Leading the Way with Power Outage Planning: The Los Angeles County Health Care Coalition’s Playbook for Power Emergencies

Los Angeles County, California
September 2023 

When extreme weather threatens power infrastructure stability and elevates wildfire risk, power utilities in California initiate public safety power shutoffs. Triggered by conditions such as high winds, dry vegetation, and extreme heat, these shutoffs are a proactive measure to reduce the likelihood of catastrophic fires. During these power shutoffs, hospital operations can be severely affected. To adequately prepare health care facilities during these times of crisis, the Los Angeles County Health Care Coalition (LA HCC) created the Healthcare Facility Emergency Power Resilience Playbook. The playbook provides practical guidance and resources to help health care facilities maintain patient care during power disruptions.

The LA HCC is a health care coalition that receives funding and guidance from the Administration for Strategic Preparedness and Response (ASPR) Hospital Preparedness Program. With support from the Hospital Preparedness Program, the LA HCC establishes partner networks, coordinates health care and emergency response, and participates in regularly required trainings and exercises. The coalition collaborates with over 1,000 partner organizations, including public health, health care, and government entities, as well as nontraditional partners like power and fuel companies, to strengthen local readiness ahead of disasters and emergencies.

In 2019, the LA HCC used Hospital Preparedness Program funding to launch a multi-year emergency power preparedness initiative to assess health care entities’ ability to operate during power disruptions, with the goal of addressing power challenges proactively. California, especially Los Angeles County, frequently experiences power outages due to seasonal weather events, high energy demands, and an aging power grid. Power outages affect more than just heating, cooling, and electricity – they also impact the use of medical equipment like dialysis machines, ventilators, and electrocardiogram machines. Additionally, power outages pose challenges to accessing patient medical records, performing surgeries, and maintaining a safe and temperature-controlled environment for patients and medications. Preparing for and responding to power outages is crucial in order to limit disruptions to patient care and protect the most vulnerable patients during emergencies.

The LA HCC serves several types of communities across the county, each of which experiences unique challenges during power outages. While some areas are urban and dense with minimal storage for generators and fuel, other areas are rural with limited accessibility for resource distribution. Some hospitals, dialysis centers, and long-term care facilities have robust, redundant emergency power systems, while others lack a backup generator. To address these challenges, the LA HCC developed an efficient and adaptable plan to help all types of health care entities prepare for and respond to power emergencies.

In 2023, the LA HCC published the Healthcare Facility Emergency Power Resilience Playbook to address gaps identified through the power preparedness initiative. The playbook details promising practices for safeguarding emergency power and provides recommended protocols for power outages. To develop this playbook, the LA HCC established and led the Emergency Power Resilience Work Group, which brought together members of the energy and health care sectors, including hospitals, skilled nursing facilities, and local power providers. The group created comprehensive protocols for each phase of the emergency management planning and operational continuum, including assessment, mitigation, response, and recovery. The playbook’s actionable guidance and resources, such as checklists, assessment tools, and tabletop exercises, help every partner understand their role in maintaining patient care during power disruptions.

This unified, community-based approach represents the health care coalition model in action. By building and maintaining partnerships with health care entities across the county, the LA HCC knew the right people to bring together to identify and mitigate a threat to the public’s health. As a result of this effort, LA HCC member organizations and community partners are equipped with the resources, tools, and protocols they need to assess vulnerabilities, implement mitigation strategies, and respond effectively so that health care entities can continue to provide critical services when the power goes out, minimizing the impact of unpredictable outages on patient care.

The LA HCC’s approach to power outage planning provides a proactive, collaborative, and adaptable framework for maintaining patient care during emergencies. By developing the Healthcare Facility Emergency Power Resilience Playbook, the LA HCC not only addressed the immediate challenges posed by power disruptions but also set a model for local preparedness and resilience. Hospital Preparedness Program funding empowered the LA HCC to bring the right partners together to solve an urgent, local challenge and protect the public’s health through meaningful, lasting partnerships.