Health care facilities gear up for HECO’s ‘last resort’ power shutoff plan that kicks in today

Major medical facilities on Maui are prepared to flip on their generators or close their clinics should they lose power under Hawaiian Electric Co.’s new plan that kicks in today. 

Under the plan, which was created in the wake of the deadly Aug. 8 wildfires in Lahaina and Upcountry, Hawaiian Electric would shut off power in high-risk areas during windy, dry conditions, a move it describes as a “last-resort measure.”

It’s a scenario that some medical facilities say they’ve already been making arrangements for.

“Preparing for electrical outages, including potential prolonged outages, is part of our standard emergency planning,” Jeremy Cooke, Maui Health’s emergency management manager, said in an email to the Hawai‘i Journalism Initiative last month. “All our hospital facilities, including Maui Memorial, Lanai Community Hospital, and Kula Hospital, have plans and resources in place to maintain operations during a power shutoff, as well as expand resources to care for a surge in patients if needed during a natural disaster or other emergency situation in our community. 

“These plans are validated annually, or more often as needed, as part of our Emergency Management Program Review, as required by accreditation and licensing agencies.”

Hawaiian Electric, which faced questions over why it didn’t shut off the power during a red flag warning leading up to last year’s fire, announced its new Public Safety Power Shutoff program at the end of May. The company said it may preemptively shut off power in high-risk areas if weather data, including statements from the National Weather Service, indicate conditions for higher wildfire risk, including strong winds, low humidity and dry vegetation. The program impacts 48,100 customers on four islands, including 26,100 customers in West Maui, Upcountry, parts of Central and South Maui and parts of central Moloka‘i.

Hawaiian Electric’s plan has been shared with the executives at Maui Health, Hale Makua and Maui Medical Group, among others.

“Based on the criteria in which the PSPS plan would be activated — yes, the plan is well thought out and would be only activated in extreme conditions and only in areas at high-risk of fire danger,” Cooke said.

Each of Maui Health’s facilities provide crucial services that come with their own unique challenges — Maui Memorial Medical Center is the only acute-care facility on island, Kula Hospital has many patients in long-term care and Lāna‘i Community Hospital is a vital resource on an island with limited health and transportation options. Cooke said Maui Health has not had to adjust its plans with the rollout of HECO’s new program. Of its facilities, Kula Hospital is the only one located in the power shutoff plan map.

“Special preparations are not needed as this is part of our routine emergency planning for each of our hospitals to ensure the safety and care of our patients and residents,” Cooke said. “In the event of a power outage, we are able to maintain our operations at full capacity using our generators. Maui Memorial has both primary and backup generators, with fuel stored on-site and additional supply reserved via an agreement with our fuel provider.”

Mat McNeff, Hawaiian Electric director for Maui, Moloka‘i and Lāna‘i, said that the hospitals were kept in the loop as the power shutoff plan was developed and finalized over the last 10 months.

“As part of the overall PSPS we did an evaluation for a lot of different things, including like the vegetation in the area, the potential for fires to reach people should they occur, the prevailing trade winds, all these different things,” McNeff said last month. “And part of that was critical infrastructure in the area. So, we did take them into account in our decision-making process. If we’re talking about hospitals for Maui, Moloka‘i and Lāna‘i, I believe the only hospital that would be potentially impacted (in the high-risk area) is Kula Hospital.”

‘WITHOUT ELECTRICITY, WE CAN’T WORK’

Maui Medical Group is another major provider on island with five clinics, including a new one in Nāpili after the fire damaged its Lahaina facility. Three clinics — Kahului, Pukalani and Nāpili — are in the areas of Hawaiian Electric’s power shutoff plan map.

Cliff Alakai, the administrator for Maui Medical Group, said his organization is confident with HECO’s plan. If there was a power shutdown for Maui Medical Group, which has no backup generator, the facilities would be closed for the duration of the outage.

“Without electricity, we can’t work,” Alakai said last month. “We shut down because (air conditioners), elevators, you need lights in the clinics, you need computers. Without that, we shut down. We never got a generator because we knew way back when if we ever had a major catastrophe of that significance all our physicians would report to the hospital because it’d be that severe — a hurricane or a tsunami or even the major fires you report to the hospital if we don’t have power here because if anybody comes in that’s very sick or injured you need a higher level of care.”

Alakai added on the power shutoff plan specifically, “Maui Electric has been really good to us. … They’ve been very helpful, we’ve talked about it. … The problem we have is if we don’t have electricity we cannot give shots or vaccines because we don’t want to open the refrigerator because we don’t want to have it spoil, so that poses a small problem if you’re in pediatrics. We can see some patients, but we generally slow down (in power outages) and then we have our employees sitting there waiting for something to do and they are sitting in the dark sometimes. I can’t send them home because nobody knows when the power will come back on.”

Hale Makua, which houses approximately 300 frail and elderly patients in Central Maui, has a backup generator and is ready for nearly any power outage, according to CEO Wes Lo. The Wailuku and Kahului facilities are not included in the power shutoff plan map but have preparations in place anyway because of the vulnerable community they serve.

“It’s huge, the peace of mind is huge for us to have the generator,” Lo said last month. “We’re not required to have (a generator), we’re super regulated, in health care we’re one of the more regulated because we have frail and elderly patients. We don’t have to have a backup generator, but we always choose to because we’re afraid of a disaster happening. You have to be prepared for that.”

Hale Makua has multiple factors to take into consideration during an emergency, from its computer systems to equipment to the hundreds of meals it serves daily. 

“Think about it, you’ve got a computerized medical-record system. What if you don’t know the last on the chart when you gave them their meds and they need their meds?” Lo said. “We have procedures if the computer goes down, but they are not perfect. So, we want to be better. We don’t have as much equipment as the hospital does, but some people rely on oxygen concentrators that have to be plugged in. Even the simplest things like food, these guys need special diets sometimes. 

“This is their home and it’s not like home for you and me where we can drive to like Cupie’s or something. … We do 900 meals a day, which is crazy. So there’s that, medical records, medication, refrigeration or medications as well as food. If we have anything expired or the temperature is wrong, the feds come in and fine us. So it is much peace of mind to have a generator. In a disaster, you want to be prepared for it.”

Many people with conditions reliant on specialized medical equipment could be impacted by the power shutoff plan.

“Individuals with medical conditions that require electronic durable medical equipment (DME) can be impacted by a power shutoff,” Cooke said. “This includes but is not limited to respiratory conditions that require devices such as ventilators, electronic insulin pumps for diabetes patients, dialysis machines, power wheelchairs, or other mobility aides, as well as electronic medication delivery systems to help manage severe chronic pain.” 

Cooke said affected patients in Maui County should always remain prepared, especially those in the high-risk areas on the power shutoff plan map.

“All residents should determine if they are in a PSPS area by visiting HECO’s website or contacting customer service,” Cooke said. “Individuals who have a condition that requires medication or life support systems should create a personal emergency plan, which includes discussing a plan for their medical equipment and medications with their doctor or pharmacist and identifying an alternate place to stay. Additionally, these individuals should fill out HECO’s Medical Needs Communication Form to sign up for advanced notice of a PSPS. During a PSPS event, hospital patients living in an impacted area will not be discharged from our hospitals unless they have the means to safely care for themselves.”

REDUCING FIRE RISK

In the week immediately after the fire, HECO President/CEO Shelee Kimura was asked at a news conference why the company hadn’t shut off the power the way some other utilities do during emergencies. Kimura noted that these kinds of plans are “controversial” and “not universally” accepted because of the hardship they pose, especially for customers with medical needs.

Shayna Decker, director of community and government relations for Hawaiian Electric on Maui, Moloka‘i, and Lana‘i, said that since Aug. 8 HECO has not necessarily changed its mind on a power shutdown plan, but has continued to try to learn from the experience.

“I don’t think it was a change, I think it’s more of like what other things can you look at as you move forward,” Decker said last month. “So as you’re looking at PSPS, it’s something that we have been talking about more with other utilities that have been doing it and doing it for a lot more years. So, I think as we got to talk to more utilities and also looked at the concept and work throughout, I think that’s what is happening as we move forward. 

“This is another measure that we can use and that’s what we’re looking at to do a whole package in our mitigation efforts.”

Decker added that the power shutoff plan is “a last-resort measure. So, that’s if all different conditions make it to a certain point at a certain point in time, then we have that measure in place if we have to use it. 

“We’re doing a lot of other different things on our system that are other measures that will also help with wildfire safety mitigation.”

McNeff said that one example of extra safety care is that when a tree branch falls on a power line, the process is now much more hands-on than it was in the past, and inspection crews are now sent to the sites where power has been compromised.

“Historically we would have tried to restore circuits that are de-energized automatically, so the device would open up, hopefully allow a few seconds for whatever the fault is in my example, like the tree branch to come across the lines, continue to fall and then re-energize after the branch has cleared the lines — that’s a measure that we take to improve reliability for customers, but we’ve stopped that practice in high wildfire areas, so we no longer automatically re-(energize),” McNeff said. “Now in high wildfire areas we will send folks out, inspect the line prior to re-energization, make sure there’s no problems.”

McNeff added, “We’ve made the devices more sensitive, we’re deploying weather stations, fire cameras, all kinds of things, we’re using drones for inspections.”

He said the technology is developing rapidly to help with the problems.

“We have devices called ‘fault indicators’ that we’ve used historically, but we’re putting a lot more out there to help point the direction to our people working on the problem to where the fault may be,” McNeff said. “Because when we need to inspect everything it matters a lot more to try to point guys in the right direction of a problem.”

Decker said HECO’s wildfire safety strategy has been in the works since 2019, “so we’ve been looking at all these measures and PSPS is an extension of that strategy.”

Hawaiian Electric has been the subject of multiple lawsuits that blame the utility’s aging power infrastructure for the fire, and the company has reportedly already shelled out millions in legal fees. Decker had a simple answer when asked if the power shutoff plan is in response to the pending lawsuits in the wake of the fires.

“No,” she said.

McNeff said that the benefits of shutting off the power outweigh the risks and hardships to customers.

“We believe so, we wouldn’t proceed if not,” he said. “You know, ultimately we are trying to save people’s lives and so historically where we thought, where we would have put a little more priority on reliability for customers, we’re moving the needle a little more towards having people be out more frequently, but the exchange is that hopefully the public, our employees, Maui County, Hawai‘i in general is safer.”

HECO has additional power shutoff plan preparation information available on its website at www.hawaiianelectric.com/psps.