Disaster Assistance
Improvements in Providing Federal Disaster Case Management Services Could Help Agencies Better Assist Victims Gao ID: GAO-10-278T December 2, 2009As a result of the damage caused by Hurricanes Katrina and Rita in 2005, the federal government funded several disaster case management programs. These programs help victims access services for disaster-related needs. This testimony addresses the following questions: 1) How did the federal government support disaster case management programs after Hurricanes Katrina and Rita, and how did federal agencies coordinate their efforts?; 2) What challenges did disaster case management agencies experience in delivering services under federally funded programs?; and 3) How will previous or existing federally funded programs be used to inform the development of a federal case management program for future disasters? This testimony is based on a July 2009 report (GAO-09-561). To complete this report GAO reviewed federal laws, regulations, and guidance, obtained data from two programs, conducted site visits to Louisiana and Mississippi, and interviewed case management providers and federal and state officials. For this testimony, GAO updated certain information.
The federal government provided more than $231 million to support disaster case management programs for victims of Hurricanes Katrina and Rita; however, breaks in federal funding hindered service delivery, and federal agencies and case management agencies faced coordination challenges. A lack of accurate and timely information sharing and incompatible data systems may have left some victims most in need without access to disaster case management services. Case management agencies experienced challenges in delivering federally funded disaster case management services due to staff turnover and large caseloads, limited community resources, federal funding rules, and a lack of coordinated outreach. For example, case management agencies saw the ability to provide direct financial assistance for items such as home repair, clothing, or furniture as key to helping victims, yet case management agencies that provided services under FEMA-funded programs could not provide direct financial assistance. Long-term recovery committees were a resource for case management agencies to obtain direct assistance, but utilizing these committees was sometimes unsuccessful. Ongoing evaluations of disaster case management pilot programs will inform the development of a federal disaster case management program, but to date, little is known about program outcomes. FEMA plans to analyze third-party evaluations submitted by the agencies administering the pilot programs to determine lessons learned and best practices for the future. According to an agency official, FEMA hopes to formalize the new program in June 2010.
GAO-10-278T, Disaster Assistance: Improvements in Providing Federal Disaster Case Management Services Could Help Agencies Better Assist Victims
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Testimony:
Before the Ad Hoc Subcommittee on Disaster Recovery, Committee on
Homeland Security and Governmental Affairs, U.S. Senate:
United States Government Accountability Office:
GAO:
For Release on Delivery:
Expected at 2:30 p.m. EST:
Wednesday, December 2, 2009:
Disaster Assistance:
Improvements in Providing Federal Disaster Case Management Services
Could Help Agencies Better Assist Victims:
Statement of Kay E. Brown, Director:
Education, Workforce, and Income Security:
GAO-10-278T:
GAO Highlights:
Highlights of GAO-10-278T, a testimony to the Ad Hoc Subcommittee on
Disaster Recovery, Committee on Homeland Security and Governmental
Affairs, U.S. Senate.
Why GAO Did This Study:
As a result of the damage caused by Hurricanes Katrina and Rita in
2005, the federal government funded several disaster case management
programs. These programs help victims access services for disaster-
related needs. This testimony addresses the following questions: 1) How
did the federal government support disaster case management programs
after Hurricanes Katrina and Rita, and how did federal agencies
coordinate their efforts? 2) What challenges did disaster case
management agencies experience in delivering services under federally
funded programs? and 3) How will previous or existing federally funded
programs be used to inform the development of a federal case management
program for future disasters?
This testimony is based on a July 2009 report (GAO-09-561). To complete
this report GAO reviewed federal laws, regulations, and guidance,
obtained data from two programs, conducted site visits to Louisiana and
Mississippi, and interviewed case management providers and federal and
state officials. For this testimony, GAO updated certain information.
What GAO Found:
The federal government provided more than $231 million to support
disaster case management programs for victims of Hurricanes Katrina and
Rita; however, breaks in federal funding hindered service delivery, and
federal agencies and case management agencies faced coordination
challenges. (See figure) A lack of accurate and timely information
sharing and incompatible data systems may have left some victims most
in need without access to disaster case management services.
Figure: Time Line of Federally Funded Disaster Case Management
Programs:
[Refer to PDF for image: timeline]
Hurricane Katrina made landfall in the Gulf Coast:
August 29, 2005.
Hurricane Rita made landfall in the Gulf Coast:
September 24, 2005.
Katrina Aid Today: December 2005 - March 2008;
Administering Agency: FEMA.
Louisiana Family Recovery Corps: January 2006 - June 2007;
Administering Agency: HHS.
Disaster Housing Assistance Program: September 2007 - February 2009;
Administering Agency: HUD.
Disaster Housing Assistance Program Transitional Closeout Program:
April 2009 - February 2010;
Administering Agency: HUD; HHS (11/09 to 2/10).
Phase 1: Cora Brown Bridge Program: April 2008 - May 2008;
Administering Agency: FEMA.
Phase 2: Mississippi Disaster Case Management Pilot Program: August
2008 - March 2010;
Administering Agency: FEMA.
Phase 2: Louisiana Disaster Case Management Pilot Program: September
2009 - March 2010;
Administering Agency: FEMA.
Source: GAO.
[End of figure]
Case management agencies experienced challenges in delivering federally
funded disaster case management services due to staff turnover and
large caseloads, limited community resources, federal funding rules,
and a lack of coordinated outreach. For example, case management
agencies saw the ability to provide direct financial assistance for
items such as home repair, clothing, or furniture as key to helping
victims, yet case management agencies that provided services under FEMA-
funded programs could not provide direct financial assistance. Long-
term recovery committees were a resource for case management agencies
to obtain direct assistance, but utilizing these committees was
sometimes unsuccessful.
Ongoing evaluations of disaster case management pilot programs will
inform the development of a federal disaster case management program,
but to date, little is known about program outcomes. FEMA plans to
analyze third-party evaluations submitted by the agencies administering
the pilot programs to determine lessons learned and best practices for
the future. According to an agency official, FEMA hopes to formalize
the new program in June 2010.
What GAO Recommends:
In our July 2009 report, GAO recommended that FEMA improve coordination
and create a time line for its new disaster case management program,
and examine pilot program outcomes to develop the program. FEMA agreed
with our recommendations. GAO is making no new recommendations.
View [hyperlink, http://www.gao.gov/products/GAO-10-278T] or key
components. For more information, contact Kay E. Brown at (202) 512-
7215 or brownke@gao.gov.
[End of section]
Madam Chairman and Members of the Subcommittee:
I appreciate the opportunity to participate in today's discussion on
disaster case management and to provide highlights of our July 2009
report entitled Disaster Assistance: Greater Coordination and an
Evaluation of Programs' Outcomes Could Improve Disaster Case
Management.[Footnote 1] Hurricanes Katrina and Rita caused
approximately $90 billion in property damage, destroyed over 300,000
homes, and displaced more than 1 million people from some of the
poorest communities in the country when they struck the Gulf Coast in
August and September 2005. To assist victims with their recovery, the
federal government stepped in and, for the first time, provided more
than $231 million to states and nonprofit organizations to support
several disaster case management programs. Disaster case management
involves helping victims access services for a range of needs,
including employment, housing, and health care. In our report, we
estimated that up to 116,000 families affected by Hurricanes Katrina
and Rita received federally funded disaster case management services.
[Footnote 2]
My statement today, based on our July 2009 report, addresses the
following questions: 1) How did the federal government support disaster
case management programs after Hurricanes Katrina and Rita, and how did
federal agencies coordinate their efforts? 2) What challenges did case
management agencies experience in delivering disaster case management
services under federally funded programs? and 3) How will previous or
existing federally funded programs be used to inform the development of
a federal case management program for future disasters?
To prepare the report, we reviewed the roles and responsibilities of
the federal government for disaster recovery services, as well as
federal laws, regulations, and guidance for the federally funded
disaster case management programs established to assist victims of
Hurricanes Katrina and Rita. We interviewed federal officials from the
Federal Emergency Management Agency (FEMA), the Department of Housing
and Urban Development (HUD), and the Department of Health and Human
Services (HHS). We conducted site visits to Louisiana and Mississippi
and interviewed organizations involved in disaster case management in
those states. We also obtained data on clients in two disaster case
management programs and used only those data elements we found to be
sufficiently reliable for the purposes of our work. We conducted the
performance audit from May 2008 to July 2009 and updated information in
November 2009, in accordance with generally accepted government
auditing standards. Those standards require that we plan and perform
the audit to obtain sufficient, appropriate evidence to provide a
reasonable basis for our findings and conclusions based on our audit
objectives. We believe that the evidence obtained provides a reasonable
basis for our findings and conclusions. A detailed explanation of our
methodology is included in our July 2009 report.
In summary, we found that FEMA, HHS, and HUD supported disaster case
management programs following Hurricanes Katrina and Rita. However,
breaks in federal funding and coordination challenges adversely
affected the delivery of disaster case management services to some
hurricane victims. Coordination challenges included a lack of accurate
and timely information sharing and incompatible data systems. In
addition, case management agencies experienced challenges in delivering
services due to large caseloads, limited community resources, federal
funding rules, and a lack of coordinated outreach. For future
disasters, FEMA is developing a federal case management program based
on evaluations of several disaster case management pilot programs.
However, we found that FEMA had not established a time line for
developing this program, and some of the evaluations had limitations,
such as a lack of information on program outcomes. In our report, we
recommended that FEMA establish a realistic and achievable time line
for designing and implementing a single, federal, disaster case
management program for future disasters, conduct an outcome evaluation
to determine the results of the disaster case management pilot
programs, and ensure that the federal disaster case management program
it develops includes practices to enhance and sustain coordination
among federal and nonfederal stakeholders. FEMA agreed with our
recommendations and is taking steps to address them; FEMA hopes to
finalize the federal disaster case management program in June 2010.
Background:
Disaster Case Management:
Disaster case management is a process that assists people in
identifying their service needs, locating and arranging services, and
coordinating the services of multiple agencies following a disaster.
While disaster case management services may include emergency relief
services, they extend beyond the immediate to address long-term
recovery needs,[Footnote 3] such as health care, employment, housing,
and other social services. Disaster case management programs may
directly provide assistance, make referrals to organizations that have
agreed to meet specific client needs, contract with other
organizations, or otherwise arrange for individuals and families to
receive needed services and resources.[Footnote 4] Disaster case
management agencies may also work in conjunction with long-term
recovery committees to serve their clients. These committees are
typically community-based organizations that bring together local
leaders to coordinate recovery efforts and provide resources, as a last
resort, to address the unmet needs of disaster victims.
Federal Role for Funding and Coordinating Disaster Case Management
Services:
The Robert T. Stafford Disaster Relief and Emergency Assistance Act
(Stafford Act),[Footnote 5] as amended, is the primary authority under
which the federal government provides major disaster and emergency
assistance, and FEMA is responsible for administering its provisions.
At the time of Hurricanes Katrina and Rita, the Stafford Act contained
no explicit authority to fund disaster case management services.
However, the passage of the Post-Katrina Emergency Management Reform
Act of 2006 (Post-Katrina Act),[Footnote 6] which amended the Stafford
Act, granted the President the authority to provide financial
assistance for case management services to victims of major disasters.
In addition to its responsibilities under the Stafford Act, FEMA has
responsibility for administering and ensuring implementation of the
National Response Framework, which became effective in March 2008 and
replaced the former National Response Plan.[Footnote 7] The Framework
maintains FEMA's responsibility for coordinating human services and
specifically includes disaster case management as a category of human
services. Moreover, the Framework requires federal agencies involved in
mass care, housing, and human services to coordinate federal response
efforts with the efforts of state, local, private, nongovernmental, and
faith-based organizations.
In September 2009, the President announced the formation of a Long-Term
Disaster Recovery Working Group, co-chaired by the secretaries of the
Department of Homeland Security (DHS) and HUD, to examine lessons
learned during previous catastrophic disaster recovery efforts, and
areas for improved collaboration between federal agencies and between
the federal government and state and local governments and
stakeholders. As part of this initiative, FEMA and HUD are co-chairing
the National Disaster Recovery Framework Working Group, which will
define the federal, state, local, tribal, private non-profit, private
sector, and individual citizen's roles in disaster recovery; design and
establish an effective coordinating structure for disaster recovery
programs; identify gaps, as well as, duplications, in recovery programs
and funding; and establish performance standards for the federal
support of state and local recovery.
The Federal Government Supported Disaster Case Management Programs, but
Breaks in Federal Funding and Coordination Challenges Hindered
Assistance:
Multiple federal agencies provided resources for disaster case
management programs to help thousands of households cope with the
devastation caused by Hurricanes Katrina and Rita, but breaks in
federal funding and coordination challenges adversely affected the
delivery of these services to some hurricane victims.
FEMA, HUD, and HHS Supported a Variety of Disaster Case Management
Programs for Hurricane Victims, but Breaks in Federal Funding Adversely
Affected Services to Some:
More than $231 million of FEMA and HHS funds have been used to support
disaster case management programs to assist victims of Hurricanes
Katrina and Rita. These programs include:
* Katrina Aid Today (KAT)--FEMA awarded a $66 million grant to the
United Methodist Committee on Relief, which then used the grant to
establish KAT, a national consortium consisting of nine social service
and voluntary organizations, to provide case management services to
Hurricane Katrina victims.
* The Cora Brown Bridge Program--Following the termination of KAT,
Louisiana and Mississippi received Cora Brown Funds[Footnote 8] from
FEMA to continue providing services to individuals and families
affected by Hurricanes Katrina and Rita.
* The Disaster Case Management Pilot Program (DCM-P)--Following the
termination of the Cora Brown Bridge Program, FEMA used funds from its
Disaster Relief Fund[Footnote 9] to establish a state-managed DCM-P
program to serve Hurricane Katrina and Rita victims in Louisiana and
Mississippi, with the primary goal of helping them achieve sustainable
permanent housing.
* The Louisiana Family Recovery Corps (LFRC) case management program--
HHS distributed emergency Temporary Assistance for Needy Families and
Social Services Block Grant funds to Louisiana, which contracted with
LFRC, to provide disaster case management services to victims of
Hurricanes Katrina and Rita.
* The case management portion of the Disaster Housing Assistance
Program (DHAP)--Using funding provided by FEMA, HUD designed and
implemented this program to provide rental assistance to eligible
victims of Hurricanes Katrina and Rita. To participate in the program,
clients also had to receive case management services.
* The case management portion of the DHAP Transitional Closeout
Program--Some DHAP clients continued to receive housing assistance
following the completion of DHAP. In Louisiana, housing assistance was
accompanied by disaster case management services. The state has used
funding provided by HUD and through HHS' Social Services Block Grant
program.
These programs began at different times and sometimes overlapped as
federal agencies identified ongoing need for services (see fig. 1).
Figure 1: Time Line of Federally Funded Disaster Case Management
Programs for Victims of Hurricanes Katrina and Rita:
[Refer to PDF for image: timeline]
Hurricane Katrina made landfall in the Gulf Coast:
August 29, 2005.
Hurricane Rita made landfall in the Gulf Coast:
September 24, 2005.
Katrina Aid Today: December 2005 - March 2008;
Administering Agency: FEMA.
Louisiana Family Recovery Corps: January 2006 - June 2007;
Administering Agency: HHS.
Disaster Housing Assistance Program: September 2007 - February 2009;
Administering Agency: HUD.
Disaster Housing Assistance Program Transitional Closeout Program:
April 2009 - February 2010;
Administering Agency: HUD; HHS (11/09 to 2/10).
Phase 1: Cora Brown Bridge Program: April 2008 - May 2008;
Administering Agency: FEMA.
Phase 2: Mississippi Disaster Case Management Pilot Program: August
2008 - March 2010;
Administering Agency: FEMA.
Phase 2: Louisiana Disaster Case Management Pilot Program: September
2009 - March 2010;
Administering Agency: FEMA.
Source: GAO.
Notes: The program dates above represent when case management services
began. Grant agreements may have been in place prior to these dates.
Louisiana received emergency block grant funding from HHS. State
officials in Louisiana designated a portion of these funds for disaster
case management.
[End of figure]
Breaks in federal funding for disaster case management programs
initiated after Hurricanes Katrina and Rita adversely affected case
management agencies and may have left victims most in need of
assistance without access to case management services. For example, as
the first federally funded disaster case management program, Katrina
Aid Today (KAT), drew to a close in March 2008, some case management
agencies began to shut down their operations. Some cases were closed
not because clients' needs had been met, but because the program was
ending, and it is unknown whether these clients obtained assistance
elsewhere or whether their cases were eventually reopened under the
Cora Brown Bridge Program.
Clients with open cases under the Bridge program were supposed to
seamlessly transition from the Bridge program into FEMA's new state
managed DCM-P program. However, in Mississippi, the state-managed pilot
program did not begin until approximately two months after its
scheduled start date, and many of the smaller case management
organizations had to lay off case managers with the hope of hiring them
back once they received federal funding. In addition, in Louisiana, the
state-managed pilot became operational in September 2009, approximately
15 months after it was scheduled to begin. The program will serve an
estimated 3,300 households that remained in FEMA temporary housing as
of April 2009.
Challenges to Coordination among Federal Agencies and Case Management
Agencies Contributed to Implementation Difficulties:
Initial coordination activities among federal agencies and case
management agencies were minimal following the hurricanes, which may
have resulted in some victims not receiving case management services
and others receiving services from multiple agencies. In previous work,
GAO has identified key practices to enhance and sustain coordination
among federal agencies,[Footnote 10] and has since recommended these
same key practices to strengthen partnerships between government and
nonprofit organizations.[Footnote 11] Key practices for coordination
include establishing mutually reinforcing or joint strategies and
compatible policies, procedures, and other means of operating across
agency boundaries.
Difficulties in coordinating disaster case management services resulted
in a lack of accurate and timely information sharing between federal
agencies and case management agencies. Case management agencies
providing federally funded disaster case management services said they
faced challenges in obtaining timely and accurate information from
FEMA; however, FEMA officials said requests for information often did
not meet their requirements. For example, FEMA approached HHS about
serving some victims of Hurricanes Katrina and Rita under its pilot
disaster case management program following Hurricanes Gustav and Ike.
When the case management agency implementing the HHS pilot requested
client information from FEMA, FEMA only provided aggregate data, which
the case management agency found unusable. According to FEMA officials,
its routine use policy precluded it from sharing client-level
information for this purpose.[Footnote 12] However, FEMA officials said
they have fulfilled many requests for information and worked with
states on how to request information. For example, FEMA provided
information to the Louisiana Department of Social Services so as to
prevent duplication of efforts or benefits in determining eligibility
for disaster assistance.[Footnote 13] In a previous report, we
identified as a lesson learned the value of standing agreements for
data sharing among FEMA and state not-for-profit agencies as a means to
expedite recovery services. Such agreements can clarify what data can
be shared and the procedures for sharing it while protecting the data
from improper disclosure.[Footnote 14]
Federally funded case management programs used different databases,
making it difficult to track clients across case management agencies,
and potentially allowing hurricane victims who applied to more than one
program to receive duplicate services. For example, clients who
received case management services through KAT may have also received
services through the LFRC disaster case management program, but because
the KAT and LFRC databases were not compatible, some case management
agencies for these two programs may not have been able to screen for
duplication of services.
Case Management Agencies Experienced a Range of Service-Delivery
Challenges, and As a Result, Some Hurricane Victims May Not Have Been
Helped:
Case management agencies experienced a variety of challenges in
delivering federally funded disaster case management services. Some
agencies had high staff turnover, and some case managers had large
caseloads, making it difficult to meet client needs. Clients frequently
needed housing and employment, according to case managers and program
data, but these resources were limited following the hurricanes.
Further, case management agencies saw the ability to provide direct
financial assistance for items such as home repair, clothing, or
furniture as key to helping victims, yet only one federally funded
program allowed case management agencies to use federal funds for
direct financial assistance.
Staff Turnover and Large Caseloads Were Barriers to Meeting Clients'
Needs:
Some case management agencies experienced high staff turnover and large
caseloads, which made it difficult to meet clients' needs. For example,
one agency reported 100 percent turnover in case managers during the
KAT program, which an agency official attributed to case managers'
expectations of a short-term assignment or to the work being too
emotionally draining. In terms of caseload size, KAT and LFRC case
managers had larger caseloads than program guidance recommended. For
example, KAT case managers had caseloads ranging between 40 and 300
clients even though the guidance recommended an average of 20 to 30
cases. Several factors may have contributed to high caseloads,
including the magnitude of the disaster and a shortage of case
managers.
Clients Needs Included Housing, Employment and Transportation; However,
These Community Resources Were Limited:
Case managers and program data indicated that one of the main needs of
clients was housing (see figure 2).
Figure 2. Most to Least Frequently Occurring Client Need by Disaster
Case Management Program:
[Refer to PDF for image: illustration]
List indicates level of need: Most frequent to least frequent.
KAT:
Housing;
Furniture and appliances;
Health and well being;
Utilities and services;
Food and nutrition;
Employment and job training;
Clothing;
Transportation;
Financial assistance;
Application assistance;
Children and youth services;
Aged and disability services;
Benefits restoration;
Legal assistance;
Language assistance.
DHAP:
Employment and job training;
Health and well being;
Housing;
Financial assistance;
Transportation;
Application assistance and benefits restoration;
Household items (including clothing and furniture);
Food and nutrition;
Aged and disability services;
Utilities and services;
Children and youth services;
Legal assistance;
Language assistance.
Source: GAO analysis of program data.
Note: KAT program data included pre-defined categories of need. For the
DHAP program, we analyzed needs assessment data for those clients with
a completed needs assessment and combined variables to create
categories comparable to KAT. The DHAP needs assessment did not include
individual questions for application assistance, benefits restoration,
furniture/appliances, or clothing; as a result, the KAT and DHAP
categories are not a one-to-one match.
[End of figure]
According to program data, approximately 67 percent of KAT clients were
displaced from their primary residence as a result of Hurricane
Katrina. As GAO recently reported, one commonly cited challenge faced
by displaced households was finding affordable rental housing, since
rents increased significantly following the storms in certain Gulf
Coast metropolitan areas.[Footnote 15] For example, HUD's fair market
rent for a two-bedroom unit in the New Orleans-Metairie-Kenner
metropolitan area increased from $676 to $1,030, or about 52 percent,
between fiscal years 2005 and 2009. We also reported that disaster
victims faced other obstacles in returning to permanent housing, such
as insufficient financing to fund home repairs and significantly higher
insurance premiums.[Footnote 16]
Case managers said client needs also included employment and
transportation, but these resources were limited. According to the
Bureau of Labor Statistics, between August 2005 and August 2006, almost
128,000 jobs were lost in eight areas of Louisiana and Mississippi that
were heavily affected by Hurricane Katrina. In addition, the
unemployment rate in the New Orleans-Metairie-Kenner metropolitan area
more than tripled between August 2005 and September 2005, and the
unemployment rate remained above pre-Katrina levels until March
2006.[Footnote 17] We previously reported that transportation services
can provide a vital link to other services and to employment for
displaced persons;[Footnote 18] yet multiple sources stated that case
management clients, particularly those living in FEMA group sites,
lacked transportation following Hurricanes Katrina and Rita. Case
management officials said lack of access to transportation made it
difficult to connect clients living in remote group sites to services
such as employment, education, and child care. Federal agencies
developed the LA Moves program to provide free, statewide transit
service for residents in Louisiana group sites; however, LA Moves
service was limited to FEMA defined "essential services," specifically,
banks, grocery stores, and pharmacies and did not include
transportation to welfare-to-work sites, employment, and human and
medical services.[Footnote 19]
Case Managers Faced Challenges in Meeting Client Needs Due to Federal
Funding Rules on Direct Assistance and Difficulties in Accessing Needed
Resources Through the Long-Term Recovery Committee Process:
Case management agencies saw the ability to provide direct financial
assistance for items such as home repairs, clothing, or furniture as
key to helping clients with their basic needs; yet such assistance was
not always available. An official from a case management umbrella
organization said that without direct service funds, short-term needs
ultimately can become long-term issues, and individuals may then become
dependent on government assistance rather than becoming self-
sufficient. Case management agencies that were part of KAT or that
provided services under FEMA-funded programs, including the state-
managed DCM-P program in Mississippi and the Disaster Housing
Assistance Program, were not permitted to provide direct financial
assistance. According to a FEMA official, direct financial assistance
was not part of these programs because FEMA already provided funding
for this purpose through the Individual and Households Program. The
maximum amount that an individual or household may receive through the
program is $25,000, adjusted annually to reflect changes in the
Consumer Price Index; however, a FEMA official noted that the maximum
amount may not be enough to meet all disaster-related needs.
While long-term recovery committees were a resource for case managers
to obtain direct assistance to address clients' unmet needs, in some
cases, the efforts to utilize these committees were unsuccessful. Some
committees were unable to help clients since the member organizations
were depleted of goods or donations to pass on to clients. In addition,
case managers also cited challenges in the process of working with
these committees. They said the process for obtaining assistance could
be onerous, time consuming, and confusing.
Case Managers Said Program Eligibility Requirements Were a Barrier to
Providing Disaster Case Management Services:
Eligibility requirements for receiving disaster case management
services varied depending on the funding source, which may have left
some in need without services. For example, KAT services were available
to victims of Hurricane Katrina but not Hurricane Rita. In addition,
LFRC officials said they initially received TANF funds only, which
limited their agencies to serving families with children. Lastly,
programs such as the Mississippi DCM-P program were restricted to
serving those receiving FEMA housing assistance. As a result of certain
eligibility requirements, some programs may not have been able to
assist individuals and families in need of case management services.
Case Managers Stated that a Lack of Coordinated Outreach May Have Left
Some without Access to Needed Services:
Many case management agencies conducted little, if any, coordinated
outreach and, as a result, those most in need of case management, such
as those residing in FEMA group trailer sites, may not have received
services. According to LFRC officials, there was no coordinated
approach for providing case management services among federally funded
programs, and as a result, residents in these group sites may not have
received needed case management services. According to a KAT official,
KAT case management agencies were not required to conduct outreach to
residents in FEMA group sites. In addition, we have previously reported
that federal efforts to assist victims of Hurricanes Katrina and Rita
with employment, services for families with children, and
transportation generally did not target group site residents.[Footnote
20]
FEMA Plans to Use Ongoing Evaluations of Pilot Programs to Inform the
Development of a Federal Disaster Case Management Program for Future
Disasters; However, Early Evaluations Had Limitations:
Several agencies' evaluations of the various disaster case management
pilot programs are ongoing, but to date, little is known about program
outcomes. FEMA and HHS completed evaluations of the initial
implementation of two pilot programs, but neither of those evaluations
included information on program outcomes, or results, such as the
extent to which clients' disaster related needs were met and what
factors contributed to client outcomes. In our July 2009 report, we
recommended that FEMA conduct an outcome evaluation of the disaster
case management pilot programs. FEMA does not plan to conduct its own
outcome evaluation, but will determine lessons learned and best
practices from third party evaluations of ongoing pilot programs
submitted by each of the agencies administering a pilot program.
According to a FEMA official, each of the third party evaluations will
examine program outcomes.
Using information from the ongoing evaluations, FEMA will develop a
model for a federal disaster case management program for future
disasters. In our report, we also recommended that FEMA establish a
time line for developing this program and ensure that the program
includes practices to enhance and sustain coordination among federal
and nonfederal stakeholders. FEMA agreed with our recommendations, and,
according to a FEMA official, the agency is hoping to formalize the
program in June 2010. Going forward, FEMA intends to implement disaster
case management services in two phases. In the first phase, HHS will
administer disaster case management services for up to 180 days using
FEMA funding. The second phase will be a state-managed disaster case
management program funded by a direct grant from FEMA to the affected
state. According to an agency official, FEMA is working closely with
HHS on all program development requirements and plans to obtain
feedback from relevant stakeholders prior to formalizing the program.
In conclusion, the federally funded disaster case management programs
implemented following Hurricanes Katrina and Rita faced unprecedented
challenges, yet they played a key role in assisting victims in their
recovery. A critical component of future recovery efforts is FEMA's
timely development of a single, federal disaster case management
program. The success of those efforts will depend, in part, on whether
agencies can improve coordination to help ensure that those most in
need receive services, and to prevent duplication of services. The
experiences of past and ongoing disaster case management pilots likely
provide valuable lessons learned regarding client outcomes and
contributing factors, and it is important to understand those lessons
and apply them to future disaster recovery efforts.
Madam Chairman, this completes my prepared remarks. I would be happy to
respond to any questions you or other members of the subcommittee may
have at this time.
GAO Contacts and Staff Acknowledgments:
For further information about this statement, please contact Kay E.
Brown at (202) 512-7215 or brownke@gao.gov. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this statement. Key contributors to this statement
were Kathryn A. Larin, Assistant Director; Susan Aschoff, Jessica
Botsford, Melinda Bowman, Nisha R. Hazra, Ryan Siegel and Walter Vance.
[End of section]
Footnotes:
[1] GAO, Disaster Assistance: Greater Coordination and an Evaluation of
Programs' Outcomes Could Improve Disaster Case Management, [hyperlink,
http://www.gao.gov/products/GAO-09-561] (Washington, D.C.: July 8,
2009).
[2] This estimate is based on information obtained from each of the
agencies that provided federally funded disaster case management
services. However, it is possible that clients may have received
services from more than one case management program.
[3] Council on Accreditation. Council on Accreditation Standards: 8th
Edition/Private (August 2008). [hyperlink, http://www.coastandards.org]
(accessed Oct. 17, 2008).
[4] ibid.
[5] Pub. L. No. 93-288, 88 Stat. 143 (1974).
[6] Pub. L. No. 109-295, Title VI, at §689f, codified at 42 U.S.C.
§5189d. The Post-Katrina Act was passed in October 2006.
[7] The National Response Plan was an all-discipline, all-hazards plan
establishing a single, comprehensive framework for the management of
domestic incidents where federal involvement was necessary.
[8] The Cora Brown fund was established in 1977 when Cora C. Brown of
Kansas City, Mo., left a portion of her estate to the United States to
be used as a special fund solely for the relief of human suffering
caused by natural disasters. It is a fund of last resort that is used
to help victims of presidentially-declared disasters who have disaster-
related needs that cannot be met by any other means.
[9] FEMA's Disaster Relief Fund is the major source of federal disaster
recovery assistance for state and local governments when a disaster
occurs.
[10] For the purposes of this report we defined "coordination" broadly
to include interagency activities that others have previously defined
as cooperation, collaboration, integration, or networking. Here, we use
this definition to describe coordination among federal agencies as well
as between federal agencies and nonfederal stakeholders. See GAO,
Results-Oriented Government: Practices That Can Help Enhance and
Sustain Collaboration among Federal Agencies, [hyperlink,
http://www.gao.gov/products/GAO-06-15] (Washington, D.C.: Oct. 21,
2005).
[11] See GAO, Nonprofit Sector: Increasing Numbers and Key Role in
Delivering Federal Services, [hyperlink,
http://www.gao.gov/products/GAO-07-1084T] (Washington, D.C.: July 24,
2007).
[12] Under the Privacy Act, an agency may disclose information without
the permission of the individual to whom the information relates for a
number of statutorily permitted purposes, including if it is determined
to be a "routine use", or one that is compatible with the purpose for
which the data was collected. The Department of Homeland Security
recently revised the routine use notice regarding its Disaster Recovery
Assistance system of records, amending and adding to the instances
where FEMA may share data from the Disaster Recovery Assistance files.
DHS/FEMA-008 Disaster Recovery Assistance Files, 74 Fed. Reg. 48763
(September 24, 2009).
[13] GAO, Disaster Assistance: Federal Efforts to Assist Group Site
Residents with Employment, Services for Families with Children, and
Transportation, [hyperlink, http://www.gao.gov/products/GAO-09-81]
(Washington, D.C.: December 11, 2008).
[14] GAO, Lessons Learned for Protecting and Educating Children after
the Gulf Coast Hurricanes, [hyperlink,
http://www.gao.gov/products/GAO-06-680R] (Washington, D.C.: May 11,
2006).
[15] GAO, Disaster Housing: FEMA Needs More Detailed Guidance and
Performance Measures to Help Ensure Effective Assistance after Major
Disasters, [hyperlink, http://www.gao.gov/products/GAO-09-796]
(Washington, D.C.: August 28, 2009).
[16] ibid.
[17] The unemployment rate increased from 4.9 percent in August 2005 to
more than 15.2 percent in September 2005. See [hyperlink,
http://www.gao.gov/products/GAO-09-796].
[18] [hyperlink, http://www.gao.gov/products/GAO-09-81].
[19] ibid.
[20] ibid.
[End of section]
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