Reforming Disaster Case Management

A key player in Louisiana philanthropy, the Irene W. and C.B. Pennington Foundation demonstrated how donors can support disaster management policy reform even at the federal level. A grant from the Foundation’s Disaster Resilience Fund in 2009 enabled the Children’s Health Fund, a nonprofit organization providing health care to underserved and vulnerable children in the U.S., to help influence reforms to disaster case management in the State of Louisiana, ultimately helping enhance long-term recovery efforts at the national level.

Disaster case management is the process of helping disaster-affected individuals and households access vital resources.

Filling critical gaps of government-run recovery programs

Prior to Hurricanes Katrina, Rita, Gustav and Ike in 2005, disaster case management services were not mandated in federal law. They were supported only by donated funds, volunteer agencies, and government appropriations following disasters. But after these hurricanes, the need for federal funding of disaster case management as a guarantee to disaster recovery became clear. The Post Katrina Emergency Management Reform Act of 2006 helped address this need, establishing a federal responsibility for disaster case management services. Consequently, the Federal Emergency Management Agency (FEMA) implemented several disaster case management programs in Louisiana, and made case management a standard part of disaster response.

However, due to the lack of agreement between federal government agencies and between these agencies and the State of Louisiana on how to streamline case management, these programs failed to effectively reach all of those in need of healthcare, mental health, and human services. For example, one program’s implementation was delayed for more than a year, and because of that, lost over $20 million in funding. Many cases were closed prematurely, and as a result, many individuals and families fell out of the system and are still in recovery even six years after the storms.  Irwin Redlener, president of the Children’s Health Fund and director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health, estimates that 10,000-20,000 children in the Gulf are not living in stable housing and lack appropriate access to education and other essential social services. The actual number will remain unknown as no case management system exists.

The Irene W. and C.B. Pennington Foundation witnessed the shortfalls of these programs firsthand in their communities and recognized the need for private philanthropy to step in.

Catalytic convening leads to an important agreement

The Irene W. and C.B. Pennington Foundation awarded funding to the Children’s Health Fund to help reform disaster case management in Louisiana. Children’s Health Fund hosted a unique roundtable in October 2009 at Louisiana State University, bringing together key decision-makers from the federal and state governments and private-sector social service organizations—people who often do not sit together—in a not-for-attribution, media-free environment with the purpose of developing recommendations for reform.  Participants included: the Federal Emergency Management Agency (FEMA); the U.S. departments of Homeland Security (DHS), Health and Human Services (HHS), and Housing and Urban Development (HUD); congressional oversight staffs; the Louisiana Recovery Authority (LRA); and Save the Children, the American Red Cross, Catholic Charities, James Lee Witt Associates, United Way, Community Initiatives Foundation, Lutheran Social Services, and United Methodists Committee on Relief. Following this roundtable, in March 2011 FEMA, HHS, and HUD signed a one-year agreement to better provide disaster case management, taking many of their polices from the Roundtable’s recommendation. Amendments included:

  1. FEMA is the lead federal agency for disaster case management. FEMA now has the authority and professional staff to oversee disaster case management.
  2. There is now a single federal model for disaster case management that assigns responsibilities to DHS and HHS and is fully funded by the federal government. Prior to this agreement, there was no comprehensive national model, leading to confusion and barriers to implementation of services across the state of Louisiana.
  3. The sharing of client data is laid out among relevant agencies and provider organizations and privacy protections are established. Sharing of personal information during a disaster is necessary for providing critical services (e.g., health treatments).

Leveraging the private donor’s convening power to advocate for necessary reforms 

The media-free, closed-door, and not-for-attribution environment was a key success factor in the development and subsequent adoption of these reforms. The Irene W. and C.B. Pennington Foundation leveraged its neutrality as a private philanthropic organization and worked with CHF to bring in complementary government agencies and other interested parties (e.g. academia, the private sector, other foundations) to find common ground and avoid duplication of efforts.

Although these recommendations to improve federal disaster case management have not yet directly resulted in legislative reforms, key government agencies (FEMA, HHS, and HUD) have shifted to a more streamlined approach to disaster case management. Congress is actively considering legislation for further reform of the Stafford Act—which governs federal disaster response—and the disaster case management agreement between agencies was an important step for further policy change. Private donors should continue to leverage their ability to convene voices to achieve such change.

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