How to prevent utility shutoff for medical reasons

Introduction

If you or someone in your home depends on electricity, gas, or water for health and safety, a shutoff can quickly become a medical emergency. The good news is that many areas have protections for medically vulnerable households, plus programs that can help you catch up on bills.

This guide walks you through practical steps you can take right now, what to ask for, and how to build a backup plan if service is interrupted.

Why utility shutoffs can be dangerous for health

Electricity dependent medical equipment

Some people rely on home medical devices that need electricity to work, such as ventilators, CPAP or BiPAP machines, oxygen concentrators, suction machines, feeding pumps, or power wheelchairs. When power stops, the device may stop, batteries may drain, and routine care can become urgent.

If you use any device that plugs in, it helps to think of electricity as part of your treatment plan, not just a household service.

Temperature control, medication storage, and basic needs

Utility shutoffs can also affect health in less obvious ways:

• Extreme heat can be dangerous, especially for older adults and people with chronic conditions or medications that affect how the body cools itself.
• Cold indoor temperatures increase risk for older adults and can worsen some health problems.
• Some medications and supplies need refrigeration or a stable temperature.
• Loss of water service can affect hygiene, wound care, infection prevention, and safe food preparation.

For many families, the medical risk is not just one device. It is the combination of health conditions, medications, and the home environment.

Act early when you get a shutoff notice

If you have received a disconnection notice, the most important move is to act before the shutoff date. Many protections are time sensitive and may require documentation.

Ask for medical protections using the right words

When you contact your utility or local regulator, ask specifically whether they offer any of the following:

• Medical certification, medical exemption, or medical delay
• Critical care, life support, or medically at risk customer status
• Third party notification, where a trusted person also receives shutoff notices
• Extra notice requirements, special outreach, or in person contact for medically vulnerable customers
• Extended payment plans tied to medical certification or hardship

Rules vary widely by state and by utility provider, and some protections apply only to certain types of utilities. USA.gov notes that disconnection policies can differ by state and may depend on weather, age, disability status, and the provider.

A concrete example of how protections can work:

• Ohio’s administrative rules describe a medical certification process when disconnection would be “especially dangerous” to health or would make necessary medical or life supporting equipment impossible or impractical, and it describes a 30 day protection period tied to certification and a payment plan.

Even if you do not live in Ohio, this gives you a useful script for what to ask about where you live: medical certification, a defined protection period, and a payment arrangement.

Gather the documentation utilities commonly require

Documentation requirements vary, but medical protections often ask for:

• The name of the person at risk and confirmation they live at the address
• A statement from a licensed clinician that loss of service would be harmful, or that medical or life supporting equipment is needed
• Clinician contact information and signature
• A time period for the certification, plus rules for renewal

Some programs allow a clinician to certify by phone at first, followed by written documentation soon after.

If you are requesting protection because of medical equipment, also prepare:

• Device name, model, and supplier contact
• How long the device can run on backup power, if you have it
• What happens if the device stops, even briefly

The FDA’s home medical device power outage booklet can help you organize exactly this kind of information and build a personal emergency file for each device you use.

Keep your request simple and specific

When you call, you can say something like:

• “Someone in my home has a medical condition that would be made worse if we lose electric service.”
• “We use medical equipment that requires electricity.”
• “What is your medical certification or critical care process, and what do you need from our clinician?”
• “Can you pause disconnection while we submit documentation and set up a payment plan?”

Write down:

• The date and time you called
• The representative’s name or ID
• Any case or reference number
• Exactly what documents you were told to submit, and by when

Get help paying the bill before service is interrupted

Medical protections can buy time, but they usually do not erase the balance. Pair protections with a plan to stabilize the bill.

Use energy assistance and crisis programs

Many households qualify for help through the Low Income Home Energy Assistance Program (LIHEAP). USA.gov explains that LIHEAP can help pay heating or cooling bills and may provide emergency services during an energy crisis, and it also explains how to find your state or territory office.

In many states, LIHEAP includes a crisis component for people at risk of disconnection or without heat. For example, Pennsylvania’s LIHEAP information describes both cash grants and crisis grants for households in immediate danger of being without heat.

Some states also describe LIHEAP as help during emergencies such as a utility disconnection. California’s LIHEAP overview page includes emergency or energy crisis assistance and points people to local agencies.

If you are not sure where to start, your state human services agency or community services agency often lists where to apply and what documents you need. Illinois, for example, provides a state program page that explains LIHEAP basics and links to how and where to apply.

Ask about payment plans and billing options

Many utilities offer options that reduce the chance of shutoff by making payments more manageable, such as:

• Extended payment arrangements
• Level billing or balanced payment plans, where bills are averaged across the year
• Due date changes
• Budget counseling or hardship plans

A regulator fact sheet example from California describes pay plans, level billing options, and the idea that additional payment options may be required when termination would be life threatening, with certification by a clinician or similar professional.

Even when protections exist, you often need to enter a payment plan by a certain deadline to keep service on.

Build a backup plan in case service is interrupted

Even if you are doing everything right, shutoffs and outages can still happen due to storms, accidents, or regional emergencies. A backup plan is part of medical safety.

Create a personal emergency file for each device

The FDA recommends building a plan that includes your device details, contacts, backup power options, and what to do when power is lost and restored.

Include:

• Device instructions and manuals
• Your clinician’s contact information
• Your equipment supplier’s contact information
• Your preferred hospital or clinic
• An emergency contact list
• A list of supplies and how many days you have on hand
• Whether any supplies or medications must be kept within a temperature range

ASPR TRACIE’s disaster planning overview for durable medical equipment also emphasizes planning for access to equipment and supplies during emergencies, especially for people using devices at home.

Plan for power and safe alternatives

Think through three layers:

• Short interruption (minutes to a few hours): batteries, charged backup packs, flashlights
• Medium interruption (hours to a day): a place you can go with power, a friend or family member, a community warming or cooling site, or a shelter
• Longer interruption (days): coordination with clinicians, suppliers, local emergency management, or a facility that can support medical needs

If you rely on a life supporting device, do not assume critical care status guarantees uninterrupted power. Ask your clinician and supplier what safe alternatives exist if electricity is unavailable.

Generator safety matters

During outages, carbon monoxide poisoning is a major risk when generators, grills, or fuel burning devices are used indoors or too close to windows. CDC provides clear safety guidance on preventing carbon monoxide exposure during outages.

If you are considering any backup power source, prioritize safety first and ask for guidance from local emergency management if you are unsure.

Food and medication safety

If you have refrigerated medications or temperature sensitive supplies, plan ahead:

• Identify which items must stay cold
• Keep a small cooler and ice packs available if appropriate
• Ask your pharmacist or clinician what temperature range matters most and how long the item can be out of refrigeration

The FDA’s booklet prompts you to plan for portable cooling and to document whether supplies must be kept at a certain temperature.

Caregiver checklist

If you are a caregiver, your role can be the difference between a stressful situation and a medical emergency.

• Check whether the household uses any electricity dependent equipment and whether backup power exists.
• Make sure shutoff notices will be seen quickly, including third party notification if available.
• Help gather documentation and submit medical certification forms early.
• Keep a written plan for where the person can go if power is interrupted.
• During extreme heat, check in at least twice a day and make sure the person can cool down safely.
• During extreme cold, help the person stay warm, safe, and monitored for symptoms.

When to seek urgent medical help

Get urgent medical care or call emergency services if you suspect someone is in danger due to loss of power, heat exposure, or cold exposure.

Examples include:

• Symptoms of heat illness such as cramps, headache, nausea or vomiting, confusion, or worsening weakness.
• Signs of cold related illness such as uncontrolled shivering, confusion, sleepiness, or worsening balance and falls risk.
• Any situation where a life supporting device cannot be used safely.

This article is educational and is not a substitute for medical advice. If you are worried about immediate safety, treat it as urgent.

How Understood Care can support you

If you want help organizing next steps, Understood Care resources that may be useful include:

• Financial support options and benefit pathways: https://understoodcare.com/uc-articles/financial-help
• Help reviewing bills and spotting opportunities to lower costs: https://understoodcare.com/care-types/analyze-bills
• Help applying for assistance programs and completing paperwork: https://understoodcare.com/care-types/application-help
• Care coordination support if medical equipment, suppliers, and services need alignment: https://understoodcare.com/care-types/care-coordination‍

FAQ

• How do I stop an electricity shutoff for medical reasons? Ask your utility about medical certification, critical care status, or life support protections, and submit clinician documentation before the shutoff date.
• What is a medical certification utility shutoff protection? It is a process where a licensed clinician confirms that loss of service would be dangerous to someone’s health, which can delay disconnection for a defined period.
• Do medical baseline programs prevent disconnection? Some areas use medical baseline or critical care status to trigger extra notice or in person contact, but you may still need a payment plan and backup power plan.
• Can LIHEAP help prevent utility shutoff? LIHEAP can help pay heating or cooling bills and may offer emergency support during an energy crisis, depending on your state.
• What if I use an oxygen concentrator or ventilator at home? Build a written backup plan with your clinician and supplier, including battery duration, safe alternatives, and where to go if power is unavailable.
• What should caregivers do if a shutoff notice arrives? Act immediately, help file medical documentation, arrange payment options, and confirm a safe place to go during heat, cold, or outages.

References

• https://www.usa.gov/help-with-energy-bills
• https://www.fda.gov/media/80782/download
• https://www.cdc.gov/natural-disasters/response/what-to-do-protect-yourself-during-a-power-outage.html
• https://www.cdc.gov/natural-disasters/psa-toolkit/avoiding-carbon-monoxide-poisoning.html
• https://www.cdc.gov/heat-health/risk-factors/heat-and-older-adults-aged-65.html
• https://www.nia.nih.gov/health/safety/cold-weather-safety-older-adults
• https://stacks.cdc.gov/view/cdc/41187/cdc_41187_DS1.pdf
• https://empowerprogram.hhs.gov/about-empowermap.html
• https://files.asprtracie.hhs.gov/documents/aspr-tracie-durable-medical-equipment-in-disasters.pdf
• https://www.occ.ohio.gov/factsheet/30-day-medical-certificate
• https://codes.ohio.gov/ohio-administrative-code/rule-4901%3A1-18-06
• https://www.phila.gov/services/water-gas-utilities/water-shutoffs/prevent-water-shutoffs/
• https://www.cpuc.ca.gov/-/media/cpuc-website/about-cpuc/documents/transparency-and-reporting/fact_sheets/overview-of-bill-protections-and-disconnection-of-service-to-residential-gas-electric-customers.pdf
• https://www.pa.gov/agencies/dhs/resources/liheap
• https://www.csd.ca.gov/Pages/Assistance-PayingMyEnergyBills.aspx
• https://dceo.illinois.gov/communityservices/utilitybillassistance.html‍