1. Understanding the Health System Impact of the Spillover Effect After Hurricane Sandy Thomas Chandler, PhD, Benita Panigrahi, MD, David Abramson, PhD, Jeffrey Schlegelmilch, MBA, MPH, Noelle Gallant, MA

3. Sandy: The 700 Year Storm? Knocked power out for 8 million people 32 ft wave recorded in New York Harbor 3 feet of snow in West Virginia

7. http://ncdp.columbia.edu/microsite-page/hurricane-sandy-october-2012/sandy- recovery-1-year-later/

8. Capacity Competenc y Capability

9. Interviews and Focus Groups

10. Capacity

11. Competency EOC Communication systems not compatible Lack of usage of EOC systems Lack of familiarity with procedures An aging workforce with no sign of backfill Losing institutional memory Concurrent budget cuts

12. Capability: Effective communication among different departments and organizations

14. Emerging Theme “The Spillover Effect” The unintended shift in baseline health system (PH + HCD) dynamics months after recovery from a disaster.

15. Vulnerable Populations Disaster 12 months 18 months Routine needs of vulnerable populations Routine capacity of HSO’s Post-disaster capacity of HSO’s Disaster CM capacity Post-disaster needs of vulnerable populations

17. New York Academy of Medicine, North Shore LIJ, An Opportunity to Innovate: The Aging of Eastern Queens and Nassau County

18. Training Program Continuity of Operations Planning Case Interviewing for Outbreak Investigations Decision-Making & Problem-Solving Under Emergency Conditions Usage of Social Media during Disasters

19. Continuity of Operations Planning “Mission Critical” Protected Redundant – Back up Systems Staff Roles + Organization (ICS) Communication Plan Coordination with Emergency Mgmt + PH Organization & Leadership Communicate Plan Resources Available & Needed Services + Client / Stakeholder Support

20. Online Training ncdp.crlctraining.org

21. Implications 1/3 of all Americans live in counties immediately bordering the oceans The sea level will continue to rise this century and impact storms like Hurricane Sandy

22. The Aging of America