Cheryl Vasconcellos said she cries every time she opens the monthly electric bills for Hāna Health, the community health center she leads in rural Maui.
Hāna Health has been paying more for electricity as it expands services for its 1,800 patients. Its facilities include a medical center offering primary, emergency and dental care, administrative offices, and on-site workforce housing.
Meanwhile, Vasconcellos said she’s bracing for electricity costs to rise. Last week, one company notified her to expect a spike in fuel prices as a result of the Iran War.
"With the current state of world affairs right now, we're anticipating a huge increase going forward," she said.
But Vasconcellos is hoping that in the near future, the center will be paying less, not more, for electricity.
Hāna Health is one of five community health centers seeking state support to construct solar microgrids with storage to power their facilities.
Senate Bill 3254 would appropriate about $2.5 million in state funds for the project, which is being spearheaded by the Hawaiʻi Primary Care Association and the microgrid developer Collective Energy.
According to estimates from Collective Energy, solar microgrids would save the participating health centers anywhere from $30,000 to $100,000 a year on electricity.
Those cost savings could be crucial as health centers look to tighten their belts to contend with impending cuts to the federal Medicaid program.
All of the health care providers named in SB 3254 are federally qualified health centers, meaning they are legally required to provide services to any patient, regardless of their ability to pay.
Hawaiʻi Primary Care Association CEO Emily Chung said Hawaiʻi's FQHCs will likely bear the brunt of Medicaid cuts if large portions of their patients lose coverage.
In a worst-case scenario, Chung anticipates the state could see its uninsured population double. If that occurs, Chung said health centers may have to dip into their operating funds to pay for care for patients without insurance.
"If we were to see a huge rise in uninsured populations… we may be at a point where some of our health centers will not be able to operate fully after a few months because they don't have the large reserves," she said.
Molokaʻi Community Health Center serves about 2,800 patients. CEO Milton Cortez said that more than 400 of its patients may become uninsured.
"We're looking at a loss of about $1.6 million starting 2027 and four years after that," he said.
Molokaʻi Community Health Center is one of the providers in line to receive funding for a new microgrid. It would bring down their energy costs by about $70,000 a year, according to Cortez.
Cortez sees those savings as key to continuing to provide services to patients who lose coverage.
What's in a microgrid future?
Each microgrid will be equipped with battery storage, which will help the centers ensure reliable access to electricity in the case of a power outage.
Outages can result in spoiled vaccinations and refrigerated medications.
"When it happens… that's thousands of dollars worth of supplies that we then need to replace," Vasconcellos said.
Power outages also interrupt patient care. Hāna Health is hooked up to a community generator, but Vasconcellos said it requires a manual kickstart, which can delay power delivery to their facility.
She said the staff keeps a small portable generator on-site in case a patient needs emergency care during a power outage. That generator produces just enough power to keep the lights and equipment in the urgent care room running.
"For us, losing power can be a big deal in terms of putting the community's health at risk, and actually people's lives at risk," Vasconcellos said.
Collective Energy founder Andrew MacCalla has seen firsthand how power outages can compromise patient care.
As the former vice president of emergency response for the humanitarian aid organization Direct Relief, he coordinated on-the-ground responses to rural medical centers impacted by disasters.
MacCalla started Collective Energy in 2021 with a goal of making the health care system more resilient to grid outages. Since then, the company has developed dozens of microgrids for community health centers nationwide.
The partnership with Hawaiʻi Primary Care Association to provide microgrids to five of the state’s FQHCs is Collective Energy's largest project in Hawaiʻi to date, and it's facing a looming deadline.
If SB 3254 passes with the requested $2.5 million allocation, state money will finance a little over a third of the project. The rest of the money comes from philanthropic donations — and hinges on the availability of federal incentives for solar projects.
The federal investment tax credit covers up to 30% of the costs of new solar installations for businesses. Under new criteria enacted by President Donald Trump last summer, construction on solar projects must begin by July 4, 2026, in order to be eligible for the tax credit.
Lawmakers therefore have a narrow window in which to fund these microgrids before the costs of the project go up, according to Cindy Kan, the director of programs and strategic partnerships in Hawaiʻi for Collective Energy.
Right now, SB 3254 seems to have momentum. It passed its third reading on the Senate Floor on Tuesday, and will now move on to the House.
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