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Los Angeles County EMS Agency Tackles Aging Hospital Generator Fleet with Deployment of Advanced, Real-Time Generator Monitoring Technology

Deployment of Power P.I.O.N.E.E.R. Tool to County’s Single Generator Hospitals Will Provide Unprecedented Situational Awareness of Generator Failures During Power Outages

The Los Angeles County Emergency Medical Services (EMS) Agency is tackling the county’s challenge of an aging hospital generator fleet by deploying an advanced technology that will provide automated, real-time alerts anytime a hospital generator experiences a mechanical problem during a power outage.

Recently, the Power P.I.O.N.E.E.R.® tool was installed at two of Los Angeles County’s single-generator, acute care hospitals. P.I.O.N.E.E.R.®, which stands for Power Information Needed to Expedite Emergency Response, continuously monitors generator performance and sends automated, real-time warnings to designated individuals anytime a generator experiences a mechanical problem during a power outage.  

The deployments represent the first time a U.S. hospital is making automated, real-time generator threat alerts available to government emergency managers. These real-time alerts are a major improvement in situational awareness and will enable accelerated deployment of government generators and provide a valuable head start in planning for a potential hospital evacuation. The early warnings will also give utilities the opportunity to quickly assess options for prioritized power restoration including switching feeder lines to a hospital in cases where two lines exist and one of them is still able to provide power to the hospital. 

Deployment of Power P.I.O.N.E.E.R. to single generator hospitals was considered especially important since these facilities have no redundant emergency power, and as a result, put patients at greater risk if the facilities experience a total loss of emergency power. The LA County EMS Agency is tapping its HHS Hospital Preparedness Program (HPP) funding to cover the cost of deploying the Power P.I.O.N.E.E.R. tool in the county’s single generator hospitals.

Power P.I.O.N.E.E.R.® was developed by the 501c3 non-profit Powered for Patients as part of a Department of Homeland Security-funded initiative to spur advances in generator monitoring technology that would provide an early warning to government officials and utilities when critical facilities face a threat to emergency power during an outage. Power P.I.O.N.E.E.R. is also designed to provide ongoing, real-time updates on the status of efforts by government officials, utilities and service providers to respond to a stricken facility.  Powered for Patients has been leading an emergency power preparedness initiative for the LA County EMS Agency since May 2019. The multi-year initiative was launched to help ensure that Los Angeles County and its municipalities, along with its electric utilities and critical healthcare facilities, are employing best practices in minimizing threats to emergency power and expediting government, utility and private sector response when threats to emergency power arise during power outages.

“Given the ongoing threat of Public Safety Power Shutoffs, and the potential for other types of power outages in Los Angeles County, we’re excited to see Power P.I.O.N.E.E.R. providing real time situational awareness of generator threats at the county’s single generator hospitals,” said Eric Cote, Project Director for Powered for Patients. “This visibility is especially important since single-generator hospitals have no redundant emergency power and in some cases are relying on older generators. As more of LA County’s single-generator hospitals deploy Power P.I.O.N.E.E.R., the impact of this powerful new tool in protecting patients will become even greater.”  

Concern about outdated hospital generators in Los Angeles County is driven by a recently completed analysis documenting a seriously aging fleet. The analysis of the generator fleet in Los Angeles County’s hospitals is part of the LA County EMS Agency’s ongoing emergency power preparedness initiative being led by Powered for Patients.  The analysis reflects survey data from the county’s 80 hospitals that participate in the Hospital Preparedness Program which have a combined total of 271 generators. The useful life expectancy of a generator is approximately 30 years of age and the recent analysis showed that 87 out of the 271 generators, or 32 percent, are older than 30 years of age, with 40 of these generators between 40 and 49 years of age and 15 of the generators older than 50 years of age.

Among LA county’s 14 single-generator acute care hospitals that participate in the Hospital Preparedness Program, nine of these facilities, or 64 percent, have generators over 30 years of age, including three with generators between 40 and 49 years of age, three with generators between 50 and 59 years of age and one with a generator that is over 60 years old.  There are no federal or state requirements that limit the age of a hospital generator as long as the generator can pass periodic tests. However, Cote noted that these tests don’t represent the true challenge an aging generator would face if it were required to operate continuously for extended periods of time.  

Despite the aging fleet, the analysis showed some positive signs when it comes to investment by hospitals in new generators. Over the past ten years, Los Angeles County hospitals have collectively purchased 48 new generators.

Extended Power Outages Triggered by Hurricane Ida Likely to Challenge Ability of Louisiana Hospitals and Nursing Homes to Comply with New Federal Rules Prohibiting Excessive Heat in Patient Care Areas

Powered for Patients, a 501c3 non-profit created after Hurricane Sandy to better safeguard emergency power for critical healthcare facilities, said today that the extended power outages caused by Hurricane Ida will seriously challenge the ability of Louisiana’s hospitals and nursing homes to comply with new federal rules intended to prevent dangerous overheating of patient care areas within healthcare facilities.

The CMS Emergency Preparedness Rule, first proposed in December 2013 by the Centers for Medicare and Medicaid Services (CMS) and finalized nearly three years later, requires hospitals and skilled nursing facilities to ensure that temperatures in patient care areas not exceed 81 degrees during power outages. For most facilities, meeting this rule requires connecting a portion of the facility’s air conditioning system to emergency power, an expensive step that many facilities have yet to undertake. The use of portable cooling devices can also help lower temperatures but in larger facilities, these devices will likely be insufficient to ensure that temperatures don’t rise above 81 degrees in all patient care areas.

The requirement that hospitals and nursing homes maintain temperatures at or below 81 degrees during power outages reflects the deadly lessons of past hurricanes, including Katrina and Irma, both of which triggered patient deaths due to extreme heat in patient care areas. Following Hurricane Irma, twelve elderly residents of the Hollywood Hills Rehabilitation Center in Hollywood, FL died after an extended power outage drove temperatures inside the facility to dangerous levels. These deaths triggered new laws in Florida mandating that nursing homes install generators capable of supporting air conditioning systems during power outages.   

As part of an ongoing emergency power resilience initiative being undertaken for the Los Angeles County Emergency Medical Services (EMS) Agency, Powered for Patients recently completed a census of the emergency power systems in Los Angeles County’s hospitals. The census revealed that many of the hospitals have not connected any of their air conditioning system to a source of backup power.    

“Through our work in Los Angeles County, we’ve seen first-hand that many hospitals have not yet made the investments needed to connect portions of their air conditioning system to emergency power in order to comply with the new federal requirements,” said Eric Cote, Project Director for Powered for Patients. “It is likely that many of Louisiana’s hospitals and nursing homes face this same challenge and as a result, a number of facilities will find it difficult to keep temperatures in patient care areas below the required 81 degrees given the forecast for dangerously hot and humid weather.” Facilities that cannot keep temperatures in patient care areas below 81 degrees may need to consider evacuating, a move that would pose an added challenge to facilities already straining in the aftermath of Hurricane Ida.

Before the CMS Emergency Preparedness Rule was enacted, emergency power requirements necessitated that a hospital would need enough generator power to cover approximately 33% of a its normal electrical load. Experts suggest that to fully back up a hospital’s air conditioning system on top of its other emergency power requirements, most hospitals would have to double the size of their generator fleet, a very expensive step that many hospitals have been unable to take.  

FEMA Generator Checklist Can Help Minimize Risk of Emergency Power Failures

Powered for Patients has posted a FEMA checklist of steps that should be taken when generators are operated for extended periods of time to reduce the likelihood of a generator failure.

“The likelihood of a long-term power outages represents a serious challenge and a potential threat to patient safety, but it’s important for hospital facility staff to know that there are steps they can take now to reduce the likelihood of a generator failure,” said Cote. “I encourage facilities to print the FEMA checklist and make sure it is distributed to all facility staff and adhered to closely.”

Cote also urged hospitals to notify their local emergency managers at the first sign of any threat to emergency power. “Facilities should not wait until a generator has failed to notify their local emergency manager that they are experiencing a problem with emergency power,” said Cote. “Instead, we recommend that a hospital notify their local emergency management agency at the first sign of any threat to emergency power. This can help expedite deployment of temporary generators.” FEMA announced yesterday that 200 generators have been deployed to Louisiana and more are expected in the coming days.

Aging Generators and Single Generator Hospitals Also Seen as a Potential Problem Amid Extended Power Outages

Among the findings of the recent Powered for Patients census of emergency power systems in Los Angeles County hospitals was a significant number of outdated generators. The useful life expectancy of a generator is approximately 30 years of age and the recent analysis showed that 30 percent of the generators among surveyed hospitals are older than 30 years of age, with 42 of these generators between 40 and 49 years of age and four generators older than 50 years of age.

In addition to an aging generator fleet, the recent census found that fifteen Los Angeles County acute-care hospitals rely on just a single generator, leaving these facilities, and the patients in them, with no source of redundant emergency power. Among these fifteen hospitals, 60 percent of their generators are over 30 years of age, with several generators over four years of age and two over 50 years of age.

“If our findings in Los Angeles County are representative of hospital generator fleet in Louisiana, there may be as many as 16 acute care hospitals in Louisiana operating with a single generator, many of which would be older than 30 years of age,” said Cote. “These are added risk factors that warrant close attention from state and local officials, especially as the power outage extends into days and even weeks in the worst-case scenario.”

Emergency management officials in Louisiana have been in touch with hospitals to determine their available generator fuel and the projected burn rates to help coordinate the fuel replenishment process.

Lesson from COVID-19: Resource Scarcity Puts American Lives at Risk

By Eric Cote, Founder, Powered for Patients

Since the COVID-19 pandemic began in early 2020, the initial shortage of coronavirus test kits, personal protective equipment (PPE) for healthcare workers and ventilators in the face of escalating numbers of confirmed coronavirus cases offered a painful lesson about a nation finding itself unprepared for a pandemic of historic proportions.

Today, as the number of Americans diagnosed with COVID skyrockets, hospitalizations have risen to an all-time high, triggering fears that hospitals will be pushed beyond the brink. The resource scarcity driving fears now is no longer ventilators or PPE but the staff needed to care for patients and operate ventilators as well as the physical space hospitals need to care for the sickest patients, including COVID victims and those recovering from heart attacks, strokes and other life-threatening conditions.

As efforts to address shortages of staff and hospital space advance, yet another serious threat worthy of attention looms: the heightened risk of power outages, an especially relevant menace in California where Public Safety Power Shutoffs have already been initiated to reduce the risk of wildfires.  

This risk of emergency power failures during power outages is all too real and their consequences can be deadly for patients in hospitals and nursing homes. During California’s 2019 Public Safety Power Shutoffs, two hospitals and five skilled nursing facilities experienced generator failures, and hospital emergency power failures during Hurricane Katrina were blamed for patient fatalities.

Single-generator vulnerability 

The consequences of losing emergency power during an outage are especially dangerous for patients in the estimated 950 non-rural hospitals across the U.S. that rely on a single generator. Another 1,100 critical access hospitals, with 25 beds or fewer and often located in remote areas, also rely on a single generator. Skilled nursing facilities licensed to provide ventilator care represent another significant threat. There are an estimated 1,350 such facilities in the U.S. and the overwhelming majority of them have no redundant emergency power. Making matters worse, a number of these single-generator hospitals and skilled nursing facilities rely on generators that in some cases are more than 40 years old.

The loss of emergency power in a single-generator facility caring for ventilator patients would represent a life-threatening emergency, as staff would have only a few hours of ventilator battery life before they would need to manually ventilate patients during the race to replace a failed generator or transfer patients to another facility.

The failure of emergency power in single-generator hospitals and nursing homes is not a remote threat. Powered for Patients documented two such failures during the 2020 Atlantic hurricane season, each resulting in the emergency evacuation of electricity-dependent patients.

With the record 2020 hurricane season behind us, winter weather joins Public Safety Power Shutoffs as the latest threat to utility power. The famous Kentucky Ice Storm, which struck in January 2009, produced one of the longest power outages in Kentucky history and triggered one of the largest deployments of temporary replacement generators in U.S. history.   

Reducing risk in an emergency

Thanks to a technology investment made in 2018 by the Department of Homeland Security, a new tool recently become available that can dramatically change the outcome for patients in single-generator facilities that face threats to emergency power during an outage. The P.I.O.N.E.E.R.® Tool connects to emergency power systems like a heart monitor connects to a patient and provides real-time, automated alerts anytime emergency power in a critical facility faces a threat. P.I.O.N.E.E.R. stands for Power Information Needed to Expedite Emergency Response.

P.I.O.N.E.E.R. was developed by Powered for Patients, a 501c3 non-profit that received a contract from DHS to create a tool that would provide automated alerts anytime emergency power faced a serious threat during a power outage. Automated, real-time warning of a threat to emergency power can be a game changer, especially for patients in single-generator facilities. Armed with this early warning, service providers can accelerate deployment of service teams and government agencies with temporary generators can ready these assets more quickly for deployment. In cases where utilities have the ability to restore power, early warning will accelerate the process. In worse-case scenarios, where emergency power cannot be repaired or replaced in a timely fashion and expedited power restoration is not possible, the early warning provided by P.I.O.N.E.E.R. will enable a significant head start in planning for a safer evacuation of patients.

Initial deployments of the P.I.O.N.E.E.R. Tool are planned for single-generator hospitals in Los Angeles County, a timely move given the rise in COVID hospitalizations and the recent resumption of Public Safety Power Shutoffs. An initiative to expand deployment of the P.I.O.N.E.E.R. Tool to all single-generator hospitals and skilled nursing facilities treating ventilator patients in the U.S. is detailed in the Power Resilience Blueprint, a COVID-inspired plan to address immediate and longer-term threats to emergency power in critical medical facilities. The Power Resilience Blueprint was developed by Powered for Patients and the Electric Infrastructure Security Council, another 501c3 non-profit involved in preparing the nation for the impact of long-term and widespread power outages. 

COVID patients requiring the support of ventilators to survive are already facing long odds. P.I.O.N.E.E.R. can reduce another risk facing these patients, especially those in facilities relying on a single generator.  

Powered for Patients Issues Guidance for Hospitals with Single Generator Emergency Power Systems Amid Potential Coronavirus Spike in Use of Ventilators

In response to the growing coronavirus crisis, Powered for Patients has provided guidance information to federal, state and local public health officials about the potential vulnerability of hospital emergency power systems that rely on a single generator.

Recent news reports have highlighted the potential shortage of ventilators should the scale of the outbreak reach a level where tens of thousands of Americans need respirators. An estimated 16% of U.S. hospitals use only a single generator and nearly all Skilled Nursing Facilities (SNFs), including those licensed to provide respirator care for patients, rely on a single generator. While a ventilator can be operated manually by clinicians to keep a patient alive, this is only done for short periods of time in extreme situations when utility or emergency power is not available.

Facilities relying on a single generator for emergency power support have no redundant emergency power in the event that their single generator fails. This represents an increased risk that should be considered by public health officials and those operating hospitals and SNFs with single generator emergency power systems.

“It’s important to note that with proper maintenance, single generators may have a low risk of failure,” said Powered for Patients project director Eric Cote. “Yet, the consequences of losing emergency power in a facility with a single generator are for more serious than the loss of a single generator in a facility with multiple generators.”

The Powered for Patients guidance information advises facilities currently treating or slated to receive coronavirus patients to test their emergency power system prior to receiving patients (or prior to receiving additional ventilator patients.) This suggestion reflects lessons learned in 2019 when Public Safety Power Shutoffs (PSPS) in California triggered the failures of emergency power in two hospitals and five skilled nursing facilities.

The Powered for Patients guidance material also includes information from FEMA Guidance Document P-1019 that includes a checklist of steps facility managers can take before, during and after disasters to minimize the risk of an emergency power system failure. The guidance material also includes a spare parts inventory and fuel consumption checklist that facility managers can use to stay on top of fuel supply and help ensure that sufficient generator supplies and consumables are on hand at a facility at all times.  

Powered for Patients Creates Real Time Emergency Power Threat Reporting Tool with DHS Funding and Partnership with Industry Leaders

Washington, D.C. – In addition to fatalities and serious injuries, other common casualties in Hurricanes Maria, Matthew, Sandy and Katrina were hospital emergency power systems. They suffered failures that ranged from debilitating to catastrophic, triggered by mechanical problems, extreme flooding or a lack of fuel. The partial or total loss of emergency power at numerous hospitals in Hurricanes Sandy and Matthew triggered emergency evacuations.  Generator failures following Hurricane Katrina were blamed for patient fatalities.

Today, a new effort is underway to tap a powerful yet under-leveraged technology that will provide government officials and utilities with the first-ever near real time, automated warning when emergency power is threatened at a hospital or other critical healthcare facility grappling with an extended power outage.

This early warning of a threat to emergency power will be provided through a new online tool being developed by the non-profit Powered for Patients with funding from the U.S. Department of Homeland Security, Cybersecurity and Infrastructure Security Agency (CISA), National Risk Management Center, through the National Infrastructure Protection Program Security & Resilience Challenge, which is implemented by the National Institute for Homeland Security (NIHS). The Security & Resilience Challenge program invests in promising technologies that can help government and the private sector tackle some of the more daunting challenges of disaster planning and response.

The early warning of a threat to emergency power provided by the dashboard can be a gamechanger, enabling emergency managers to accelerate deployment of government generators and generator fuel. Government transport for private generator service teams unable to navigate road closures in getting to client sites could be marshalled faster. Armed with near real time warning of a threat to emergency power at a critical facility, utilities could shift restoration priorities to restore utility power before emergency power is lost. Success by government agencies or utilities in their respective efforts to aid a stricken facility would protect patients, including some of the most vulnerable, whose ability to endure hasty evacuations is often precarious.

Mechanical fault detection and automated reporting technology is the cornerstone of the prototype developed by Powered for Patients through the DHS contract. This technology is being connected to emergency power systems in increasing numbers by hospitals, water systems, waste water treatment plants and cell tower operators across the U.S. The slightest mechanical hiccup or a low fuel level triggers an automated, real time notification via text or email, alerting facility managers and their service providers to any situation requiring immediate attention.  This technology also has advanced capabilities that can diagnose a serious problem remotely, a powerful capability for unmanned facilities like cell towers and pumping stations for water and waste water treatment systems.

Despite the growing use of this advanced technology, no hospital, water system or waste water treatment plant in the U.S. has shared this valuable data stream with government officials or utilities. The primary reason: they’ve never been asked. That’s changing thanks the Department of Homeland Security funding provided to Powered for Patients, the 501c3 non-profit created after Hurricane Sandy to better safeguard emergency power and accelerate utility power restoration for critical healthcare facilities impacted by disaster.  

Since the majority of U.S. hospitals do not use fault detection and automated reporting technology, the emergency power reporting Dashboard is being designed to receive manually submitted reports. This design feature will enable every hospital in the U.S. to use the Dashboard along with skilled nursing facilities and large dialysis centers, neither of which generally use the advanced fault detection and automated reporting technology for their emergency power systems.  

Among the challenges vexing emergency responders and public health preparedness officials has been limited situational awareness about the status of back-up power at hospitals and other critical infrastructure. In past incidents where hospital emergency power has been threatened, communications from impacted facilities to government officials and utilities seeking assistance has been disjointed and oftentimes delayed.  Rarely has a notification of a threat to emergency power been provided at the first sign of trouble, a reality that deprives government officials and utilities of a head start that could make the difference between hospitals having to evacuate or not.

Technology Company Competitors Join Forces to Make Real Time Data Sharing a Reality

Among the early accomplishments of the Powered for Patients project was enlisting many of the major providers of mechanical fault detection and automated reporting systems as active participants in the initiative. The companies include Automated Logic Corporation, a subsidiary of United Technology Corporation, Blue Pillar, Eaton and Schneider-Electric.  

While generally competitors on any given day, these companies are working jointly with Powered for Patients to help address the technology challenges associated with providing real time or near real time status reports to government officials and utilities. Since each of these companies provides its clients with their own type of alerts when emergency power is threatened, the Powered for Patients project will achieve another milestone by having its Dashboard synthesize each company’s data streams into a single data stream populating its online dashboard with red, yellow, green threat level indicator. This dashboard will provide government officials and utilities with a quick-glance view of unfolding threats to emergency power as well as updates on the status of response activities.

To achieve this ambitious goal, Powered for Patients has partnered with Talus Analytics, a women-owned business that specializes in translating complex data into actionable information. Led by PhD-level scientists with experience in real-time operations support, Talus has extensive experience coordinating data sharing and facilitating effective, data-driven decision making. Talus has done previous work for DHS and FEMA and is currently providing support to the CDC on another project related to sharing hospital status information with government officials to enhance disaster response.

Stakeholder Engagement Process Helps Create New Protocol Needed to Govern Real Time Information Sharing

As part of its Security & Resilience Challenge project, Powered for Patients launched a stakeholder engagement initiative to elicit input on pressing questions around how real time generator status reports from hospitals will be shared with government officials and utilities. A key consideration has been balancing privacy concerns of facilities with the need to give government officials and utilities enough real time or near real time information to enable accelerated response. Powered for Patients has worked with the four technology providers to develop an information sharing approach in which no hospital emergency power status data will actually be shared with Powered for Patients. Instead, these fault detection and automated reporting companies will provide a data feed on behalf of their clients through a secure Application Program Interface (API) that provides only the status information needed to populate the Dashboard’s red, yellow, green threat level indicator.

Input was sought from government officials and hospitals to inform the development of a voluntary protocol to govern communications and response activities of these stakeholders when real time or near real time alerts about threats to emergency power are transmitted through the Dashboard.

A number of hospitals and hospital systems across the country have engaged with Powered for Patients on the project. Miami Valley Hospital in Dayton, Ohio and Texas Health Resources, a 14-hospital health system in Texas, have signed on as a pilot sites to test live data sharing, a key step before the data sharing protocol can be finalized. UCI Health, part of the University of California Health System, will be providing input on the new information sharing protocol and is assessing opportunities to engage as a pilot test site. Huntington Hospital in Pasadena will also be helping with the development of the new information sharing protocol as will the Martin Luther King Hospital in Los Angeles.

Powered for Patients is working closely with the American Hospital Association (AHA), and its professional membership group, the American Society for Health Care Engineering (ASHE), to recruit additional facilities for the project. AHA and ASHE also provided input on the creation of the voluntary protocol that will govern emergency power status sharing by hospitals with government officials and utilities through the Dashboard.  State hospital associations taking an active role include the California Hospital Association, the Florida Hospital Association and the Texas Hospital Association.

To help ensure input from local and state emergency managers and public health officials on the information sharing protocol, Powered for Patients has partnered with the National Emergency Management Association (NEMA), the Association for State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO) and the International Association of Emergency Managers (IAEM). 

“Powered for Patients is grateful to the many stakeholders that are working closely with us to help leverage life-saving technology in an unprecedented way,” said Eric Cote, Project Director and Founder of Powered for Patients. “Having hospitals and other critical health care facilities share real time or near real time generator status reports with government officials and utilities during a disaster through our Dashboard represents a major breakthrough in improving situational awareness. Adding to this success by synthesizing multiple vendor data streams into a single data stream that populates the dashboard with a threat level indicator will be a groundbreaking accomplishment.”   

Cote credited the technology companies involved in the project for making major contributions to the initiative. “We applaud the technology companies that have worked closely with us to share valuable information about their technology along with their insights on how our Dashboard synthesizing their data feeds can be optimally developed,” said Cote. “We look forward to continuing our work with these companies beyond the current project to help commercialize the prototype we’re developing to enable all critical facilities using fault detection and automated reporting technology to share near real time data with government officials and utilities.”

Powered for Patients Receives DHS Funding to Leverage Real Time Emergency Power System Status Reports During Disasters

Powered for Patients is excited to announce that a proposed research initiative it submitted to the Department of Homeland Security has been selected as one of ten innovative research and development programs as part of the DHS 2018 National Infrastructure Protection Plan (NIPP) Security & Resilience Challenge.

Funding and support for the project is provided by the U.S. Department of Homeland Security, National Protection and Programs Directorate, Office of Infrastructure Protection, through the National Infrastructure Protection Program Security & Resilience Challenge, which is implemented by the National Institute for Hometown Security (NIHS).

Through the DHS project, Powered for Patients and its technology partner Talus Analytics will create a prototype to consolidate data streams from various remote monitoring and automated reporting systems connected to emergency power systems into a single data feed with a Red, Yellow, and Green risk indicator scale.

“This DHS award is a great honor and provides us with a tremendous opportunity to demonstrate the value of improving situational awareness of emergency power system status for government officials and utilities when emergency power is threatened at critical healthcare facilities during disasters,” said Powered for Patients Project Director Eric Cote.

The prototype Powered for Patients is developing with Talus Analytics will provide government officials and utilities with a single dashboard through which to view and assess unfolding threats to emergency power at hospitals impacted by disaster across the U.S. In addition to hospitals, this real time information sharing about generator status will be sought for large dialysis centers and nursing homes and the water systems and waste water treatment systems serving critical healthcare facilities.

Real time awareness of threats to emergency power will enable accelerated response by government officials in forestalling the loss of emergency power through deployment of temporary generators or generator fuel. For utilities, this early warning could enable utilities to shift restoration priorities and restore utility power prior to the loss of emergency power.  

“The success of this exciting project will depend on the active engagement of stakeholders in government, healthcare, the utility sector and the emergency power industry including those companies with proven fault detection and automated reporting systems,” said Cote. “I look forward to continuing to engage with key stakeholders in the weeks and months ahead.” 

The following stakeholder pages have been set up on the Powered for Patients website to provide additional details about how individual stakeholders can participate in the project. 

Government Stakeholders
Healthcare Facility Stakeholders
Emergency Power System and Fault Detection Technology Providers
Electric Utilities
Water and Waste Water Treatment Utilities

Powered for Patients is grateful to the many stakeholders that have engaged in this project, including:

Government Partners

  • Association of State and Territorial Health Officials (ASTHO)
  • International Association of Emergency Managers (IAEM) 
  • National Emergency Management Association (NEMA)

Healthcare Sector Partners

  • American Hospital Association (AHA)
  • American Society for Healthcare Engineering (ASHE)
  • Florida Hospital Association
  • Tufts Medical Center

Technology Partners

  • Blue Pillar, Inc.
  • Cummins
  • Eaton
  • EcoEnergy, Subsidiary of United Technologies Corporation
  • Expert MicroSystems
  • Schneider-Electric
  • United Technologies Corporation

To learn more about the Powered for Patients DHS NIPP Security & Resilience Challenge award, please visit the project page on the Powered for Patients website.

Powered for Patients Providing Guidance on Safeguarding Emergency Power for States in Hurricane Florence’s Path

Washington, D.C. – September 10, 2018 – As the threat of Hurricane Florence intensifies, Powered for Patients, a 501c3 non-profit created after Hurricane Sandy, is urging government officials, utilities and healthcare facilities in Florence’s path to take important steps now to safeguard emergency power and accelerate prioritized power restoration for critical healthcare facilities impacted by Hurricane Florence.

Powered for Patients was created in the aftermath of Hurricane Sandy when the failure of emergency power systems at six New York City area hospitals prompted emergency evacuations. The non-profit’s mission is to safeguard emergency power and expedite power restoration for critical healthcare facilities by fostering increased collaboration and information sharing between critical healthcare facilities, government and utilities when emergency power is threatened during disasters.

“Hurricane Florence can be expected to produce prolonged power outages that will seriously challenge the ability of emergency power systems to operate for the duration of the power outage,” said Eric Cote, Project Director for Powered for Patients. “This reality makes it critically important for facility managers at hospitals, skilled nursing facilities and dialysis centers take steps now to ensure that their emergency power systems are as prepared as possible for extended operation. This preparation includes a careful review of critical system components, topping off fuel tanks and checking spare parts inventory.”

Powered for Patients has published an Emergency Power System Resilience Checklist that details the key steps facility managers should take before, during and after a disaster to safeguard emergency power systems. This checklist, based on FEMA guidance, also includes a spare parts checklist to help facility managers inventory spare parts and address shortages prior to Florence’s landfall. (See attached checklists) These checklist are part of Protecting Patients When Disaster Strikes, a Playbook for safeguarding emergency power and expediting power restoration published in 2017 with Department of Homeland Security funding by Powered for Patients and the Rhode Island Emergency Management Agency. While developed for use in the State of Rhode Island, much of the Playbook’s content is applicable for any state impacted by a disaster.  

Powered for Patients is also urging emergency managers, public health officials and utilities to review protocols for how threats to emergency power and prioritized restoration for critical healthcare facilities should be addressed. These protocols should detail how a facility should notify government officials and utilities of a threat to emergency power and how government, utilities and impacted facilities should communicate to address any unforeseen threats to patient safety due to power outages or a loss of emergency power.  These protocols should be shared with all critical healthcare facilities before Hurricane Florence strikes. 

“We’ve learned from previous disasters that there is often a lack of clarify around the steps critical healthcare facilities should take in terms of communicating with government officials and utilities if there is a threat to patient safety arising from the lack of utility power or the loss of emergency power,” said Cote. “This uncertainty can put patient safety at risk.”   

In 2017, Powered for Patients introduced a new early warning protocol that calls on critical healthcare facilities in a disaster area to provide an early warning to a designated government official at the first sign of any threat to emergency power. This early warning can give government officials a critical head start in replacing generators if service crews are unable to resolve a mechanical threat and it also enables utilities to shift restoration priorities to restore power to a facility before emergency power is lost.

This new protocol was published in Protecting Patients When Disaster Strikes and in Roadmap to Resiliency, a white paper co-authored by Powered for Patients and the American Society for Healthcare Engineering (ASHE), a personal membership group of the American Hospital Association.

“Providing early warning of a threat to emergency power is the optimal best practice but this can’t happen if a healthcare facility doesn’t know who in government or at their utility they should contact and when once a threat to emergency power is detected,” said Cote.

Cote urged emergency managers, public health officials, utilities and critical healthcare facility administrators to address these critical communication protocols before Hurricane Florence strikes.

Protecting Patients When Disaster Strikes Playbook on Safeguarding Emergency Power Formally Unveiled

Providence, RI – August 24, 2017 – Emergency management officials, public health leaders, and healthcare facility administrators gathered at Women & Infants Hospital on Thursday for the presentation of Protecting Patients When Disaster Strikes, a new playbook that will be used to advance Rhode Island’s work to safeguard the emergency power needs of critical healthcare facilities before disasters strike.

The clear, centralized guidance in Protecting Patients When Disaster Strikes derives from years of emergency preparedness planning and training by the Rhode Island Emergency Management Agency (RIEMA), the Rhode Island Department of Health (RIDOH), the Healthcare Coalition of Rhode Island, healthcare facilities, and other partners. Although the event was held at Women & Infants Hospital, all healthcare facilities can use the playbook, including nursing homes, health centers, and assisted living communities, as well as other community organizations.

“Rhode Island is susceptible to power outages stemming from natural disasters such as hurricanes, winter storms, floods, as well as human-caused and technological incidents. Protecting our citizenry and critical infrastructure is the top priority of our agency. Therefore, it is crucial that we work together as a state to assist critical facilities that are dependent on power to provide support to Rhode Island’s most vulnerable populations,” said RIEMA Director Peter Gaynor.

“Climate change and cyber threats are just two of the emerging issues we must be mindful of as we look forward and work to secure Rhode Island’s power infrastructure,” said Director of Health Nicole Alexander-Scott, MD, MPH. “RIDOH’s Center for Emergency Preparedness and Response has done tremendous work with hospitals and emergency preparedness partners throughout the state on planning for and training for emergencies, as well as learning from actual incidents. Protecting Patients When Disaster Strikes will help smaller facilities such as nursing homes, health centers, and assisted living communities, follow their lead and ensure that all Rhode Islanders, including the state’s most vulnerable populations, will continue to get the health services and care they need during emergencies.”

“At Women & Infants Hospital, the safety of our patients, visitors, and staff is of utmost importance, and ensuring our readiness to respond in the case of an emergency or a disaster is critical,” said Diane Rafferty, interim president and chief operating officer, Women & Infants Hospital. “We are proud to be able to work collaboratively with the state agencies and other health care providers in planning for emergencies. This playbook will now be one more valuable tool in our preparedness toolbox.”

The playbook includes inventory material, emergency power supply contacts, facility manager checklists, and reporting information and is comprised of a four-phase planning process to help facilities safeguard their emergency power systems and expedite power restoration. The four phases are:

  • An assessment of potential power vulnerabilities and guidance on how to address vulnerabilities before a disaster occurs.
  • Guidance on how facilities can ensure reliable emergency power, should the grid go down.
  • Guidance on how to operate while under emergency conditions and how to sustain efforts during emergency power operations for four days or longer.
  • Information on the post-disaster recovery process, and how to best learn as an organization and most effectively prepare for subsequent emergencies.

Rhode Island is the first state to implement the initiative and will be a model for a nationwide push of the Powered for Patients program. Having officially entered hurricane season in June, the playbook could not have been completed at a better time. A copy of the playbook will be distributed to healthcare facilities and community partners through the state.

Protecting Patients When Disaster Strikes was developed using funding from the U.S. Department of Homeland Security. The playbook references partnerships with the U.S. Army Corps of Engineers, the Federal Emergency Management Agency, National Grid, the Hospital Association of Rhode Island, the American Society of Healthcare Engineering, and the U.S. Department of Health and Human Services, among other organizations. RIEMA and RIDOH’s Center for Emergency Preparedness and Response worked with the nonprofit Powered for Patients on its development.

“One of the key lessons learned after Hurricane Sandy was that federal officials lacked sufficient situational awareness of failing hospital generators. The Rhode Island initiative will help address this problem by developing a protocol for how to best share information about threats to backup power systems with government officials and utilities,” said Eric Cote, project director for Powered for Patients.

First DHS-funded, state-specific Stakeholder Engagement Initiative wrapping up with important findings and far reaching outcomes

The DHS-funded Stakeholder Engagement Initiative launched by the Rhode Island Emergency Management Agency (RIEMA) and Powered for Patients in October 2015 is nearing its conclusion and will help set the stage for similar initiatives in other states. Key state stakeholders involved in the project have included the Rhode Island Department of Health; the Rhode Island Office of Energy Resources; National Grid, the state’s primary electric utility; and the Hospital Association of Rhode Island. Several federal agencies have been active participants including FEMA, DHS, and HHS.

After more than a year of stakeholder meetings, emergency power system vulnerability assessments and strategic planning, a key outcome of the initiative will be a comprehensive Playbook, entitled Protecting Patients When Disaster Strikes. The Playbook details the key responsibilities of stakeholders across a four-phase planning and operational continuum to safeguard emergency power systems and expedite power restoration.

The Playbook will also introduce new consensus protocols that can become a national model for enhancing situational awareness of emergency power system status during disasters. (More to come on this once the Playbook is officially published in the coming weeks.)

New Online FEMA Emergency Management Institute (EMI) Course on the ABC’s of Temporary Power (IS-815) Highlights the work of Powered for Patients

From its inception, Powered for Patients has worked closely with FEMA leaders and officials from the U.S. Army Corps of Engineers (USACE) responsible for the management and deployment of the federal fleet of temporary generators to meet the needs of critical infrastructure facilities whose generators fail during disasters.

A part of this work has been Powered for Patients’ active promotion of the FEMA/USACE online Emergency Power Facility Assessment Tool (EPFAT). A facility’s registration of its emergency power system through the online EPFAT system enables FEMA and USACE to accelerate deployment of temporary generators during a disaster.

As part of this ongoing collaboration, FEMA is helping to spread the word about the work of Powered for Patients.  FEMA’s new online Emergency Management Institute (EMI) course on the ABC’s of Temporary Power (IS-815), highlights the work of Powered for Patients. Information about the new FEMA course is available at https://training.fema.gov/is/courseoverview.aspx?code=IS-815