TODAY’S STUDY: Energy Storage Solutions For Medically Vulnerable Households In Power Outages
Home health care in the dark; Why Climate, Wildfires and Other Emerging Risks Call for Resilient Energy Storage Solutions to Protect Medically Vulnerable Households from Power Outages
Marriele Mango and Annie Shapiro, June 19, 2019 (Clean Energy Group)
Every day, power outages are a fact of life in America’s health care system. Outages compromise the delivery of health care to millions of residents reliant on electricity for in-home medical equipment. Even short-term power outages can adversely affect public health; more often than not, the elderly, the sick, and the poor are most negatively impacted. For residents dependent on electricity for in-home medical equipment, an outage can be potentially fatal.2
Solar and energy storage technologies can protect vulnerable populations in the event of an outage. With the right policies, incentives and market designs in place, these resilient power technologies can serve all in need of reliable and resilient power systems.
Battery storage systems, which can store electricity for use when grid power is unavailable, can prevent a home health care routine from being upended by an outage, but few people are aware that residential battery storage is a resilient power option. For many that would benefit the most from this technology, high upfront costs remain a barrier. As outages become more commonplace and the need for home health care continues to grow, obstacles to accessing home battery storage will need to be addressed and solutions prioritized to ensure that medically vulnerable households can safely withstand a power outage.
This report examines the risks associated with power outages for individuals reliant on electricity for in-home medical and mobility equipment. An overview of existing data systems illustrating the demographics of this population is provided and the mitigation strategies currently used to assist these individuals during emergencies are described. A set of recommendations is included to suggest concrete opportunities to improve access to resilient power technologies.
What is Resilient Power?
First and foremost, resilient power is the ability to deliver continuous, reliable power even when the electric grid goes down for an extended period of time. Truly resilient power should be generated onsite, should not be dependent on supply chains that may be disrupted during catastrophic events, and should provide benefits throughout the year, not just during emergencies.
Solar PV paired with battery storage (solar+storage) represents a clean, reliable alternative to traditional generators, one that isn’t prone to fuel supply disruptions and can deliver savings through the year. When the grid is running normally, a resilient solar+storage system produces energy to meet onsite electricity use, manages demand for grid electricity, and can even generate revenue by participating in utility and grid services programs. When there is a power outage, a resilient system disconnects from the grid and operates independently as a microgrid, a process known as islanding, powering critical loads until grid power is restored. This combination of savings and resilience benefits, along with falling technology costs, has led more and more building owners to consider and implement solar+storage as a cost-effective resilient power solution.
While solar combined with battery storage is an ideal resilient power technology combination, battery storage can also store power from the main grid for use during an outage.
Home health and home care are on the rise, as more people opt to receive care at home rather than in an institution such as a hospital or nursing home. For many, home health care means relying on electricity-dependent medical equipment, such as oxygen concentrators and nebulizers. There are currently at least 2.5 million individuals reliant on electricity for in-home medical equipment in the United States. There are potentially millions more who rely on electricity-dependent devices and other services to aid in their daily “home care” living tasks, such as climbing up the stairs, bathing, or making a meal. For these households, reliable power can be a matter of life or death. Even a short-term power outage can quickly become a life-threatening situation. Despite this heightened risk, there are limited opportunities for low-income, medically vulnerable populations to access in-home backup power systems.
Natural disasters and severe weather are resulting in more frequent and longer duration power outages. Electric power outages almost doubled in duration in 2017, compared to 2016.4 Five months after Hurricane Maria decimated Puerto Rico’s energy infrastructure, 400,000 people remained without power. 5 In 2018, Hurricane Michael and Hurricane Florence each left upward of a million people in the dark across the Southeast United States.
For individuals reliant on electricity for home care and home health services, an inability to access power can result in a medical crisis. Health care complications, including outage-related issues like medical device failure, accounted for almost one-third of the estimated 4,645 additional deaths in the three months following Hurricane Maria.8
New utility strategies for wildfire prevention also threaten to disrupt home health care routines for already vulnerable residents. Wildfires have become rampant in states like California, where drought and high winds can exacerbate forest fires. In order to avoid another Camp Fire catastrophe, some California utilities are looking to de-energize, or shut down, the grid for periods of time when transmission lines and utility equipment are most likely to spark a fire. Deemed “public safety power shutoffs” by some utilities, de-energizing the grid as a preventative measure would leave customers in the dark for hours, days, or even a week at a time, even if there is no fire.9
Pacific Gas and Electric (PG&E), California’s largest utility, has already indicated that the 2019 wildfire season could result in five to 15 grid shutoffs.10 For medically vulnerable households, these precautionary outages could result in an inability to operate critical medical devices.
According to Michael Wara, director of the Climate and Energy Policy Program at Stanford and member of California’s Wildfires Blue Ribbon Commission, “Everyone who lives in wildfire country in California, which is something like 20 percent of the state, needs to be thinking about this problem as something they need to solve. . . . It’s not going to be something that the utility can really solve for them in the near term.”11
Hospitals and other medical institutions are required to install and regularly test alternate backup power sources to ensure the facility will be prepared in the event of an outage; however, for home health care patients, only those with financial means can invest in a backup power system.12
Diesel generators, the most readily available residential backup power option, require frequent refueling, often emit pollutants, are prone to failure, and can lead to sickness or death when used improperly. 13 Generators can also be difficult to operate and refuel, especially if an individual is weak, mobility impaired and living independently.
Battery storage is a safe and reliable emergency power resource. When combined with solar PV, it can provide a longer duration of backup power than storage alone. Places like Puerto Rico have already begun to see the value of resilient energy. A combination of donated and purchased systems doubled rooftop solar installations in Puerto Rico in the year after Hurricane Maria and resulted in 10,000 new residential battery systems.14 Increased resiliency was the leading motivation for the installations.
Programs to assist electricity-dependent households in gaining access to battery storage remain limited to regional pilot projects. As extreme weather trends persist, and power outages become more frequent events, those responsible for the well-being of medically vulnerable communities will need to build on existing resilient power programs and recognize battery storage as essential to emergency preparedness. In doing so, electricitydependent residents will be able to confidently shelter in place or safely wait for evacuation in the event of severe weather and power outages.
Key Recommendations for Advancing Battery Storage for Medically Vulnerable Individuals
Support research. So far, the impact that outages have on medically vulnerable households remains only narrowly explored, and even fewer resources are available regarding the role of battery storage in mitigating those impacts. Energy security and resilience in home health care should be funded as a priority research field within public health, including issues regarding low-income access to technology innovation and the public health benefits of installing resilient power systems in home health care settings.
Develop better data. The lack of a comprehensive, publicly available dataset makes it difficult to determine the exact size and demographic characteristics of the in-home, electricity-dependent population. In order to determine the size and scope of the electricity-dependent population, agencies such as Medicare and Medicaid should pool resources, coordinate data, and fund researchers to develop more reliable information into a single, unified source.
Technology innovation and market development. There is no market today for third-party providers to offer solar and storage technologies to home health care households. There is an urgent need for a comprehensive market development effort that will focus on technology innovation to develop suitable products and bring down costs.
Utility administered residential battery storage programs. In addition to maintaining a database of electricity-dependent residents, utilities should provide battery storage to homes to protect against outages as part of new residential battery storage services. States should consider requiring utilities to provide these critical technologies as a service for customers who depend on electricity to power medical equipment in their homes. Expanding utility energy efficiency programs to include battery storage also would establish a steady stream of funding for low-income battery storage programs.
Expand Medicare coverage to include in-home battery storage. If battery storage was included in the list of Medicare eligible durable medical equipment (DME), doctors would be able to prescribe battery storage. Medical device providers would then supply resilient power systems to home health care residents dependent on electricity for medical equipment…