Emergency power reliability at health-care facilities has long been a topic of debate. After Hurricane Sandy, that conversation may be heating up even more.

Hospital back-up power is governed by an array of rules, regulations, and guidelines, many rooted in parts of the National Electrical Code (NEC). Location-specific design, testing, and maintenance are addressed in NFPA 99 – Healthcare Facilities; broad guidelines are covered in NFPA 110 – Emergency and Standby Power Systems. The chief hospital accrediting body, The Joint Commission, references both in its requirements for back-up power.
As comprehensive and detailed as these are, there may be gaps. Proclaimed skeptics of hospital readiness point to the flooding of back-up systems in Sandy as evidence. One, Arthur Kellerman, the policy chair at Rand Corp., was quoted by ProPublica as saying it was “remarkable” that the major hospitals still have critical back-up systems located in basements prone to flooding.

George Mills, director of engineering for the Joint Commission, says hospitals have some discretion in how they configure and place back-up systems, though some code wording does opaquely reference flood protection. They must rigorously and routinely test their systems for reliability, but a detailed hazard vulnerability analysis (HVA) typically governs system design and installation.

“Each organization needs to look at the HVA and see how to manage their systems through that,” he says. “Hospitals generally have to identify the risks they perceive to the public and then work to mitigate that risk.”
Designing for natural disasters, however, can be tricky. Threats vary based on geography, climate, and weather history, Mills says. But unprecedented events, similar to Sandy, can alter risk assessments. Following Hurricane Katrina, the Joint Commission issued an alert of sorts that advised locating back-up systems above expected flooding levels. But hospitals, he says, have to consider risk-benefit scenarios and weigh the costs of relocating systems or designing new ones that may be more costly to install. Post-Sandy, Mills says, some New York-area hospitals did engage in some second-guessing.

“Some said they wished they had maybe done a more thorough job looking at HVA assumptions,” he says. “But the theorem we go by here is that organizations appear to pay attention to the most recent events. If they haven’t experienced flooding, that’s low on their radar.”