Reluctant Recovery Standing Still And On The Run

10th October, 2008

Recovery marching in place after the media hype is over:  pageantry with recovery standing still while on the run playing roulette with the inevitable – another storm marching in to scatter resources both residents, recovery staff, and volunteers. 

Evacuation is a crowded hour of making choices of what is critical need and what is to be left for collateral damage.  Returning is rainbow or rubble – the first producing exasperation at the enormity of the effort and cost of evacuation. The latter frustration at the effort in vain as the crowded hour in the trunk of the family car can not sustain the family for long while the engine of recovery sputters out of fitful slumber back into a labored motion. Failover capability is not built into the recovery equation. 

Current practice in the Gulf Coast allows raw recruits, from diverse educational backgrounds,  to practice Case Management while in a loose unmonitored, or untested, fast tracked short term apprentice type  training programs without course testing or accreditation in place, all-the-while employed in  full fledged case management in the field.

Pay rates for these positions are spiraling upward, with assistance from Federal and private grants, to pay rates that are four to six times the basic wage rate in short term contracts from one to two years.  Equipped with training manuals in three ring binders bolstered with two day training sessions and power point presentations – these Case Manager recruits struggle, at this late hour in the Katrina recovery,  to implement broad scope programs without  readily available matching resources for the clients while having  personal issues embracing the “out of the box” concepts and, in some cases, struggling with their own recovery.

The hardy resilient successful case managers in the field are usually “street smart” and resourceful outspoken advocates for the residents they are assigned to. Their training coming from social services or self apprenticeship in the field over years in disaster work. Case Managers in the disaster regions are forced to develop their own resource list compiled from networking with fellow case workers who all embrace the “me too” program. By attrition – it is the survival of the fittest and well trained suitable case managers are high demand and short on supply.

One outcome of this high case manager turnover is that residents can have a dozen or more case managers, with varying skill sets, over the term of their long term recovery. The flip side is the resident that goes from relief organization to relief organization soliciting multiple case managers – an enormous waste of a critical resource. But the practice, also called “door knocking”, is very beneficial for the residents as they get to cherry pick the available resources and to program test case managers until they settle on the one case manager producing the required outcome. The door knocking program would be easily overcome if all the relief organizations were mandated to report to a central data base. Although one is available, CAN, no one is mandated to use the data bases and, by design, access is flawed by the fact that no government agency can access the data base – not even FEMA.

After the end of the privately funded Katrina Aid Today there was a drive to develop funding for case management and the outcome of that was that now 10% of the hurricane impacted population has 90% of the Case Managers. The remaining 90% of the hurricane impacted residents have only 10% of the available case managers in the region who are either volunteers or privately funded by faith based relief efforts. Discussion on this current crisis is muffled by contract gag restraint placed on those participating in some contract programs preventing them from talking publicly about issues they are having with programs they have under contract. There is discussion that they are searching for funding for Case Managers for the 90% of the residents not being currently served – but reality is that those best able to do that solicitation are tied up in the current contract implementation. Gustav, Ike, and time passed from Katrina have decimated the labor pool that was previously focused on Katrina – management, staff, and volunteers.

The infrastructure of recovery would be more robust if the funding was more flexible with respect to soliciting, housing and funding for training both outsourced and local personnel for recovery specialists. Along with that - working the distribution of emergency resources simultaneously with immediate and long term case management assignment to streamline the recovery and, also, apply the skills of the Case Managers while the resources are readily available at the beginning of the recovery equation.

Maintaining case manager consistency with simplified and repeatable processes for implementing fast tracked family continuity would produce significant reductions in downtime for the family unit being served. In short – Case Management must become monitored with tested training as well as a fully funded facet of the recovery process in the aftermath of a disaster. Else the recovery is disproportionably applied across the socio economic spectrum and the outcome relative to case management training and case manager availability – or lack there of.  End result a stalled, erratic, and reluctant recovery in the aftermath of Katrina this three years hence.