Nyack Summer 2020

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COVID-19: A PROMISING NEW TREATMENT 3 SUMMER DANGERS PARENTS NEED TO KNOW CELEBRATING 125 YEARS

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Montefiore Nyack Hospital Updates FROM THE PRESIDENT

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century and a quarter ago, visionary leaders and community members recognized the need for a hospital for Nyack and its surrounding communities.

Through their commitment and generous philanthropy, Nyack Hospital became a reality. From those early beginnings and with the ongoing help of countless supporters throughout our 125 years of existence, our hospital has flourished to become the premier academic community hospital in the lower Hudson Valley it is today—Montefiore Nyack Hospital. For the past 125 years, our hospital has been guided by our unwavering commitment to serve the diverse healthcare needs of our evergrowing community.

In this commemorative magazine, we have put together informative content featuring the hospital’s historical timeline and photos blended with our modern-day health articles and medical information. I want to express how incredibly fortunate I feel to be a part of this milestone celebration of an institution with such a long legacy of community service.

Now, 125 years later, as we are all grappling with the “new normal” brought on by the impact of the COVID-19 global pandemic, we can look back on the hospital’s long legacy of caring for our community as we also look forward to making more impactful memories together. As always, our goal is to provide the best possible care with compassion, dignity and respect. I am humbled by this incredible responsibility, yet uplifted on a daily basis to pass a thriving and emboldened Montefiore Nyack Hospital on to future generations. I invite you to visit our special anniversary microsite at montefiorenyack125years.org.

Best regards,

MORE SPECIALISTS. MORE SERVICES. MORE LOCATIONS. HIGHLAND MEDICAL—MORE REASONS THAN EVER. Access care when you need us and where you need us. Highland Medical, P.C., the trusted network of physicians and specialists who have been providing care to our community for years, helps you and your family stay healthy.

CALL 1-866-550-HMPC. FOR A COMPLETE LISTING OF PROFESSIONALS AND SPECIALTIES, VISIT

HIGHLANDMEDICALPC.COM.

CALLING YOUNG ARTISTS

Montefiore Nyack Hospital invites Rockland County residents, ages 5 to 18, to submit an original piece of art for the Pediatric Unit of the new Emergency Department. Submissions will be accepted from now until August 1, 2020. Seven winners will be selected by a panel of judges.

Submissions must be flat and should be sized 8 inches by 10 inches or 9 inches by 12 inches, suitable for fitting in a standard frame. The subject matter may be a theme of the artist’s choice.

Artwork must be original and photography is excluded from the contest.

Entries can be submitted by sending a photo of the piece and a copy of the entry form to publicrelations@montefiorenyack.org. Winning submissions will be announced in September 2020 and winners only will be contacted. To find the entry form and contest rules, visit www.montefiorenyack.org/artcontest.

For more information, email publicrelations@montefiorenyack.org.

Mark Geller, MD President and Chief Executive Officer

facebook.com/MontefioreNyack

@MontefioreNyack

@MontefioreNyack

EDITORIAL STAFF Lauren Malone, Senior Director of Public Relations and Marketing Rose Croke, Marketing Manager Briana Tolve, Marketing Manager Celia Vimont, Contributing Writer

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IN THIS ISSUE

spring/summer 2020

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A PROMISING NEW TREATMENT FOR COVID-19 PATIENTS Convalescent plasma therapy is being used by doctors at Montefiore Nyack Hospital as part of a nationwide study.

THE 411 ON SMARTPHONE INJURIES How to avoid “text neck” and other modern ills.

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NEW PEANUTALLERGY DRUG A new medication can prevent severe reactions to accidental exposure.

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STRONGER TOGETHER, STRONGER THAN EVER Montefiore Nyack Hospital and the people it serves have been partners for 125 years.

Take a trip through our proud history via this anniversary timeline.

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3 SUMMER DANGERS EVERY PARENT NEEDS TO KNOW With schools out of session, unstructured time brings risks. Follow these expert tips to keep kids safe.

MONTEFIORE NYACK HOSPITAL EARNS DISEASE-SPECIFIC CARE CERTIFICATION FOR HIP AND KNEE REPLACEMENT PROGRAM

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he Joint Replacement Center at Montefiore Nyack Hospital has earned The Joint Commission’s Gold Seal of Approval for Hip and Knee Joint Replacement by demonstrating compliance with The Joint Commission’s national standards for healthcare quality and safety in disease-specific care.

This certification recognizes healthcare organizations that provide clinical programs across the continuum of care for knee and hip replacement. The Gold Seal is a symbol of quality that reflects a healthcare organization’s commitment to providing safe, high-quality patient care.

The certification is a testament to the first-class care provided by the entire team at The Joint Replacement Center and to the dedicated hospital staff who are committed to providing an excellent standard of care in a critical patient-based environment.

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A PROMISING NEW TREATMENT

FOR COVID-19 PATIENTS CONVALESCENT PLASMA THERAPY IS PART OF A NATIONWIDE STUDY.

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octors at Montefiore Nyack Hospital are using convalescent plasma—a blood component with antibodies taken from people who have recovered from COVID-19—to treat patients with severe cases of COVID-19.

The hospital is participating in a national, FDA-approved research study on convalescent plasma therapy, organized by the Mayo Clinic and involving dozens of hospitals across the nation.

“Plasma treatment introduces the virus as a foreign body to the patient’s immune system, teaching it that the virus is something it should fight,” explains Michal Tracz, MD, a nephrologist at Highland Medical, P.C. Rockland Renal Associates.

Dr. Tracz is leading the multidisciplinary

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team working on the plasma program, along with pathologist Vandana Hoon, MD, Director, Department of Pathology at Montefiore Nyack Hospital. Early data suggests it could be effective in treating patients with severe cases of COVID-19.

“Until we develop effective drugs or vaccines, this may be our best hope of fighting COVID-19 in our community,” says Dr. Tracz. “One COVID convalescent plasma donation can save the lives of up to three people.”

HOW IT WORKS Convalescent plasma has been used as far back as the Spanish flu in 1918, and has been used on patients with other illnesses, including polio, measles

and SARS, explains Dr. Hoon.

Before donated blood can be used, it must be tested for safety. It then goes through a process to separate out blood cells so that all that’s left is plasma with antibodies.

The immediate goal of this research is to determine if convalescent plasma can improve the chance of recovery for people with the most severe cases of COVID-19. A second goal is to test whether convalescent plasma can help keep people who are moderately sick from getting sicker.

“The treatment takes up to a week to take effect,” says Dr. Tracz. “We’re hoping we see improvement in breathing. We think the most promising candidates

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are patients who are about to go on a ventilator, or who have just been placed on a ventilator.”

Two doctors are evaluating which patients qualify for plasma. Dr. Tracz coordinates with the Mayo Clinic to receive FDA approval to treat the patients, which usually happens within a matter of hours. Once approval is received, Dr. Hoon coordinates with the New York Blood Center to receive the plasma doses.

Currently, the New York Blood Center, which is supplying the plasma, is sending the hospital enough plasma to treat several patients a day. “We’ll be reporting results in four hours, in seven days and again in 30 days after patients receive the plasma,” says Dr. Tracz.

ARE YOU A POTENTIAL DONOR?

The success of the convalescent plasma therapy program hinges on available supply.

If you have recovered from COVID-19, consider donating your plasma. The New York Blood Center coordinates the process.

To donate, you must have documentation of a positive COVID-19 test result and: • be symptom-free for at least 14 days and have a test result showing you’re no longer infected with the virus or • be symptom-free for at least 28 days.

If you’re interested in registering as a plasma donor with the New York Blood Center, visit their website at nybc.org.

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THE 411 ON

SMARTPHONE INJURIES SIMPLE STEPS CAN HELP YOU AVOID “TEXT NECK” AND OTHER MODERN ILLS.

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martphone overuse injuries such as “text neck,” “selfie elbow” and “swiper’s thumb” are becoming more common as people spend hours a day using their phones and other digital devices.

Overuse injuries were a problem in the workplace—and in society at large—long before smartphones and other digital devices were invented. But now that we’re spending so much time on our phones, and social media has become so integral to our personal and professional lives, this type of injury is becoming much more prevalent.

Jason Fond, MD, Director of Orthopedic Surgery at Montefiore Nyack Hospital, explains common overuse injuries related to tech use, and how they can be avoided: TEXT NECK: When you stare down at your phone for long periods, your neck stays in one position, which can lead to muscle spasms and tension. Poor posture from hunching over while you’re looking down adds to neck and back strain.

SWIPER’S THUMB: The technical name for this is de Quervain’s tenosynovitis. If you repeatedly move the thumb up and down or away from your palm—such as when you swipe on your phone—the tendons on the back of the thumb can become inflamed and painful.

SELFIE ELBOW: This is similar to “tennis elbow,” a type of tendinitis that occurs when you experience inflammation in the tendons that run

along the arm from the hand to the elbow. Tendons are cord-like structures that connect bone to muscle. Tendinitis often results from overuse. For example, when you frequently take selfies, extending your arm while also trying to keep a firm grip on your phone, tendinitis can result.

TEXT CLAW: After you’ve been texting for a while, your hand can feel as if it’s been frozen into a claw. The problem can lead to carpal tunnel syndrome, a painful, progressive condition that can cause tingling or numbness in your hand and wrist, as well as a sharp, piercing pain that shoots through your wrist and up your arm.

Carpal tunnel syndrome is caused by pressure on the median nerve, which runs from the forearm into the palm through a small space in the wrist called the carpal tunnel.

TREATMENT OPTIONS A number of non-surgical treatments for digital device overuse injuries are available, including over-the-counter anti-inflammatory medication, wearing a brace, and physical and occupational therapy.

If your hands, wrists or arms hurt from digital overuse, the most important thing you can do is to give them a rest.

If that doesn’t ease the pain, try using over-the-counter anti-inflammatory medication such as ibuprofen to reduce pain and inflammation. You also can buy a brace for your wrist, elbow or hand to provide support.

If those steps don’t help, it’s time to consult a doctor for a medical evaluation. The quicker the problem is addressed, the sooner your symptoms can be reversed or made better. Prompt treatment also reduces the risk that the problem will extend to your shoulder.

Your doctor may recommend corticosteroid injections to provide temporary relief. Some people can benefit from physical or occupational therapy to increase flexibility and

strength in the tendons in the hand, wrist and arm.

Surgery is a last resort if all other treatments fail. Surgery for carpal tunnel syndrome releases pressure on the median nerve. The procedure for tendinitis involves repairing the damaged tendon.

The best way to avoid surgery or other medical treatment is to take breaks from your digital devices. Change your digital habits now, so that a minor irritation doesn’t end up being a major health issue.

TIPS FOR PAIN-FREE USE OF DIGITAL DEVICES To avoid injuries from digital device overuse, follow these guidelines: ✔ Break up your screen time, and give yourself rest periods. Set an alarm to remind you to take a break or shift position. ✔ Gently stretch your wrists and neck. ✔ Change your body position often. Stand up and walk around every half hour. ✔ Keep your shoulders relaxed and your elbows close to your body, with your hands, wrists, forearms and thighs parallel. ✔ When using a computer, adjust your chair height so your feet are flat on the floor and your knees equal to, or slightly lower than, your hips. Consider using a standing desk.

Many people find they help reduce back and neck pain.

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NEW PEANUTALLERGY DRUG: A WAY TO BUILD TOLERANCE ALTHOUGH NOT A CURE, A NEW PEANUT-ALLERGY MEDICATION COULD PREVENT SEVERE REACTIONS TO ACCIDENTAL EXPOSURE.

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he U.S. Food and Drug Administration (FDA) has approved the first oral immunotherapy treatment for peanut allergy in children and teens ages 4 to 17. The treatment gives children who are allergic to peanuts a new option to protect them against accidental exposure, says MaLourdes de Asis, MD, Section Chief of Allergy and Immunology at Montefiore Nyack Hospital.

Peanuts are among the most common food allergies, affecting an estimated 1.6 million children in the United States.

The new treatment, called Palforzia, consists of peanut protein. It should significantly reduce the severity of allergic reactions after accidental peanut exposure, according to Dr. de Asis.

“Palforzia will only be prescribed by allergy specialists, and the child must be enrolled in a special program to have access to the medication,” she explains.

The treatment involves ingesting small and standardized doses of peanut protein, which are increased gradually over months,

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to build the child’s tolerance to peanuts.

Before a child is prescribed the medicine, an allergist will perform testing to confirm he or she is allergic to peanuts, explains Dr. de Asis. If so, the child will be given a small amount of the medication, and monitored carefully over several hours to make sure there is no adverse reaction.

The dose is gradually increased, with careful monitoring by the doctor.

Once a certain dosage is reached without an adverse reaction, the child will go home and continue to take that dose every day. The patient then returns every two weeks to get a higher dose during a monitored office visit, for up to six months.

“The highest dose is equivalent to two peanuts,” says Dr. de Asis.

ONGOING TREATMENT To stay desensitized to peanuts, the child will have to take a daily maintenance dose of Palforzia indefinitely. The drug, in powder form, can be mixed into semisolid food, such as applesauce, yogurt or pudding. “You have to take it after eating

a full meal,” explains Dr. de Asis.

Palforzia can cause stomach upset or vomiting. And even when the treatment is successful, children and their families have to be careful about peanuts. “The treatment won’t allow you to eat a peanut butter sandwich, and you will still have to carry an EpiPen to treat an acute allergic reaction,” says Dr. de Asis.

Despite any potential drawbacks, Palforzia has been welcomed by patients and their families. “For some families, peanut allergy has a huge impact on their quality of life,” explains Dr. de Asis.

“For them, it’s worth it to do this so they don’t have to be anxious about the child having a dangerous reaction to peanuts.”

Another new peanut-allergy treatment, which would be administered through a skin patch, may be approved by the FDA later this year. “This treatment provides a lower level of peanut protein, so it may provide less protection, but it could be a good alternative for kids who can’t tolerate the oral treatment,” says Dr. de Asis.

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PREVENTING PEANUT ALLERGY Recent studies have shown that the early introduction of peanuts to infants at 4 to 11 months of age significantly reduces the risk of development of peanut allergy, especially in infants who are at high risk.

Guidelines issued by the American Academy of Pediatrics suggest that parents should introduce most babies to peanutcontaining foods around the time they begin eating other solid foods, typically 4 to 6 months of age. The guidelines recommend that infants eat about 2 grams of peanut protein (the amount in 2 teaspoons of peanut butter), three times a week.

Don’t give infants whole peanuts, which are a choking hazard.

Infants should get their peanuts in prepared peanut-containing foods such as peanut butter spread on bread or crackers.

High-risk infants—those with a history of severe eczema and/ or egg allergy—should undergo a blood or skin-prick test before being given foods containing peanuts. The test results can help to determine how, or even if, peanuts should be introduced in the child’s diet.

“If a child has mild to moderate eczema, parents can try giving their child peanut butter at home, but if they’re worried about a reaction, they can do it in a pediatrician’s or allergist’s office,” says Dr. de Asis. “If your child has asthma, you may also want to introduce peanut in an allergist’s office, or at least talk to your pediatrician before trying it at home.”

To find an allergy and immunology specialist, visit our Physician Finder at montefiorenyack.org or call 845-353-9600 for more information.

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STRONGER TOGETHER, STRONGER THAN EVER MONTEFIORE NYACK HOSPITAL AND ITS COMMUNITY HAVE BEEN PARTNERS FOR 125 YEARS. ON THESE PAGES, TAKE A TRIP THROUGH OUR PROUD HISTORY. 10

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uring the COVID-19 crisis, Montefiore Nyack Hospital and its community have been united as never before. As healthcare providers, staff and administrators work tirelessly to give care and find new treatments, the community has been providing donations—of masks, equipment, money and meals—as well as moral support. Parades by first responders and car clubs; musicians playing for staff at shift changes; messages of support staked on lawns and chalked on the sidewalk; and “hugs for helpers” cards and artwork from children have lifted our spirits and renewed our energy. Truly, we are all in this together.

That partnership has been strong from our earliest days as Nyack Hospital. As we prepare to recognize the 125th anniversary of our founding, we reflect on how we started and how far we’ve come— and look forward to an even brighter future.

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1895

THE BIRTH OF OUR COMMUNITY HOSPITAL NYACK HOSPITAL IS INCORPORATED “The necessity of conveying persons from this place or vicinity to New York city for surgical operations or any hospital treatment was so firmly realized that a number of public-spirited citizens met together in 1894 and seriously considered the advisability of making hospital facilities here …,” according to a history of the time. Initial funds were raised in the summer of 1896 by a “Kirmess,” a festival that drew inspiration from medieval merrymaking. It was the first of several such fundraisers held under the direction of philanthropic organizer Miss Lila Agnew Stewart.

1900

HOSPITAL DOORS OPEN

1926

In the early years, Nyack Hospital used a horse-drawn ambulance, but by 1919 it acquires its first motorized vehicle, a shiny modern ambulance. By then, the hospital also has constructed a Nurses Home to house its growing staff.

A three-story addition begun in 1926 eventually increases Nyack Hospital’s capacity to 80 beds. During these years, an impressive group of attending physicians and staff (shown above, right) treats ever-growing numbers of patients. The hospital continues to benefit from the strong support of the community, including the newly organized women’s groups The Dioko Society and the Pearl River Branch of the Women’s Auxiliary.

REVVING UP

1930s-1940s

The brand-new Nyack Hospital is a two-story structure with nine beds, a reception room, an operating room, a nurse’s parlor and a dining room.

Room rates are $7 per week in the ward and $12 per week in the sole private room. Local women play a key role in funding and supporting the hospital though the Women’s Auxiliary.

1919

AN AMBITIOUS ADDITION

ROOMS TO GROW Through the 1930s and 1940s, new services as well as upgraded amenities are available for patients. By 1930, 1,295 babies have been born in the nursery at the newly expanded hospital (bottom).

The number of private rooms (top left) had increased. Visitors were greeted by a stylishly appointed main lobby and could meet patients in a light-filled sun porch (top right). And by 1940, the hospital could boast three dental operating rooms.

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1950s THROUGH 1990s: EXPANDING TO SERVE THE COMMUNITY 1957 ALWAYS ON CALL

1964

BABY BOOM

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THE DEBUT OF THE ICU

By 1964, Nyack Hospital has 164 beds and 22 bassinets. That year, 7,370 patients are admitted and 839 babies are born in the hospital. In 1968, a Premature Nursery Center is opened.

CORONARY CARE UNIT OPENS A brand-new, three-bed Coronary Care Unit is created to provide meticulous monitoring of patients with serious cardiac problems.

The hospital opens a new Intensive Care Unit for specialized, around-the-clock monitoring, thereby expanding patient care and offering additional opportunities for nurse training.

1971

The hospital switchboard is a lifeline to the community, providing 24-hour call service.

By now, the hospital’s Ambulance Corps has acquired two modern, well-equipped ambulances, responding to more than 900 calls each year. More than eight in 10 of those the Corps attends are brought to Nyack Hospital for Treatment.

1968

1973

FAMILY PLANNING CENTER LAUNCHES The new Family Planning Center opens to provide education about reproductive health for members of the community.

MORE BEDS AND BASSINETS The addition of the M. Montgomery Maze Pavilion, shown here under construction, increases capacity to 323 beds and 27 bassinets.

1976 PEDIATRIC INTENSIVE CARE UNIT OPENS The completion of this unit enables the hospital to eliminate unnecessary patient transfers from Rockland County to New York City.

1978

AREA RESOURCE HOSPITAL DESIGNATION

Nyack Hospital is one of six hospitals in the seven-county Hudson Valley Region given this designation, due to its total care capabilities for seven categories of emergencies: behavioral, burn, cardiac, highrisk, infant, poison, spinal cord and trauma.

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1979

TENS OF THOUSANDS SERVED In 1979, the hospital admits 15,074 patients; 32,916 people visit the Emergency Room; 1,280 babies are born at the hospital; and 4,538 phone the Poison Control Center.

1981

BIG PLANS FOR EXPANSION

1985

NEW PAVILIONS OPEN

1987

MORE PEDIATRIC SERVICES

On August 7, a celebration is held for the long-awaited five-story addition, including the Johnson Pavilion and Doctors Pavilion.

Magnetic Resonance Imaging (MRI) and a new Computed Tomography (CT) scanner are now in use at the hospital.

1999

1995 On June 17, Nyack Hospital celebrates “100 Years—A Century of Caring” with a health fair, parade, bed race, band concert, fireworks and more.

ENHANCED IMAGING

The Costello Intensive Care Nursery and the Raso Diagnostic Center open, expanding both the Pediatric Department and the Pediatric Residency Program.

Ground is broken for a five-story tower to expand Emergency, Critical Care, Pediatric and Radiology services.

HAPPY 100th ANNIVERSARY!

1993

CANCER CENTER OPENS

SAME-DAY SURGERY The Ambulatory Care Center for same-day surgery opens, using the latest medical practices to allow many patients to recuperate at home.

In November, Nyack Hospital opens the state-of-the-art Union State Bank Cancer Center, bringing advanced and comprehensive cancer care under one roof in Rockland County.

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21st CENTURY: THE FUTURE OF HEALTHCARE IS NOW 2008

FAST SERVICE IN THE ED

2013

2014

The Prenatal Center and the Wound Care Center open.

The Behavioral Health Center, The Infusion Center, the Judith Trust Assessment Center and The Rapid Decision Unit open.

EXPANDED PRENATAL AND WOUND SERVICES

NEW MEANS TO HEAL MIND AND BODY

2016

2015

The hospital’s Emergency Department is the first in the region to implement a 30-minute service standard.

COMPREHENSIVE CARE FOR MS The hospital’s Madlyn Borelli Multiple Sclerosis Center is dedicated.

2018

A PARTNERSHIP FOR PATIENTS

ANOTHER TRANSFORMATION BEGINS The hospital breaks ground for its Care Transformation Project, which will include a new Emergency Department and Medical Village.

2019

SAFER SENDOFFS

On June 14, the hospital celebrates “Montefiore Nyack Day” in recognition of its official affiliation with the Montefiore Health System.

The Transitional Care Unit opens, providing continued care to help patients with a safe return home or to a skilled nursing facility.

2020

EXPERT CARE FOR COVID-19 PATIENTS A portion of the new Emergency Department was opened to treat the influx of COVID-19 patients requiring ICU care.

At Montefiore Nyack Hospital, the battle continues for the hundreds of direct care providers who are putting their lives on the line every day—to save lives. Our heartfelt thanks go to those who have already generously donated, but we still need to reach our goal of $200,000. If you can, please take a moment now and donate to our COVID-19 Crisis Fund by going to montefiorenyack.org/donate-now.

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SUMMER DANGERS EVERY PARENT NEEDS TO KNOW

WITH SCHOOLS OUT OF SESSION, UNSTRUCTURED TIME BRINGS RISKS. FOLLOW THESE EXPERT TIPS TO KEEP KIDS SAFE.

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or medical professionals who specialize in trauma—the treatment of severe or life-threatening injuries—the summer months are considered “trauma season,” especially for children and teens, now out of school.

Jennifer Pastiglione, MSN, RN, APN, Trauma Program Manager at Montefiore Nyack Hospital, outlines three major concerns, and how to help kids stay safe.

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TEENS, TEXTING AND DRIVING. Cell phones are a huge distraction for teenage drivers. Tell your teen to turn off their phone or put it on silent when they get in the car. Do your part: Don’t text or call your teen when you know they’re driving.

If your teen needs to use the smartphone for directions, make sure they program it and set up the phone

before they start driving.

Check the Apple or Google Play app stores for “safe driving” apps that prohibit texts and calls from going through while a person is driving. Some apps will send messages telling people that you’re currently driving and will call them back when you arrive.

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KIDS LOCKED IN HOT CARS. Parents think they would never forget their child is in the car and leave them locked in during the summer heat. However, statistics show this potentially fatal situation happens to families from all walks of life. Kids are usually forgotten in cars while their parent or guardian runs an errand or even attends an event.

These three steps can help you avoid accidentally leaving your child in the car: • Make it a routine to open the back

door every time you park.

• Leave something important in the back seat, such as your pocketbook, your cell phone or a lunchbox. Or take off a shoe and put it in the back.

• Place a stuffed animal in the car seat.

When you put your child in the car seat, put that stuffed animal in your passenger seat. Buckle the stuffed animal in to serve as a reminder.

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BIKE-ACCIDENT INJURIES. Young people (and adults, too) can keep safe while biking by: • Always wearing a helmet, and making sure it’s a good fit.

• Being vigilant while riding in order to prevent falls. Pay attention to your surroundings, and don’t be distracted by using your cell phone.

• Having a headlight on your bike for the dusk and evening hours. Bright or reflective clothing also can help.

Montefiore Nyack Hospital is the only American College of Surgeons verified Level III Trauma Center in Rockland County. Learn more at montefiorenyack.org/trauma-center.

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160 North Midland Avenue Nyack, NY 10960

SAVE THE DATE

34TH

ANNUAL GOLF CLASSIC TO BENEFIT MONTEFIORE NYACK HOSPITAL

MONDAY AUGUST 31, 2020 FOR MORE INFORMATION, CALL 845-353-3333

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