The smaller islands of the archipelago of New York City (NYC) have built heritage that reflects the history of quarantining undesirable and vulnerable populations in institutions such as hospitals, asylums, and prisons. North Brother Island (NBI) in the East River is one such place, home to Riverside Hospital and other institutions from 1885-1963. The NYC archipelago is vulnerable to multiple effects of climate change including sea-level rise, shoreline erosion, increased flooding, and storm surge. In order to confront the dangers that climate change presents to the built heritage on NBI, a hybrid approach of preservation interventions and landscape architecture strategies are needed. Using a values-based preservation approach as the foundation, I developed a projective design to address shoreline erosion, building stabilization, selective deconstruction, and public access to NBI, which is currently managed as a bird sanctuary. I have designed a low energy tidal zone on the rapidly eroding northeastern shore of the island using constructed reefs. The area of the island where colonial wading birds have nested is protected from human access with a dry-laid masonry wall. Both the reef and wall are constructed with debris recycled from buildings on the island that need to be deconstructed due to instability. The forestry strategy augments the existing vegetation on site and uses salt tolerant species in the meadow, woodland, scrubland, and wetland, which will all be increasingly inundated as sea-levels rise. The design solution will allow for limited and seasonal access to this island with a rich and important quarantine history.