Hospitals face many challenges—insurance reimbursement, staff shortages, treating the uninsured, replacing aging equipment, adapting to new health care regulations —so that energy efficiency may not be a top priority. Rising energy costs are beginning to change that, however.  Hospital energy costs have been rising from 15-25% annually, on average, for the past few years in the USA.  As budgetary pressures mount, hospital administrators are discovering that energy efficiency offers a cost savings opportunity they cannot ignore. Every dollar a nonprofit healthcare organization saves on energy is equivalent to generating $20 in new revenues (assumes 5% NOI).

To meet these challenges and opportunities in improving healthcare delivery, E3I has developed a specific expertise to design and deliver sustainable energy strategies to hospitals using a proven roadmap approach including holding meetings with decisionmakers to establish goals and objectives, conducting energy and water audits and benchmarking, identifying and getting agreement on high, low and medium return energy investment opportunities (including no cost adjustments), and addressing operating and capital budgeting requirements and implementation plans.  E3I was retained by Children’s National Medical Center as their sustainable energy advisor to create and implement a short- and long-term sustainable energy strategy to improve energy, operational, and financial performance while meeting operational needs within the highly complex medical campus. Beginning in 2010, E3 performed energy auditing and facility benchmarking using its real-time web-based energy monitoring system – Nextep Solution - to identify low cost, high return energy saving opportunities as well as longer term capital investment opportunities in sustainable energy, culminating in a Strategic Energy Management Plan for the C-level supported by the facilities management staff with energy savings redirected to support healthcare delivery excellence.

The hospital has realized over $2 million in annual savings in energy costs at its main campus with plans to expand the Nextep monitoring solution to 15 remote sites to identify energy efficiency opportunities and implement bulk electricity purchases across all hospital facilities. The planned next phase is to improve hospital resilience and reduce risk during a grid outage.

E3 International (E3I) is partnering with Belize Water Services (BWS), a private company majority-owned by the Government of Belize, to identify opportunities to reduce operating costs and environmental impacts through the implementation of sustainable energy solutions for potable and waste water treatment under a United States Trade Development Agency (USTDA)-funded contract.  E3I is engaging with stakeholders both internal and external to Belize Water Services, including the Ministry of Energy, Science and Technology, and Public Utilities, to optimize its feasibility study results and serve as a model for future clean energy projects throughout the Caribbean and Central America.

Belize Water Services has multiple water and wastewater treatment facilities around the country, currently serving 55,000 customer accounts and growing.  The solutions that E3I is considering as part of the feasibility study include wind, solar PV, and biogas.  The feasibility study will include both technical and financial due diligence to determine optimal system configuration and financial structure, considering both public private partnership and build-own-operate, and an environmental assessment as required by Belizean regulations. The outcome of the study, which involves in-depth meteorological evaluation of priority BWS sites, is an open competitive procurement of the technologies and related services to best meet the client’s operating, financial, and environmental objectives and to better serve the government and people of Belize. The E3I team brings decades of international renewable energy and energy efficiency project development, finance, and advisory experience and expertise to this initiative--including public-private partnerships in the Central American and Caribbean region and beyond.  The collaboration between Belize Water Services and E3 International began as part of a Reverse Trade Mission for Central American and Caribbean water service companies sponsored by the U.S. Trade Development Agency.

Faced with growing capacity and transmission problems, power companies are searching for additional energy sources that can be brought on line quickly and economically to satisfy peak demands. A key source already exists: distributed generation (DG) units now used only for periodic power backup by industrial and commercial businesses. As energy demands continue to soar, Independent System Operators (ISOs) around the country are establishing or expanding load curtailment programs that include aggregation of DG assets, while state agencies develop interconnection standards to ensure grid integrity and operational safety, ultimately allowing DG owners to sell energy to the grid. E3I has been at the forefront of developing DG solutions in the USA, including: New York State Energy Research and Development Authority (NYSERDA) projects to develop and pilot New York City’s first Emergency Demand Response Program, developing technical and operational guidelines to ensure program success. We have also worked with NYSERDA and the US DOE to evaluate DG aggregation within price responsive load markets, including day ahead, deficiency, and real time markets and with the California ISO, the NYISO and the PJM (Pennsylvania, New Jersey, and Maryland) ISO to develop DG aggregation programs.  E3I is actively involved in developing and implementing interoperability approaches to allow demand response resource to patriciate in the NYISO ancillary services market by providing non-spinning reserves to support grid reliability.

CFM (Calea Ferată din Moldova, which means ″Moldovan Railway″ in Romanian) is the only railway operator in the Republic of Moldova. It is responsible for passenger and cargo transportation, as well as the railway infrastructure maintenance. Given the poor situation of the infrastructure and rolling stock, as well as the lack of energy management procedures in place, the energy needs of CFM are significantly higher than other rail operators in the region, which is especially relevant in Moldova because of high energy costs. The company energy cost is over 25 million € per year (17 million € in diesel for traction, but also 8 million € in diesel, electricity, gas and heat for non-traction purposes), which represents 25% of the working costs for the company and generates over 90,000 tons of CO2 per year. In this context, CFM has identified energy efficiency as a strategic area for reducing operational costs, improving quality and reliability of service and mitigating the environmental impact of its operations. The first phase of the programme will include the implementation of an Energy Efficiency Programme, which EBRD is supporting with this project.

The main purpose of the activity is to provide CFM with the technical information and tools to gradually improve the process of metering and monitoring the use of natural resources (mainly energy ones) across its operations, and utilize the related information to improve efficiency, reduce operational costs and improve overall control of environmental impact, including: A review of energy efficiency investment areas which have already been investigated by CFM and form part of their investment plan (rolling stock modernization), ensuring the integration of best available technologies through adoption of life-cycle criteria; a review of energy/environmental management practices at the rail sector in Moldova and preliminary assessment of energy efficiency and carbon emission reduction “hotspots”, with particular focus on the quality of rolling stock and built environment (e.g. railway stations, service buildings, offices); setting up and training a functional service unit within the organisation aimed at identifying/assessing areas for energy savings, identifying energy performance indicators and appropriate benchmarks, and defining appropriate instruments/channels to report performance/results achieved in line with international standards; and exploring the feasibility of some specific opportunities and complementary ways for financing energy efficiency in the company, including energy performance contracting.