Executive Office Located at: 2101 Richmond Road | Victoria, BC V8R 4R4 Canada Mailing address: 1952 Bay Street | Victoria, BC V8R 1J8 Canada

Tel: 250-370-8040| Fax: 250-370-8750 islandhealth.ca

Excellent health and care for everyone, everywhere, every time.

January 27, 2020 Canadian College of Health Leaders 292 Somerset Street West Ottawa, ON K2P 0J6 Dear Nominating Committee: Re: Island Health Nomination for the CCHL Energy and Environmental Stewardship Award Please accept the enclosed nomination submission for the Energy and Environmental Stewardship Award. Island Health recognizes the link between the environment and human health, as we strive to create healthier, stronger communities. Since Island Health last received this award in 2013, the organization has remained committed to the pursuit of excellence in energy and environmental stewardship. We have also continued to provide leadership in addressing climate change and its affects on its facilities and the communities we serve. Through energy conservation, greenhouse gas reduction, waste diversion, and environmental initiatives, Island Health continues to reduce its environmental footprint. This success would not have been possible without engagement from staff, community members, patients and other public service organizations. Island Health senior leadership have incorporated advancing energy and environmental stewardship best practices as a key objective in the organization’s five year strategic framework so that these goals diffuse to all areas of the organization for many years to come. Thank you for your consideration of the attached submission. Sincerely,

James Hanson Vice President Operations and Support Services Attachment pc: Kathy MacNeil, President & Chief Executive Officer Dean Anderson, Corporate Director, Facilities Management Deanna Fourt, Director, Sustainability & Business Continuity Joe Ciarniello, Energy Manager

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Energy and Environmental Stewardship Award – Nomination Template

Nominee name: Vancouver Island Health Authority (Island Health) Nominator name: James Hanson, Vice President, Operations and Support Services

1. Introduction Island Health is a publicly funded, regional health authority in British Columbia serving more than 790,000 people on Vancouver Island and surrounding regions. The health authority provides care through a network of hospitals, clinics, health units, and long-term care facilities, in addition to environmental and public health services.

Table 1: Key Facts

As the organization expands its services, Island Health is committed to minimizing its footprint through energy reduction, resource conservation, and waste diversion initiatives. The Energy and Sustainability Department works strategically to achieve these goals for the health of our communities and planet.

Description FiguresGross Floor Area 583,695 m2

Annual Operating Budget $2.5 BillionClient Population >794,000 (6.8% of which is Indigenous)Employees >22,000Medical Staff >2,000Volunteers & Auxiliary ~6,000Buildings >230Acute Care & Rehabilitation Beds 1,728Long-Term Care Beds & Assisted Living Units 6,593Mental Health & Substance Use Beds 1,503

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2. Evidence of Results

Utility and Greenhouse Gas (GHG) Emission Savings

Table 2. Annual Utility Savings Energy Source Annual Savings $

(avoided cost) Annual Savings Units

Annual Sq ft Reduction

Electricity (Cumulative savings since F2007)

$2,200,000 25,886,000 kWh +33 kWh/sq ft

Natural Gas (Cumulative savings since F2007)

$1,300,000 34,472,480 ekWh -131 ekWh/sq ft

GHG Emission Reduction (Reduction from 2007 levels)

$80,850 (avoided costs for carbon offsets)

3,080 tonnes CO2e -30 kg CO2e/sq ft

Water (Average reduction since F2015)

13,415 m3 -0.346 m3/sq ft

Steam Oil Note: Cumulative water savings are not tracked by the organization.

Energy and Greenhouse Gas (GHG) Reduction Island Health’s goal is to achieve a 33.3% decrease in energy use intensity (EUI) from F2008 levels by F2024. As of F2019, progress has been demonstrated by an 11.3% reduction. A major heat recovery chiller project, along with continuous optimization efforts, will bring the organization much closer to the F2024 target. Reducing GHG is a provincial and organizational commitment. In 2018, emissions per floor area were at their lowest since carbon reporting began. A cornerstone for emissions reduction is heat recovery chillers, thereby using more of BC’s clean hydro-produced electricity. This is reflected in Table 2 above, showing a rise in electricity consumption per square foot. Emissions and energy use are decreasing in existing buildings by reducing waste and improving efficiency. Table 3 highlights emissions reduction projects from the recent fiscal year, saving $179,612 in energy costs.

Table 3. Summary of Emissions Reduction Projects for 2018/19 Fiscal Year

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Water Conservation

Note: Water data does not include two new hospitals which recently opened. Water is another precious and expensive resource essential for health care. Water use is monitored at all major sites and reviewed quarterly with facilities staff. Several Island Health facilities have completed water audits, and emergency water planning is currently in development. Moving away from once-through cooling systems and old inefficient plumbing fixtures has helped reduce consumption. Figure 1 above demonstrates the annual reduction at existing sites for the past five years.

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Figure 1: Water Use

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Solar Energy One of Vancouver Island’s largest photovoltaic solar arrays is at West Coast General Hospital in Port Alberni, which even caught the attention of David Suzuki. There are also four solar thermal installations preheating hot water and reducing natural gas use at Island Health sites. Table 4 shows the annual savings from these low maintenance systems.

Table 4. Annual Impact from Solar Systems

Biogenic Fuel Between 2015 and 2018, Island Health reduced its carbon impact by 3,345 tonnes of CO2 through purchasing biogenic fuel sources. Carbon Neutrality For the past decade, Island Health has been a carbon neutral organization. BC-based offsets are purchased annually to reduce emissions to net-zero. For 2018 GHG emissions, Island Health paid $759,150. The offsets incent emissions reduction projects in the province.

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Green Buildings As our communities grow, so do our hospitals and services, causing our impact to expand. We ensure each new facility is more efficient and environmentally-friendly. Island Health is committed to achieving LEED Gold certification for new standalone construction, with four LEED Gold facilities and one LEED Silver facility already in place.

Waste Disposal and Diversion

Table 5: Annual Waste Diversion

Waste Reduction Initiatives

• Island Health’s staff champion initiatives to reduce waste generated in their hospital units. • An initiative to reduce plastic cups by changing the practice to refill cups resulted in

approximately 6,200 cups diverted from the landfill by a single department in one year. • Some departments use plastic alternatives to store patients’ belongings, like reusable

baskets. An awareness campaign is in development to educate patients to bring their own reusable bags to the hospital.

Waste Type Weight Diverted from Landfills (kilograms)Cardboard 289,995Co-mingled Recyclables 88,536Organics 38,037Mixed Paper 7,664Plastics 6,687Sideload Recyclables 6,859Total 437,778

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Other Environmental Initiatives

Transportation Island Health promotes environmentally-friendly commuting and transportation options by:

• Reducing GHG emissions from fleet with four electric vehicles (EVs) and several hybrids. • Providing six EV chargers to staff and public across three sites with two more added this

year at another facility. • Offering a reduced bus pass price for staff. • Providing preferred parking for those in a carpool program. • Operating a shuttle bus service to transport employees between the two largest hospitals. • Increasing the use of bicycles and bike storage along with other end of trip amenities. • Promoting Bike to Work Week each spring with over a thousand Island Health employees

participating.

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Paper • In 2019, Island Health began using tree-free paper, made from a by-product of sugar

production, as its standard 8.5x11 paper source. This significantly reduces paper GHG emissions.

• Several initiatives have digitalized operations to reduce paper consumption, such as electronic health records and online ECG readings, resulting in a paper use decline of 7% in 2019.

Virtual Care Delivery

• Island Health provides virtual care options to patients, to avoid driving long distances to see specialists. Since 2007, when Telehealth services began, patients have been saved from driving over 22,000,000 kilometres.

Anesthetic Gas Reduction • Anesthetic gas is a significant source of GHG emissions, and generates more emissions

each year than the organization’s fleet vehicles. Since 2013, Island Health has reduced emissions from anesthetic gas by over 50% (approximately 1,297 tCO2e) as noted in Figure 2.

• Island Health’s anesthesiologists lowered emissions by using a more environmentally-friendly gas. Installing anesthetic machines also reduced waste gases.

Gardens

• All acute and long-term care sites provide the healing benefits of gardens. • Some Island Health sites have community gardens with traditional plants used by local

First Nations such as the new North Island hospitals in Courtenay and Campbell River. • Staff and community come together to make these gardens beautiful.

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Figure 2. Island Health's Emissions from Anesthetic Gas

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Storm Water Management

• Island Health is committed to preserving natural resources through responsible storm water management, including rainwater capture and storage, permeable pavement, and green rainwater infrastructure.

3. Sustainability of Environmental Initiatives and Organizational Resources

Island Health has a Sustainability and Business Continuity Department and Energy Department supporting the organization’s efforts to reduce environmental impact. The two teams are responsible for long-term planning and sustaining initiatives. In addition, the Sustainability and Energy Departments have allocated budgets to conduct studies and implement initiatives. Island Health also has a team responsible for managing waste diversion contracts and a Healthy Built Environment Consultant promoting healthy infrastructure in the community. An Energy Use and Conservation Policy is in effect, requiring ongoing consideration of energy and environmental impacts for infrastructure projects, equipment procurement, and facility operations. Moreover, a three-year Strategic Energy Management Plan (SEMP) outlines plans, goals and targets to reduce energy consumption and GHG emissions. This plan along with the annual Carbon Neutral Action Report (CNAR) are published online to remain transparent and accountable to the community. The CNAR reports on all emissions from in-scope sources such as buildings, fleet vehicles, and office paper. Annual funding is available for Carbon Neutral Capital Projects (CNCP) from BC’s Ministry of Health for emissions reduction projects. Through this program, the Energy Department has received more than $4,000,000 over five years. The Energy Team is also actively involved with infrastructure renewal projects to ensure new systems are as energy efficient as possible. Real-

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time energy monitoring software is available at major sites to support energy reduction. Island Health also uses utility and carbon tracking software for monitoring, reporting, and accountability. Furthermore, Island Health is committed to working towards the provincial government’s GHG reduction targets. The public sector target for 2030 is a reduction of 50% emissions from 2007 levels. To achieve this target, Island Health regularly engages with the Province’s Climate Action Secretariat, Ministry of Health, and other health authorities through the Provincial Environmental Technical Team (PETT). The organization provides input on regulations and policies in support of energy and environmental stewardship, shares best practices and collaborates on initiatives. Finally, Island Health is a longstanding member of the Canadian Coalition for Green Health Care and has worked with the Coalition on several pilot projects including measuring medical imaging equipment for Energy Star ratings and conducting a major infrastructure climate change adaptation vulnerability study with Engineers Canada. 4. Corporate Business Plan, Senior Management Endorsement, and Corporate

Culture Island Health’s five-year Strategic Framework (2020-25) is a high-level vision of where the organization wants be in 2025. It contains four high-level goals and twelve objectives. One of the goals is “to pursue operational excellence and innovation across the entire organization to increase value in our services while caring for the environment.” Under this goal, the health authority identified reducing its environmental footprint as a contributing objective: “Island Health will fulfill its responsibility as a positive contributor to environmental sustainability and climate change response.” This objective was added to the Strategic Framework as a direct result of feedback from Island Health’s staff during the consultation process. The most recent Multi-Year Plan for 2019/20-21/22 outlines strategies and tactics to help achieve the Strategic Framework. This includes reducing GHG emissions through optimizing building systems, energy efficient infrastructure, and fleet electrification. In January 2020, Island Health’s President and CEO authored a message on the Island Health intranet site to foster a culture of environmental stewardship, as well as an article in the public Island Health Magazine for environmental awareness. Overall, Island Health aspires to “advance environmental stewardship best practices in our buildings, services, processes and culture to ensure our environmental footprint is minimized,” as stated in the Multi-Year Plan.

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5. Impact on Quality Patient Care Patient care and safety is at the forefront of all decision making regarding energy and environmental initiatives. We strive to implement initiatives that benefit patients and staff, in addition to the natural environment. For example, installing anesthetic workflow machines reduces waste and anesthetic gases entering the indoor environment, limiting patient health risks as well as decreasing GHG emissions. A successful linen utilization campaign aimed to reduce energy use from heated blankets in the renal department. Addressing patient comfort was a key priority to ensure they stayed warm during treatment. Patients were directly engaged with a visual survey, so individual needs could be addressed. The campaign succeeded in reducing the need for heated blankets by allowing patients to bring their own blankets from home. Island Health is committed to achieving LEED Gold green building certification in all new standalone construction. During this process, indoor environmental quality LEED credits are obtained to foster a safe, healthy, and environmentally-friendly indoor environment. New facilities enhance patient experience and comfort through the controllability of lighting, thermal comfort, access to daylight and natural features. For patient health and safety, low-emitting materials are used and indoor pollution is minimized. Major construction projects involve robust engagement with patients, staff, and community members. In this fiscal year alone, Island Health received over $310,000 in incentives from BC’s utilities for implementing energy conservation projects. Incentives have been reinvested back into energy and priority infrastructure projects. These projects focus on patient care by renewing aged infrastructure. Renewals, additions and new facilities are constructed to a higher level of energy efficiency than what is being replaced. Operational savings from energy and environmental initiatives remain in Island Health’s budget to be invested into the organization, either to increase operational efficiency or to contribute to expanding health care services.

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6. Additional Positive Impacts, Staff & Community Engagement, and Organizational Philosophy

Additional Positive Impacts

• Promoting environmental stewardship at our organization results in healthier communities.

• Staff members feel more satisfied and empowered when Island Health communicates its environmental values.

• Island Health has become a leader in BC for its results in energy and environmental stewardship.

• The health authority is proud to reduce its climate impact by decreasing GHG emissions and achieving carbon neutrality. Island Health supports mitigation and adaptation, which are essential as the world faces a climate emergency.

Staff Engagement Initiatives

• Facilities staff are a targeted engagement group for energy and water conservation. Best practices are shared through an annual workshop, multiple webinars, and provincial conferences. Island Health participates in BC Hydro’s Energy Wise Network for behaviour change initiatives.

• Staff are regularly engaged through various communication channels including articles, announcements, and direct email.

• Island Health’s Green Intranet provides information and resources for staff, including toolkits to implement initiatives.

• In the past five years, over 75 staff members received ‘Green Champion’ training to coordinate environmentally-friendly campaigns.

• In 2018/19, three gardens were created at Island Health sites through staff wellness grants, to support staff and preserve the environment.

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Community Engagement Initiatives

• Island Health creates local partnerships through the Community Wellness Grant Program. Funds are distributed to organizations promoting community well-being and healthy lifestyles. In the past three years, over $245,000 was awarded to projects also promoting environment stewardship.

Table 6. Island Health Funded Projects

• Island Health works with municipalities, regional districts and local organizations to

promote positive environmental and health outcomes. The health authority advocates for the adoption of the Healthy Built Environment Linkages Toolkit, to ensure communities are designed for health and well-being.

• The public Island Health Magazine often includes informative articles to build community awareness on environmental topics such as wood smoke impacts and active transportation.

• Island Health engages and educates community members through its website and social media channels, reaching almost 9,000 and 10,000 people on Facebook and Twitter respectively.

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Organization's Philosophy on Environmental Sustainability • Our purpose states that Island Health will “create healthier, stronger communities and a

better quality of life for those we touch.” • Through the CARE Values, the “C” stands for Courage to do the right thing, which includes

doing our part to care for our planet. • The Strategic Framework states, “We will advance environmental stewardship best

practices in our buildings, services, processes, and culture to ensure our environmental footprint is minimized.”

• Kathy McNeil, President & CEO, published her personal commitment to better care for the Earth in 2020 on the Island Health Intranet site.

• Island Health recognizes that all of us must take responsibility for the health of the planet and our communities.

• Together we can make small (and big) changes to green Island Health, our communities and our planet.

7. Conclusion

Island Health is acting to fulfill its responsibility as a positive contributor to environmental sustainability and climate change response. Through a strategic energy management program and ongoing environmental initiatives, the organization is reducing its impact on the natural environment. These initiatives are supported by senior management and the Board of Directors, as indicated in our Strategic Framework. Island Health is committed to environmental stewardship so the people we serve will have a healthy future and live in communities well adapted for the significant changes that lay before us.