Challenge

Control Montefiore Health System and Medical Centers energy budget while increasing ROI through low-risk and diverse strategies and initiatives.

What Makes Montefiore Health System different from other hospitals and medical centers? 

“Going green” and “sustainability” are trending words that we hear thrown around a lot today. More and more organizations claim that they are going green and reducing their carbon footprint. So, what makes Montefiore different? Montefiore has been producing and using sustainable energy since 1993, with new and ever-evolving innovative programs. But what makes them really unique is the deep knowledge and passion among the staff to implement sustainable solutions. While many companies say they are ‘going green’, Montefiore is living it. 

We sat with Ed Pfleging, Vice President of Facilities & Real Estate, and Jeff Hogan, the Energy & Sustainability Manager of all Montefiore Health System hospitals and centers, to learn about their relationship with energy and their goals for the future.  

The Montefiore Health System currently manages four hospital sites in the Bronx and recently acquired several new facilities in Westchester County. With these new facilities, the Montefiore Health System now equals a total of  9 million square feet comprised of hospitals, medical centers, and  ambulatory care facilities These acquisitions have brought Montefiore closer to achieving the team’s ultimate goals for the future.

One of Montefiore’s primary business objectives for the future is to grow its presence and influence in the community. To do this, they work to remain in touch with community leaders and their patients. Montefiore currently manages the health of 300,000 capitated and shared risk patients and hope’s to grow this number to 1 million. Another primary objective is to increase the number of high-end procedures such as liver transplants, heart transplants and cancer treatments performed at their hospitals and to continue to grow specialty services.

To achieve these goals, the Montefiore Health System has grown substantially over the last 5 years, by acquiring hospitals that could no longer afford high-end technology. Focusing on a holistic approach to medicine that includes education through preventative care is also part of the overall strategy. From making phone calls to ensure that discharged patients are taking their medication, to home scales that connect to the hospital and monitor patient weight, Montefiore prides itself on first class efficiency and creativity.

Ambulatory care facilities, which are smaller and more localized medical centers dispersed throughout the community, also play a part in keeping Montefiore’s vision for the future on track. These facilities allow Montefiore to treat more patients outside of the hospital, leaving more hospital beds open for patients requiring high-end procedures and/or more intricate care. 

Montefiore is impressive in its reach and objectives, including finding the perfect workflow to move patients through the system and align their employees, but how does it power the whole endeavor? 

Montefiore’s cogeneration and energy management plant: innovative sustainability

Ed had just begun working at Montefiore when the hospital built its first plant 25 years ago.  The decision to become a co-generator was spearheaded by strong board support to invest in energy efficient technology that provided a healthy financial payback.  The decision also hinged on new federal energy laws that mandated public utilities provide backup services if requested by a co-generation facility.  Montefiore’s first plant was interconnected with Con Edison through a single feeder.  Unfortunately this single feeder failed from time to time and the plant did not have the resilience or redundancy to withstand these failures that caused blackouts. When Montefiore’s whole system went down they were forced to switch to emergency generators. After dealing with this for 5-6 years, the decision was made to expand the cogeneration plant to eliminate dependency on the Con Edison feeder and to install additional capacity for redundancy when the plant required service. The total plant has a capacity of 10MW and a connected load of 8MW.

Today, Montefiore Medical Center has the longest running cogeneration facility of any New York City hospital. It not only produces power for Montefiore, but also regularly exports power back to the Con Edison energy grid when economically advantageous. A byproduct of the electrical generation is heat, which can be recovered through Montefiore’s Heat Recovery Steam Generator (HRSG).  That energy or heat is piped to Montefiore’s boilers to reduce the amount of fuel needed to fire the boilers and ultimately create steam.  Typically, Montefiore’s Cogeneration Plant staff can provide 75% of the campus steam load through the heat recovery process, which is used to heat water and regulate the temperature in its buildings.  

The process of generating electricity at central power plants and sending it to end users miles and miles away is only 30% efficient.  By generating power onsite and capturing a byproduct of that electrical generation, the process of cogeneration can be upwards of 80% efficient.  When compared to the local utility, Montefiore’s cogeneration plant will require significantly less fuel to meet the facilities electrical and thermal demands.  The enclosed system also prevents emissions from polluting the air and reduces demands on New York City’s electric power transmission and distribution system. The plant is now over 20 years old and generates 90% of Montefiore’s power. The health system has recently applied for additional grants that would fund a second cogeneration facility within the system.

With the cogeneration plant functioning so successfully, a large part of Montefiore’s focus is on purchasing gas. Naturally, they want to use as little gas/energy as possible to reduce its carbon footprint.

The team at Montefiore understands that both the purchasing and management of gas can make a big difference. Initially, they bought their gas directly from Con Edison, but then moved to an independent agent that would lock them into fixed-rate plans when the price was low. However, they began having issues when some of these practices proved to be quite risky and the relationship became unreliable. The hospital needed an energy management partner it could trust.

Their decision to change energy management partners came on the heels of deregulation, which in turn created a lot of new broker and partnership options. At that time, Ed met with Arthur Debowski, an energy advisor at Great Eastern Energy (GEE), and Arthur laid out a long-term plan for Montefiore. Ed, needing to focus on multiple other projects, felt that he could trust Arthur to manage the acquisition and management of Montefiore’s gas. “I am not an expert in buying energy,” says Ed, “I rely on Arthur and GEE to make the right decisions that are consistent with Montefiore’s business strategy and philosophy.”

How energy brings sustainability

Electricity and gas management isn’t the only way Montefiore has contributed to the energy landscape. With their own funds, along with NYSERDA and FEMA grants, they’ve done the following: Revamped their cogeneration plant and are working towards adding an additional plant; are in the process of installing two green roofs; upgraded to LED lighting, use a food digester, recycle all waste products and are educating the community through outreach programs that focus on healthy living and environmental sustainability.

Ed believes that being efficient and effective is at the heart of sustainability. This naturally flows from his engineering background and mindset. “Most of us in facility management are engineers and our training emphasizes these ideals,” said Ed. “Being environmentally friendly is paramount as we strive to reduce our carbon footprint. This is not just in terms of electricity and natural gas, but in terms of our overall waste as well. For example, we received a $900,000 grant to place a green roof on one of our hospitals.” Green roofs, with their vegetation, are a great way to keep buildings cooler by insulating them year round. In the Bronx it also helps retain water and keep it from running into the community’s one-pipe sewer system, which can flood when it is at capacity.

The hospital received an additional $750,000 grant from The New York City Department of Environmental Protection (DEP) to support the development of a green roof at its Wakefield campus as well.

Further, for Ed and his staff, their mission is ongoing. For instance, in 2014, when NYC Mayor, Bill de Blasio committed to reduce New York City’s greenhouse gas (GHG) emissions by 80% by 2050 in what he called the ‘Carbon Challenge,’ Montefiore, since the inception of the Carbon Challenge, has reduced its carbon footprint by 19% across its network of hospitals. 

Montefiore New Rochelle has also made efforts to become more sustainable by installing a state-of-the-art food digester, which eliminates organic waste from the garbage that would normally go into landfill. Installed in November 2014, it has already diverted 70 tons of food waste, which equates to taking 6-7 cars off the road.

At the end of the day, Ed credits the majority of Montefiore’s successful energy management and sustainability endeavors to having an intelligent and experienced team that manages the cogeneration plant and an energy management department that focuses on reducing their energy consumption.

What’s Ahead for Montefiore Health System regarding sustainability?

As previously mentioned, Montefiore will be adding a second green roof to one of its hospitals. The New York City Department of Environmental Protection (DEP) has a green infrastructure program, which accepted Montefiore into its grant program. Jeff Hogan is currently working with the DEP on final logistics and will start implementing the roof in the spring at Wakefield Hospital where Arthur of GEE manages their energy purchasing and management.

Q&A with Ed and Jeff

What makes your relationship with Great Eastern Energy work?

Ed: It takes time to develop a relationship. Arthur is out there every day and the outcome has been positive. He is fighting for us. As our trusted expert in gas, he is looking for opportunities that make sense for us. We have very open communication.

In the beginning, I sometimes doubted Arthur’s strategy, but he was always right in the end. I have come to respect the fact that Arthur is out there every day studying the energy market and working hard for us.

In regards to energy and your impact on the hospital, what are you most proud of?

Ed: Our cogeneration facility because it is an engineering feat and a success that allows us to be self-sustainable and in charge of our own destiny. The Environmental Protection Agency even named Montefiore as one of five winners of the Annual Energy Star Combined Heat and Power (CHP) Award. In fact, the Montefiore Moses campus was without interruption before, during and after the hurricane, and helped assist the Bronx by receiving several patients from other hospitals impacted by the storm. Its staff even provided coffee to police from their open and fully functioning coffee shop, when there were no other functioning facilities in the area. Hence the hospital’s coined nickname, “Shining Star of the Bronx”.

What advice would you give other executives on taking charge of their energy resources?

Ed: Hire the right staff; knowledgeable engineers and sustainability managers who understand the technical processes. It’s a team effort - use both consultants and internal managers. Surround yourself with experienced professionals whether it’s brokers, suppliers or consultants such as Arthur from GEE. Do I need Arthur to buy my gas? No, I could probably make all of those decisions on my own. But Arthur brings so much more to the table. My job is not to be an expert in the gas market. Work with people who are trustworthy and form long-term relationships with those who are looking out for your company’s best interests. I’d also recommend staying on the cutting edge by hiring a sustainability manager who is looking to invest in the future. In other words, surround yourself with a strong and reliable team that supports your goals and gets the job done.

What are the major challenges of your job?

Jeff: Inspiring change in an organization. People are comfortable with the status quo. Getting them to change their patterns and way of thinking towards energy, sustainability and waste management can be a challenge. We need to let them know that we are trying to provide equal standards for less money, or better standards like LED lighting and green roofs.

How do you decide what new sustainability initiative you will go after next? Do you have any new programs upcoming that you didn’t already mention?

Jeff: I’d like to look into “real-time energy management.” I want to understand and track where and how energy is being consumed at all campuses and Montefiore buildings. What buildings are using the most and least energy? Why are certain areas of these buildings using more energy?

A real-time energy management system would obviously make my work easier but it would also allow us to present data to our financial department and in turn, move initiatives along faster.

Three takeaways:

1. There are easy ways to “go green” and be more sustainable. First, look to the low hanging fruit by switching to LED lights or purchasing renewable energy. You can also take on slightly larger projects like adding a green roof and/or solar panels. An energy advisor can help you with this, as well as help reduce your energy consumption by understanding when and where you are using your energy.

2. Being sustainable is good for everyone. Through education and proactive initiatives, Montefiore has created a healthier and happier community while also meeting and exceeding its goals. 

3. Hire experts in sustainability. Whether it’s employees, consultants, agencies or advisors, an expert can help your company be more efficient and effective. Bringing an expert on board will allow you to focus on your primary responsibilities, while they stay on top of the latest sustainability trends and technologies.