Greg Santa Maria is the director of public safety at Sanford Health. In this profile, he shares his experience responding to the 9/11 attacks, his role in coordinating evacuations during Hurricane Dorian in Florida and, through it all, his continual process of learning and sharing expertise.
Becoming a first responder
Greg Santa Maria was born in Queens and grew up in Massapequa Park, on the south shore of Long Island. His father was a Marine for 26 years who then went on to work for the Metropolitan Transportation Authority after his discharge. After his father passed away when Santa Maria was 13, he and his two siblings worked together with their mother to keep family traditions alive.
Following his graduation from Farmingdale High School, Santa Maria went to work selling custom car and home stereo systems on Long Island.
In the late 1980s, Santa Maria’s younger brother became a volunteer firefighter in Massapequa and encouraged him to do the same; he did.
Santa Maria helped respond to a motorcycle accident with two critical patients just weeks into his training and felt helpless at the scene. “After what I saw, I pledged to myself that I would never be in that position again, so I went to school and became an EMT,” Santa Maria said.
From there, Santa Maria became an advanced EMT-III and then a paramedic. After working as a paramedic in Queens for a time, a position opened up for the paramedic program director at St. Vincent’s Hospital in Manhattan, and Santa Maria started in that role in January of 1996.
In 1995, there had been a sarin gas attack in Tokyo carried out by the cult movement Aum Shinrikyo. As a result, the U.S. Department of Defense created a three-week immersion program for responding to terrorist attacks in America’s 10 largest cities. Santa Maria became one of 50 people in New York City to be chosen for that training group.
Subsequently, Santa Maria served on the Disaster Preparedness Committee in New York City, which carried out high-level training exercises to prepare New York City to respond to a terrorist attack.
At the same time, Santa Maria trained people at St. Vincent’s to respond to terrorist attacks, but the larger preparedness program that he requested had too high a price tag to be implemented.
Responding to the 9/11 attacks
“Our hospital was the closest trauma center to Ground Zero,” Santa Maria said. “I got off the subway two minutes after the first plane hit.”
While fire trucks were flying by and people had stopped and were all looking downtown, Santa Maria walked out into the street and saw one of the World Trade Center buildings with a big hole in it and smoke coming out.
Santa Maria started up the command center at St. Vincent’s, and shortly thereafter, the second plane hit. They knew then it was no accident; they were dealing with intentional attacks.
This would be no quick response. Santa Maria’s command center at St. Vincent’s remained open for more than three months, 24/7, with workers taking on 12-hour shifts.
“That day changed who I was, and there was never any turning back.”
In early 2002, as interest in how health care systems respond to terrorist attacks rose dramatically, Santa Maria was asked to speak around the country on his experience. The next year, Santa Maria came to Sioux Falls for a trauma conference at then Sioux Valley Hospital where he met Cindy Baldwin, currently the senior executive director of clinical risk and regulatory services at Sanford Health, and interestingly, his current supervisor.
Following the conference, he sent her an email saying that he put South Dakota on his list of places to retire. Baldwin responded, “If you’re serious about that, call me.” This began a conversation between the two about Santa Maria moving to Sioux Falls to take a position with Sioux Valley Hospital and Health Systems.
Developing Sanford Health’s response team
As Santa Maria faced exhaustion from three years of post-9/11 training and constant preparedness work, he seriously considered taking up the Sioux Valley offer. He felt the opportunity to come to South Dakota to find better work-life balance and a better lifestyle was too good to pass up. So he joined Sioux Valley a year later.
Of course, Sioux Valley subsequently became Sanford Health, a much larger organization in greater need of risk management and emergency preparedness. He accepted the position and, on his arrival, created the Hospital Incident Management Team. The goal of this team was to deploy trained personnel to emergencies and disasters within the organization’s footprint.
As Sanford Health grew to include the Fargo, Bismarck, and Bemidji regions, the response team became larger and Santa Maria’s role became ever more important.
Santa Maria helps coordinate statewide training for emergency preparedness in South Dakota. They conduct training and exercises in tornados, epidemiological events like an Ebola or coronavirus outbreak, as well as terrorism and cyberterrorist attacks.
Facing Hurricane Dorian
In September 2018, Santa Maria received a call that there was an emergency situation at Sanford Aberdeen. In responding to that incident, he was forced to overcome his 25-year-long fear of flying. “That particular event changed my life because I started flying again,” Santa Maria said. This would be a necessity in order to respond to Hurricane Dorian in Florida one year later.
Growing up on Long Island, Santa Maria was familiar with hurricanes, and with fear of flying out of the way, he could easily travel to Florida to aid the three Good Samaritan Society locations in a time of potential disaster.
In Florida, they set up three separate responses — one in Daytona, one in Kissimmee, and one in DeLand, using Kissimmee as the Florida operations center, a response structure that was customized by his team on the fly.
In Sioux Falls, his team moved their portable command center from the Sanford Center to the Good Samaritan Society’s National Campus. This created a solid communications link between organizational leadership and Sanford and Society responders on the ground in Florida.
What followed was a series of long days and nights for Santa Maria and his team, as well as many other Sanford and Society staff. “It started to become clear to me that it was my biggest response since 9/11, and it ended as one of the most efficient response experiences I’ve been a part of,” Santa Maria said.
It was a difficult decision, but Hurricane Dorian elevated to Category 5 and had devastated the Bahamas, becoming the worst natural disaster in that country’s history. Working with local emergency management, it was determined that the Good Samaritan Society locations in Kissimmee and Daytona needed to be evacuated immediately.
“It wasn’t the storm itself that was necessarily a problem. Our primary concern was the heavy rain that came with it. Our previous experiences with Hurricane Irma in 2017 taught us that this storm could cause major flooding, however the storm track was uncertain,” said Santa Maria. “Ultimately, we would rather move people to a safer location and be wrong about the flood threat than keep them there and place them in grave danger.”
It was a team decision, it was a unanimous one, and it worked. The team in Florida safely relocated 240 skilled nursing and assisted living residents, as well as hundreds of senior living tenants from both Kissimmee and Daytona.
A month later, Santa Maria returned to take care of after-action work and prepare for comparable future events.
The importance of relationships
“When you have a disaster like that, there’s a relationship that occurs between responders. I think it’s spiritual — you connect at a new level of trust and respect, and you naturally protect each other,” Santa Maria said. He felt like he had a new family in Florida.
“People have to know who you are because they’re much more comfortable working with you if you have a personal relationship with them,” Santa Maria said. “It brings your response to the next level because you’re not just there doing a job — you’re there with family to make sure that everyone is ok. You’re making life-and-death decisions, so they need to know that you can manage whatever comes at you and that they can trust you.”
One of Santa Maria’s favorite sayings about disasters is this: “Disasters are a long-term game; sometimes you hit a grand slam, and other times you get punched in the face. But each time you get up, move on, and you focus on the end of the game, where winning is the only option.”
Santa Maria completed a master’s thesis, focusing on how human physiology and neurochemistry affects decision-making in stressful situations. He wants to be able to identify ways to overcome the initial chemical surges in the body and teach people how to be better decision makers in crisis situations.
Santa Maria is now exploring potential topics for his doctoral dissertation and is strongly considering continuing research along the same lines. He has plans to never retire and sees a potential third career as a college professor, bridging the operational and academic worlds in the education of emergency managers.
At Sanford Health, he already brings in an evidence-based practice model, drawing on academic research in making operational decisions. His team has focused heavily on the World Association for Disaster and Emergency Medicine’s framework to create a model for disaster response and has modeled the current organizational emergency operations plan off of that and other academic and operational research.
“Sanford Health gave me a blank whiteboard and said, ‘Create your dream here,'” said Santa Maria. “We like to fly with no barriers. Let’s explore how to do this.
“We don’t close doors. Everyone’s opinion is valued. I surround myself with people who are creative, outside-the-box thinkers. We debate constantly, listen to each other’s opinions and genuinely respect each other,” Santa Maria said.
Still sharing expertise
Santa Maria has already presented on the Hurricane Dorian response with a colleague from Kissimmee at a national conference. Next year, he and his colleagues will present at several major conferences, sharing their model and conducting an all-day workshop on independent living and long-term care evacuation.
“As we continue to grow and teach people, our practices will be adopted. We get calls from all over the country about the training that we do,” Santa Maria said. “We’re hoping that we can create a snowball effect that produces one standard response model for health care across the United States.”
In his doctoral program, Santa Maria gets to write about the things he does at Sanford Health. He utilizes his continuing education to reflect on past events and improve life here. It’s an ongoing process of learning and teaching, teaching and learning.
Ultimately, he wants to change the response paradigm, making it more effective, and create a model that saves as many lives as possible. After losing many friends and co-workers on Sept. 11, 2001, he strongly believes that losing responders is never acceptable, and his work is focused based on that belief. It has become his calling.
“I wouldn’t trade emergency management for anything. It’s what defines me. There’s no one in this business that doesn’t know that it’s my passion. A profession couldn’t have picked me better.”
Get to know Greg Santa Maria
- Education: State University of New York-Empire State, American Military University, and A.T. Still University of Health Sciences. He has an undergraduate degree in public affairs with a concentration in emergency management and a master’s in emergency and disaster management. He is currently working on a doctorate in health science, with a concentration in global health and politics, and planning to graduate by the end of 2021.
- Family: Greg has two children who followed in his footsteps — son Dominick is a flight medic with Sanford Health, and daughter Samantha is an EMT in Sioux Falls, studying to be a paramedic.
- Hobbies: Captain of an ice hockey team, playing and collecting guitars, spending time with his German shepherd, and continuing his education.
- Evacuated Good Samaritan Society residents return home
- First responders cover it all at Sanford International