Beacon Christian Community Health Center Presentation shared at the 4/13/23 8th Annual Community Health Care Association of New York State (CHCANYS) Emergency Management Conference held at Baruch College NYC.

1. Sandy to Migrants; How
Preparedness Brings Hope”
Bill Leo, ITCPM, IWLC, FLSE, CLI, EMT
Beacon Christian Community Health Center
April 13,2023

2. Who is Beacon Christian Community Health
Center
• Faith-based, non-profit, community-based health center begun in 2006 – 1st of its
kind in NY State
• Inspired by Tim Keller – “go outside the four walls of the church”
• 20,000 visits/year – primary care, ancillary services
• Whole-person model – integrates physical, mental, emotional, relational and
spiritual health
• Led Staten Island responses to H1N1, Superstorm Sandy, COVID-19 and
vaccination program
• Involved with dialogue on local, state and national levels on issues of healthcare
for the underserved – the “public square”
• Student ministry to over 17 medical, osteopathic, dental, nursing, and other allied
health professional schools in NYC through www.beacon360.org
• 2-Clinical sites, 1-Behavioral Health Site, 1-Woman’s Health Site.

3. Demographics
• NW Corner of Staten Island, in NYC
• Diverse patient population
• Hidden but notable, embedded undocumented community from
mostly Central/South America, Africa, and Indo-Pakistani subcontinent.

4. Area of Service
Mariner’s Harbor, Staten Island

5. In The Beginning
• Before Sandy we had H1N1
• In 2012 the EM planning of the center was minimal
• We had NO written plan
• We Relied on common sense
• We Relied on Community awareness
• We relied on relationships (CHCANYS)
• We relied on Americares.

6. Super Storm Sandy

7. Time To Prepare

8. Hurricane Sandy – October 29-31,2012
Hurricane Sandy hit Staten Island on Oct. 29, 2012, causing massive
flooding, extensive damage, and 24 deaths. The storm coincided with
high tide and affected the island's coastal areas, especially Great Kills
Park and Miller Field. Staten Island has been recovering and rebuilding
from the storm with various programs and infrastructure projects for
storm resilience. Hurricane Sandy was one of the large-scale tragedies
that Staten Island faced this century.

9. Lessons Learned
• PREPARE! PREPARE! PREPARE!
• Know your community
• Know your staff
• Know your partners
• Diversify your voice and data network
• Keep in contact with staff
• Purchase generators
• Planning should be SMART not obvious.

10. Lessons Learned
CREATE YOUR WRITTEN
EMERGENCY MANAGEMENT
PLAN!.

11. Lessons Learned
BEACON CHRISTIAN COMMUNITY HEALTH CENTER
EMERGENCY MANAGEMENT PLAN.

12. Lessons Learned

13. In 2016 along came the great motivator

15. Amend Plans
Emergency management plans must be
updated annually to ensure compliance
with the November 2016 Centers for
Medicare and Medicaid Services (CMS)
Emergency Preparedness Rule.

17. COVID 19
• DOH MPox Exercise a few months prior
• March 13,2020 Beacon Leadership declared a CODE BLACK
• March 16,2020 NYC Schools closed
• Beacon leadership informed all staff non-essential personnel could
work remote
• Beacon Leadership began to use full PPE.

18. Called To Be a “Beacon” on Staten Island post-
COVID-19

19. Called To Be a “Beacon” on Staten Island
• Worked with CHCANYS and Americares
• We worked closely with DOHMH on establishing our vaccine clinics
• We were the first on Staten Island to receive the Moderna vaccine for
distribution
• We did a drive-up vaccination distribution and incorporated food
distribution
• Established walk-up vaccine clinics at the local parks
• Established walk-up vaccine clinics at NYCHA Houses
• Opened one office for Covid-19 ONLY patients and one for NO symptoms,
wellness visits.

20. Technology
• We installed auto temperature monitors for patients and staff at all
doors
• We upgraded hot spots for EMR access at remote vaccine locations
• Brought in a telehealth platform (Chiron)
• Invoked short text for vaccination clinics
• Upgraded security so we could control clinic access only for those
scheduled.

21. Testing & Food Program

22. National Recognitions

23. Testing & Food Program

24. Backpacks & Toys Programs

25. Ongoing needs for COVID-19 recovery on
Staten Island
• Community outreach – food pantry, clothing/gift outreach
• 700+ families served and prayed over to date
• 120+ ongoing spiritual conversations
• Many decisions committing to Christ
• Counseling – both professional and spiritual
• Mental health
• Spiritual care
• Communications: increase awareness of a “Beacon of Hope” to the
community in the wake of COVID-19. Reach and recruit more people
wanting to experience whole person care.

26. DEACTIVATION OF ICS
• February 1, 2023
• Activated Code Normal
• All chairs put back in waiting room pre Covid
• No mask mandated for Patients.

27. Lessons Learned
• We need to maintain PPE that will last a longer duration
• We need to make sure we have adequate storage for surplus PPE
• Track EVERY $$.

28. 20,000 ways to reach Staten Island post-
COVID-19

29. The Migrant Asylee
“Emergency”

30. October 9, 2022
Project Hospitality ask, “CAN YOU HELP US!”.

31. The Late Sunday Afternoon
Call
Project Hospitality ask, “CAN YOU HELP US!”.

32. Who are our patients?
Country of Origins – Honduras & Peru
600 patients, 200 Families.

33. How do we communicate?
Fortunately, we have staff who speak the language and can
translate.

34. Duration?
6 to 9 months or?.

35. Get to the hotel - STAT
Our CMO raided her own medicine cabinet and stopped at
local CVS for supplies

36. Beacon Code Yellow
Mass Casualty/Disaster.

37. MCI – Mass Causality Incident
“an event that overwhelms the local healthcare system, where the
number of casualties vastly exceeds the local resources and capabilities
in a short period of time.” Any MCI can rapidly exhaust available
resources for not only the MCI but the normal day-to-day tasks of the
clinic. Each clinic should institute a surge plan in preparation for
anticipated, progressive, insidious ("notice" events), and sudden-onset
("no-notice" events) disasters occurring within the community.

38. Migrant “A Mass Casualty Situation” or
Equivalent or MCI Lite?
• Many people impacted at once
• Local systems may not be able to handle under normal circumstances
• Problems to face will vary from locale to locale, group to group
• Needs can be, and usually are, overwhelming
• Unsure of what the future holds – need to mitigate/prepare for future
crises.

39. Emergency Preparedness concepts
• Mitigation Phase
• Preparation Phase
• Crisis/Disaster Response Phase
• Recovery Phase.

40. What Did Beacon Do?
• Mitigation
• Basic plan for action
• Background research – know the potential target population
• Frequent updates/pulse check.

41. What Did Beacon Do?
• Preparation
• We “got the call” – 200 families, ~600 people, half of them
children, already and suddenly sent to a hotel complex on Staten
Island by City DHS, there ~1 week already (Oct 2022)
• Situational assessment – who/what/where/when/how?
• Mobilized staff and analyzed assets availability
• Mapped out potential physical facilities and resources
• Hotel complex, available rooms
• Knowing limitations “What can we/CAN’T we do?”
• Resources – “asylees” or “refugees”? What are the rules?.

42. What Did Beacon Do?
• Response
• Set up surge filters based on situational analysis onsite
• Basic triage, care – phases:
• Acute phase – took care of the very sick, hospitalized severe
cases
• Integration phase – got almost 200 kids into NYC education
system working with DOE and DOH, mass vaccinations; TB
screens (10% latent TB+ with a number of “coughers”)
• Established care for all interested – focused on those needing
chronic disease management (Hepatitis, AIDS, Syphilis).

43. What Did Beacon Do?
• Recovery
• Transition patients to getting services at Beacon or handing off
wherever else in the city they ended up
• Cutting back on onsite services as needs are met; can “dial up” or
“dial down” as needed.

44. GOAL
Keep them out of the hospital.

45. Incident Command Structure (ICS)

46. Incident Commander (IC)
• Chief Executive Officer (CEO) – Primary IC
• Chief Operating Officer (COO) Also wears the Chief Technology and
Public Information Officer hats – (Backup IC).

47. Public Information Officer - PIO
Public Information Officer (PIO) - Discussed with staff the policies
surrounding speaking with the press.

48. Liaison Officer
Chief Medical Officer (CMO) - coordinated needs with all including NYC
and Feds as needed.

49. Safety Officer
Chief Operating Officer (COO) – Monitored all safety and security needs
including the dynamics of threats and gangs forming.

50. Hazzard Vulnerability Analysis (HVA)
• Need for security & safety
• Need for reimbursements
• Need for staff
• Need for emergency Medicaid and CHP
• Need for partner help (DOE, DOHMH, CHCANYS, CMS, ABW).

51. Operations Section Chief
Chief Medical Officer (CMO) - The Operations Section Chief is normally
the person with the greatest technical and tactical expertise in dealing
with the problem at hand.

52. Incident Action Plan (IAP)
• Refrigerator for vaccines
• Exam table (Massage table)
• Sheets/Pillows
• Water
• Amenities for staff
• Secure Wi-Fi.

53. Hotel Clinical Room

54. Planning Section Chief
• Chief Medical Officer (CMO)
• The CMO would summarize the day daily as well as hold calls with
specific, and all section chiefs as needed.

55. Logistics Section Chief
Chief Medical Officer (CMO) - The Logistics Section Chief oversees the
provision of all the incident’s support needs—such as ordering
resources and providing facilities, transportation, supplies, equipment
maintenance, equipment fuel, communications and food and medical
services—for incident personnel.

56. ICS – Logistics

57. Identify Needs
• Sought grants (i.e.,Hispanic)
• Sought medical supply donations
• Purchased portable massage tables as exam tables
• Sought water
• Utilized surplus PPE from Covid
• Worked with DOH on temp article 28
• Created special department to track expenses and revenue
• Worked with CHCANYS to understand emergency Medicaid
reimbursements.

58. Finance/Admin Section Chief
• Finance/Administration Section Chief oversees staff responsible for
recording personnel time, negotiating leases, maintaining vendor
contracts, administering claims and tracking and analyzing incident
costs
• CFO – Tracked all expenses and revenue
• Dir. HR – Tracked Staff Time
• Money vs. Mission.

59. Deactivated ICS February 1st
• Returned to code normal
• At Hotel 2 days a week
• Migrants now coming to the center if needed on off days
• The Hotel is now an additional temporary site and will continue due to the
fluidity of the situation
• January the children were enrolled in CHP
• All migrants being NAP’ed and we are receiving wraps
• Migrants are now being seen more at the clinic vs. hotel
• Improved revenue is now being realized thanks to many on Emergency
Medicaid.

60. Lessons Learned
• Light, Fast, Flexible
• Have a clear plan
• Know your boundaries
• Know the target
• Constant connections and collaborations with local/regional/federal
agencies – thanks to NYCDOE, NYCDOH, NYSDOH, HRSA, CMS,
CHCANYS, Project Hospitality, SI elected leaders, nursing colleges, both
local hospitals, elected officials and many others
• Track expenses and resources.

61. Lessons Learned
Develop a surge plan in preparation for anticipated, progressive,
insidious ("notice" events), and sudden-onset ("no-notice" events)
disasters occurring within the community.

62. Closing
• We had a PLAN – We were as PREPARED as we could be
• During Covid we were a “Beacon”
• During the migrant crisis we have become “Hope”
• We have helped so many with whole person care!
• With Sandy it was more spiritual as many lost everything
• With Covid it was very much emotional due to the isolation
• With Migrants its clinical due to the duration of travel and lack of care
from the originating country.

63. We now can plan for what we know
and use lessons learned for what we don’t!

64. From Sandy to Migrants our
Preparedness Has Brought Hope!

65. THANK YOU!

66. THANK YOU!