The Federal Government Supported Disaster Case Management Programs for the First Time after Hurricanes Katrina and Rita, but Breaks in Federal Funding May Have Hindered Assistance to Victims

		Through Varied Funding Mechanisms, FEMA, HUD, and HHS Supported a Variety of Disaster Case Management Programs for Victims of Hurricanes Katrina and Rita

Since the hurricanes nearly 4 years ago, more than $209 million of FEMA  and HHS funds have been used to support disaster case management  programs to assist victims of Hurricanes of Katrina and Rita, one of which  was administered by HUD. As a result of ongoing budget negotiations between FEMA and Mississippi,  the state-managed DCM-P program in Mississippi did not begin until  August 2008, approximately 2 months after it was scheduled to, according  to officials from the Mississippi Commission for Volunteer Services. FEMA and HUD Provided Some Oversight of Disaster Case Management Programs, but Monitoring of KAT Was Limited and Coordination Challenges May Provide Lessons for Future Disasters

		Although Initial Oversight of KAT Was Limited, FEMA and HUD Used a Variety of Methods to Monitor Subsequent Disaster Case Management Programs

In the aftermath of Hurricane Katrina and in the absence of explicit  authority to fund disaster case management, FEMA believed it had limited  responsibility for overseeing international donations allocated to UMCOR  and limited authority to ensure all aspects of the grant proposal for KAT  were carried out. FEMA reviewed reports from the Mississippi state  agency that administered the state-managed DCM-P program. As a result, some victims  may not have received case management services while others may have  received services from multiple providers. Case Management Agencies Experienced a Range of Service- Delivery Challenges, and As A Result, Those Most in Need of Services May Not Have Been Helped

		Staff Turnover and Large Caseloads Were Barriers to Meeting Clients’ Needs

According to various sources, some case management agencies  experienced high turnover in case managers, which made it difficult to  meet clients’ needs. Case managers said that client needs also included employment and  transportation, but these community resources were limited. 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. FEMA Plans to Use Evaluations of Pilot Programs to Inform the Development of a Federal Disaster Case Management Program for Future Disasters; However, Some Evaluations Have Limitations

FEMA and other agencies are conducting evaluations of disaster case  management pilot programs. Based on its evaluation and those already provided by HHS  and HUD, FEMA will not have information on program outcomes for its  DCM-P program, the HHS pilot, or DHAP case management services,  which could provide information on the results of the various programs  such as the extent to which clients’ disaster-related needs were met. However, a FEMA official said FEMA does  not have a time line or goal for developing this program. This lack of  coordination contributed to a lack of timely information sharing and  uncoordinated outreach, which was exacerbated by incompatible  databases. In addition, absent sufficient coordination, case management  agencies experienced challenges in delivering services. Appendix I: Objectives, Scope, and Methodology

The objectives of this report were to determine (1) what steps the federal  government took to support disaster case management programs after  Hurricanes Katrina and Rita, (2) how federal agencies oversaw the  implementation of these disaster case management programs, (3) the  challenges case management agencies experienced in delivering disaster  case management services under federally funded programs, and (4) how  previous or existing federally funded disaster case management programs  will be used to inform the development of a federal case management  program for future disasters.
Why GAO Did This Study

As a result of the unprecedented damage caused by Hurricanes Katrina and Rita in 2005, the federal government, for the first time, funded several disaster case management programs. These programs help victims access services for disaster-related needs. GAO was asked to review (1) steps the federal government took to support disaster case management programs after the hurricanes, (2) the extent to which federal agencies oversaw the implementation of these programs, (3) challenges case management agencies experienced in delivering disaster case management services, and (4) how these programs will inform the development of a federal case management program for future disasters. GAO reviewed relevant laws and guidance, obtained data from two programs, conducted site visits to Louisiana and Mississippi, and interviewed case management providers and officials from federal and state agencies involved in disaster case management.

What GAO Found

Federal agencies provided more than$209 million for disaster case management services to help thousands of households cope with the devastation caused by Hurricanes Katrina and Rita, but breaks in federal funding adversely affected services to some hurricane victims. The Federal Emergency Management Agency (FEMA) awarded a grant of $66 million for initial case management services provided by Katrina Aid Today (KAT) shortly after the hurricanes made landfall. When this program ended in March 2008, FEMA provided funds for additional programs to continue services. As a result of ongoing budget negotiations between FEMA and Mississippi, the state-managed Disaster Case Management Pilot (DCM-P) program in Mississippi did not begin until August 2008, approximately 2 months after it was scheduled to, and FEMA's DCM-P program in Louisiana was never implemented. Consequently, some victims most in need may not have received case management services. FEMA and the Department of Housing and Urban Development (HUD) provided some oversight of disaster case management programs, but monitoring of KAT was limited and coordination challenges may provide lessons for future disasters. As recovery continued, FEMA and HUD provided additional monitoring of subsequent programs. Coordination challenges contributed to implementation difficulties, such as a lack of timely information sharing. For example, client information provided by FEMA to the Mississippi state agency implementing the DCM-P program was invalid or out-of-date for nearly 20 percent of eligible clients. As a result of incompatible databases and inconsistent outreach efforts, some victims may have received services from multiple agencies while others may not have been reached. Case management agencies experienced challenges in delivering federally-funded disaster case management services due to large caseloads, limited community resources, and federal funding rules. Some case management agencies experienced high turnover, and some case managers had caseloads of more than 100 clients, making it difficult to meet client needs. KAT and HUD data indicated that the most frequently occurring needs among clients included housing and employment, 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 assistance. FEMA and other agencies are evaluating disaster case management pilot programs to inform the development of a federal disaster case management program for future disasters, but some of the evaluations have limitations. For example, some evaluations will not assess program outcomes, such as whether clients' needs were met. In addition, FEMA did not include stakeholder input in designing its evaluation of multiple pilot programs. According to FEMA officials, the agency does not have a time line for developing the federal disaster case management program.