Health Care Emissions Impact Calculator frequently asked questions

Start with defining the boundaries of your organization. Different types of organizational GHG boundaries include equity share approach, control approach, and financial or operational. Most health systems will fall under the financial or operational control model. Learn more about which boundary model best fits your organization in chapters 3 and 4 of the GHG Protocol Corporate Accounting and Reporting Standard.

We suggest that any health facility or system that has not completed a GHG emissions inventory and feels the process is daunting start with quantifying scopes 1 and 2 emissions, but consider excluding refrigerants. It will be a very small percentage of their Scope 1 emissions, and there is not a lot a facility can do to reduce these emissions outside of reducing leaks or switching to a more climate-friendly refrigerant. The data for scopes 1 and 2 should be fairly easy to find because your organization should already be tracking it. We also know we have relevant decarbonization interventions right now to reduce scopes 1 and 2 emissions.

If your organization has never conducted a Scope 3 GHG inventory, we recommended starting with a few categories in Scope 3 that your organization has data for and can reduce emissions in right away. These categories include Category 3 (fuel and related activities), which comes from stationary combustion, and Scope 2 emissions. By switching to REC-owned renewable energy, you can significantly reduce emissions in this category. Additionally, Category 5 (waste), Category 6 (business travel), Category 7 (employee commuting), and Categories 8 and 13 (upstream and downstream leased assets) are good places to start, as your organization should already be tracking this data and should have options for reducing emissions in many of these categories right now.

Even if a building or leased space falls under your chosen boundary, it may be very difficult to obtain activity data for those locations. A GHG inventory will take time to develop, so while you are working on adding more detail to your inventory each year, make sure you are transparent in explaining why you included or excluded certain activities. The goal for your GHG inventory is to be as complete and accurate as possible while being transparent with your process. The development of a comprehensive GHG inventory for your organization is a journey, not a sprint. 

 If your organization has leased vehicles for your fleet, you would still add the purchased fuel to your Scope 1 (mobile fleet combustion), because even though it is a leased vehicle, you do have the ability to choose the vehicle to lease based on fuel type. The actual lease amount of the vehicle can be captured in Scope 3, Category 1 (products, goods, and services). Upstream or downstream leased assets’ GHG emissions (most often buildings or spaces in a building) can be captured in Scope 3 Categories 8 and 13. If the organization pays for the utility bills directly for those leased spaces, you could choose to count that energy or emissions in your Scope 1 (stationary combustion), Scope 1 (fugitive emissions), and Scope 2 (purchased electricity, steam, hot or chilled water). Either option works, and we recommend you explain why you chose to account for those activities under a certain scope. 

The calculator is updated each year with updated EPA emission factors for at least Scope 2 GHG emissions. When other emission factors for Scope 1 or Scope 3 are updated, we also update those emission factors. We are continuing to make the calculator more user-friendly, along with moving away from spend-based methodology for Scope 3 categories when possible.

It will likely take several years to develop a detailed and complete GHG inventory. An inventory of scopes 1 and 2 emissions, minus calculating fugitive emissions from refrigerants, should be fairly easy, since the required data for those activities should be readily available in your organization (most are utility bills). Developing a complete Scope 3 GHG inventory that includes 15 categories will take more time. We recommend starting with a Scope 3 GHG inventory that includes emissions for categories where you can easily find data and reduce emissions through decarbonization interventions first, over time you will add more detail to your inventory. 

We hope you have a science-based target of achieving net-zero emissions by 2050. If you have this goal, your baseline year becomes less important. Having a net-zero goal is more about achieving net-zero emissions as an organization rather than achieving a certain amount of GHG emission reduction per year. As far as how often you should quantify your GHG emissions, there is no one-size-fits-all answer. You may choose to update your scopes 1 and 2 emissions each year since this information is more easily obtainable. You may choose to update all or some of your Scope 3 emissions or not update categories for which you have not implemented any interventions to reduce emissions each year. 

Currently, no database exists that provides specific emission factors for a particular product, product line, or activity for Scope 3 categories. The EPA created a spend-based methodology database to allow for the estimation of Scope 3 GHG emissions. Many manufacturers are now starting to develop an emission factor for each of their sold products.

You can upload up to 300 facilities into the system Excel sheet. Save all of your facility sheets in one folder, and you can upload all of your facility sheets into the system Excel sheet at one time. The system Excel sheet will quantify all of your facility emissions and also allow you to compare facilities to one another. Comparing similarly sized facilities will help you identify outliers (like those with high GHG emissions) as well as facilities that are very efficient or have lower emissions. 

It will most likely take your organization years to develop a comprehensive GHG inventory. If you are trying to meet a science-based target (50% GHG emission reduction across all three scopes by 2030 and net-zero emissions by 2050), it is imperative for your organization to actively reduce emissions while developing a GHG inventory. While an inventory will identify activities that generate a lot of GHG emissions, we already have a good idea of what those activities are, the interventions currently available to eliminate or reduce emissions, and the technological advancements needed to reduce emissions from other activities.

While it may be nice to see how your facility or system’s decarbonization work compares with other similarly sized facilities or systems, at this point, achieving net-zero emissions is the most important commitment to have. While striving for a low energy use intensity (EUI), continuing to work on energy and water efficiency, and reducing waste are important pillars of decarbonization, achieving the science-based milestones of 50% reduction across all 3 scopes and net-zero emissions by 2050 is more important. Another thing to remember when comparing your facility or system to others is that not all facilities are created equal. You could have two 400-bed hospitals that are each approximately 850,000 square feet, yet they both have very different EUIs. One possible reason for this is that the services offered in each facility could differ greatly. (For example, one facility could have a lot more outpatient clinic space or administrative space). Using the EPA’s Greenhouse Gas Equivalencies Calculator could be a good way to show your staff or the public how the amount of GHG emissions your organization produces each year compares with other well-known activities.

Location-based purchased electricity is when an organization purchases electricity from a local utility company, and the purchased electricity electrons make it to your electrical meter. Market-based electricity is when an organization purchases electricity from a third party, but the electrons may or may not make it to your meter. Review the GHG Protocol Scope 2 Guidance for more information on the differences between location-based and market-based purchased electricity. 

To count your purchased renewable electricity as zero emissions, you must own the Renewable Energy Certificate (REC). If you do not own the REC, you must use the EPA region emission factor when calculating your Scope 2 purchased electricity emissions, because someone else owns the REC and therefore they can count the renewable electricity as zero emissions. If the owner of the REC and the consumer of the renewable electricity both count the emissions as zero, you would be double counting.

More ways to have zero emissions from purchased electricity: Several contractual instruments allow businesses to claim zero-emission electricity in the absence of a REC attestation. Purchased market-based electricity (or other fuel sources) includes these types of contracts that do not necessarily provide the purchaser-owned RECs, but can deliver carbon-free electricity. Examples include:

• Certain utilities offer green tariff programs that customers can sign up for directly, under which the customer pays a rider fee and receives environmental claims in return.
• PPAs (power purchase agreements) and VPPAs (virtual power purchase agreements) where a contract delivers the environmental benefits of carbon-free electricity without a typical REC attestation.
• Larger customers can sometimes create unique contracts with or receive special treatment from their utilities that convey environmental benefits without having RECs created and verified in the wholesale market. The seller of the renewable energy can retire the RECs on behalf of the client. 

As long as the contract documentation clearly outlines the delivery of renewable energy attributes as part of the deal, organizations can claim carbon-free electricity.

Examples of carbon-free electricity with zero emissions (without owning RECs) include:

• Carbon-free electricity without RECs: Some parts of the country, like the mid-Atlantic region, have all-attribute tracking systems whereby a traceable certificate is created for every MWh of power, whether it is renewable or not – the western region does not have such a system. Western Renewable Energy Generation System only creates and tracks certificates for energy types that are deemed renewable per California’s Renewables Portfolio Standard program. In the absence of such certificates, contractual instruments are typically used to establish claims to the environmental attributes of carbon-free power.   
• Carbon-free electricity documentation: In cases where renewable power is not actively procured by an organization, it can in some cases be allocated to them by investor-owned utilities. The organization can accept these allocations on behalf of its customers (participating campuses or facilities) who pay for them as part of an exit fee incurred when they stopped purchasing power from the utilities, and the organization receives documentation from the utilities for the quantity and type of attributes they can claim.

It is rare for purchased renewable electricity to make it to your meter unless it is onsite renewable electricity. Read below for how to handle possible emissions from purchased renewable electricity. 
Direct delivery: Direct delivery of renewable power to a facility can only be claimed when there is an onsite renewable energy project (like solar) and onsite power consumption is coincident with onsite power production. Otherwise, electrons simply follow the laws of physics, and a system of contracts and certificates (attribute tracking) is used in wholesale markets to attribute generation from specific sources to individual entities.   

Accounting for Scope 3, Category 3 when the REC-owned renewable electricity you purchased does not make it to your meter: transmission and distribution (T&D) losses for renewable electricity. Dirty power is still coming to your hospital. 

• Consumption vs. generation. A REC may only cover your consumption, but it will not cover the losses so you have to enter them in the T&D section. 
• If you can prove the electrons made it to you from the grid, then you don’t have to input T&D losses, but you most likely got a mix of dirty energy so you have to account for the T&D losses. 

For a contracted health care worker or any contract employer working in one of the organization’s facilities, any emissions resulting from activities that the contracted staff are directly engaged in onsite (at the reporting entity’s facilities) will certainly be included in that entity’s scope 1 and 2 (and select Scope 3) emissions totals, regardless of whether that staff was employed directly or contracted. However, there are upstream emissions associated with procuring the services of a contracted health care worker, because the reporting entity must take on a share of the operating emissions and other emissions associated with running that employment service. The entity conducting the GHG inventory would apply the fees they pay to the employment service organization, but not the salary of the staff, to an appropriate spend-based emission factor.
 
For the USEEIO category shown below, which seems most appropriate for this, the emission factor is 0.03 kg CO2e/$ (based on AR5 GWP values)

Employment services

Employment services'. This industry group comprises (1) Employment Placement Agencies and Executive Search Services, (2) Temporary Help Services, and (3) Professional Employer Organizations.

For the user to input data and see results, they must first choose the EPA region they live in at the top of the instructions page and choose the type of data they are inputting at the top of each section (actual, estimated, not estimated, not occurring). 

The user must choose whether the spend for a particular activity is product, goods and services, or capital goods.