The new crisis of community health centers: the need for backup power

HEALDSBURG, California — The 2017 Tubbs Firethat killed 22 people and destroyed 5,600 buildings was already a stressful time at the Alliance Medical Center clinic here, as workers picking grapes in nearby vineyards streamed into the nonprofit community health center with burns, smoke inhalation symptoms and other crises.

Then the power went out.

Work at the center, about 70 miles (110 kilometers) north of San Francisco, came to a halt. Staff did not have access to electronic medical records and could not fill prescriptions. The refrigerators used to store medicines stopped working, destroying $30,000 worth of vaccines.

“It would be fine if we never had to go through this again, but the reality is that it will happen,” said Alliance CEO Sue Labbe. “But we will be prepared now.”

In May, the clinic — which serves 13,000 patients a year, mostly underinsured and uninsured essential workers who work in wine country's fields, hotels and restaurants — installed a new rooftop solar and battery storage system. Dozens of solar panels, spread across the south- and west-facing parts of the clinic's green roof, generate sufficient power for the center's clinical areas, the server room that supports electronic records, and the refrigerators where crucial medications are stored. Batteries stacked in metal cabinets in the parking lot at the back of the building can keep things running for up to 15 hours after the sun goes down.

Humanitarian aid organization Direct Relief paid for the $500,000 scheme as part of its Power for Health initiative. The six-year-old program was created to help community health centers, which serve the nation's most vulnerable patients, cope with more frequent power outages caused by extreme weather and fickle electrical grids.

“We assume there will be power, but that assumption is not as valid as it was a few years ago,” said Thomas Tighe, president and CEO of Direct Relief. “Places where there is a high risk of disruptions and high dependence on these health facilities must be prepared.”

Direct Relief typically donates medications and supplies to these facilities and others like them. But when Hurricane Maria hit Puerto Rico in 2017, turning off electricity in some areas for up to 11 monthsclinics on the archipelago asked for something else: power.

“Before Maria, we were not a grant provider for infrastructure projects,” says Tighe. “But it was essential to carrying out our mission. You can't send medicines if they can't keep them cold, that's just a shame.”

After that, Tighe realized that unreliable power was a widespread problem community health centers, serving more than 30 million patients in 14,000 locations. Extreme weather was sometimes the culprit, but so were planned safety outages and rolling blackouts, where a utility shuts off power during times of excessive demand, such as during a heat wave.

The impact could be financially crippling for clinics and devastating for patients who had few or no other health care options. One of Direct Relief's partners in New Orleans lost $250,000 in vaccines after Hurricane Ida in 2021.

Labbe said power became an even bigger problem after the Tubbs fire, since the utility started operating preventive closure when the wind picks up to prevent forest fires from starting. Then there were the weather conditions themselves: not only fires, but also winter rain showers. “It was a matter of when, not if, the disasters come fast and furious,” she said. “This is the new normal when you are in an area prone to natural disasters.”

The Power for Health grant covers the full cost of a rooftop solar and battery storage system and five years of maintenance support. Since 2018, Direct Relief has helped install systems in 19 centers nationwide. It has 48 projects in development across eight states and Puerto Rico, including five tribal health care facilities, with the goal of raising $100 million to fund more than 200 additional energy resilience projects across the United States.

Without outside support, it would be impossible for clinics like Alliance to fund systems, Labbe said. “We've been longing for solar power, but we're a nonprofit with tight margins. It would come from funds to pay vulnerable patients,” she said.

Adding rooftop solar and battery storage can also save clinics money on their utility bills, especially in places where energy costs are rising. “The economic savings alone will be comparable to giving an annual subsidy,” Tighe said.

Magali Nuñez has experienced multiple blackouts in the three years she worked at the Healdsburg clinic's front desk. Once, during a safety shutdown, a patient was drilling his tooth. He had walked to the clinic, so staff had to transport him via Lyft to another facility to complete the procedure. “It can get a little crazy,” she said.

The new power source also opens up the opportunity to help patients in new ways, said Rachel Farrell, founder and CEO of Harmony Health in Marysville, California, an hour's drive north of Sacramento. Harmony Health also installed a solar and storage system this spring with a Direct Relief grant. The clinic had experienced dozens of outages in recent years, so many that the clinic's vaccine refrigerator eventually exploded completely. “We are losing so many vaccines, it's just terrible,” she said.

In addition to primary and behavioral care, Harmony Health offers a birthing center, substance abuse treatment, chiropractor and acupuncture services, and a free overnight clinic for immigrants.

Now that backup power has been installed, Farrell also wants to offer the clinic as a refuge for the community in times of extreme weather. Temperatures have been known to reach well over 110 degrees in the summer, creating a dangerous situation if the air conditioners are turned off in the event of a malfunction.

“We could be a cooling center during an emergency, where patients can come and have a safe place,” she said.

______

Associated Press coverage of philanthropy and nonprofits is supported by the AP's partnership with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP's philanthropic coverage, visit https://apnews.com/hub/philanthropy.

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