2019 Energy to Care Award Application

The Energy to Care Awards honor health care facilities that reduce energy consumption by 10 percent in a single year or by 15 percent over two years. The program also recognizes previous award winners that reduce energy consumption by 5 percent from previous year.

The energy use reduction percentage is calculated by comparing energy use in the baseline year to the performance year. Energy use is defined as weather normalized SOURCE EUI in units of kBtus/sf/yr. This data can be found by pulling a report from your Energy Star Portfolio Manager account. The award requires that an ASHE member conduct a peer review on the application and data submitted.

Energy to Care participants (with ASHE members on staff) are invited to participate in the Energy to Care Awards program.

For the 2019 awards, the energy use reduction percentage is calculated by comparing SOURCE EUI in the baseline year of 2017 (Jan. 1, 2017-Dec. 31, 2017) or 2016 (Jan. 1, 2016 - Dec. 31, 2016) to the performance year of 2018 (Jan. 1, 2018-Dec. 31, 2018).

APPLICATION INSTRUCTIONS

APPLICANT DETAILS

You will need to collect the following prior to completing this application:
• Facility name in Energy Star’s portfolio manager
• Energy Star’s Portfolio Manager number
• Facility contact (must be ASHE member)
• Facility contact ASHE member number
• Facility contact Title and Department
• Facility contact phone and email

REDUCTION IN ENERGY USE

Data in this section should be obtained from your Energy Star Portfolio Manager Account.

IMPORTANT NOTE: The baseline year must be either 2017 or 2016. Facilities choosing to use a base year of 2016 must show a 15 percent SOURCE EUI decrease from 2016 to 2018 to qualify for an award. Facilities choosing to use a base year of 2017 must show a 10 percent decrease from 2017 to 2018 to qualify for an award. Please note the performance year for all facilities is 2018 (Jan. 1, 2018 thru Dec. 31, 2018).

You will need to collect the following prior to completing this application:
• Baseline year weather normalized SOURCE EUI (2016 or 2017) in kBtu/sf/year
• Performance year weather normalized SOURCE EUI (2018) in kBtu/sf/year
• Percent reduction in SOURCE EUI from baseline year to 2018 - To calculate this reduction, use the formula: (Baseline year SOURCE EUI – 2018 SOURCE EUI)/Baseline year EUI (shown as a percentage).
• Has this facility previously received an Energy to Care Award?

Please note that first time winners must achieve a 10% or greater SOURCE EUI reduction if the facility uses 2017 as a baseline year, or a 15% reduction if 2016 is the baseline year. Previous Energy to Care award winners must show a 5% or greater reduction in SOURCE EUI to qualify for another award.

DATA ACCURACY

Before submitting your application, please ensure your data in Portfolio Manager is accurate.

As part of the data verification, it is a requirement that the facility energy use information must be reviewed by a peer. The peer review must be completed by an ASHE member or ASHE chapter. Please include the contact information for your peer reviewer in this section.

You will need to collect the following prior to completing this application:

• Peer reviewer name*
• Peer reviewer ASHE membership number or ASHE chapter*
• If entering an ASHE chapter, please use the full name of the chapter, not an acronym.
• Peer reviewer's company or organization*
• Peer reviewer's phone number*
• Peer reviewer's e-mail*






















Data in this section should be obtained from your Energy Star Portfolio Manager Account.


Answer should be in kBTUs/sf/year.


Answer should be in kBTUs/sf/year.


(Baseline year SOURCE EUI – 2018 SOURCE EUI)/Baseline year EUI (shown as a percentage)



As part of the data verification, it is a requirement that the facility energy use information must be reviewed by a peer. The peer review must be completed by an ASHE member or ASHE chapter. Please include the contact information for your peer reviewer in this section.




If entering an ASHE chapter, please use the full name of the chapter, not an acronym.









Energy to Care award winners receive a Facility Award to display in their as well as an Individual Award to display for the facility manager or group responsible for the energy reduction.

FACILITY AWARD AND NOTIFICATION OF SENIOR LEADERSHIP

The FACILITY AWARD will be sent directly to SENIOR LEADERSHIP (designated below). In addition, ASHE Leadership will provide a letter of congratulations to the senior leader for the facility selected to win the Energy to Care Award. We need to know how you would like your award to appear if you are selected as a winner:
You will need to collect the following prior to completing this application:
• Facility name (written exactly as it should be listed on the award)
• Facility City
• Facility State
• Name of senior leader to be notified (Please include first and last name)
• Title
• Shipping address
• Shipping City, State and Zip code
• Senior leader's phone and e-mail address

INDIVIDUAL AWARD
This award is sent to the facility manager or group responsible for the energy reduction.

You will need to collect the following prior to completing this application:
• Shipping Name: (Name of contact at the facility who will receive the award through shipping.)
• Shipping address, City, State and Zip code

The individual award winner can be one person or a team. Please write exactly as it should be listed on award, i.e. Joe Smith or XYZ Hospital Facilities Department.



We need to know how you would like your award to appear if you are selected as a winner:


Please write it exactly as it should be listed on the award








Please include first and last name.
















Please write it exactly as it should be listed on the award. Please include city and state.


Please include the full name that you wish to have listed on your Individual Award.


Name of contact at the facility who will receive the award through shipping.















Finally, ASHE will recognize winners of the award at the 2019 Annual Conference in Baltimore, Maryland (July 14-17). We would like to know if you intend to send a representative to accept the award.

Will a representative be available to attend the 2019 ASHE Annual Conference July 14-17 in Baltimore?*






By typing my name below, I confirm that the energy consumption data that I have entered into my Portfolio Manager account for the facility and timeframe listed above is accurate to the best of my knowledge. I have reviewed my data and confirm that any identified input errors have been corrected. I understand that if selected as an Energy to Care winner, ASHE will publicize my award and share our energy efficiency successes. Typing my name below will act as my digital signature for this application.


Digital signature of facility contact






Powered by Smartsheet Forms
Privacy Policy   |   Report Abuse
Your submission is being processed. Please do not close this browser window until complete.