1. X Hospital’s Sustainable Energy Management Plan

2. Prescription for Energy Savings Agenda 1. Overview of Duke Energy’s Prescription for Energy Savings 2. Why Manage Energy? ― Benefits of an Energy Management Plan 3. Energy Assessment Results 4. Draft Energy Plan

3. Overview of Duke Energy’s Prescription for Energy Savings Program

4. PES Program Objectives Help Duke Energy’s Healthcare customers achieve fast and sustainable savings Leverage Duke’s energy efficiency programs such as Smart Saver for helpful incentives Monitor and verify performance improvements via the ENERGY STAR ® benchmarking tool Document success stories to be used with a broader audience

5. A partnership between Duke Energy and its hospital / health system customers to help them reach their sustainability goals and objectives through the development of a Sustainable Energy Management Plan…start to finish. A four-legged stool – all with experience in helping hospitals identify and resolve energy issues: Hospital / Health System Duke Energy ICF International Engineering Firms What is the Program?

6. Benchmark & Evaluate --ENERGY STAR Portfolio Manager Tool * Share ENERGY STAR facilities with Duke Energy Opportunity Finder Sustainable Energy Management Plan Webinar Duke Energy Incentives Planning session with Duke Energy & ICF Sustainable Energy Management Plan Action Workshop Measurement & Verification 6 PES Program Components * Access the ENERGY STAR archived webinars on the prescriptionforenergysavings.com home page to learn about these tools 1 1 8 8 7 7 5 5 4 4 3 3 2 2 9 9 Energy Assessment 6 6

7. Duke Program Benefits Potential to save 10%+ in energy costs above baseline Assistance with Energy Plan preparation Assistance in presenting plan to senior management Expertise of Duke Energy, ICF, Engineering Firm XYZ, and ENERGY STAR Networking with healthcare industry peers Minimal cost

8. Why Manage Energy?

9. Why Start with Energy? Energy is largest subset of a building’s environmental footprint Energy efficiency provides financial returns Use energy savings to implement other green features

10. Energy is the First Step to Going Green Highly visible strategy for going green. Energy saving activities directly involve employees’ every day behaviors: Turn off lights, power down computers, use blinds, recommend ideas related to their jobs, etc. Energy efficiency is an investment in green that can give back green Educate employees to reduce energy at work and at home.

11. Benefits of a Sustainable Energy Management Plan Provides a plan for continuous improvement in energy performance and continuously striving to minimize our impact on the environment and community health Demonstrates environmental stewardship & leadership Employee engagement in greening efforts External example regarding impact on the environment and community health Demonstrates fiscal responsibility and stewardship

12. What’s Different About These Hospitals? Hospital AHospital B

13. Hospital A ENERGY STAR – top 25% $2.58/SF in energy costs X% more efficient than Hospital B Reputation Hospital B Average energy performance Room for Improvement $X/SF in energy costs

14. $X million $5.74 million The Bottom Line: Annual Energy Costs Hospital B Hospital A $X million annual savings Insert Participating Hospital Name

15. Equivalent to the Emissions from…. X passenger vehicles X million gallons of gasoline Electricity to power X homes for one year Energy use of X homes for one year X acres of forest Recycling X tons of waste instead of sending it to a landfill

16. Energy Assessment Results Energy Performance Energy Assessment

17. Is 446 kBtu/SF/YR high or low for a hospital? Answer: ??? Is 60 MPG high or low for an automobile? Answer: Common Knowledge How do we assess hospital energy performance?

18. Fuel Efficiency: MPG Building Performance: 1 to 100 Score Comparative Metrics

19. U.S. EPA Energy Performance Rating System Building Energy UseHighest Lowest 1001255075 Benchmark Score The system overlays a 1 to 100 scale over national data, which gives relative meaning to energy use. Number of Buildings

20. 11007550 Invest Adjust Maintain Energy Performance Rating 25 Adjust Invest Level of Focus Interpret Your Energy Performance Score O&M Invest Maintain Invest Year

21. X Hospital’s Energy Performance Score 12 Month Period Ending Energy Score Source EUIEnergy Spend $X million

22. Potential Financial Impact of X% Reduction Goal 12 Month Period Ending % reduction* Energy Score Estimated Cost Savings *Percent reduction compared to FY20XX **Assumes no SF increases and energy rates remain the same Cumulative Savings: $X million

23. Financial Impact (Examples) Energy Costs Have Increased 2006: $X million 2007: $X million 2008: $X million 2009: $X million X% square footage increase since 20xx Efficiency gains in new construction and energy efficiency measures have resulted in more efficient use of energy. Ex: New Energy Plant in x/20xx

24. Costs Avoided (Examples) What if your EUI was the same every year as it was in 20XX? Energy spend would have been: $X more in 20xx $X million more in 20xx Total: $X million more in energy costs

25. Energy Assessment The preliminary survey identified X number of primary cost saving opportunities. When summed up, the projects identified total to an energy, and related cost savings potential of approximately $X per year, with an estimated implementation cost of $X. The combined overall simple payback is X years

26. Draft Sustainable Energy Management Plan

27. Energy Management Vision Insert vision

28. Business Proposition Cost Reduction A X% reduction in energy use compared to 20xx energy consumption would result in annual savings of $X Attract and Retain Healthcare Professionals Growing evidence that “green” hospitals attract & retain employees Quality of Care High performance hospitals can positively impact patient care Community Leadership First do no harm

29. Energy Plan Goals Insert goals

30. Objectives / Actions Insert objectives/actions

31. Energy Plan Add in highlights of the plan

32. Energy Projects TBD based on energy assessment report

33. THANK YOU! Q & A DISCUSSION