On Oct. 29, 2012, Superstorm Sandy slammed into the eastern seaboard of the U.S., decimating parts of New York and New Jersey while extending its reach of destruction as far north as Canada and as far south as North Carolina. But for the healthcare industry, New York City served as a microcosmic example of what can happen to a healthcare system under the worst of circumstances—both the good and the bad.

And to prevent a large part of the bad from happening again, Mayor Michael Bloomberg rolled out a $20 billion plan to strengthen building standards and backup power requirements to protect the city from hazards of climate change. “Another Sandy is inevitable, and New York isn’t ready. But it can be,” said Russell Unger, executive director of the city’s Urban Green Council and chair of the Building Resiliency Task Force, in a press release. His task force was charged with outlining steps to fortify the city against future weather threats.

When Sandy struck, five acute care hospitals and one psychiatric hospital were closed, resulting in the emergency evacuation of almost 2,000 patients, according to the task force’s report. These cascading closures of providers during and after the storm strained the system citywide. Hospitals that remained open were forced to operate beyond normal capacity, which was difficult to sustain for long periods of time and managed by reducing services like non-emergency surgeries or outpatient procedures.

To complicate matters even further, the report states, disruptions to other citywide systems—transportation, fuel, telecommunications, and power—had their own affect on healthcare, from power outages to transportation restrictions limiting employees from getting to work.

Overall, the report says an estimated $1 billion in costs can be associated with emergency response measures during and immediately after Sandy, with another $1 billion estimated will be needed for repairs and mitigation at damaged healthcare facilities.

To alleviate a bulk of these complications when the next big storm inevitably hits, the city’s report includes several recommendations focused on healthcare specifically. Here’s a closer look at the 12 initiatives outlined:

  1. Construction codes will require a higher level of protection and critical systems redundancy for hospitals built in the 500-year floodplain.
  2. By 2030, existing hospitals must meet a subset of the construction codes through building retrofits.
  3. Three public hospitals (Bellevue Hospital, Metropolitan Hospital, and Coney Island Hospital) were identified as being at-risk of flooding due to storm surge, and the city will aim to ensure their EDs are protected and available in the case of a weather event.
  4. New nursing homes and adult care facilities must be built with additional resiliency measures for emergency power systems so staff and patients can shelter in place during disasters.
  5. Nursing homes in the 100-year floodplain must meet standards by 2030 for the protection of electrical equipment, emergency power systems, and domestic water pumps.
  6. Existing adult care facilities in the 100-year floodplain must elevate or protect electrical equipment and install an emergency generator.
  7. Funding will be made available to assist with upfront costs of certain mandated retrofit projects at nursing homes and adult care facilities.
  8. To reduce the risk of forced evacuations during power outages in hot summer months, funding will be available for installation of emergency power solutions at nursing homes and adult care facilities.
  9. Funding will be disbursed to support emergency operations plans for providers that serve large outpatient populations in communities where medical services may be reduced significantly during disasters.
  10. Assistance will be provided to help pharmacies reopen quickly after a disaster.
  11. A best practice guide and outreach plan will be developed to help community-based providers understand the importance of telecommunications resiliency and options available.
  12. Ways to use electronic health records to prevent permanent loss of data and quickly restore services after a disaster will be identified.

While specific to the New York metropolitan area, the responses to very real weather threats may offer sparks of inspiration for disaster preparation in plenty of other parts of the country. Read the full healthcare section of the report at http://on.nyc.gov/11PdEri.