Why these doctors started writing medical ‘prescriptions’ for solar power

Anna Goldman, a primary care physician at Boston Medical Center, got tired of hearing that her patients couldn’t afford the electricity needed to run breathing assistance machines, recharge wheelchairs, turn on air conditioning or keep their refrigerators plugged in. So she worked with her hospital on a solution.

The result is a pilot effort called the Clean Power Prescription program. The initiative aims to help roughly 80 patients with complex, chronic medical needs keep the lights on.

The program relies on 519 solar panels installed on the roof of one of the hospital’s office buildings. Half of the energy generated by the panels helps power Boston Medical Center. The rest goes to patients who receive a monthly credit of about $50 on their utility bills.

Kiki Polk was among the first recipients. She has a history of Type 2 diabetes and high blood pressure.

On a warm fall day, Polk, who was nine months pregnant at the time, leaned into the air conditioning window unit in her living room.

“Oh my gosh, this feels so good baby,” Polk crooned, swaying back and forth. “This is my best friend and my worst enemy.”

An enemy, because Polk can’t afford to run the AC. On cooler days, she uses a fan or opens a window instead. Polk knows the risks of overheating during pregnancy, including added stress on the pregnant person’s heart and potential risks to the fetus. She also has a teenage daughter who uses the AC in her bedroom — too much, according to her mom.

Polk got behind on her utility bill. Eversource, her electricity provider, worked with her on a payment plan. But the bills were still high for Polk, who works as a school bus and lunchroom monitor. She was surprised when staff at Boston Medical Center, where she was a patient, offered to help.

“I always think they’re only there for, you know, medical stuff,” Polk said, “not the personal financial stuff.”

Polk is on maternity leave now to care for her baby, the tiny Briana Moore.

Goldman, who is also BMC’s medical director of climate and sustainability, said hospital screening questionnaires show thousands of patients like Polk struggle to pay their utility bills.

“I had a conversation recently with someone who had a hospital bed at home,” Dr. Goldman said. “They were using so much energy because of the hospital bed that they were facing a utility shut off. “

Goldman wrote a letter to the utility company requesting the power stay on. Last year, she and her colleagues at Boston Medical Center wrote 1,674 letters to utility companies asking them to keep patients’ gas or electricity running.

Goldman took that number to Robert Biggio, the hospital’s chief sustainability and real estate officer. He’d been counting on the solar panels to help the hospital shift to renewable energy, but sharing the power with patients felt like it fit the health system’s mission.

“Boston Medical Center’s been focused on lower-income communities and trying to change their health outcomes for over 100 years,” said Biggio. “So this just seemed like the right thing to do.”

Standing on the roof amid the solar panels, Goldman pointed out a large vegetable garden one floor down.

“We’re actually growing food for our patients,” she said. “And similarly, now we are producing electricity for our patients as a way to address all of the factors that can contribute to health outcomes.”

Many hospitals help patients sign up for electricity or heating assistance because research shows that not having power or heat increases respiratory problems, mental distress and makes it harder to sleep. These are common problems for low- and moderate-income patients, said Aparna Bole, a pediatrician and senior consultant in the Office of Climate Change and Health Equity at the Federal Department of Health and Human Services.

But Bole said BMC’s approach to solving them may be the first of its kind.

“To be able to connect those very patients with clean, renewable energy in such a way that reduces their utility bills is really groundbreaking,” said Bole.

Bole is using a case study on the solar credits program to show other hospitals how they might do something similar.

Boston Medical Center officials estimate the project cost $1.6 million, and said 60% of the funding came from the federal Inflation Reduction Act. Biggio has already mapped out plans for an additional $11 million in solar installations at the Boston Medical Center.

“Our goal is to scale this pilot and help a lot more patients,” he said.

The expansion he envisions would allow a 10-fold increase in patients who could be served by the program, but it still would not meet all the demand.

For now, each patient in the pilot program receives assistance for just one year.

Boston Medical Center is looking for partners who might want to share their solar energy with the hospital’s patients in exchange for a higher federal tax credit or reimbursement.

Eversource’s vice president for energy efficiency, Tilak Subrahmanian, said the pilot was a complex project to launch, but now that it’s in place, it could be expanded.

“If other institutions are willing to step up, we’ll figure it out,” said Subrahmanian, “because there is such a need.”

This story comes from NPR’s health reporting partnership with WBUR and KFF Health News.