Power shutoffs, heat and smoke: hospice at home in Southern California

What is SCE Medical Baseline?

Medical Baseline is a Southern California Edison (SCE) program for homes where someone relies on powered medical equipment or needs heating or cooling for a medical condition. It lowers the bill, and it puts the household on SCE's list for outage notices.

SCE says you may qualify if you, or someone who lives with you full time, regularly uses electrically powered medical or life-support equipment, is sensitive to temperature and needs air conditioning, or has a life-threatening illness or weak immune system that needs heating or cooling. SCE's equipment list includes an oxygen concentrator, an air mattress or hospital bed, a suction machine, a nebulizer, an infusion pump, a CPAP, a pulse oximeter and a motorized wheelchair. Devices used for therapy but not medically needed do not count.

The program adds 16.5 kilowatt-hours of electricity per day at the lowest baseline rate. Customers on a rate plan without a baseline, such as Time-of-Use, get a flat 11% discount instead.

How do you apply for Medical Baseline?

Apply early, before fire season or the next heat wave. SCE says the allowance shows on the bill within one to two billing cycles.

1. Step 1

   Get the form

   Apply online through the form on SCE's Medical Baseline page, or print the application and fill in pages 1 and 2. Questions: SCE at 1-800-655-4555.

2. Step 2

   Have a medical professional sign

   Part 2 of the form must be signed by a licensed doctor (MD or DO), physician assistant (PA) or nurse practitioner (NP). A hospice doctor or nurse practitioner can sign, so ask your hospice team. The form also asks whether the person is under hospice care. For the online form, have the signer's email address ready; SCE sends them the signature request.

3. Step 3

   Send it

   Online, it goes when the medical professional signs. By mail, send it to SCE's Medical Baseline Allowance Department at the address on the form.

4. Step 4

   Keep it current

   SCE asks for recertification every two years for a condition that is not permanent and every four years for a permanent one. Keep your phone number and email current with SCE so the outage notices reach you.

Does Medical Baseline keep the power on?

No. Medical Baseline does not stop a shutoff or keep power flowing to your home. What it adds is warning: before a Public Safety Power Shutoff, SCE contacts Medical Baseline customers the way they chose, and if it cannot reach them it says it will send a technician to the door.

Rotating outages are different. The state grid operator orders them in a grid emergency, usually during extreme heat, and they typically last about an hour. SCE says it may have as little as 10 minutes before they start, so a personal warning may not come. Plan as if the power can go out at any time.

Which utility serves your home?

The name of your electric company is on your bill. Each utility sets its own rules; the details here are SCE's unless the row says otherwise.

What is a Public Safety Power Shutoff?

A Public Safety Power Shutoff (PSPS) is when the utility turns off power on purpose, so its lines do not start a fire in strong wind and dry weather. SCE says it starts notices up to three days ahead, then two days, one day and one to four hours before. Sudden wind changes can mean little or no notice.

Anyone can sign up for shutoff alerts by address at scepsps.com, including a son or daughter who lives elsewhere. During a shutoff, SCE opens Community Resource Centers and crew vehicles with charging for portable medical devices, water, ice and Wi-Fi; the locations go on SCE's outage map, usually about a day before.

In Ventura County, 211 Ventura offers PSPS Care Coordination at no charge to SCE customers in high fire risk areas, including people who rely on life-sustaining medical equipment. It connects them with local help before, during and after a shutoff. Dial 211.

What is SCE's Critical Care Backup Battery program?

SCE provides a portable backup battery for a medical device to customers who are enrolled in Medical Baseline, use an electrically powered medical device, and live in a high fire risk area. SCE says delivery, setup and training come at no charge. A contractor calls eligible customers; questions go to 800-736-4777. Customers who do not qualify can look at rebates on portable power stations and generators in the SCE Marketplace.

How do you plan backup oxygen for an outage?

An oxygen concentrator stops when the power stops. On hospice, oxygen and other equipment for the terminal illness come through the hospice, so start with the hospice nurse.

• Ask who the oxygen supplier is, what the backup is if the power goes out, and how to reach the supplier after hours.
• Ask how long each backup tank lasts at the person's ordered flow rate, and how many tanks to keep at home. Tanks do not need power.
• If there is a portable concentrator, ask whether it runs on a battery and for how long. FDA advises checking the instructions or asking the supplier whether a device can run on a battery or generator.
• Keep tanks upright and secured, and at least 5 feet from heat sources, open flames and electrical devices. No smoking, candles or gas lanterns near oxygen; use battery flashlights.
• When power comes back, check that the concentrator's settings did not change.
• Ask the nurse what to do if a powered air mattress or hospital bed loses power.
• If a medicine must stay cold and the power is out for more than a day, call the hospice nurse or the pharmacist before using it.

Is a generator safe?

Yes, but only outdoors. Ready.gov says to run a generator at least 20 feet from windows, doors and attached garages, and to have working carbon monoxide alarms on every level of the home. SCE says never to plug a generator into a wall outlet or wire it into the electrical panel yourself; talk to an electrician, and California law requires you to tell SCE first about a permanent hookup. Never use a gas stove or oven to heat the home.

Why does heat matter for someone on hospice?

Heat is a greater risk for someone on hospice because of age, illness and medicines. CDC says adults over 65 and people with chronic illness are at the highest risk in hot weather, and many medicines, even over-the-counter ones, lower the body's ability to handle heat. Ask the hospice nurse whether any of the person's medicines do, and what to watch for.

Heat waves are also when rotating outages happen, and an outage can stop both the air conditioner and the medical equipment. Decide ahead of time where the person could go if the home gets too hot. If the person cannot safely leave home, call the hospice nurse line to talk through the options.

Where are the cooling centers in each county?

Most centers open only during a heat event, and hours vary by site. Call before you go. Links to each county's page are in the sources at the end of this page.

What should you do about wildfire smoke?

Keep the person inside with the windows and doors closed, and watch the air quality on AirNow's Fire and Smoke Map. AirNow advises a "clean room": one room with a portable air cleaner that has a true HEPA filter, or a home system with a MERV 13 or higher filter. Do not burn candles, fry or broil food, or vacuum without a HEPA filter while the air is smoky.

People with heart or lung disease should check with the nurse before using an N95 mask, because it can make breathing harder. Call the nurse line if breathing gets worse; read more on COPD and lung disease.

What if you are told to evacuate?

Leave right away. Take the medicines, the comfort kit, backup oxygen, the POLST and a phone charger, and tell the hospice where the person is going and how to reach you. SCE and FDA both suggest telling your local fire department that someone at home depends on powered medical equipment; ask whether it keeps a list.

Federal Medicare rules (42 CFR 418.113) require every Medicare-certified hospice to have an emergency plan. The plan must cover power failures and natural disasters, how the hospice follows up with its patients during an emergency, and how it tells local officials about patients who need help to evacuate. Ask the hospice you use what its plan means for your home.

Common questions about power outages and hospice

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