2_Title SlideHealthcare Sector Meet Up

Monday, June 8th, 2020

1:00 PM – 2:30 PM ET

Allison KirbyRE Tech Advisors

Resources & Closing

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Agenda

Welcome & Program Updates

Shanti Pless, NREL: Zero Energy Resources

Travis English, Kaiser Permanente: Zero Energy Clinics

4 Speaker Debrief and Electrification Discussion

Speaker Q&A and Priorities Discussion

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Thank you to our Steering Committee Members!

• Darren Dageforde, UNMC (Co-Chair)

• Edna Lorenz, Beaumont Health (Co-

Chair)

• Corey Zarecki, Gundersen Health

• James Symanski, US Department of

Veteran Affairs

• Jon Utech, Cleveland Clinic

• Kara Brooks, ASHE

• Kyle Tafuri, Hackensack Meridian

Health

• Mary Statz, UW Health

• Pat Lydon, Legacy Health

• Richie Stever, UMMC

• Kirby Brendsel, Welltower

Sector Priorities

Priority 1: Publish solutions outlining energy efficiency and zero energy-ready design as strategies for energy resilience planning. Generate coverage in mainstream press on this topic.

Priority 2: Curate and create resources supporting energy efficiency as a priority within shifts in healthcare services and a changing model of care. Ensure Better Buildings Solutions Center content and ongoing partner engagement offerings are aligned with trends in industry—including increased focus on outpatient clinic services and medical office buildings.

Priority 3: Promote and help partners develop successful communication strategies for obtaining high-level buy-in for pursuing energy efficiency projects.

Congratulations to Cleveland Clinic!

• Cleveland Clinic Foundation achieved its Better

Buildings Challenge Energy Goal!

• Energy reduction topped 22% from a 2010

baseline

• Energy reduction measures

• LED retrofits

• Optimized air exchange rates in operating rooms

• Employee engagement initiatives

• Congrats to the team at Cleveland Clinic!

Waste Reduction Pilot

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• The Pilot was launched to address the 2.7 billion tons of industrial solid waste

and more than 260 million tons of municipal solid waste the U.S. generates

annually.

• DOE is working with partners to help them develop or refine goals, identify

benchmarks, determine performance metrics, track performance, and validate

results.

• Over 30 partners from various Better Buildings sectors are participating

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Today’s Presenters

Shanti PlessNational Renewable Energy

Laboratory (NREL)

Travis EnglishKaiser Permanente

Shanti PlessNational Renewable Energy Laboratory (NREL)

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Zero Energy Buildings: 2020 Resources and Industry

OverviewShanti Pless

Senior Buildings Energy Efficiency Research Engineer

NREL Commercial Buildings Energy Research Group

June 2020

Net Zero Site Energy Building

Net Zero Source Energy Building

Net Zero Energy Emissions Building

Net Zero Energy Cost Building

http://energy.gov/eere/buildings/articles/doe-releases-common-definition-

zero-energy-buildings-campuses-and

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Zero Energy Building (ZEB) Source Definition

An energy-efficient building, where on an annual source energy basis, the actual annual delivered

energy is less than or equal to the on-site renewable exported energy.

Zero Energy Ready Building

Building or Campus or District or Portfolio

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Next Generation of ZEBs will be…

• Taller

• District Scale

• High Load Building Types

• Grid Friendly

• More Resilient

• More and everywhere…

• 500+ projects targeting zero

• Zero Energy School Districts

• Zero Energy Districts

• 100% Renewable Commitments• 5 states• Over 100 cities• Multiple utilities• Corporate commitments

• Zero Energy Stretch Codes• CA Title24 required for residential- working towards commercial• Boulder and Denver working on 2030 Zero Energy Building Codes now

Zero Energy Catching on

NREL | 22

100% Renewable Commitments driving Zero Energy Building Codes

• LEED-0

• Living Building Challenge

• Zero Code from Architecture 2030

• DOE Zero Energy Building standard definition

Zero Energy Certifications

LEED – 0: Offsite Accounting

https://www.usgbc.org/sites/default/files/LEED_Zero_Program_Guide.pdf

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Offsite Renewables In Zero Code

https://zero-code.org/wp-content/uploads/2018/04/Zero-Code-TSD-OffSiteRenewables.pdf

Zero Energy Trends

Codes , Standards and Resources: Advanced Energy Design Guide for Achieving Zero Energy

More information: https://www.ashrae.org/technical-resources/aedgs

AEDGs:• Design guidance by building type and climate zone

• Supported by case studies and energy modeling

• Developed by leading industry experts• Looked to for beyond code recommendations

Large Hospitals 50% AEDG Scope• Applies to hospitals larger than 100,000 ft2

• With the following common space types:o Cafeterias, kitchens, and dining facilities

o Administrative, conference, lobby, lounge, and office areas

o Reception and waiting areas and examination and treatment rooms

o Clean and soiled workrooms and holding areas

o Nurse stations, nurseries, patient rooms, hallways, lockers, and restrooms

o Operating rooms, procedure rooms, recovery rooms, and sterilizer equipment areas

o Pharmacies, medication rooms, and laboratories

o Triage, trauma, and emergency rooms

o Physical therapy and imaging/radiology rooms

o Storage, receiving, laundry, and mechanical/electrical/telecomm rooms

• Does not cover specialty spaces such as data centers, parking garages, and campus utilities such as chilled water and steam

Hospital Recommendation Summary• Envelope

o Approximately 45% more insulated than Standard 90.1-2004

• Interior lighting

o Recommendations that result in a 25% reduction in whole-building LPD

o Sample layouts for patient rooms, nurse stations, operating rooms, recovery rooms, treatment rooms, exam rooms, labor and delivery rooms, imaging suites, enclosed offices, and conference rooms

• Building footprint

o Articulated footprint examples to maximize daylight access in the buildings

• Exterior lighting

o Recommendations that reduce lighting power for parking lots and drives by more than 33% over Standard 90.1-2004

• Task lighting

o LED surgery light recommendations that save 60% of the energy used for surgery lighting and significantly reduces the energy demands for cooling the surgeons and warming their patients

• Elevators and kitchens

o Recommended use of traction elevators exclusively throughout the building, and regenerative traction elevators for high-use areas

o Numerous tips to conserve energy in hospital kitchens and cafeterias

Hospital Recommendation Summary• ENERGY STAR exclusive plug-in equipment

• Best-in-class plug-in equipment where ENERGY STAR does not apply

• Average SWH savings of 13% over Standard 90.1-2004

• Aggressive reduction in reheat resulting from decoupling space conditioning loads and ventilation loads while meeting Guidelines for ACH and pressurization

• A best-in-class surgery suite central air handling system

Three HVAC system types that result in significant energy savings over standard equipment• Water source heat pumps with a DOAS• Four-pipe fan coils and a DOAS• Mixed-air variable volume air handler with separate outdoor air treatment and a

heat recovery chilled water system

• Additional HVAC recommendations• Aggressive supply air temperature reset and zone airflow setback• Airside pressure drop and coil face velocity reductions• Elimination of steam boilers• High ΔT chilled water loops• Demand controlled ventilation• Airside energy recovery

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American Geophysics Union Net Zero Renovation in DC

http://building.agu.org/

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United Therapeutics UnisphereNet Zero New Construction Goal, Silver Spring, MD

http://utunisphere.com/

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Taller requires more creative PV integration

South Façade PV in Denver produces more than optimal tilt in Northeast…

– 1,000 kWh/kW+

– Also provides seasonal balance with winter peak production

– Image credit Bouldercommons.com

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Denver Water Zero Energy Campus Operations

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High Load Net Zero Labs

Image courtesy Sasaki Architects

California Air Resources Board Vehicle Testing Lab, Riverside CA

• 380,000 ft2, ~47 kBtu/ft2/yr design goal

• Net Zero with large scale battery storage and 120+ EV charging stations to harmonize ZEBs with the southern California duck curve grid

• Will be largest ZEB (size and load) in design now…https://www.arb.ca.gov/html/socalfacility/socalfacility.htm

What is next in zero energy labs?

NREL | 39

• Strategies in procurement, modular design, alternative financing, and off-site construction

• Off-site and design for modular components key strategies to reach zero energy on a budget

• How far can we go utilizing this strategy?

Zero Energy Trends

Codes , Standards and Resources: All Electric and Title 24 in California

More information: https://buildingdata.energy.gov/cbrd/resource/1655

“Off-site construction can reduce project construction time by between 40 and 50 percent, because several aspects of the construction process can be completed simultaneously, rather than sequentially as is required in traditional construction

Fewer months on-site also reduces expenses such as general contractor fees, utilities, security, and other related facility costs. A shorter time frame also has the benefit of minimizing length of impact on neighbors. “

http://modular.org/documents/document_publication/mckinsey-report-2019.pdf

Offsite will Save Time and Money

Permanent Modular Off-Site Construction

• 20%-40% faster to build*

• 5%-95% construction off-site in a factory*• Volumetric modular, wall panels, etc

• 3% of new construction in 2017*• Multifamily and hotels

• Higher quality

• Can be cheaper to build

• Any program that can be modularized

• New investment from outside construction industry.

But does it result in more efficient buildings? Perhaps…

* Modular Advantage by Modular Building Institute (https://www.modular.org)

Healthcare Manufacturing from Blox● Volumetric Modular Healthcare units in US by BLOX:

http://dev.bloxbuilt.com/construct/● Video of Alabama factory:

https://www.youtube.com/watch?v=qvmJma-Q_dw

NREL Industrialized Construction Innovation webpage

Industrialized Construction of Fully Operational 100% Solar-Powered Medical Facilities

Thanks and Questions: Zero Energy Modular Healthcare?

Build Stack Power Begin Care

Shanti Pless, NRELShanti.pless@nrel.gov

Travis EnglishKaiser Permanente

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Kaiser Permanente’s Santa Rosa MOB

• Medical Office Building in Santa Rosa, CA

• 87,300 square feet

• All-electric, net-zero

• Anticipated LEED Gold

• Features

• 60 doctors’ offices

• 95 exam rooms

• 8 procedure rooms

• On-site café with outdoor patio and Wi-Fi

• Charging stations for EVs

FGI & ASHRAE & ASHE Joint Research

Free Report for ASHRAE Members

https://technologyportal.ashrae.org/Report

https://technologyportal.ashrae.org/Report/Detail/707

The evidence-basis behind most

of the standard is POOR !!

0

50

100

150

2002

01

7 E

ner

gy C

on

sum

pti

on

-kB

TU /

sf-

yr

Energy Use Intensity - KP New-Build Clinic Buildings

Energy

2012 - 2014 OpeningsAverage EUI = 125

> 2015 OpeningsAverage EUI = 70

2009 - 2011 OpeningsAverage EUI = 140

KP Santa Rosa Medical Office Building

87,000 ft2 – LEED Platinum Pending

All-electric HVAC (zoned heat pumps)

Consumption – Production = 36.8 – 31.8 = 5 kBTU/ft2-yr

Net Zero Clinics- Kaiser Permanente’s Santa Rosa Medical Office Building

The building’s envelope is made from energy-efficient, and

durable, insulated interlocking cladding panels

Net Zero Clinics- Kaiser Permanente’s Santa Rosa Medical Office Building

The windows are equipped

with light-sensing material

that darkens in response to

solar radiation.

Net Zero Clinics- Kaiser Permanente’s Santa Rosa Medical Office Building

• HVAC system

• Uses a heat pump for

each thermodynamic

zone

• Eliminates chillers

and heat pipes

• No boiler!

Net Zero Clinics- Kaiser Permanente’s Santa Rosa Medical Office Building

Independent office controls use thermal diffusers that open & close ventilation dampers to maintain a

desired temperature

Typical Clinic Design – Natural Gas Boiler System

Natural Gas Heating SystemBuilding heating load 12/6/2019 – 2/4/2020 = 320.5 MMBTU

Natural gas use 12/6/2019 – 2/4/2020 = 1,113 MMBTU

System efficiency = 29%

Energy Performance Gap – All Electric

Energy performance

gap, building – 7%

Energy performance

gap, PV – 17%

Kaiser Permanente’s Santa Rosa MOB

Medical Office Building in Santa Rosa, CA

87,300 square feet

All-electric, net-zero

Travis.R.English@kp.org

714-469-9553

Speaker DebriefTravis & Shanti

Energy Efficiency, Zero

Energy, and Resilience

Discussionwww.slido.com event code #BBSummit

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New! “Healthcare Sector Priorities: Relevant Resources” Page

This page highlights solutions

and resources for healthcare

organizations related to this

year's Healthcare Sector

Priorities, as set by the Better

Buildings Alliance Healthcare

Sector Steering Committee

Page link here

Additional Resources

• Healthcare Sector Page – Link

• Kaiser Permanente’s Medical Center Microgrid – Link

• UMMC Engages Leadership Through ASHE Energy To Care Treasure Hunt – Link

• Gundersen Health System Low-Energy Design – Link

• DaVita’s Top-User Water Efficiency/Management Program – Link

• How Buildings Of All Shapes And Sizes Are Becoming Zero Energy Users – Link

Other Sessions Featuring Healthcare Partners

• Stump the Chumps: How to Optimize Critical Facilities

• Wednesday June 10th, 3:00 – 4:30 PM EST

• Featuring Daniel Mastin, New York-Presbyterian Hospital

• The Path Forward: Perspectives on Prioritizing Energy Efficiency

(Closing Plenary)

• Thursday June 11th, 3:00 – 4:30 PM EST

• Featuring Jon Utech, Cleveland Clinic Foundation

Better Buildings: Summer Webinar Series

BEHIND THE METER

DISTRIBUTED ENERGY

RESOURCES:

BEST PRACTICES FOR INTEGRATING

DERS INTO COMMERCIAL BUILDINGS

July 8

PROGRAM DESIGN WITH

EVERYONE IN MIND:

LOW-INCOME SOLAR

PROGRAM STRATEGIES

July 9

THE DYNAMIC DUO:

UNLEASH PUBLIC SECTOR ENERGY

SAVINGS WITH FINANCING AND

TECHNICAL ASSISTANCE

July 14

CASE IN POINT:

OREGON’S RECENT EFFORTS TO

REDUCE PLUG LOAD ENERGY

CONSUMPTION

July 22

STRATEGIES TO COMBINE

ENERGY + HEALTH UPGRADES

IN MULTIFAMILY HOUSING

July 21

EVERYONE HAS A

DATA CENTER:

HOW TO BE AN ENERGY

CHAMPION FOR YOURS

July 28

SUCCEED WITH

SUBMETERING:HOW TO MAKE THE BUSINESS CASE

August 4

NEXT-GENERATION BUILDING

PERFORMANCE POLICIES:

MAXIMIZING ENERGY SAVINGS AND

ENVIRONMENTAL IMPACTS

July 16

Shanti PlessNational Renewable Energy Laboratory

(NREL)

shanti.pless@nrel.gov

Additional

Questions?

Please Contact Us

Better Buildings Solution Centerhttps://betterbuildingssolutioncenter.energy.gov/

General Inquiriesbetterbuildings@retechadvisors.com

Program Supportksanderson@retechadvisors.com

Follow us on Twitter@BetterBldgsDOE

Travis EnglishKaiser Permanente

Travis.R.English@kp.org

Allison KirbyRE Tech Advisors

akirby@retechadvisors.com