators provide backupTwo 2.5 MW diesel generators provide backup Steam turbine-driven Chillers produce Chilled Steam turbine-driven Chillers produce Chilled
WaterWater Heat Recovery Equipment produces Steam for Heat Recovery Equipment produces Steam for
both campusesboth campuses
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Why Why ALLALL Hospitals should consider CHP Hospitals should consider CHP Hospitals with high dependence on Information SystemsHospitals with high dependence on Information Systems The largest facility in a CommunityThe largest facility in a Community Facilities with Level III Trauma CentersFacilities with Level III Trauma Centers Critical Access Hospitals which operate the only Emergency Critical Access Hospitals which operate the only Emergency
Department in a regionDepartment in a region Facilities contemplating major renovations/expansionsFacilities contemplating major renovations/expansions Hospitals considering replacement of their Physical Plant Hospitals considering replacement of their Physical Plant
EquipmentEquipment Those desiring Capital Infusion or Operating Cost SavingsThose desiring Capital Infusion or Operating Cost Savings Facilities in areas subject to frequent power disruptionsFacilities in areas subject to frequent power disruptions Hospitals serving disaster prone CommunitiesHospitals serving disaster prone Communities
-Terrorist-Terrorist -Natural-Natural -Technical-Technical
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Who owns and pays for CHP at a Hospital?Who owns and pays for CHP at a Hospital? HospitalHospital
– Self FundingSelf Funding– Federal, State and Local GrantsFederal, State and Local Grants– Low Interest Loans for Publicly owned facilitiesLow Interest Loans for Publicly owned facilities– Hospital Authority BondsHospital Authority Bonds
Capital PartnersCapital Partners– Local Power Utility Local Power Utility – Local Natural Gas UtilityLocal Natural Gas Utility– Third Party InvestorsThird Party Investors– Energy Services Companies (ESCos)Energy Services Companies (ESCos)
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Financing MechanismsFinancing Mechanisms
Off Balance Sheet FinancingOff Balance Sheet Financing– Protect the Balance Sheet of the Protect the Balance Sheet of the
Borrower/Lessee from underlying debtBorrower/Lessee from underlying debt Financing AlternativesFinancing Alternatives
– Operating leases – defined by Operating leases – defined by “FASB 13”“FASB 13”– Capital leases – Capital leases – “Note and Security”“Note and Security”– True lease – Hybrid offering True lease – Hybrid offering “purchase option”“purchase option”– Leverage lease – Bond equivalent with Leverage lease – Bond equivalent with “no “no
purchase option” purchase option” onlyonly “lease renewal” “lease renewal”
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Outsourcing AlternativesOutsourcing Alternatives
Finance, design-build, own and operateFinance, design-build, own and operate– Local utility companyLocal utility company– Energy Services Company (ESCO)Energy Services Company (ESCO)
Terms and conditions will varyTerms and conditions will vary– Energy services agreementEnergy services agreement– Commodity sales agreementCommodity sales agreement
Public private partnershipsPublic private partnerships– Public and private entities partner to benefit the Public and private entities partner to benefit the
communitycommunity
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Typical Outsourcing Business StructureTypical Outsourcing Business Structure
Hospital
FuelProcurement
Operations & Maintenance
Energy Conservation
Measures
CHP Design, Procurement & Installation
Performance Guarantees including: Cost, Schedule, CHP
Efficiency and Demand Side Energy Savings
Natural Gas and Grid Power (back up
and grid dispatch)
CHP and Existing Hospital Central Plant
(chillers, boilers, emergency generators,
transformers and switchgear)
CHPOn-Site Generation and Chilled Water and Steam
Operating LeaseorCommodity Sales (kW, Ton/Hrs, PPH)
Credit
Primary
LLCFinancingEntity
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
CHP at Existing Hospitals… CHP at Existing Hospitals…
May need to first consider current energy usage, May need to first consider current energy usage, efficiency, and age or condition of existing efficiency, and age or condition of existing equipment- equipment- chillers, boilers, HVAC, lighting, chillers, boilers, HVAC, lighting, controls, emergency generators, etc.controls, emergency generators, etc.
Energy conservation measures create savings that Energy conservation measures create savings that may offset the capital cost of implementing CHPmay offset the capital cost of implementing CHP
ESCo’s offer ESCo’s offer “performance contracting”“performance contracting” where where they will they will “guarantee”“guarantee” the annual energy savings the annual energy savings and incorporate CHP as part of the energy and incorporate CHP as part of the energy conservation measure programconservation measure program
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Frequently Asked QuestionsFrequently Asked Questions Zoning RestrictionsZoning Restrictions Neighborhoods Neighborhoods
– Pro or ConPro or Con
– NoiseNoise
– Aesthetics/CostAesthetics/Cost
Size/Land RequirementsSize/Land Requirements ScalingScaling
– how big is too bighow big is too big
– how small is too smallhow small is too small
Who will Operate it?Who will Operate it?
VulnerablityVulnerablity– Natural Gas Flow in a disasterNatural Gas Flow in a disaster
– Underground PipingUnderground Piping
– On Site Combustible FuelOn Site Combustible Fuel
Perceptions of past Perceptions of past TechnologiesTechnologies– Co-GenCo-Gen
Who will buy the Fuel?Who will buy the Fuel?
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
How to get StartedHow to get Started Contact or visit a hospital that currently has a CHP Contact or visit a hospital that currently has a CHP
installation and installation and ““kick the tireskick the tires”” Form your teamForm your team
– CHP ConsultantCHP Consultant– Local Utility (Electric and possibly Natural Gas)Local Utility (Electric and possibly Natural Gas)– Internal StaffInternal Staff
Screening Analysis/Energy Conservation AuditScreening Analysis/Energy Conservation Audit– Current Energy UtilizationCurrent Energy Utilization– Possible Energy Conservation Measures in existing facilityPossible Energy Conservation Measures in existing facility– Preliminary Assessment of Value to the HospitalPreliminary Assessment of Value to the Hospital
““Go/No Go” Decision to continue to FeasibilityGo/No Go” Decision to continue to Feasibility
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
How to get Started (continued)How to get Started (continued)
Feasibility StudyFeasibility Study– EngineeringEngineering
– Business Business Structure/Capital Structure/Capital Source OptionsSource Options
Hospital Self FinanceHospital Self Finance 33rdrd Party Party Local Utility as Capital Local Utility as Capital
PartnerPartner
– Delivery System Delivery System OptionsOptions
Convention Convention Design/Bid/BuildDesign/Bid/Build
Design/BuildDesign/Build CombinationsCombinations
– Financial Proforma Financial Proforma ScenariosScenarios
Operating SavingsOperating Savings Capital SavingsCapital Savings
““Go/No Go” Decision to proceed to DesignGo/No Go” Decision to proceed to Design
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
4 WeeksPhase 2
Stakeholder Involvement Options
1. Self Fund Project
2. Outsource/Leaseback Project
3. Put the Project on the Shelf –
“GO/NO GO”
2 Weeks
Screening
Analysis
Report
Phase 1
6 to 9 MonthsPre-Purchase
Construction Phase Services
Final Design
Phase 4
Report
+ NPV Economic Analysis
+ Preliminary Lease AgreementFeasibility Study
3 Months
Pre-Construction Services
Environmental Permits
Report
+ GMP for Final Design & Construction
+ Lease Agreement
Phase 3
Preliminary Design
Typical CHP Project DevelopmentTypical CHP Project Development
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Resources and ContactsResources and Contacts Gulf Coast Regional CHP Application CenterGulf Coast Regional CHP Application Center
– List of Hospitals using CHP in Texas and USList of Hospitals using CHP in Texas and US– Independent CHP assistance, resources, information and Independent CHP assistance, resources, information and
LinksLinks– List of Engineering Firms, Developers, Equipment List of Engineering Firms, Developers, Equipment
Suppliers, VendorsSuppliers, Vendors– www.gulfcoastchp.orgwww.gulfcoastchp.org
Green Guide for Health CareGreen Guide for Health Care– Copy of Green Guide for Health Care free downloadCopy of Green Guide for Health Care free download– www.GGHC.orgwww.GGHC.org
Hospitals for a Healthy Environment at Hospitals for a Healthy Environment at – www.h2e-online.orgwww.h2e-online.org
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Resources and Contacts (continued)Resources and Contacts (continued) United States Combined Heat and Power United States Combined Heat and Power
Association at Association at http://uschpa.admgt.com http://uschpa.admgt.com US Department of Energy - Energy Efficiency and US Department of Energy - Energy Efficiency and
Renewable Energy: Distributed Energy Program at Renewable Energy: Distributed Energy Program at http://www.eere.energy.gov/de/http://www.eere.energy.gov/de/
US Environmental Protection Agency - Combined US Environmental Protection Agency - Combined Heat and Power Partnership at Heat and Power Partnership at http:// http://www.epa.gov/chp/www.epa.gov/chp/
NYS Research and Energy Development Authority NYS Research and Energy Development Authority at at www.nyserda.orgwww.nyserda.org
Contact the Panelists – last slides in your packageContact the Panelists – last slides in your package
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
Questions and AnswersQuestions and Answers
Page Page 6464
Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
About the SpeakersAbout the Speakers
Daniel Bullock Daniel Bullock DirectorDirector
Gulf Coast CHP Applications Center Gulf Coast CHP Applications Center
4800 Research Forest Drive4800 Research Forest Drive
The Woodlands, TX 77381The Woodlands, TX 77381
[email protected]@HARC.Edu
281-364-6087281-364-6087
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
About the SpeakersAbout the Speakers
Ed Mardiat, DBIAEd Mardiat, DBIAPrincipal, Director of CHP Development Principal, Director of CHP Development
Burns and McDonnell EngineersBurns and McDonnell Engineers
9400 Ward Parkway9400 Ward Parkway
Kansas City, MO 64114Kansas City, MO 64114
[email protected]@BurnsMcD.Com
816-822-3344816-822-3344
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
About the SpeakersAbout the Speakers
Robert Moroz, AIA, LEED APRobert Moroz, AIA, LEED APPresidentPresident
Healthcare Facilities Consultation and PlanningHealthcare Facilities Consultation and Planning
3301 Texas Star Lane3301 Texas Star Lane
Austin, Texas 78746Austin, Texas 78746
[email protected]@SWBell.Net
512-327-1538512-327-1538
Page Page 6767
Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
About the SpeakersAbout the Speakers
Kim Shinn, P.E., LEED APKim Shinn, P.E., LEED APDirector of Sustainable DesignDirector of Sustainable Design
TLC Engineering for ArchitectureTLC Engineering for Architecture
6 Cadillac Drive, Suite 200 6 Cadillac Drive, Suite 200
Brentwood, Tennessee 37027Brentwood, Tennessee 37027
[email protected]@TLC-Eng.Com
615-297-4554615-297-4554
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Texas Hospital Association AudioCastTexas Hospital Association AudioCast November 1, 2005 November 1, 2005Energy $aving $olutions for HospitalsEnergy $aving $olutions for Hospitals
About the SpeakersAbout the Speakers
Gail Vittori, LEED APGail Vittori, LEED APCo-DirectorCo-Director
Center for Maximum Potential Building SystemsCenter for Maximum Potential Building Systems
8604 FM 9698604 FM 969
Austin, TX 78724 Austin, TX 78724
[email protected]@CMPBS.Org
512-928-4786512-928-4786