University of Texas M.D. Anderson Cancer Center

PROGRESS REPORT

The University of Texas MD Anderson Cancer Center has a longstanding commitment to energy and sustainability planning and conservation. With more than two decades of experience, we have developed an Energy Conservation Master Plan, implemented two Energy and Sustainability Strategic Plans, and consistently reported in compliance with the UT System's Policy on Sustainable Practices (UTS 169). Through these efforts, we have achieved a nearly 40% reduction in our total energy use per square foot (Energy Utilization Index or EUI), surpassing UT System's targets for FY2021, and have increased our total recycling rate to over 25%.

Effective energy management and conservation leadership require advancing projects that align with existing facilities work and advocating for initiatives that benefit MD Anderson, though some may need engineering support for implementation. Our program aims to identify and prioritize high-value opportunities, leveraging continuous efficiency monitoring tools, retrocommissioning activities, and detailed construction project reviews.

Building on the successes of our prior plans, MD Anderson introduced a new Energy and Sustainability Master Plan in FY2021. This plan is organized around four interrelated pillars and includes tasks that engage stakeholders beyond our typical facilities teams.

GOALS

This report details our current activities and accomplishments, aligned with the four pillars of our Energy and Sustainability Strategic Plan, outlined in the sections below. Many of our energy and sustainability efforts span multiple fiscal years, and utility cost-reduction measures marked with an asterisk (*) represent continuing efforts.

Beginning in FY2022, the UT System embarked on its third 10-year goals period. The initial 10-year base goal was a 10% reduction in energy use, with a stretch goal of 15%. The second 10-year goal aimed for a 5% reduction, with a 10% stretch target. The current 10-year goal is a 5% reduction in annual energy per square foot across the portfolio, with a 10% stretch goal. The UT System institutions successfully achieved the previous two goals, collectively resulting in over $1.2 billion in savings and substantial reductions in greenhouse gas emissions.

MD Anderson's Energy and Sustainability Strategic Plan, published and endorsed in FY2021, complements the UT System's energy reduction goals by reinforcing sustainable practices, driving meaningful change, and forming new partnerships to advance our energy and sustainability programs. Our strategic plan is guided by a clear mission and vision that inform each goal and initiative.

Mission: MD Anderson is committed to responsibly reducing carbon and waste stream impacts, while conserving resources to the benefit of our patients and community.

Vision: Achieving environmental stewardship through sustainable practices that uphold our core values by integrating environmentally responsible initiatives into every aspect of our operations, fostering a culture of innovation, and promoting awareness.

The sections below detail the goals under each of our four strategic plan pillars -- Conservation, Education, Measurement, and Sustainability -- as well as the progress of tasks supporting these goals.

A core focus within our strategic plan is on efficient, sustainable design and construction. MD Anderson's Master Facilities Framework plans for an addition of 10 million gross square feet to our owned and operated portfolio. One of the most impactful ways to reduce energy use is through designing and building high-performance buildings.

MD Anderson regularly updates its Owner's Design Guidelines and assesses project designs for utility performance. Our Engineering and Project Delivery teams play a crucial role in ensuring that our facilities remain efficient and innovative. These teams are integral to the building commissioning process for new construction and renovations, ensuring operational performance aligns with the design intent.

The Master Facilities Framework provides an opportunity to inspire teams to deliver efficient buildings. Recently, we have strengthened our focus on commissioning and first-year building performance by incorporating these priorities into contracts, design guidelines, and job roles within the Energy and Utility Programs team.

Conservation:

The Conservation pillar drives our mission-aligned strategy to reduce consumption, minimize waste, and ultimately promote a healthier environment that supports the health and well-being of our communities. This pillar is central to our strategic plan, reflecting our commitment and prioritization of energy and sustainability principles. Through eliminating waste and reducing unnecessary utility usage, MD Anderson frees up essential funds that would otherwise be allocated to utilities and waste disposal, directly supporting our institution's mission to cure cancer.

Our first goal under this pillar is to identify and prioritize opportunities using data-driven insights. To this end, MD Anderson teams are committed to optimizing resources through robust continuous monitoring and retrocommissioning practices. We also value stakeholder collaboration, which is vital in refining our conservation strategies to ensure relevance and efficacy.

The second goal focuses on establishing a sustainable purchasing program. By promoting conservative purchasing practices and building a renewable energy strategy, we aim to make sustainable resource use a foundational part of our institutional procurement and operational practices.

Our final goal is to develop efficient, high-performance buildings with minimal environmental impact. Our high-performance building projects aim to incorporate energy and water efficiency, applying digital models to assess alternative approaches. This ensures that we optimize resource use from the ground up. Additionally, our commitment to sustainability extends through recycling initiatives during construction and renovation, fostering a lifecycle approach to resource management.

This report's Implementation Schedule section details notable retrocommissioning projects currently underway, demonstrating our active commitment to conservation through impactful projects.

Tasks supporting objective to support of FM Senior Leadership to prioritize resources of highest payoff activities.

1. Met with FM Leadership quarterly to review energy and sustainability activity and prioritize resources.
2. Key projects gaining leadership support and funding from this team include a comprehensive laboratory air change and setback project (Clinical Research Building), an exterior LED lighting upgrade, maintenance allowing participation in utility demand response programs, a fault detection and reliability centered maintenance solution for Pharmacy space compliance, and an automated fault detection and diagnostics solution for MDACC's South Campus chilled water distributed plant system.

Tasks supporting objective to improve efficiency of existing buildings through retrocommissioning program; Prioritize opportunities by making data driven decisions.

1. Clinical Research Building (300K sqft): Energy Project design complete; 10% building energy reduction; lab air change reduction, setbacks *
2. South Campus Research Buildings 1 and 2 (280K sqft):
3. Decarbonization project to replace old fire tube boilers with heat recovery chillers and condensing boilers: In design. *
4. SCRB1 laboratory setbacks: Completed in FY2024.
5. Operating Room Energy Projects
6. Phase 1: Connect to patient scheduling system; program and commission setback; completed FY2024.
7. Expansion to other existing ORs in FY2025. *
8. Add strategies to ODGs and control drawings. *
9. Pavilion OR AHU sequence/setpoint optimization; in progress. *
10. South Campus Microgrid Study and Generator Replacement. *
11. Water monitoring programs in South Campus (weekly rounds and reports).
12. Groundwater recovery study for Proton Therapy building for use in campus cooling towers. *
13. Added outside air flow measuring devices louver replacement project to better control outside air in Old Clark clinic (325K sqft).
14. LeMaistre clinic (170K sqft) HVAC optimization and setbacks. *
15. Night Setbacks in renovated/reconstructed spaces: Life Science Plaza (70K sqft) and NW Houston (80K sqft). *
16. Woodlands clinic comprehensive controls and setback project: Savings potential of more than 10% total building energy use. *
17. West Houston clinic setbacks: Avoidable cost and some scope identified for zone-level setbacks; savings opportunity of 7-8% of building energy use. *

Tasks supporting objective to explore processes of continuous efficiency monitoring.

1. See Energy Tools section below for more information on monitoring-based commissioning and automated fault detection and diagnostics (AFDD) accomplishments and development.

Tasks supporting objective to establish a renewable energy strategy.

1. With active design and construction projects, net zero principles were explored on several projects.
2. Solar installations and solar-ready construction were studied for new 251K square foot Consolidated Services Center and a 600K sqft parking garage.
3. A full net zero study was performed for the Sugar Land Houston Area Location and Surgery Center with the purpose of supporting high-performance design options as well as determining a potential path towards net zero energy. The study used life cycling analysis and carbon emission reductions to evaluate options and develop a list of recommendations to support MD Anderson's sustainability goals. The study yielded many innovative ideas that are being incorporated into the design, including a heat recovery chiller design modeled to show benefit for hot water thermal storage and air source heat pumps for auxiliary heating. Projected energy usage was shown to be reduced by 39%. Geothermal was studied, as well as options for solar arrays. Each included potential Inflation Reduction Act and utility rebate opportunities. Net zero energy could be achieved at this site with a combination of solar and green power purchases.

Tasks supporting objective to apply energy and water efficient design practices to new construction and renovation projects.

1. Energy and Sustainability Commitments: Energy and sustainability commitments have expanded as part of MD Anderson's Master Facilities Framework. Early design charrettes included numerous energy and sustainability-focused meetings. Projects committed to energy and commissioning deliverables throughout design and construction, with milestones requiring signoff before progressing to subsequent stages.
2. Major Project Commitments to Commissioning: Most active major projects committed to commissioning across all project phases. Notable efforts include:
3. Northwest Houston Facility Project $mdash; Phases 1 and 2: This 80,000-square-foot hospital was purchased and renovated by MD Anderson. Our in-house commissioning program collaborated with the project manager, contractors, and the operations team to address open issues discovered in the existing building. Key open items are scheduled for resolution in Phase 2.
4. West Houston SBO: A 52,000-square-foot buildout of shelled space at our West Houston clinic. The commissioning efforts focused on meeting the customer's requirement for a functional, code-compliant building by the projected completion date.
5. ROC Rooftop Unit Replacement: This project goes beyond a simple replacement, addressing original design flaws by replacing rooftop units, installing duct heaters, and other improvements. Enhanced in-house support during commissioning ensures the design intent is achieved and resolves longstanding operational issues.
6. Additional In-House Commissioning Support:
7. 1MC Floor 23 and 24 Buildout: Converting shelled floors into office spaces for the Executive Leadership Team.
8. School of Health Professions Relocation to 1MC Floors 6, 7, and 10: Partial demolition and full renovation of 135,000 square feet to accommodate classrooms, labs, and administrative offices.
9. Zayed Floor 2 Completion: For relocation of SCT GMP and Core Labs
10. Main Building OR Renovations (ORs 28, 29, 30): Operating room setbacks tied to procedure scheduling systems.
11. Pharmacy Modifications: Compliance with USP 797 and USP 800 codes, with the in-house commissioning team ensuring consistent efficiency across projects, contractors, and facilities.
12. Collaboration with District Thermal Energy Plant: In FY2024, MD Anderson collaborated with the Texas Medical Center's district thermal energy plant to include heat recovery in contracts. Heat recovery chillers (HRCs), previously disallowed, are now included in several MD Anderson buildings in design that will be connected to the district plant. MD Anderson has already integrated HRCs in non-district utility facilities, like SCRB5 and BRF designs. HRCs, key to decarbonization, serve as electric heating and cooling devices and offer high energy efficiency, potentially reducing energy needs by 10% in energy-intensive buildings and becoming nearly emissions-free when powered by renewable energy.
13. ASHRAE Guideline 36 Integration: Most new buildings and major renovation projects now incorporate ASHRAE Guideline 36's high-performance HVAC operation sequences. The Energy and Building Operations Technology teams collaborated with consultants to update control drawings and master specifications, ensuring new projects and renovations reference these high-performance sequences. Automated fault detection and diagnostics (AFDD) tools are configured to monitor issues and sequence overrides.
14. Project Design Reviews for Master Facilities Framework: In supporting the Master Facilities Framework, MD Anderson's facilities teams review and comment on project designs, submittals, and RFIs with a focus on minimizing energy use. Recent design reviews included airflow setbacks, temperature setbacks, and high-performance sequences per ASHRAE Guideline 36 for the following projects:
15. South Campus Research Building 5: 603,000-square-foot laboratory (in construction; completion in 2027)
16. Clinical Services Building: 758,000-square-foot clinic and support facility (in construction; completion in 2027)
17. Consolidated Services Center: 251,000-square-foot warehouse (in construction; completion in 2026)
18. Biosciences Research Facility: 290,000-square-foot vivarium (design complete; completion in 2028)
19. Sugar Land Houston Area Location and Surgery Center: 473,000-square-foot clinic and surgery center (in design; completion in 2028)
20. Northwest Houston Imaging Facility: 45,000-square-foot diagnostic imaging facility (existing structure; project in design; completion in 2026)
21. Project Documentation and Compliance: A library of energy and sustainability deliverables was created, with contract language updated as needed. Energy and Commissioning deliverable matrices are used by MD Anderson projects to ensure required deliverables, supporting performance intent, are met and compliant with MD Anderson's design guidelines.
22. Chilled Water Condensate Recovery: Most projects include chilled water condensate recovery. Given Houston's climate, this water, collected during significant cooling, can be reused for cooling tower makeup, irrigation, or other non-potable purposes.
23. New Technology Pilots: Adiabatic steam generators were studied and included in several new designs as part of ongoing efforts to pilot innovative technologies.
24. Updates to Energy and Commissioning Design Guidelines: Revisions to the design guidelines now require the creation of an Energy Performance Plan, contributing to a larger Operational Building Plan and setting parameters for fault detection and diagnostics.

Building designs supporting objective to implement energy modeling for projects.

1. South Campus Research Building 5
2. Clinical Services Building
3. Consolidated Services Center
4. Biosciences Research Facility
5. Sugar Land Houston Area Location and Surgery Center (also included net zero study and energy modeling)

Tasks supporting objective to prioritize recycling and energy efficiency efforts during construction and renovation.

1. New facility construction projects now include construction recycling and the reporting thereof.
2. Site HVAC utilities performance requirements are defined in specifications. Deliverable is an Efficient Utilities Consumption Plan to minimize energy consumption during construction. This plan is drafted by the construction contractor and reviewed by the commissioning agent.

Education:

The Education pillar focuses on building a culture of energy efficiency and sustainability through strategic communication, staff engagement, and institutional transparency.

Our primary goal is to engage our workforce to foster a culture that values energy efficiency, adopts sustainable practices, and embraces transparent operations. We aim to achieve this by identifying and empowering energy and sustainability champions throughout the organization, alongside promoting accessible energy and sustainability tools that are user-friendly for all staff members.

The second goal within this pillar is to elevate our energy and sustainability initiatives, enhancing visibility both within MD Anderson and within the broader community. By making our initiatives known, we strengthen our alignment with the institution's mission to eliminate cancer while fostering a proactive culture that consistently goes beyond regulatory compliance in sustainability and energy performance.

The following objectives are directly tied to these goals, with specific tasks scheduled for FY2024 and FY2025 outlined in each section below.

Tasks supporting objective to identify and cultivate energy and sustainability champions throughout Facilities Management and the Institution.

1. Created Energy Tool Response Workflow
2. Workflow created and implemented as part of a collaborative goal between the Energy team and Patient Care operations team.
3. Desire was to increase interaction with various fault detection and energy diagnostic tools while measuring the effectiveness of clearing issues. The vision was to interact in a recurring meeting format to stay on track, provide education where needed, and discuss roadblocks.
4. Key component included establishing triage champions to access expertise when needed rather than focus on creating singular experts the whole process.
5. Workflow included digital communication outside of phone calls and emails.
6. Pilot goal was to create and clear at least 2 high priority tasks per month (currently team is accomplishing an average of 6 tasks per month).
7. FY25 progress will include expanding this workflow to several more property group teams (1 of 7 facility operations teams are actively utilizing the workflow).
8. Expand Energy and Sustainability reach through recently formed Institutional Environmental Sustainability Advisory Committee (IESAC).
9. Approval by Executive Leadership Team to adopt and design to ASHRAE 90.1-2022 and LEED Gold (version chosen at SD phase). UT System standards require ASHRAE 90.1-2019 and LEED Silver. SECO required version is currently ASHRAE 90.1-2016. This change will advance energy strategies, introduce some new renewable and heat recovery requirements, and foster more innovative sustainable designs.
10. Gained approval to include construction recycling for all major capital projects. Recycled materials are tracked throughout the projects. *
11. Partnered with dining services on composting program. *
12. Investigation into Joint Commission Voluntary Certification Program, something that is nearly met with current programs. *
13. Partnered with Patient Care operations on in-house commissioning training in conjunction with the construction of a facility in our Main Campus. Plans to repeat training with other operations teams with new construction upcoming.
14. Partnered with Fleet team to promote alternative fuel vehicles and eco-friendly vehicle programs during fleet information sessions.

Tasks supporting objective to promote and utilize energy and sustainability tools.

1. Began a pilot effort to develop a flexible platform that can visualize data from our submetering database. The "Energy App" that is being developed in collaboration with MD Anderson's Power Platform community will allow the Energy Team to share information from meters and tools via reporting or directly to other tools.
2. Continued the buildout of "information" homes in Microsoft Teams for fault detection reports, energy dashboards, collaborative tasks (MS Planner), shared files, etc.

Measurement:

The Measurement pillar is focused on capturing, understanding, and sharing data on institutional consumption while estimating savings achieved through targeted mitigation efforts. This pillar enables us to pinpoint key areas of improvement, assess impacts pre- and post-implementation, and establish sustainable baselines essential for maintaining efficient operations across the organization.

Our first goal within this pillar is to quantify and communicate MD Anderson's energy consumption and recovery metrics across different buildings and functional areas. To support this, we aim to (1) measure, analyze, and report energy demand and consumption in detail, and (2) develop a robust program to maintain critical measurement devices like submeters, ensuring ongoing accuracy and reliability of our data.

The second goal is to expand our measurement capabilities by pursuing innovative metrics and standards. We commit to exploring nationally recognized programs, including Energy Star and Practice Greenhealth, actively tracking advancements in technology and metrics, and conducting life cycle assessments to support waste reduction and enhance our sustainability profile.

The tasks supporting these objectives, outlined in the following sections, underscore our dedication to measurement as the cornerstone of impactful, sustainable decision-making.

Tasks supporting objective to create schedule to verify/calibrate devices and to publish measurement program data where accessible by all stakeholders.

1. Created a submetering verification database and a repeatable calibration program. This began as a concept in Excel in FY2023/24, and it is being converted into a Power App as an effort in FY2025. The current task is focused on enhancing the submetering program using reliability centered maintenance principles. Sensor dashboards and reporting will be created to support a submeter program that is informed by current data and previous sensor maintenance before generating work orders for field verifications. *
2. Drafted list of all key sensors that have high impact on building operation and energy performance. This supports an ongoing effort to identify highest priority sensors and calibration processes. *

Performance indicators promoted to support objective to establish cornerstone metrics for key energy and sustainability reduction goals.

1. EUI (energy use per area): to be grouped by building type and age; EUI targets for new buildings vs EUI current will be tracked; EUI baseline (expected energy) vs current EUI will also be tracked where baselines have been established.
2. ECI (utility cost per area)
3. Carbon emissions per square foot: similar to items above, but to benchmark carbon footprint per area.
4. Sub-metrics to be developed:
5. Utility rates per provider per site (trended over time)
6. Performance against budget (energy and cost)
7. Engagement metrics: avoidable cost from analytic results, number of diagnostic faults, etc.
8. Activities supporting performance indicators:
9. Expanded carbon dashboard to include transportation fuels and waste streams.
10. Consolidated metrics, building information, and automated performance diagnostics for use in monitoring building performance. Future effort to establish intelligent baselines that can be monitored by operations teams. *

Tasks supporting objective to setup a process to estimate and track first year building performance.

1. Defined energy performance assurance plan and added language to commissioning specifications used on projects.
2. Established and published cornerstone metrics (detailed above) for presenting energy and sustainability data in Operational Building Plans.

Sustainability:

The Sustainability pillar ensures that energy and sustainability initiatives become integral to our daily practices.

Our first goal is to commit to efficient operations across all routine activities by developing standardized procedures for operations and maintenance, coupled with processes to identify and correct inefficiencies as they arise.

Our second goal focuses on embedding successful practices into sustainable routines. Through monitoring-based commissioning and a commitment to continuous improvement, we safeguard our progress, ensuring that achievements in energy reduction are maintained and do not revert to less efficient practices.

The third goal is to adopt a comprehensive reduce, reuse, recycle program, reflecting our commitment to flexible, progressive waste recovery. This includes supporting existing internal waste recovery efforts while exploring innovations in recycling practices that align with our sustainability mission.

Tasks supporting objective to demonstrate operation and maintenance procedures to maximize efficiency of existing systems.

1. Created comprehensive database for nearly every managed space type at MD Anderson establishing temperature and setback standards for each. This effort will have significant impact on spaces as they are constructed, informing design and construction teams of our expectations and providing consistency across facilities. This database can also be used in the retrocommissioning of spaces.
2. Maintain established real-time, daily, and monthly monitoring-based automated tools (see Energy Tools section).
3. Heat recovery chiller daily monitoring.
4. Heat exchanger repair and replacement to restore performance (Mays Clinic, Dan L. Duncan Building, Gimbel).
5. Added interval meter data to EnergyCAP, allowing for granular visualization of monthly utility bills and utility trends.
6. Utilization of continuous monitoring-based commissioning to identify warranty and other items not meeting building's intended operation.

STRATEGY FOR ACHIEVING GOALS

MD Anderson pursues energy conservation and sustainability through a collaborative effort of cross-functional teams supporting each mission area of the institution. MDA's commitment to stewardship of the principles of energy efficiency and sustainability is promoted through three strategic level teams: The Energy and Sustainability Strategy Team, the Energy Core Team (ECT), and the Institutional Environmental Sustainability Advisory Committee (IESAC).

The Energy and Sustainability Strategy Team is composed of key contributors and program owners of the Energy and Sustainability Strategic Plan. This team meets monthly to discuss progress against existing goals and to plan future activities. In addition to this team, a Solid Waste and Recycling Committee composed of EHSSEM, Environmental Services, Parking and Transportation, Materials Management staff, and Facilities Customer Advocates was formed to discuss the challenges and opportunities with sustainability with frontline staff. This committee meets quarterly to increase recycling awareness, review opportunities for improvement, and share innovative ideas.

The Energy Core Team (ECT) is composed of senior facilities management leadership including the Chief Facilities Officer and Vice President of Facilities Management (FM); Associate Vice Presidents for Research and Administrative Facilities (RAF), Patient Care and Prevention Facilities (PCPF), Environmental Health and Safety Sustainability and Emergency Management (EHSSEM), Engineering and Building Systems Management (EBSM), and Facilities Management Business Services (FMBS); the Director of Engineering Construction Services; and the Director of Energy and Utility Programs. The ECT meets every quarter to discuss energy goals and trends, share best practices, approve resources for energy conservation measures, and set priorities related to policy and resource application. This core team is also responsible for tracking the energy portion of the Strategic Plan goals.

In FY2023, MD Anderson formed the Institutional Environmental Sustainability Advisory Committee (IESAC) with the purpose to oversee our environmental stewardship programs and foster the development and education of these programs. This multidisciplinary group includes a leadership representative with voting privileges in the following areas: Executive Leadership Team, Facilities Management, Research Administrative Facilities, Health Safety Sustainability and Emergency Management, Engineering Building Systems Management, Institutional Finance, Innovation, Faculty, and Supply Chain Management. The current chair is MD Anderson's Chief of Staff.

In support of our energy and sustainability efforts at the Facilities Management level, MD Anderson building directors have included in their position descriptions the following responsibilities:

1. Monitors and manages energy performance for assigned buildings.
2. Takes appropriate actions to ensure buildings perform within set targets.

This structure formally expands the energy conservation and efficiency improvement team to include the building operations and maintenance personnel, which facilitates energy conservation as part of daily operation. Energy sub-teams exist at each operations team level. These teams include maintenance supervisors, building operations leadership, Engineering, building automation, and Energy Management. The Energy Management and Engineering teams also create, maintain, and promote energy training and analytic tools so our building operators can gain ownership of this important function.

IMPLEMENTATION SCHEDULE

In this report, progress toward our goals, objectives, and tasks are summarized annually in the Progress Report sections above. The following is a selected list of notable projects, either currently underway or scheduled for FY2025, which advance the Conservation pillar of our strategic plan by prioritizing data-driven decision-making. MD Anderson's operations and energy teams also leverage monitoring-based commissioning tools to reduce waste and focus retrocommissioning efforts for maximum impact.

In implementation

1. Clinical Research Building Energy Project
2. LeMaistre Clinic Setbacks
3. OR Setbacks
4. Energy Recovery Wheel Replacements: Gimbel, Pickens, and 1MC

In design

1. SCRB1 and SCRB2 Boiler Replacements and Heat Recovery Chillers
2. Woodlands clinic setbacks and controls modifications
3. SCRB1 and SCRB2 Microgrid Study and Generator Replacement

In development

1. West Houston clinic setbacks and controls modifications
2. SCRB2 laboratory setbacks
3. Life Science Plaza setbacks and retrocommissioning
4. Northwest Houston setbacks and retrocommissioning
5. BSRB LED retrofit

AGENCY FINANCE STRATEGY

Funding Mechanisms for Energy Conservation:

MD Anderson uses two work streams to provide an opportunity to fund and implement energy efficient measures. The first stream is dedicated solely to energy-driven projects. These projects must align with MD Anderson's energy initiatives strategy and meet specific payback thresholds to be included in the annual budget. Energy conservation measures are evaluated based on a simple payback period target of 5 years or less (20% ROI), though each project undergoes a holistic review. In most cases, MD Anderson uses in-house resources and pursues the low or no capital energy conservation measures (ECMs) that might be available through retrocommissioning or similar optimization or waste reduction processes.

The second work stream involves Facility Management's capital plan. This plan is based on an asset management strategy that considers asset lifecycles and operational requirements. Projects are ranked based on an internal scoring sheet and are then evaluated to see if they become part of the respective annual budget or deferred to a future fiscal year. The scoring methodology considers factors such as safety, regulatory code compliance and operational impact. While these projects are typically not 100% energy driven, they do contribute to the overall impact of our sustainability goals through rigorous design review, operationally efficient configuration, and use of latest technology (as appropriate) to positively influence energy conservation. Many capital projects contain opportunities to provide incremental energy-saving benefits with additional investment. These opportunities are reviewed annually with quarterly touch points.

For ECMs that require capital funding, two mechanisms are available: the CRR/FRM or funding from the Energy Rebate Account.

1. CRR/FRM Funding: Capital Repair and Replacement (CRR) and Facilities Repair and Maintenance (FRM) are funding categories that MD Anderson has available on an annual budget basis, with distinctions based on capital versus maintenance accounting criteria. Proposed ECMs must compete with other institutional needs to obtain funding priority from this source.
2. Energy Rebate Account: The Energy Rebate Account was established as a collection point for funds MD Anderson earns from utility rebates for energy efficiency improvements or participation in the demand reduction programs that exist through local energy distribution companies and ERCOT (as explained in more detail in the following section). MD Anderson collects approximately $800K annually from the utility rebate programs described below, along with some recycling revenue.

Program Funding from Utility Rebate Programs:

MD Anderson has been an active participant in CenterPoint's Healthcare Energy Efficiency Program (HEEP), Data Center Energy Efficiency Program (DCEEP), and Standard Offer Program (SOP) for many years. CenterPoint Energy's HEEP program team has worked closely with our energy team to identify and validate eligible energy efficiency opportunities in both new construction projects and retrocommissioning efforts. MD Anderson has also leveraged the 179D Energy Efficient Commercial Building Tax Deduction for large construction projects. Currently, a study is underway to assess whether the Inflation Reduction Act (IRA), which absorbed and expanded the benefits of 179D, can further accelerate the adoption of lower carbon footprint strategies.

Program Funding from Demand Response Programs:

MD Anderson operates over 50 MW of emergency stand-by power to ensure continuity of patient care and research, even during power disruptions from external sources, such as hurricanes. Demand response programs provide mechanisms that incentivize consumers to reduce electricity usage during peak demand periods on the utility power grid. These programs allow electric customers to decrease their peak electricity usage during critical load times, benefiting power system reliability and offering financial incentives.

The EBSM team oversees MD Anderson's demand response efforts, utilizing two programs to maximize benefits and payments:

1. Direct contract with CenterPoint Energy for the summer demand response program.
2. ERCOT participation for the remaining months, facilitated by a UT System consultant.

Other Incentives:

MD Anderson has leveraged the 179D Energy Efficient Commercial Building Tax Deduction for large construction projects. A study is currently underway to assess whether the Inflation Reduction Act (IRA), which expanded the 179D benefits, can offer new opportunities to accelerate the adoption of low-emission energy designs, such as geothermal and solar.

Current Opportunities:

In addition to the ongoing demand response and recycling programs, the following are key initiatives where energy incentives are actively being evaluated and pursued:

1. Consolidated Services Center (HEEP and I79D, 2026)
2. South Campus Research Building 5 (HEEP and 179D, 2027)
3. Clinical Services Building (HEEP and 179D, 2027)
4. Sugar Land facility (HEEP and 179D and IRA opportunities, 2028)
5. Biosciences Research Facility (HEEP and 179D, 2028)
6. South Campus Garage— solar opportunity (IRA, pending project approval)
7. 1MC Data Center Upgrades (HEEP/DCEEP, 2025/6)
8. 1MC data center chiller project (HEEP/DCEEP, 2025/6)
9. UPS Replacement/Data Center Upgrades at CPB and Guhn Rd (HEEP/DCEEP 2025/6)
10. Upgrade VFD's and Rebuild SRB Chillers (HEEP, 2024/5)
11. Install Fluid Applied Roof on South Campus Research Buildings 1 and 2 (HEEP, 2025/6)
12. Replace Walk-in Coolers in Clark Clinic Main Kitchen (HEEP, 2025/6)
13. CPB HVAC Systems VFD's Replacement (HEEP, 2025/6)
14. PTC1 BAS Upgrade (HEEP, 2025/6)
15. BSRB - Elevator Split System (HEEP, 2025/6)

EMPLOYEE AWARENESS PLAN

Staff Training:

With increasingly sophisticated building systems and controls, educating staff on efficient operation techniques has become essential. The tools and techniques for efficient operations often require the staff to unlearn past practices for operating systems.

Regular meetings are scheduled to review activity, trends, and any associated controls adjustments made affecting energy. Changes to set points and overridden controls can have significant impacts on system efficiency and occupant comfort. While the need to periodically override and adjust systems due to unforeseen failures exists, strategies to minimize these overrides have resulted in lower annual energy consumption.

Operations teams provide HVAC training with energy efficiency in mind and incorporate energy tool insights into their weekly meetings and activities.

Operational Efficiency:

MD Anderson's building operations have been integral to the institution's energy success for each of our strategic plans. Operations teams routinely review energy tools, triage energy indicators, recommend energy and water conservation activities, and provide team energy training.

Our operations teams are also continuing to study and include valuable Reliability Centered Maintenance practices such as performance-based maintenance schedules and IoT-like principles of combining relevant building data and history to maintenance decisions. These practices align with our energy tool principles, facilitating data-sharing between systems and optimizing energy resource usage.

Energy Tools:

MD Anderson has developed tools for use in support of energy trending, dashboards, and usage metrics. These real-time, daily, monthly, and annual tools are essential to managing the energy performance of buildings. Each provides a prospective that will assist in prioritizing energy related retro-commissioning, as well as managing day-to-day operation of key energy consuming equipment. Recurring meetings with each operations group and energy team include the education for the use of these tools.

MD Anderson deploys some level of energy tool insights at the daily level for over 70% of its total footprint. Below are descriptions of the energy tools in place at MD Anderson. Below are key FY2024 additions or enhancements to our energy tools.

Clockworks:

1. Pharmacy Compliance Dashboards: Created and began using Clockworks to monitor Temperature, Humidity, Air Change, and Pressure with the added benefit of insight into what is causing a compliance issue; team has decided to add all pharmacies to the platform.
2. Zone Level Dashboards: Worked with Clockworks development team on zone level dashboards. Next iteration in FY2025 planned to include some trim and response (ASHRAE Guideline 36) monitoring.
3. Chiller Diagnostics: Developed preliminary scope with Clockworks. To be developed for implementation FY2025.

EnergyCAP:

1. Updated all operations team custom dashboards, which can be viewed live in MS Teams without logging into the front end of the software.
2. Updated Carbon/Greenhouse Gas dashboard and Institutional dashboard for the Institutional Environmental Sustainability Advisory Committee (IESAC) and posted to MS Teams.
3. Implemented single sign on (SSO) to simplify user connection to tool.

EnergyCAP (Monthly and Annual Energy Tool):

EnergyCAP is a utility invoice management software that allows for powerful energy management insights at the building area, mission area, and organizational level. EnergyCAP, MD Anderson's primary database for processing around 300 monthly utility invoices, also includes submeters and interval data, enabling detailed insights down to the meter level. Since utility accounts can serve an individual building or a building group, this configuration allows dynamic power views to be made available for each operations team that be reviewed from the mission area level down to the meter level. There are a variety of dynamic reports including EUI (energy per square foot), monthly use and cost trends for each commodity, place performance comparisons for benchmarking, and commodity performance. EnergyCAP data is stored in a SQL database and can be queried and used as a data source for other energy tools. The software has powerful external dashboarding capabilities. These dashboards have been incorporated into established channels for MD Anderson energy teams in Microsoft Teams and on SharePoint.

Recently, EnergyCAP has expanded to include carbon accounting. MD Anderson has added carbon dashboards for our facilities and have started including some fleet and waste stream emissions data to EnergyCAP.

KPI Fault Detection (Daily Energy Tool):

In-house key performance indicators (KPIs) and daily energy fault reports have been developed for eight major buildings. These reports pinpoint potential energy waste each day, enabling operations personnel to quickly address and resolve equipment issues. By archiving energy-related faults by system, the tool generates a historical daily energy record at the building system level, supporting both immediate corrective action and the maintenance of new conservation measures.

Automated reports are run daily, and analysis links and reminders are emailed weekly to operations, engineering, and energy stakeholders for prompt review.

Energy Pulse (Daily Energy Tool):

Daily energy pulse and trend graphs, generated using data from the building automation system (BAS), are automatically transmitted to key operations and engineering staff. These reports help identify potential changes in building energy usage by comparing trends against outdoor air conditions. Building-specific reports run daily with reminders sent weekly to mission-area stakeholders, enabling quicker responses to shifts in energy use and providing automated measurement and verification for conservation activities. Additionally, these reports assist in troubleshooting meter or control issues that may impact performance.

The reports also support the transition from time-based to performance-based preventive maintenance (PM). For example, weekly graphs showing HVAC filter differential pressure help the operations team track filter performance, verify expected function, and optimize replacement schedules.

The tool also monitors known sources of potential energy waste, such as open fume hoods and malfunctioning humidification valves. Hourly, daily, and monthly trend analysis allows the tool to serve as a sustainability resource, reinforcing prior efficiency improvements. Custom KPIs and views can be configured to track specific conservation efforts across facilities.

Automated Fault Diagnostics and Building Analytics:

Alongside in-house tools, MD Anderson leverages Clockworks Analytics, a cloud-based platform that provides enhanced HVAC diagnostics, advanced trending, and task management. This tool goes beyond basic fault detection by creating a digital model of equipment, enriched with metadata that categorizes system and sensor relationships. The model is constructed using detailed control sequences and mechanical schedules, allowing for a comprehensive approach to identifying and addressing HVAC issues.

Chilled Water Plant Optimization Software:

MD Anderson's South Campus includes eight distinct, submetered building areas served by four chilled water (CHW) plants connected along a CHW piping loop. With a total cooling capacity of 12,800 tons, these plants handle cooling loads ranging from 200 tons in winter to 7,500 tons at summer peak. As part of a coordinated energy project, plant sequences and the global pumping strategy were completely redesigned and commissioned as a unified system.

A Niagara-based optimization software engine now provides full automation and optimization, using equipment models, operating curves, known constraints, and real-time data on cooling capacity and outside air wet-bulb temperature. This system determines the equipment configuration that minimizes total power demand and sends stage up/down commands to meet campus cooling needs efficiently. Additionally, the software supports sustainability goals by communicating target efficiencies, enabling quicker identification of inefficiencies.

Microsoft Teams and SharePoint:

Microsoft Teams has been adopted as a collaborative platform for MD Anderson's operations teams, supporting conservation activities across each mission area. Public channels have been configured with action items, meeting notes, energy conservation measure (ECM) lists, and energy dashboards to facilitate team access and maximize opportunities for engagement.