Assisting One Applicant At A Time

1

Disaster Case Management

• Assisting One Applicant At A Time

2
Disaster Case Management

• WHAT IS DISASTER CASE MANAGEMENT?
• Disaster Case Management is a partnership
  between the provider and the client who together
  develop a comprehensive disaster recovery plan.
• The plan assesses, organizes, coordinates and
  monitors the services and resources that address
  disaster-caused unmet needs and outlines the
  steps necessary for the individual or family to
  recover from the disaster.

3
Disaster Case Management

• Through this partnership, disaster case managers
  assists applicants to gather the resources
  necessary to accomplish their disaster recovery
  plan.
• When the difference between insurance
  assistance, federal/state assistance and personal
  resources versus the verified disaster-caused
  damages are inadequate, the term unmet needs is
  used to describe the deficit.

4
Disaster Case Management

• Disaster Case Management is not a new concept.
  For over 15 years voluntary agencies have been
  organizing, training, and implementing a system
  to provide this service.
• Case Managers traditionally have been unpaid
  volunteers who give their time to assist others
  who have been impacted by the disaster.

5
Disaster Case Management

• Katrina Aid Today
• October 2005 through March 31, 2008
• 68 million for a National Consortium of nine
  agencies to assist survivors
• 783 case managers provided 141M in disaster
  assistance services to over 70,000 households in
  34 states
• Cora Brown funded Bridge Case Management Program
• April 1, 2008 through May 31, 2008
• Extension that assisted former KAT agencies in
  completing remaining open cases from the KAT
  program
• Assisted 1,173 households

6
Disaster Case Management

• PKEMRA
• Congress passed the Post-Katrina Emergency
  Management Reform Act of 2006 (PKEMRA) Section
  689f (Section 426, Stafford Act) Case Management
  Services
• that the President may provide case
  management services, including financial
  assistance, to State or Local government agencies
  or qualified private organizations to provide
  such services to victims of major disasters to
  identify and address unmet needs.

7
Disaster Case Management

• Disaster Case Management Pilots
• PURPOSE
• To develop a system that provides federal
  funding, in partnership with the impacted state,
  and local agencies to carry out a collaborative
  Disaster Case Management program that will assist
  individuals and households affected by a
  federally declared IHP disaster
• Three models of DCM
• Early response for immediate needs
• Short term casework for housing and job placement
• Long term recovery case management
• FEMA has funded five DCM-Pilot programs

8
Disaster Case Management

• State Disaster Case Management Pilot Program
• June 1, 2008 to June 1, 2009
• Focused on FEMA Temporary Housing Units
• State Case Management Structure
• FEMA provides program guidance for proposal
• State applies for funding via proposal
• Lead Agency provides program oversight
  standardizes case management, coordinates
  communication, and distributes funds
• Service provider provides case management
  services and ensures recovery objectives are met
• Best practices and lessons learned are captured
  for future program development

9
Disaster Case Management
10
Disaster Case Management

• MCMC Structure
• Three Tiered management approach
• Tier I-MCMC/MCVS (leadership staff)
• Provides direction and leadership of project,
• support to field management staff
• Tier II-MCMC/LESM (field management staff)
• Main point of contact for affiliates in the field
• Tier III-Affiliates (affiliate level staff)
• Implement program and provide client services

11
Disaster Case Management

• Program Target
• To ensure that clients of Hurricanes
  Katrina and Rita with remaining Disaster-caused
  housing needs transition from FEMA supported
  temporary housing to a permanent and sustainable
  housing solution.

12
Disaster Case Management

• How do we achieve our target?
• Mission Statement
• The mission of the Mississippi Case Management
  Consortium is to deliver high quality disaster
  case management services to clients who meet
  eligibility criteria by focusing on the case
  management processes of assessment, planning,
  advocacy, linking and monitoring.

13
Disaster Case Management

• Where do we serve?
• Statewide program utilizing a consortium of
  affiliate organizations that communicate,
  collaborate, coordinate, and cooperate in their
  efforts to provide high quality disaster case
  management services
• Consortium includes affiliates who provide
  specialized services to individuals with
  disabilities and other special needs, as well as
  to those who require language assistance.

14
Disaster Case Management

• Who do we serve?
• Eligible clients include individuals with
  remaining disaster caused housing needs who are
  currently residing in FEMA funded housing
  including travel trailers, hotels/motels, mobile
  homes.
• Affiliates will receive a list of cases that
  they are to serve, from MCMC, based on
  information provided by FEMA to consortium
  leadership. Cases will be assigned based on
  affiliate capacity, geography, and information
  provided by each affiliate concerning their
  current caseload rosters.

15
Disaster Case Management

• Unique Elements
• Disaster Case Managers-caseload target, 25
• Estimators-each affiliate has allocation of
  funding for estimators to be used in the case
  management process.
• Standardized processes-staffing, budgets, forms,
  reporting
• CAN-coordinated assistance database for client
  data tracking
• Coordination with HUD/DHAP
• Support Staff-leadership and field management
  staff will act as a resource to the affiliates
  implementing the program.
• CMPS, CMAs, ME, Finance, Estimator, PR,
  website, volunteer specialist, government
  liaison/advocacy
• Nearly 400 employees including case managers,
  supervisors, estimators, administrative support
  staff

16
Disaster Case Management
17
Disaster Case Management

• ACF Disaster Case Management Pilot
• Administration for Children and Families Office
  of
• Human Services Emergency Preparedness and
  Response (OHSEPR)
• Jim Davis, HHS/ACF

18
Disaster Case Management

• ACF Pilot Project Principles
• HHS former Secretary, Michael Leavitt envisioned
  a disaster case management program that would
  return citizens and communities to their
  pre-disaster capabilities and lay the foundation
  for future improvements.
• Self-sufficiency
• Self-Determination
• Flexibility and Speed
• Support for States
• Federalism
• Catholic Charities USA envisioned a human dignity
  model.

19
Disaster Case Management

• Key Components of Disaster Case Management
  Programs
• Integrates with existing state, local, and
  voluntary programs.
• Augments existing programs to fill gaps in needed
  services.
• Deploys quickly to disaster impact scene.
• Scales to any size disaster, particularly if the
  affected area encompasses multiple states.
• Is based on the principles of self-determination,
  self-sufficiency, federalism, flexibility and
  speed, and support for states.

20
Disaster Case Management

• ACF Pilot Project Objectives
• Develop a model program that will augment
  existing state capability to perform disaster
  case management and casework following a Major
  Disaster Declaration under the Stafford Act.
• Develop the guidance for disaster case management
  in consultation with Voluntary Agencies,
  Non-Governmental Organizations, and Federal
  partners.
• Monitor and evaluate, state and local community
  progress.
• Develop, implement, and refine Disaster Case
  Management best practices.

21
Disaster Case Management

• ACF Pilot Project Objectives
• Abt Associates Review existing best practices,
  including
• disaster case management training curricula,
• training requirements, and
• develop a training program that meets the needs
  of the model disaster case management program.
• Catholic Charities, USA Identify a cadre of
  trained personnel who are available to respond to
  a disaster within 72 hours.
• Catholic Charities, USA Test and assess the
  feasibility and value of the model disaster case
  management program.

22
Disaster Case Management

• Key Components of the ACF DCM Model
• Deploys within 72 hours following FEMA
  notification
• Includes a three-tiered system of National,
  Regional and Local providers (client to case
  manager ratio is 351)
• Uses an electronic case management database and
  resource tracking tool
• Involves active outreach specials needs
  populations
• Encourages connection to existing social
  services, disaster resources, medical and mental
  health resources
• Enrollment is limited to 6 months total program
  is 18 months.

23
Disaster Case Management

• 2-Week Pilot Timeline (2008)
• September 1
• Gustav makes landfall along the Louisiana coast
  as a Category 2 hurricane. 1.8 million residents
  evacuate the southern parts of Louisiana,
  Mississippi, and Alabama.
• September 2
• The President makes a Federal disaster
  declaration for Louisiana, including an
  Individual Assistance (IA) declaration for 43
  Louisiana parishes.
• September 3
• FEMA receives a request from Louisiana for the
  DCM Program. ACF notifies Abt to activate
  program 4pm.

24
Disaster Case Management

• Timeline Continued
• September 4 5 (Pilot Days 1 -2)
• National Team Coordinator in Louisiana prior to
  landfall.
• Regional Team members gather in Baton Rouge, at
  the Joint Field Office (JFO).
• Human Services Team Members begin deploying to
  the affected area.
• September 6 (Pilot Day 3)
• 16 Regional Team members and 6 other observers
  attend an all-day training program at the JFO.

25
Disaster Case Management

• Timeline Continued
• September 7 (Pilot Day 4)
• The Regional Team begins to provide disaster case
  management services to Gustav individuals
  adversely impacted by the disasters.
• September 8 17 (Pilot Days 5 14)
• The Regional Team, along with the Catholic
  Charities Baton Rouge local affiliate, continue
  to provide disaster case management services.
  Over the two week pilot test period, 647 client
  cases, involving a total of 1,924 individuals,
  were opened.

26
Disaster Case Management

• Timeline Continued
• September 12
• Hurricane Ike makes landfall near Galveston (TX),
  but still causes significant flooding and other
  damage in southern Louisiana area previously
  affected by Gustav.
• September 15
• The U.S. Public Health Service Commissioned Corps
  Officers started deploying to serve as additional
  disaster case managers.

27
Disaster Case Management

• New Beginnings Outreach
• Operation Hope
• Society Saint Vincent De Paul Baton Rouge
• Terrebonne Readiness and Assistance Coalition
• United Way of Acadiana
• Volunteers of America Greater New Orleans

• NRC Local DCM Agencies
• Advocacy Center
• Catholic Charities, Baton Rouge
• Catholic Charities Lake Charles
• Catholic Charities New Orleans
• Family and Youth Counseling Agency
• ICNA Relief
• GRACE Community Services

28
Disaster Case Management

• Affected Population
• Data as of April 30, 2009 identifies the
  following
• 6,816 open cases
• 779 cases closed
• 18,320 individuals assisted
• 26 of all cases are reporting disabilities.
• 40 are children under 18 years of age.
• 78 of open cases are heads of households between
  the age of 18-61.
• 21 of open cases are heads of households over
  age of 62.

29
Disaster Case Management

• Affected Population Continued
• 46 report an annual income of less than
  15,000/year.
• 18 report an annual income between
  15,000-30,000/year.
• 6 report an annual income over 30,000/year.
• 30 not reporting income.
• 74 female head of household.
• 23 male head of household.
• 21 report head of household as single female
  parent.

30
Disaster Case Management

• Major Strengths
• The DCM Program initiates services within 72
  hours of activation.
• Validation of the importance of starting DCM
  services as soon as possible after the disaster.
• The appropriateness of the three-tiered staffing
  framework.
• Use of volunteers as program support and subject
  matter experts.
• Linkages to healthcare, human services, mental
  heath and disaster related services.
• Outreach provided to special needs populations.
• Call center serves as point of intake for
  clients.

31
Disaster Case Management

• Primary Areas of Improvement
• Pre-identified National Team members were not
  deployed by the National Partner to the disaster
  site.
• Pre-capacity building of voluntary agencies is
  needed to boost staffing and pre-train.
• Need for POCs (to connect services) and
  pre-disaster capacity building.
• Lack of resources (i.e., few community donations)
  with regards to housing, utilities and food
  assistance.

32
Disaster Case Management

• Next Steps
• Awaiting approval of capacity building funds and
  approval from FEMA.
• ACF is awaiting results of After-Action Review of
  DCMP contracted by FEMA.
• ACF is in the process of funding a Small Business
  Innovative Research Idea to enhance IT platform.
• Lessons learned are being applied to glean best
  practicesongoing.
• ACF is collaborating with FEMA to establish a
  joint management team.

33
Disaster Case Management
34
Disaster Case Management

• Moving Communities from Coordination to
  Collaboration
• CAN serves its initial goals
• Reducing the burden on agencies and clients by
  supporting a common operating system
• Providing tools to move from coordination to
  collaboration
• Building on the core strength of client
  information tracking
• CAN is seen as a platform for extending successes
  to the continuum of disaster recovery activities.
• The Client and their record becomes the central
  hub for managing a variety of relationships
  along a timeline of recovery.
• Providing a platform for sharing information for
  emergency assistance, community assessment,
  recovery case management and reconstruction,
  mitigation, and preparedness
• Facilitating and supporting the adoption of
  standards amongst organization and their vendors.

35
Disaster Case Management

• Benefits of a Shared Platform
• The shared platform prompts or enables
  communities to move from coordination to
  collaboration
• Requires adoption of common operating procedures
• Promotes development of standards
• Results in consistent and comprehensive set of
  services for clients along a continuum of care.
• Example Communities
• Katrina Aid Today
• Sarasota COAD
• San Francisco CARD
• Mississippi Case Management Consortium
• Disaster Case Management Pilot- Texas

36
Disaster Case Management

• Continuity of Information Sharing
• Information collected at each phased of the
  disaster is available to organizations to promote
  continuity of services, reduce duplication of
  effort, and decrease the burden on the client.
• The connection between ARC and CAN participating
  agencies ensures data collected during the
  response phase is available to organizations
  active in the recovery phase.
• Shared access to all individual records within a
  disaster
• Establishes baselines for eligibility
• Promotes on-going information sharing and
• Prevents silos of information.
• Assignment of cases to agencies/case managers
  encourages collaboration to meet client needs.
• Use of a common resource database to describe
  services provided establishes consistent method
  for categorizing services delivered.

37
Disaster Case Management

• Broadening Information Sharing
• Needs Assessments
• CRWRC- Community and individual assessments of
  rebuilding needs
• Coordinated Intake Process
• 2-1-1 based intake and referral to case
  management services
• Long term recovery committees and unmet needs
  tables
• Building a case for integrated support tracking
  activities and progress.

38
Disaster Case Management

• Broadening Information Sharing
• Volunteer Effort
• Tracking volunteer activities
• Attributing contribution of volunteer hours to
  individual clients
• Rebuild Management
• Detailing client rebuild needs and estimating
  resources to complete rebuild.
• Tracking individual client rebuilds.
• Attributing resources and hours to individual
  clients.

39
Disaster Case Management

• Supporting Standards for Information Sharing
• Business Process
• Common method for collecting and identifying
  client related information
• Disaster Client Data Standard
• Integrating National VOAD case management
  standards
• Development of standard disaster case management
  client forms
• Common method for collecting and identifying
  disaster related resources.
• Partnering with AIRS to create a disaster
  resource taxonomy
• Engaging with partners to integrate a disaster
  taxonomy within practices
• Promoting the operating model of 2-1-1s
  collecting disaster response and recovery
  resources.

40
Disaster Case Management

• Supporting Standards for Information Sharing
• Technology Implementation
• Common method for collecting and identifying
  client related information
• Client data exchange and synchronization standard
  between software vendors
• Client data import tools
• Common method for collecting and identifying
  disaster related resources
• Promoting implementation and use of AIRS
  standards for data exchange between vendor
  systems

41
Disaster Case Management

• What Do Users Say?
• Why is CAN is worthwhile
• When agencies enter the necessary information, it
  is convenient to find all information on a client
  in one database instead of surfing several.
• CAN minimizes questions asked, which I feel puts
  the client at ease.
• CAN helped to verify information about the client
  and tracked clients recovery.
• CAN helps me to stay organized.
• CAN helps me to maintain the records I keep on
  the client and to manage a large number of case.
• I know where my clients stand and what their
  needs are without putting them through the mill
  over and over again.

42
Disaster Case Management

• What Do Users Say?
• What are the greatest benefits of the CAN
  technology
• Accessibility to client records across multiple
  agencies.
• The ability to see if clients have received
  assistance through other agencies, to control the
  duplication of services.
• Coordination of services no matter where the
  client is (pre or post disaster).
• Increase speed faster results for clients,
  faster method for getting client history, for
  sharing information, for tracking clients.
• In addition to sharing client information, it
  improves the ability of agencies to convey what
  they have to offer to others, too.
• Intra-agency case management.
• Record keeping, access to and ability to produce
  reports.

43
Disaster Case Management

• After Action Review
• Contract awarded to Alon, Inc. to review
• Program implementation process
• Financial outcomes
• Proposed objectives
• Documented comments from stakeholders
• Documented best practices and lessons learned
• FEMA will develop a model to be used in future
  disasters based on information obtained from all
  DCM pilots

44
Disaster Case Management

• Updates
• Five current pilots
• MS
• LA
• LA-ACF
• HUD
• TX
• Next steps
• Review best practices and lesson learned
  accumulated to-date
• Implement a hybrid DCM-P inclusive of two
  models Early response for immediate needs and
  long term recovery case management

45
Disaster Case Management

• For Additional Information contact
• Captain Roberta Lavin, Director
• Office of Human Services Emergency Preparedness
  and Response
• Administration for Children and Families
• roberta.lavin_at_acf.hhs.gov
• [phone] office
• Kaee N. Ross, MPH, MSW
  
• Office of Human Services Emergency Preparedness
  and Response
• Administration for Children and Families
  
• KaeeN.Ross_at_ACF.hhs.gov
• [phone]

46
Disaster Case Management

• Stephen P Carr II, MA, MFT
• MS Case Management Consortium
• Stephen_at_mc-mc.org
• [phone]
• Liz Lawrence Bowen
• Coordinated Assistance Network
• liz_at_can.org
• [phone]

47
Disaster Case Management

• Liz Gibson
• Senior Program Manager
• Disaster Case Management (DCM)
• FEMA Headquarters
• liz.gibson_at_dhs.gov
• [phone]
• Tanya Stevenson
• Program Specialist
• FEMA HQ
• tanya.stevenson_at_dhs.gov
• 202-212-5719