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Report to Congressional Requesters: 

United States Government Accountability Office: 
GAO: 

July 2009: 

Disaster Assistance: 

Greater Coordination and an Evaluation of Programs' Outcomes Could 
Improve Disaster Case Management: 

GAO-09-561: 

GAO Highlights: 

Highlights of GAO-09-561, a report to congressional requesters. 

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. 

What GAO Recommends: 

GAO recommends that FEMA (1) establish a time line for developing a 
disaster case management program, (2) include practices to enhance 
coordination among stakeholders involved in this program and (3) 
evaluate outcomes of disaster case management pilot programs to inform 
the development of this program. FEMA agreed with our recommendations 
and is taking steps to address them. 

View [hyperlink, http://www.gao.gov/products/GAO-09-561] or key 
components. For more information, contact Kay Brown at (202)512-7215 or 
brownke@gao.gov. 

[End of section] 

Contents: 

Letter: 

Background: 

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: 

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: 

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: 

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: 

Conclusions: 

Recommendations for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Objectives, Scope, and Methodology: 

Appendix II: Comments from the Department of Homeland Security: 

Appendix III: Comments from the Department of Housing and Urban 
Development: 

Appendix IV: GAO Contacts and Acknowledgments: 

Related GAO Products: 

Table: 

Table 1: List of Organizations Interviewed: 

Figures: 

Figure 1: Time Line of Federally Funded Disaster Case Management 
Programs for Victims of Hurricanes Katrina and Rita: 

Figure 2: Most to Least Frequently Occurring Client Need by Disaster 
Case Management Program: 

Figure 3: Evaluations of Federally Funded Disaster Case Management 
Pilot Programs: 

Abbreviations: 

DCM-P: Disaster Case Management Pilot: 

DHAP: Disaster Housing Assistance Program: 

FEMA: Federal Emergency Management Agency: 

HHS: Department of Health and Human Services: 

HUD: Department of Housing and Urban Development: 

KAT: Katrina Aid Today: 

LFRC: Louisiana Family Recovery Corps: 

Post-Katrina Act: Post Katrina Emergency Management Reform Act of 2006: 

SSBG: Social Services Block Grant: 

Stafford Act: Robert T. Stafford Disaster Relief and Emergency 
Assistance Act: 

TANF: Temporary Assistance for Needy Families: 

UMCOR: United Methodist Committee on Relief: 

[End of section] 

United States Government Accountability Office: Washington, DC 20548: 

July 8, 2009: 

The Honorable Joseph I. Lieberman: 
Chairman: 
Committee on Homeland Security and Governmental Affairs: 
United States 
Senate: 

The Honorable Mary Landrieu: 
Chairman: 
Ad Hoc Subcommittee on Disaster Recovery: 
Committee on Homeland 
Security and Governmental Affairs: 
United States Senate: 

Hurricane Katrina made landfall on the Gulf Coast in late August 2005 
and caused more than $80 billion in estimated property damage, making 
the storm the most expensive natural disaster in the history of the 
United States. Approximately 300,000 homes were destroyed or rendered 
uninhabitable. Less than one month later, Hurricane Rita struck the 
same region, severely damaging or destroying more than 23,600 homes in 
southwest Louisiana and southeast Texas and causing $10 billion in 
estimated property damage. Together, Hurricanes Katrina and Rita 
displaced more than 1 million people from some of the poorest 
communities in the country. To help hurricane victims recover from the 
unprecedented damage and displacement caused by the storms, the federal 
government provided more than $209 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 August 2009, nearly four years after the storms, the last federally 
funded disaster case management program for victims of Hurricanes 
Katrina and Rita is scheduled to end despite the thousands who still 
require assistance. Given the unprecedented damage and displacement 
caused by the hurricanes and the continuing recovery needs of victims, 
GAO was asked to review the federal government's efforts to leverage 
governmental and nongovernmental resources to help victims with their 
recovery. GAO has issued reports on housing, health care, the role of 
voluntary organizations, and services for victims residing in Federal 
Emergency Management Agency (FEMA) trailer group sites, among others. 
[Footnote 1] This report focuses on federally funded disaster case 
management programs and addresses the following key questions: 

1. What steps did the federal government take to support disaster case 
management programs after Hurricanes Katrina and Rita? 

2. How did federal agencies oversee the implementation of these 
disaster case management programs? 

3. What challenges did case management agencies experience in 
delivering disaster case management services under federally funded 
programs? 

4. How will previous or existing federally funded disaster case 
management programs be used to inform the development of a federal case 
management program for future disasters? 

To address these questions, we reviewed the roles and responsibilities 
of the federal government for disaster recovery services, as well as 
federal laws, regulations, and guidance related to the federally funded 
case management programs established to assist victims of Hurricanes 
Katrina and Rita, including the federal government's authority to 
establish or fund post-disaster case management programs. We also 
reviewed prior GAO work on best practices for coordination among 
federal agencies and between federal and nonfederal stakeholders. We 
interviewed federal officials from FEMA, the Department of Housing and 
Urban Development (HUD), and the Department of Health and Human 
Services (HHS). We focused our review on Louisiana and Mississippi, as 
those were the states most directly affected by Hurricanes Katrina and 
Rita, and conducted site visits to Baton Rouge and New Orleans, 
Louisiana; and Biloxi, Gulfport, Moss Point, Jackson, and Pascagoula, 
Mississippi. We conducted, either in person or by phone, interviews 
with organizations involved in disaster case management in these states 
(see table 1 in appendix I for a comprehensive list of the 
organizations interviewed). During these interviews, we obtained 
information on, among other topics, coordination between government 
agencies and case management agencies and challenges to helping clients 
meet their recovery needs. We selected interviewees to ensure that we 
spoke to representatives from a range of appropriate organizations 
serving Hurricane Katrina and Rita victims. In both states we spoke to 
the majority of disaster case management providers for the Katrina Aid 
Today (KAT) program and selected providers for the Disaster Housing 
Assistance Program (DHAP). We also spoke with selected providers for 
the state-managed Disaster Case Management Pilot (DCM-P) program in 
Mississippi. We did not interview disaster case management providers 
who served victims that relocated to other states. The views of the 
disaster case management providers we spoke with cannot be generalized 
to all organizations that provided disaster case management services to 
victims of Hurricanes Katrina and Rita. In addition to the interviews, 
we obtained summary data on KAT clients from the Coordinated Assistance 
Network database maintained by the American Red Cross and received 
record-level data from the Tracking-at-a-Glance database used for DHAP. 
These data included, among other variables, information on the needs of 
case management clients. We assessed the reliability of these data 
sources and used only those elements we found to be sufficiently 
reliable for the purposes of this report. For more information on our 
scope and methodology, see appendix I. We conducted this performance 
audit from May 2008 to July 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 based on our audit objectives. 

Background: 

Disaster Case Management: 

Case management is a process that assists people in identifying their 
service needs, locating and arranging services, and coordinating the 
services of multiple providers.[Footnote 2] Disaster case management 
uses the same process to help people recover from a disaster. The 
Council on Accreditation[Footnote 3] says disaster recovery case 
management services "plan, secure, coordinate, monitor, and advocate 
for unified goals and services with organizations and personnel in 
partnership with individuals and families. …[They] include practices 
that are unique to delivery of services in the aftermath of emergencies 
and major incidents." The Council on Accreditation adds that while 
disaster case management services may include emergency relief 
services, they extend beyond the immediate to address long-term 
recovery needs,[Footnote 4] such as health care, employment, housing, 
and other social services. In line with the Council on Accreditation 
standards, 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 5] In addition, according to the Council on 
Accreditation, the process of disaster case management generally 
includes assessment, recovery planning, service delivery, monitoring, 
and advocacy. 

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 a 
variety of local leaders--such as members of voluntary organizations, 
civic organizations, social service agencies, local churches, and case 
management agencies. Long-term recovery committees coordinate recovery 
efforts and provide resources to address the unmet needs of disaster 
victims when all other resources have been exhausted or when current 
resources are inadequate based on the victim's recovery plan. These 
committees often include unmet needs committees, or roundtables, at 
which case managers from member organizations present cases in order to 
obtain resources for clients in need. 

Federal Role for Funding and Coordinating Disaster Case Management 
Services: 

The federal role for funding and coordinating disaster case management 
was not explicitly defined until the passage of the Post-Katrina 
Emergency Management Reform Act of 2006 (Post-Katrina Act).[Footnote 6] 
The Robert T. Stafford Disaster Relief and Emergency Assistance Act 
(Stafford Act)[Footnote 7], as amended, is the primary authority under 
which the federal government provides major disaster and emergency 
assistance to states, local governments, tribal nations, individuals, 
and qualified private, nonprofit organizations. FEMA is responsible for 
administering the provisions of the Stafford Act. At the time of 
Hurricanes Katrina and Rita, the Stafford Act contained no explicit 
authority to fund disaster case management services. The Post-Katrina 
Act amended the Stafford Act and, among other things, 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 replaced the former National 
Response Plan--a framework for managing the federal response to 
disasters.[Footnote 8] Under the National Response Plan, in effect at 
the time of Hurricanes Katrina and Rita, FEMA was responsible for 
coordinating the delivery of human services to support state, regional, 
local, tribal government, and nongovernmental organization efforts. 
This included coordinating victim-related human services for recovery 
efforts such as counseling, support for persons with special needs, and 
expediting the processing of new federal benefits claims, among others. 
While the National Response Plan did not explicitly include or exclude 
disaster case management services, the Plan did state that close 
coordination is required among those federal agencies responsible for 
response operations and recovery activities, and other nongovernmental 
organizations providing assistance. 

In January 2008, the National Response Plan was revised and replaced 
with the National Response Framework, which became effective in March 
2008. The Framework maintains FEMA's responsibility for coordinating 
human services, and specifically includes disaster case management as 
one of several categories of human services. The National Response 
Framework recognizes the need for collaboration among the myriad of 
entities and personnel involved in response efforts at all levels of 
government and the nonprofit and private sectors and places increased 
responsibility on FEMA for coordinating with voluntary organizations. 
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 previous work, GAO has stated that these 
updated requirements for coordination with voluntary organizations are 
more extensive and specific than in the National Response Plan, and 
FEMA officials have told GAO that voluntary agency liaisons, who are 
FEMA employees, will fill this role.[Footnote 9] 

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. These programs overlapped and began at 
different times, as federal agencies identified ongoing need for 
services (see figure 1). We estimate that, at most, nearly 116,000 
families affected by Hurricanes Katrina and Rita relied on federally 
funded disaster case management services supported by FEMA, HUD, and 
HHS to obtain assistance in rebuilding their lives.[Footnote 10] 

Figure 1: Time Line of Federally Funded Disaster Case Management 
Programs for Victims of Hurricanes Katrina and Rita (Administering 
agency): 

[Refer to PDF for image: time line illustration] 

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 (FEMA): December 2005 – March 2008; 

Louisiana Family Recovery Corps (HHS): January 2006 – June 2007; 

Post-Katrina Emergency Management Reform Act enacted: October 4, 2006; 

Disaster Housing Assistance Program (HUD): September 2007 – February 
2009; 

Phase 1: Cora Brown Bridge Program (FEMA): April 2008 – May 2008; 

Phase 2: Mississippi Disaster Case Management Pilot Program (FEMA): 
August 2008 – May 2009. 

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] 

FEMA: 

In October 2005, during the immediate aftermath of Hurricane Katrina, 
the Department of State transferred $66 million of international 
donations to FEMA to finance disaster case management services for 
households affected by Hurricane Katrina.[Footnote 11] Although FEMA 
had not previously funded disaster case management, FEMA had proposed 
that international donations be used for this purpose due to the 
unprecedented magnitude of the damage and displacement caused by 
Hurricane Katrina. FEMA awarded a $66 million, 2-year case management 
services grant to the United Methodist Committee on Relief (UMCOR). 
[Footnote 12] UMCOR used the grant to establish KAT, a national 
consortium consisting of nine social service and voluntary 
organizations, to provide case management services to victims of 
Hurricane Katrina. As part of its case management system, the grant 
specified that UMCOR would initiate or support long-term recovery 
committees in all disaster affected states and KAT consortium members 
were to participate in these organizations. Furthermore, KAT consortium 
members were required to use the Coordinated Assistance Network 
database to track client information and case management activities. 

Although case management services provided by KAT were scheduled to end 
in October 2007, FEMA used interest accrued on the $66 million in 
charitable international donations--about $2 million--to allow KAT 
consortium members to continue providing disaster case management 
services through March 2008. KAT ended its activities on March 31, 
2008, and according to program data, served more than 69,000 
households. 

To assist the thousands of victims of Hurricanes Katrina and Rita that 
were still without permanent housing and continued to need case 
management services as KAT ended, FEMA collaborated with the states of 
Louisiana and Mississippi on a two-phase disaster case management 
program that would continue until March 1, 2009. The first phase used 
Cora Brown funds,[Footnote 13] given directly to Louisiana and 
Mississippi state governments--$524,000 and $502,000, respectively--to 
continue providing case management services to individuals and families 
affected by Hurricanes Katrina and Rita. This assistance--referred to 
as the Cora Brown Bridge Program or Phase 1--lasted from April 1, 2008 
to May 31, 2008, and, according to FEMA officials, served 1,747 clients 
in Louisiana and 1,314 in Mississippi who still had open KAT cases. 
Rather than giving the funds to the KAT organization, the states 
distributed the funds directly to the case management agencies that 
provided services under KAT, since the KAT program had officially 
ended. The intent of the program was to provide "bridge" case 
management services for clients while FEMA developed the second phase. 

For the second phase of the program, FEMA used funds from its Disaster 
Relief Fund[Footnote 14] for a state-managed DCM-P program. Through 
this pilot, case management services were intended for households in 
Louisiana and Mississippi affected by Hurricanes Katrina and Rita with 
the primary goal of helping them achieve sustainable permanent housing. 
Eligible families included those living in FEMA temporary housing, 
those with health-related concerns living in FEMA-funded hotels or 
motels, and those whose case management services were not fully 
completed in the Cora Brown case management program. FEMA awarded a 
conditional grant of $25.4 million to Mississippi in July 2008 and the 
program became operational in August 2008.[Footnote 15] The Mississippi 
Commission for Volunteer Services administered the program in 
Mississippi and created the Mississippi Case Management Consortium of 
13 member organizations. The program was scheduled to end March 1, 
2009, however FEMA extended the program until June 1, 2009. As of March 
2009, the Mississippi Commission for Volunteer Services reported that 
the consortium had served more than 3,000 families throughout 
Mississippi. According to FEMA officials, in October 2008, FEMA awarded 
an initial grant of $32.5 million to Louisiana to implement the DCM-P 
program, but the state was unable to implement the program due to the 
withdrawal of a lead agency. According to the lead agency officials, 
the agency withdrew due to the short time frame in which services were 
to be provided and the lack of direct assistance funds. In February 
2009, FEMA provided an adjusted grant award of $8.4 million, but 
Louisiana was unable to secure a contract with a different lead agency, 
the Louisiana Family Recovery Corps (LFRC), according to FEMA 
officials. According to LFRC officials, they declined to implement the 
program because there was not sufficient time in which to provide 
services, among other reasons. Because LFRC declined, the state of 
Louisiana proposed using funds allocated for the DCM-P program for 
construction instead. However, FEMA officials said this proposal was 
declined because it does not fall within the case management services 
for which the funds were originally intended. In addition, FEMA 
officials said it is unlikely that the DCM-P program will be 
implemented in Louisiana. 

HHS: 

Following the hurricanes, Congress appropriated emergency funding to 
states to help affected individuals and families through two programs 
administered by HHS, the Temporary Assistance for Needy Families (TANF) 
and Social Services Block Grant (SSBG) programs.[Footnote 16] These 
programs, through federal grants made to states, assist needy families 
with children and provide social services to individuals. HHS 
distributed $32.7 million in emergency TANF funds to Louisiana, which 
entered into a memorandum of understanding with LFRC to provide human 
services, including case management, to victims of Hurricanes Katrina 
and Rita residing in Louisiana. In October 2006, LFRC received 
approximately $18.5 million in emergency SSBG funds from the state. The 
contract between the state of Louisiana and LFRC required that 70 
percent of the TANF and SSBG funds be used for direct assistance and 30 
percent of the funds for case management assistance. LFRC awarded 
grants to nonprofit agencies to provide case management services across 
the state of Louisiana from January 2006 through June 2007. 

Due to federal eligibility criteria for these programs, LFRC could only 
use TANF funds to support needy households with minor children and SSBG 
funds could be used to support low-income households with or without 
minors. In addition, program rules limited TANF-funded emergency 
assistance to 4 months. According to an evaluation of LFRC, the program 
provided case management services to more than 9,500 families in 
Louisiana. 

HUD: 

When it became clear that existing housing efforts to assist victims of 
Hurricanes Katrina and Rita would be insufficient, FEMA and HUD signed 
an inter-agency agreement in July 2007 for HUD to design and implement 
a pilot grant program known as the Disaster Housing Assistance Program 
(DHAP).[Footnote 17] The main purpose of DHAP was for HUD to provide 
rental assistance to eligible victims of Hurricanes Katrina and Rita 
from September 1, 2007 to March 1, 2009.[Footnote 18] Eligibility for 
DHAP was determined by FEMA and included anyone who was displaced from 
their homes as a result of Hurricanes Katrina or Rita and consequently 
was either receiving or was eligible to receive rental assistance 
administered by FEMA. To participate, clients also had to receive case 
management services.[Footnote 19] 

DHAP was funded by FEMA, using up to $585 million from its Disaster 
Relief Fund. According to HUD officials, $63.8 million of these funds 
supported the case management portion of the program. While HUD worked 
through its existing network of local public housing authorities in 
several states across the U.S. to implement DHAP, 59 percent of cases 
were in Louisiana, and only 1 percent of cases were in Mississippi. In 
turn, many public housing authorities contracted with other agencies to 
provide the case management services required by the program. On August 
5, 2008, the Mississippi Case Management Consortium--the organization 
created to implement FEMA's state-managed DCM-P program--took over the 
case management portion of DHAP for most new DHAP clients in 
Mississippi, according to HUD officials.[Footnote 20] HUD data 
indicated that over 30,000 clients received case management. Some DHAP 
clients will continue to receive housing assistance through a DHAP 
transitional closeout program until August 31, 2009.[Footnote 21] 
States may request to provide case management services during the 
transitional closeout period. For clients in Louisiana, HUD officials 
said they signed an agreement on March 20, 2009 with the Louisiana 
Recovery Authority to provide case management to 16,000 clients in the 
DHAP transitional closeout program. According to HUD officials, no 
other states have made similar requests to continue case management 
services. 

Breaks in Federal Funding Adversely Affected Disaster Case Management 
Services to Some Hurricane Victims: 

The discontinuous nature of the federally funded disaster case 
management programs initiated after Hurricanes Katrina and Rita led to 
breaks in funding that 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 case 
management program--KAT--drew to a close in March 2008, some case 
management providers began to shut down their operations and case 
managers were laid off. Officials from two KAT agencies noted that some 
cases were closed not because clients' needs were met, but because the 
program was ending. It was not until 3 days before the official end of 
the KAT program that FEMA announced the continuation of services 
through FEMA's Cora Brown Bridge Program. Because eligibility was 
limited to those with open KAT cases, and since FEMA did not require 
case management agencies to track clients who continued to have 
disaster-related needs, but whose cases were closed only because the 
KAT program ended, it is unknown whether some clients still in need of 
case management obtained assistance elsewhere or whether their cases 
were eventually reopened when the case management agencies received the 
Cora Brown Bridge program funding. 

The break in federal funding after the Cora Brown Bridge program ended 
also forced some case management agencies to shut down their programs 
as they waited for the new federal program to start. Clients with open 
cases under the Cora Brown Bridge program were supposed to transition 
from the bridge program, which ended on May 31, 2008, to FEMA's state- 
managed DCM-P program, which was supposed to begin in June 1, 2008. 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.[Footnote 22] In addition, while Louisiana received an award 
letter from FEMA for the program in February 2009--8 months after the 
program was intended to begin--the program never became operational in 
the state due to time constraints. An official at one case management 
agency in Louisiana said the organization used at least $225,000 of its 
own resources to keep clients' cases active while waiting for a 
decision on whether Louisiana would receive funds for a state-managed 
DCM-P program. However, not all case management agencies had the 
resources to continue to provide services. According to the Mississippi 
Case Management Consortium, many of the smaller case management 
organizations were unable to find alternative resources to pay the case 
managers hired in June for FEMA's state-managed DCM-P program and had 
to lay off case managers with the hope of hiring them back once they 
received federal funding. 

The breaks in service after the bridge program concluded left 
additional hurricane victims in need of services without access to case 
management. Although FEMA guidance estimated that it would refer 8,378 
people to the state-managed DCM-P program in Mississippi, FEMA referred 
only 5,456 people to the Mississippi state agency administering the 
pilot program. Of those, 3,432 had been served as of March 2009. 
[Footnote 23] According to FEMA, the difference between the target 
estimate and actual number of clients assigned to the Mississippi 
state-managed DCM-P program is accounted for by the number victims in 
FEMA temporary housing that moved into more suitable housing before the 
pilot program became operational. A FEMA official also told us that the 
primary method for relocating applicants to more suitable housing was 
DHAP, which required clients to participate in case management 
services. However, data do not exist to determine if victims who found 
more suitable forms of housing outside of DHAP received disaster case 
management services. In addition, FEMA guidance estimated that 18,820 
clients were to be referred to the Louisiana DCM-P program. However, 
because the program was never implemented in Louisiana, it is likely 
that many of these clients did not receive services since nonprofits 
throughout the state would not have been able to absorb these clients, 
according to LFRC officials. 

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. When Hurricane Katrina made 
landfall, specific policies and procedures for handling international 
cash donations to the federal government had not yet been developed. 
[Footnote 24] According to a FEMA official, FEMA acted as a pass- 
through for the international funds. FEMA approved the grant proposal 
submitted by UMCOR and relied on reports of the program objectives in 
the proposal to monitor the implementation of KAT. As stipulated in the 
grant proposal, UMCOR submitted quarterly financial and performance 
reports to FEMA that contained information on program objectives, the 
number of referrals provided and utilized, and other indicators. 
According to a FEMA official who had a key role in overseeing the UMCOR 
grant, FEMA reviewed the reports, frequently participated in 
discussions with KAT representatives, attended regular quarterly 
management meetings with KAT members, and provided technical guidance 
to KAT personnel. FEMA discussed challenges to implementing KAT with 
UMCOR, but believed it was beyond the scope of its authority to ensure 
that all aspects of the grant proposal were carried out. For example, 
the grant proposal stated that UMCOR would initiate or support the 
formation of long-term recovery committees, and representatives from 
KAT agencies would participate. According to case management agencies, 
these committees did not always operate effectively. While FEMA 
officials were aware of this challenge, the agency did not believe it 
had authority to take action. 

Similarly, FEMA relied on the procedures specified in the approved 
grant proposal for obtaining information on clients. The grant proposal 
stipulated that KAT case management agencies would utilize the 
Coordinated Assistance Network database to input case management data 
and to provide for easy transfer of information between agencies. The 
Coordinated Assistance Network[Footnote 25]--initiated and developed by 
charitable disaster response organizations--is the national database 
used to coordinate and manage service delivery for disaster relief 
organizations, including KAT partners. According to KAT guidance, it is 
a tool for sharing referral information and services, storing client 
information, and transferring clients between partners without 
interruption to service. This database is also used to extract client 
information, case management services provided, needs, recovery plan 
outcomes, information on case closings, and demographic information for 
reports and evaluation purposes. KAT selected the Coordinated 
Assistance Network as the database for coordinating case management 
services and reporting on outcomes and indicators. 

Data from the Coordinated Assistance Network database provided limited 
information on overall program outcomes for KAT clients, in part 
because the extent to which data were consistently entered into the 
system varied, but recent changes will help case management agencies 
use the database more consistently in the future. UMCOR provided FEMA 
with quarterly reports from KAT that contained data generated from the 
Coordinated Assistance Network, but FEMA did not assess the 
completeness or reliability of the data because government agencies are 
not permitted to access the database.[Footnote 26] In addition, because 
the Coordinated Assistance Network does not receive federal funds, FEMA 
had no authority to audit the system, according to a FEMA official. 
According to a third party evaluation of KAT, many KAT staff and 
external stakeholders stated the Coordinated Assistance Network 
database was successful in helping agencies communicate with one 
another, track resources, and generate progress reports. However, data 
on certain variables were missing for a large number of clients because 
users of the system did not consistently enter complete information. As 
a result, the database is of limited use in understanding outcomes of 
the program as a whole such as the frequency of certain client needs 
and the extent to which those needs were met. Representatives of the 
Coordinated Assistance Network told us that changes have since been 
made to the database to help case management agencies enter data more 
consistently, which may help track outcomes in the future.[Footnote 27] 
For example, according to the representatives, the database now has the 
capability to require entry in certain data fields. 

As recovery continued and FEMA's role in funding disaster case 
management became explicit, FEMA and HUD used various methods--such as 
reviewing disaster case management data, conducting site visits, and 
providing technical support--to oversee later disaster case management 
programs. FEMA reviewed reports from the Mississippi state agency that 
administered the state-managed DCM-P program. The Mississippi state 
agency was required to report to FEMA on a quarterly basis on all 
state- managed DCM-P program activities and costs, and include a 
narrative summary of the program's status, accomplishments, and 
challenges. In addition, FEMA assigned a DCM-P coordinator to 
Mississippi to provide coordination and technical assistance. FEMA 
reviewed the quarterly reports and conducted site visits. FEMA's DCM-P 
program also provided funding for monitoring staff, which were 
responsible for testing data reliability, according to a FEMA official. 
To monitor the implementation of DHAP, HUD produced weekly reports from 
its case management database and hired a contractor to monitor and 
provide technical assistance to DHAP grantees, according to HUD 
officials. The contractor also reviewed data quality and followed up 
with DHAP grantees on the case management program, irregularities in 
DHAP reports, and any implementation challenges. HUD also established 
monitoring tasks for DHAP grantees based on caseloads, as well as 
scores on various key processes and output and outcome metrics. 

Challenges to Coordination Among Federal Agencies and Case Management 
Agencies Contributed to Implementation Difficulties: 

Federal agencies and case management agencies faced challenges in 
following key practices for coordination in delivering disaster case 
management services. In previous work, GAO has identified key practices 
to enhance and sustain coordination among federal agencies,[Footnote 
28] and has since recommended these same key practices to strengthen 
partnerships between government and nonprofit organizations.[Footnote 
29] Key practices for coordination include establishing mutually 
reinforcing or joint strategies and compatible policies, procedures, 
and other means of operating across agency boundaries. While FEMA had a 
lead role in coordinating other types of disaster assistance after 
Hurricanes Katrina and Rita, their role for coordinating disaster case 
management was not explicit. Initial coordination activities among 
federal agencies and case management providers were minimal following 
the hurricanes. As a result, some victims may not have received case 
management services while others may have received services from 
multiple providers. Challenges faced by federal agencies and case 
management providers in following key practices for coordination may 
provide lessons for disaster case management services in future 
disasters. 

Lack of Accurate and Timely Information Sharing: 

Difficulties in coordinating disaster case management services resulted 
in a lack of accurate and timely information sharing between federal 
agencies and case management providers. State and local agencies 
providing federally funded disaster case management services faced 
challenges in obtaining timely and accurate information from the 
federal agencies overseeing the programs. For example, the Mississippi 
state agency administering the FEMA state-managed DCM-P program faced 
challenges receiving complete and accurate information from FEMA. 
According to officials in Mississippi who managed the program, FEMA 
provided clients' names with addresses or phone numbers, but these were 
often invalid or out-of-date. According to a FEMA official, FEMA has no 
method for tracking clients, and clients voluntarily contact FEMA to 
provide updated information. Program managers reported that case 
management providers in Mississippi were unable to contact more than 
1,000 clients, out of a total of more than 5,000 clients, due to 
disconnected phone numbers or incorrect addresses. According to the 
FEMA official, FEMA's information sharing policies under the Privacy 
Act precluded the agency from providing registration numbers that would 
have allowed the agency to match cases with clients served through 
previous programs and more easily identify and contact eligible 
individuals.[Footnote 30] While FEMA attempted to update information on 
these clients, a FEMA official told us the work was time consuming 
because client contact information could be stored in various FEMA 
databases. In addition, officials from a public housing authority in 
Mississippi told us they were notified by HUD that they would receive 
DHAP clients only 5 days prior to the deadline for processing housing 
assistance payments for the clients, which was a difficult timeframe to 
meet.[Footnote 31] 

In addition, some case management providers faced difficulties in 
obtaining information from FEMA that may have facilitated the 
coordination of service delivery. To protect the privacy of disaster 
victims, FEMA shared limited client information, potentially resulting 
in some eligible hurricane victims not receiving services. For example, 
according to an official of a case management agency operating in 
Louisiana and an HHS official, FEMA approached HHS about serving some 
victims of Hurricanes Katrina and Rita under its pilot disaster case 
management program for Hurricanes Gustav and Ike. The potential clients 
were residing in FEMA-provided travel trailers and mobile homes but may 
not have been receiving case management services because the state- 
managed pilot program never became operational in Louisiana. However, 
when the case management agency implementing the HHS pilot requested 
client information from FEMA to determine whether it was already 
serving any of these disaster victims and to assess its capacity to 
serve additional clients, FEMA only provided aggregate data on the 
number of mobile homes and travel trailers in each parish. The case 
management agency found this information unusable.[Footnote 32] 
According to FEMA officials, its routine use policy specifies that for 
an organization to obtain client-level information, it must indicate a 
specific service it intends to provide to the disaster victims for 
which information is requested. As FEMA officials explained to us, such 
a request for client-level information from the case management agency 
implementing the HHS pilot would have been denied based on this policy. 

Incompatible Databases: 

Many of the databases used by case management agencies--including those 
used by KAT, LFRC, and agencies that provided case management services 
under DHAP--were not compatible, leading to confusion regarding the 
services clients may have received. As GAO has reported, to facilitate 
coordination, agencies need to address the compatibility of data 
systems to operate across agency boundaries.[Footnote 33] The 
incompatibility of the databases made it difficult to track clients 
across agencies, and some hurricane victims who applied to more than 
one program may have received duplicate services. For example, clients 
who received case management services through KAT may have also 
received services through LFRC, but because the KAT and LFRC 
databases--the Coordinated Assistance Network database and 
ServicePoint, respectively--are not compatible, some case management 
agencies for these two programs may not have be able to screen for 
duplication of services.[Footnote 34] 

While case management agencies that operated under KAT and FEMA's 
state-managed DCM-P program used the Coordinated Assistance Network 
database in an effort to facilitate consistent data collection across 
case management agencies and to report information on their programs, 
government agencies could not access the system, creating 
inefficiencies. The database, which offers tools for case management, 
allows disaster relief organizations to communicate about clients' 
needs and services offered. However, because government agencies 
administering case management programs are not given access to the 
system, officials from Mississippi who administer FEMA's state-managed 
DCM-P program told us they had to incorporate a nonprofit agency as an 
intermediary in its management structure to access and collect data for 
the state to report to FEMA. The Mississippi DCM-P program officials 
considered this process inefficient. 

Inconsistent Outreach: 

Many case management agencies conducted little coordinated outreach, if 
any, 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. GAO has reported that to achieve a common outcome, partner 
agencies need to establish strategies that work in concert or are joint 
in nature to help align their activities and resources.[Footnote 35] 
Case management agencies we spoke to acknowledged that victims residing 
in FEMA group sites needed a range of services and may have been those 
most in need. In addition, we previously reported that FEMA officials 
said that those who remained in group sites were the hardest to serve 
people including the elderly, persons with disabilities, and unemployed 
people.[Footnote 36] According to LFRC officials, there was no 
coordinated approach for providing case management services among 
federally funded programs, and without a coordinated approach to case 
management, residents in these group sites may not have received needed 
case management. 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 37] FEMA's 
state-managed DCM-P program specifically targeted those in FEMA-funded 
temporary housing, including group sites. However, in Mississippi, for 
example, FEMA's housing advisors[Footnote 38] were not always aware of 
FEMA's DCM-P program, and this lack of coordination led to confusion 
and frustration among FEMA housing advisors, case managers, and 
clients, according to Mississippi officials. 

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. For example, one case management agency reported 100 
percent turnover in its case managers during the KAT program. An 
official at this agency said turnover was high because case managers 
expected a short-term assignment or found the work too emotionally 
draining. While KAT partners tried to reduce staff turnover through 
incentive systems such as flex time and bonuses and through staff 
meetings to determine how best to share resources to support case 
managers, according to a KAT summary of its quarterly reports, the 
retention of case managers was an ongoing challenge for maintaining the 
capacity to serve clients. Similarly, an evaluation of LFRC showed 
that, in one focus group, six out of nine participants did not know who 
their current case manager was because of staff changes; others 
described their replacement case managers as lacking knowledge about 
available resources.[Footnote 39] 

Caseloads were generally significantly higher than suggested by program 
guidance for earlier programs, which adversely affected the assistance 
provided to clients. KAT guidance suggested that one case manager could 
handle an average of 20 to 30 cases, and LFRC caseloads were to be 
limited to 25 clients; however, several case management agencies we 
spoke with that operated under these programs reporter much higher 
caseloads. For example, some KAT case managers said they had 40 open 
cases at a time, while other KAT case managers said caseloads were as 
high as 300 clients per case manager. KAT's summary of its quarterly 
reports also states that senior management became concerned that new 
cases were not being opened fast enough and agreed that the pace needed 
to be accelerated despite case managers' already high caseloads. In 
addition to KAT, LFRC case management agencies also reported having 
heavy caseloads; for example, case managers at one LFRC partner agency 
reported caseloads ranging from 60 to 100 clients. Several factors may 
have contributed to high caseloads including the magnitude of the 
disaster and a shortage of case managers. Multiple case management 
agencies said the number of hurricane victims outnumbered case manager 
capacity, and some case management agencies had to turn clients away or 
had waiting lists as a result. For victims who did receive services, 
case managers may not have been able to build more personal 
relationships to fully understand clients' recovery needs in order to 
provide assistance. Case management agencies operating under later 
programs such as DHAP and the Mississippi DCM-P program have not 
exceeded required caseload sizes of 50 and 25 cases, respectively. 
According to a Mississippi DCM-P official, this is because staffing for 
the program was based on a fixed number of clients. 

Clients Had Multiple Needs Including Housing, Employment, and 
Transportation; However, These Community Resources Were Limited: 

Case managers said one of the main needs of clients was and continues 
to be housing; however, housing resources have been limited following 
the hurricanes. According to program data, approximately 67 percent of 
KAT clients were displaced from their primary residence as a result of 
Hurricane Katrina. As GAO previously reported, Hurricane Katrina 
destroyed or made uninhabitable an estimated 300,000 homes,[Footnote 
40] and more than 82,000 rental housing units in Louisiana and more 
than 20,000 rental housing units in Mississippi had major or severe 
damage following the 2005 Gulf Coast Hurricanes, according to statewide 
HUD data.[Footnote 41] We previously reported that under HUD's 
Community Development Block Grant program--a key program providing 
federal funds to rebuild housing in Louisiana and Mississippi--the 
states have used the majority of funding to assist homeowners rather 
than renters. For example, while Louisiana allocated $8 billion of 
$10.4 billion in Community Development Block Grant funding to establish 
the Road Home program to help homeowners rebuild, $1.7 of the $10.4 
billion went to rental, low-income housing, and other related housing 
projects. Further, for the Road Home program, Louisiana estimated a 
$2.9 to $5 billion shortfall in funding to help homeowners.[Footnote 
42] In addition, we reported that through the Gulf Opportunity Zone 
Act, which provided low-income housing tax credits to help finance the 
development of rental housing, only 17 percent of the rental housing 
units with major or severe damage in the state of Louisiana, and 45 
percent of the similarly damaged units in the state of Mississippi, 
would be addressed.[Footnote 43] The limited availability of housing 
following Hurricanes Katrina and Rita has made it difficult to help 
some clients with their recovery needs. For example, HUD officials 
estimate that approximately 12,000 former DHAP clients may need and be 
eligible for long-term housing assistance through the Housing Choice 
Voucher program.[Footnote 44] HUD is in the process of transitioning 
families to this program. 

Case managers said that client needs also included employment and 
transportation, but these community 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, an Urban Institute report stated that several hundred 
thousand former residents of New Orleans and the Gulf Coast lost their 
jobs as a result of Hurricane Katrina.[Footnote 45] Despite some job 
recovery since Hurricanes Katrina and Rita, some DHAP case managers 
recently stated that employment was still a common need among their 
clients. We previously reported that transportation services can 
provide a vital link to other services and employment for displaced 
persons;[Footnote 46] yet multiple sources stated that clients, 
particularly those living in FEMA group sites, needed transportation 
following Hurricanes Katrina and Rita. For example, 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.[Footnote 47] 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 48] Data from KAT and DHAP indicated the 
types of resources clients needed to aid in their recovery (see figure 
2). 

Figure 2: Most to Least Frequently Occurring Client Need by Disaster 
Case Management Program: 

[Refer to PDF for image: illustration] 

The following lists are prioritized by level of need from 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 predefined 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 and appliances, or clothing; as a result, the KAT and DHAP 
categories are not a one-to-one match. 

[End of figure] 

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 without direct service funds, short-term needs 
ultimately can become long-term issues because individuals have to rely 
on the social service system to fulfill their needs and may become 
dependent on government assistance rather than becoming self 
sufficient. For example, a family might come into a case management 
program with a need for money to fix their roof, but they may not 
qualify for government assistance outside of disaster case management 
to repair their home. Direct assistance funds to repair their roof 
might help them stay on track, but if these funds are unavailable, the 
family could require long-term housing assistance at a much greater 
cost. In addition, case management officials said that referrals to 
other resources were not always available or had waiting lists. For 
example, an official administering the FEMA state-managed DCM-P program 
in Mississippi said there were minimal resources available for clients 
to obtain assistance for needs such as rental and utility deposits. In 
addition, according to an Urban Institute report, many nonprofit social 
service organizations that existed before the storms were no longer 
operating while others may not have been able to operate at their 
previous capacity due to sustained damage.[Footnote 49] 

Depending on the funding source, some case management agencies could 
provide direct assistance to clients while others could not. Using 
emergency TANF and SSBG funds provided by HHS through the state of 
Louisiana, LFRC case management agencies were allowed to give up to 
$3500 in financial assistance to a client. LFRC stipulated in contracts 
with its case management agencies the types of goods and services 
allowed as direct assistance, such as living accommodations and 
transportation. However, according to an evaluation of LFRC, the case 
management agencies did not have a shared understanding about how funds 
could be used, which affected a client's ability to access needed 
items. For example, some LFRC case management agencies allowed case 
managers to provide funds for medical costs or labor and material costs 
to rebuild homes, whereas other LFRC case management agencies did not. 
[Footnote 50] Case management agencies that were part of KAT were not 
allowed to use dollars from international donations distributed by FEMA 
on direct assistance to clients. However, KAT case management agencies 
could refer clients to other organizations or use private funds to 
provide direct assistance to clients. Case management agencies 
providing services under FEMA-funded programs, including the state- 
managed DCM-P program in Mississippi and the DHAP program, could not 
provide direct assistance. According to a FEMA official, direct 
assistance was not part of these programs because FEMA already provided 
direct service funding through the Individual and Households Program. 
The maximum amount that an individual or household may receive through 
the Housing Assistance and Other Needs Assistance programs within the 
Individual and Households Program is statutorily capped at $25,000, 
[Footnote 51] adjusted annually to reflect changes in the Consumer 
Price Index.[Footnote 52] In addition, there are caps on the amount 
of assistance that can be provided to individuals and households for 
some items within these programs. For example, FEMA can provide up to 
$5,000, also adjusted annually, for home repair assistance. According 
to case management officials, not all clients qualify for the maximum 
amount of assistance available through the Individual and Households 
Program, and a FEMA official noted that the maximum amount may not be 
enough to meet all disaster-related needs. 

According to case managers, the different funding rules on direct 
assistance resulted in clients "shopping around" for services. Case 
managers we spoke with stated that some clients went to more than one 
agency for services to find one that could provide direct assistance, 
particularly in Louisiana where multiple agencies were providing 
disaster case management at the same time in the same communities. 
Since disaster case management programs used different and incompatible 
databases to record client information, some clients likely received 
duplicate services since case managers could not track clients across 
programs. As a result, some hurricane victims may have gone through the 
intake process more than once with different case managers affiliated 
with different case management programs, creating additional work for 
case managers with already high caseloads and preventing them from 
helping other victims who had not yet received assistance. 

While long-term recovery committees were a resource for case managers 
to obtain direct assistance to address clients' unmet needs, in some 
cases, utilizing these committees was unsuccessful. Some committees 
were unable to help clients since the member agencies 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. 
For example, a third-party evaluation of the KAT program[Footnote 53] 
and officials at one case management agency we interviewed stated that 
cases received intense scrutiny from committee members, which left case 
managers intimidated and humiliated. Further, the evaluation of the KAT 
program indicated there was confusion associated with the long-term 
recovery committee process because there may have been multiple 
committees operating in the same area. For example, according to a case 
management official, if there were several committees in the same 
county, case managers did not know whether they had to present their 
cases to each committee individually.[Footnote 54] Case management 
officials we interviewed also said long-term recovery committees were 
organized differently. For example, one case management official said 
some committees combined money from all organizations and used the 
pooled money to assist clients while other committees did not combine 
funds; without one common funding source, clients could receive 
assistance from multiple organizations in the same committee, but they 
did not always receive money in a timely matter since they had to wait 
on checks from multiple sources. 

Case Managers Said that Program Eligibility Requirements Were a Barrier 
to Providing Disaster Case Management Services: 

Eligibility requirements to receive disaster case management services 
also varied depending on the funding source. Federal funds provided by 
FEMA for KAT could only be used for victims of Hurricane Katrina, even 
though a portion of the disaster affected area included victims of 
Hurricane Rita as well.[Footnote 55] LFRC officials said they could not 
help other hurricane victims such as the elderly residents in FEMA 
trailer sites because the emergency TANF funds they used restricted 
their agencies to serving families with children. LFRC eventually 
received SSBG funds that were not restricted to families with children, 
which widened eligibility for disaster case management assistance. 
However, according to an evaluation of the LFRC case management 
program, expansion of client eligibility was not clearly communicated 
outside of LFRC, and key stakeholders were not aware that services were 
available to a wider population; these stakeholders identified this as 
a shortcoming of the program.[Footnote 56] 

Eligibility guidelines that restricted disaster case management 
programs to serving those residing in FEMA temporary housing or 
receiving FEMA housing assistance may have prevented some programs from 
assisting other individuals or families in need of case management 
services. Case managers at an agency in Mississippi said they were 
aware of at least 200 households who needed assistance but were not 
eligible for services through the FEMA state-managed DCM-P program 
because they were not in FEMA housing. In addition, officials at a case 
management provider in Louisiana said there were thousands of families 
deemed ineligible for FEMA's Louisiana DCM-P program that would have 
benefited from disaster case management. Data are not available to 
determine whether ineligible individuals ultimately received services. 

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. FEMA hired a contractor to evaluate the 
implementation of two FEMA-funded programs--the state-managed DCM-P 
program in Mississippi and Louisiana and the HHS disaster case 
management pilot program for victims of Hurricanes Gustav and Ike. The 
contractor will submit its evaluation to FEMA by June 30, 2009. In 
addition, a FEMA official said the contractor will likely evaluate, at 
a later date, the disaster case management portion of the DHAP programs 
for victims of Hurricanes Katrina, Rita, Gustav and Ike and a DCM-P 
program in Texas. In addition to FEMA's evaluation of their programs, 
HHS provided FEMA with an evaluation of the disaster case management 
pilot program it administered. HUD and the agency managing the DCM-P 
program in Mississippi will also provide FEMA with evaluations of the 
disaster case management pilot programs they administered (see figure 
3). These evaluations vary in scope. For example, the Mississippi Case 
Management Consortium, the agency managing the Mississippi DCM-P 
program, is conducting an evaluation that will adhere to program 
guidance and examine whether the targets and objectives of the state- 
specific strategies were met. The Consortium will also evaluate 
financial and programmatic performance to ensure that appropriate 
disaster case management outcomes were provided for clients of 
Hurricanes Katrina and Rita. The HUD evaluation of DHAP case management 
for victims of Hurricanes Katrina and Rita will include, among other 
areas, an assessment of implementation challenges and successful case 
management activities.[Footnote 57] 

Figure 3: Evaluations of Federally Funded Disaster Case Management 
Pilot Programs: 

[Refer to PDF for image: illustrated table] 

Programs evaluated: 

Agency conducting evaluation: Federal Emergency Management Agency; 
Hurricanes Katrina and Rita: Mississippi Disaster Case Management Pilot 
Program: Evaluation planned or in progress; 
Hurricanes Katrina and Rita: Louisiana Disaster Case Management Pilot 
Program: Evaluation planned or in progress; 
Hurricanes Katrina and Rita: Disaster Housing Assistance Program: 
Evaluation may occur at a later date; 
Hurricanes Gustav and Ike: HHS Disaster Case Management Pilot Program: 
Evaluation planned or in progress; 
Hurricanes Gustav and Ike: Texas Disaster Case Management Pilot 
Program: Evaluation may occur at a later date; 
Hurricanes Gustav and Ike: Disaster Housing Assistance Program: 
Evaluation may occur at a later date. 

Agency conducting evaluation: Department of Health and Human Services 
(HHS); 
Hurricanes Katrina and Rita: Mississippi Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Katrina and Rita: Louisiana Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Katrina and Rita: Disaster Housing Assistance Program: 
[Empty]; 
Hurricanes Gustav and Ike: HHS Disaster Case Management Pilot Program: 
Evaluation complete; 
Hurricanes Gustav and Ike: Texas Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Gustav and Ike: Disaster Housing Assistance Program: 
[Empty]. 

Agency conducting evaluation: Department of Housing and Urban 
Development; 
Hurricanes Katrina and Rita: Mississippi Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Katrina and Rita: Louisiana Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Katrina and Rita: Disaster Housing Assistance Program: 
Evaluation may occur at a later date; 
Hurricanes Gustav and Ike: HHS Disaster Case Management Pilot Program: 
[Empty]; 
Hurricanes Gustav and Ike: Texas Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Gustav and Ike: Disaster Housing Assistance Program: 
Evaluation planned or in progress. 

Agency conducting evaluation: Mississippi Case Management Consortium; 
Hurricanes Katrina and Rita: Mississippi Disaster Case Management Pilot 
Program: Evaluation planned or in progress; 
Hurricanes Katrina and Rita: Louisiana Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Katrina and Rita: Disaster Housing Assistance Program: 
[Empty]; 
Hurricanes Gustav and Ike: HHS Disaster Case Management Pilot Program: 
[Empty]; 
Hurricanes Gustav and Ike: Texas Disaster Case Management Pilot 
Program: [Empty]; 
Hurricanes Gustav and Ike: Disaster Housing Assistance Program: 
[Empty]. 

Source: GAO. 

Notes: The agencies listed hired contractors to conduct all, or part, 
of the evaluations on their behalf. 

The evaluations of the Disaster Housing Assistance Program examine the 
case management portion only. 

[End of figure] 

Neither FEMA's evaluation nor the HHS or HUD evaluations will provide 
information on the outcomes of case management services. Unlike an 
outcome evaluation, which assesses the extent to which a program 
achieved its outcome-oriented objectives, the FEMA and HHS evaluations 
are process or implementation evaluations.[Footnote 58] According to 
the statement of work for the FEMA evaluation, the contractor will 
assess program implementation from the time FEMA funded the programs to 
the time case management services began. For example, the contractor 
will evaluate whether funds granted were administered within guidelines 
and compare the planned costs versus actual costs of the programs. 
However, the contractor will not examine program results, such as 
whether clients' needs were met and what factors contributed to client 
outcomes. A FEMA official said the evaluation only focuses on overall 
implementation rather than the provision of services because they 
believe the case management process is very similar for all programs. 
HHS' evaluation examined the early implementation of the disaster case 
management pilot during the first 2 weeks of the program and developed 
recommendations regarding this period. According to a HUD official, the 
data analysis completed by the contractor conducting the evaluation, 
which was intended to provide information on client outcomes, did not 
allow HUD to derive substantial conclusions.[Footnote 59] 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, FEMA said 
that the agency expects to receive other evaluations of the Mississippi 
DCM-P program and HHS pilot that may provide information on individual 
program outcomes. Further, these evaluations will provide limited 
information to assess the causes and results of challenges we have 
identified, including barriers to coordination and information sharing. 

In addition, FEMA's evaluation of all of the disaster case management 
pilot programs is limited in that stakeholders were not asked to 
provide input regarding the evaluation design. According to the 
American Evaluation Association's Guiding Principles for Evaluators, 
evaluations should include relevant perspectives and interests of the 
full range of stakeholders. The statement of work for FEMA's evaluation 
required that the contractor consult FEMA and other stakeholders in 
identifying performance measures, setting performance standards, and 
designing the evaluation. FEMA officials said they contacted HHS 
officials early on in the development of the evaluation; however, 
officials at HHS and at the case management provider implementing the 
HHS pilot said they had no involvement in designing FEMA's evaluation 
and had not been contacted to provide input. FEMA officials also stated 
that they did not ask other organizations for input on their evaluation 
design. As a result, stakeholders that likely had more intimate 
knowledge about the programs evaluated by FEMA's contractor were not 
able to provide input that may have strengthened the evaluation. 

Using information from its evaluation and those from other agencies, 
FEMA will develop a model for a federal disaster case management 
program for future disasters. However, a FEMA official said FEMA does 
not have a time line or goal for developing this program. Establishing 
a time line that includes major activities that need to take place and 
completion dates for all activities leading up to them can help to 
identify potential problems that could arise during program development 
and determine whether the time line is realistic and achievable. Until 
FEMA develops its disaster case management program, providing federal 
funds for disaster case management services will be done on a case-by- 
case basis, depending on the magnitude of the disaster. In addition, 
while stakeholders were not involved in designing FEMA's program 
evaluation, FEMA officials told us they will have stakeholder meetings 
when they develop the future federal disaster case management program. 

Conclusions: 

Federally funded disaster case management programs following Hurricanes 
Katrina and Rita faced unprecedented challenges, in part because of the 
sheer size of the disaster, yet they played a key role in assisting 
individuals and families in their recovery and will remain a component 
of future disaster recovery efforts. The scarcity of significant 
community resources has continued to limit the ability of case 
management agencies to make referrals and connect clients to needed 
resources. More than 3 years after Hurricanes Katrina and Rita made 
landfall on the Gulf Coast, many individuals and families remain in 
temporary housing, have yet to regain employment, and continue to need 
other services to rebuild their lives. 

As the federal government seeks to improve its overall disaster 
response, a critical component in doing so is FEMA's development of a 
single, federal disaster case management program. However, the time 
line for creating this program has not yet been established. Providing 
disaster case management services on a case-by-case basis will likely 
result in many of the same problems we identified for Hurricane Katrina 
and Hurricane Rita programs; however, establishing a single program may 
address some of these challenges--such as those related to gaps in 
funding and insufficient coordination--and also help ensure that scarce 
resources are used effectively. Developing a time line for this program 
is critical to help FEMA and other organizations better plan given the 
uncertainty of when and how large the next major disaster will be. 

Given the magnitude of devastation caused by Hurricanes Katrina and 
Rita, we recognize the efforts made by multiple federal agencies to 
meet the overwhelming need for disaster case management services. But 
difficulties in coordinating various stakeholders, both federal and 
nonfederal, may provide lessons learned for providing services 
following future disasters. FEMA's role for coordinating disaster case 
management was not explicit at the time of Hurricanes Katrina and Rita, 
and initial coordination activities among federal agencies and case 
management providers were minimal following the hurricanes. 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. Improving 
coordination among federal and nonfederal stakeholders that provide 
disaster response and recovery services, such as state governments, 
voluntary agencies, and community-based recovery organizations, could 
help overcome these challenges and help ensure that those most in need 
of services are reached, that federal and state entities and case 
management agencies have accurate client information to provide timely 
service delivery and avoid duplication of services, and that victims 
receive the specific services and assistance required for recovery. 

Although significant federal resources were expended to provide 
disaster case management services to victims after Hurricanes Katrina 
and Rita, there remain important gaps in our understanding of how well 
these programs worked and what could be done to improve future case 
management programs. While existing evaluations will address some of 
these gaps, a better understanding of program results--including 
whether those most in need received services, client outcomes, factors 
that contribute to those outcomes, and the role of specific services 
such as direct assistance and long-term recovery committees--may 
require further study. It is only by conducting additional evaluations 
that not only cover these issues, but also involve all stakeholders and 
address limitations of existing data sources, that policymakers will 
have the information they need to identify and quantify needs and 
develop more effective case management programs for future disasters. 

Recommendations for Executive Action: 

We recommend that the Secretary of the Department of Homeland Security 
direct the Administrator of FEMA to take the following three actions: 

1. Establish a realistic and achievable time line for designing and 
implementing a single, federal disaster case management program for 
future disasters. 

2. Ensure that the federal disaster case management program FEMA 
develops includes practices to enhance and sustain coordination among 
federal and nonfederal stakeholders. 

3. Conduct an outcome evaluation to determine the results of disaster 
case management pilot programs that have assisted victims of Hurricanes 
Katrina and Rita, as well as pilot programs for victims of subsequent 
disasters. Such an evaluation will further inform the development of 
the federal disaster case management program for future disasters. 

Agency Comments and Our Evaluation: 

We provided a draft of this report to HHS, the Department of Homeland 
Security's (DHS) FEMA, and HUD for review and comments. HHS' 
Administration for Children and Families reviewed the report on behalf 
of the department and provided a technical comment, which we 
incorporated into the report. FEMA provided comments that are 
reproduced in appendix II. HUD's Office of Public and Indian Housing 
provided comments on behalf of the department that are reproduced in 
appendix III. 

FEMA agreed with our recommendations and is taking steps to address 
them. FEMA said the agency is actively pursuing all program development 
requirements for the single, federal disaster case management program, 
and once those requirements are identified, will create a work plan to 
assist in addressing the challenges GAO identified and to establish a 
time line for developing the program. FEMA also stated that it will 
coordinate with stakeholders to ensure that the future program includes 
practices to enhance or sustain coordination by establishing a disaster 
case management program team with HHS that will develop plans for the 
future program. In addition, FEMA said it will host stakeholder 
meetings to discuss the results of the evaluations of disaster case 
management pilot programs and long-range program planning. Further, 
FEMA said it is modifying its existing evaluation of disaster case 
management pilot programs to include a detailed review of the results 
of the independent evaluations of the pilot programs and to also 
evaluate the Texas DCM-P program and the case management portion of 
DHAP. However, we continue to believe FEMA should conduct an outcome 
evaluation to determine the results of disaster case management pilot 
programs; such an evaluation would assess whether those most in need 
received services, client outcomes, factors that contribute to those 
outcomes, and the role of specific services such as direct assistance 
and long-term recovery committees. FEMA also provided technical 
comments, which we incorporated into the report as appropriate. 

HUD generally agreed with our recommendations but requested that our 
recommendation to include practices to enhance and sustain coordination 
in the new federal disaster case management program include additional 
detail about the role of HUD. However, we did not revise our 
recommendation as HUD's role in disaster case management remains 
unknown pending FEMA's development of this program. Regarding our 
report findings, HUD disagreed with our characterization of the 
department's monitoring of disaster case management services after 
Hurricanes Katrina and Rita. We revised the report to better reflect 
HUD's efforts in this area. Further, HUD provided additional 
information on its efforts to evaluate the case management portion of 
DHAP for victims of Hurricanes Katrina and Rita, and for victims of 
Hurricanes Gustav and Ike, as well as its efforts to collect 
qualitative information during its evaluation process. We also 
incorporated this information in the report. HUD provided additional 
comments to enhance or clarify information in the report, which we 
incorporated as appropriate. 

As agreed with your offices, unless you publicly announce the contents 
of this report earlier, we plan no further distribution until 30 days 
from the report date. At that time, we will send copies to appropriate 
congressional committees, HHS, the Department of Homeland Security, 
HUD, and other interested parties. The report will also be available at 
no charge on the GAO Web site at [hyperlink, http://www.gao.gov]. 

If you or your staff have any questions about this report, please 
contact me 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 report. Key contributors to this report are 
listed in appendix IV. 

Signed by: 

Kay Brown: 
Director, Education, Workforce, and Income Security Issues: 

[End of section] 

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. 

For our study, we limited our review of federally funded disaster case 
management programs to Louisiana and Mississippi as these were the 
states most directly affected by Hurricanes Katrina and Rita, and we 
conducted site visits to Baton Rouge and New Orleans, Louisiana; and 
Biloxi, Gulfport, Moss Point, Jackson, and Pascagoula, Mississippi. To 
inform our findings, we interviewed federal agencies and state 
government agencies involved in disaster case management, case 
management providers, and academic organizations. See table 1 for a 
comprehensive list of the organizations we interviewed. We conducted 
these interviews in person or by phone. We focused our interviews on 
disaster case management providers who served clients in Louisiana and 
Mississippi and selected interviewees to ensure that we spoke to 
representatives from a range of appropriate organizations serving 
victims of Hurricanes Katrina and Rita. We spoke to the majority of 
disaster case management providers in both states for the Katrina Aid 
Today (KAT) program, selected providers in both states for the Disaster 
Housing Assistance Program (DHAP), and selected providers for the 
state- managed Disaster Case Management pilot program in Mississippi. 
We did not interview disaster case management providers who served 
victims that relocated to other states. The views of the disaster case 
management providers we spoke with cannot be generalized to all 
disaster case management organizations that served victims of 
Hurricanes Katrina and Rita. 

Table 1: List of Organizations Interviewed: 

Federal agencies: 
Department of Health and Human Services (HHS); Department of Housing 
and Urban Development (HUD); Federal Emergency Management Agency 
(FEMA); Office of the Federal Coordinator for Gulf Coast Rebuilding. 

State agencies: Louisiana; 
Department of Social Services; 
Louisiana Recovery Authority. 

State agencies: Mississippi; 
Department of Human Services; 
Governor's Office of Recovery and Renewal; 
Mississippi Commission on Volunteer Services. 

Case management providers: National level; 
Catholic Charities USA; 
Katrina Aid Today; 
United Methodist Committee on Relief. 

Case management providers: By state; Louisiana; 
Advocacy Center Louisiana; 
Catholic Charities, Baton Rouge; 
Catholic Charities, New Orleans; 
DHAP Greater New Orleans; 
Greater New Orleans Disaster Recovery Partnership; 
Jefferson Parish Housing Authority; 
Louisiana Family Recovery Corps; 
Salvation Army, New Orleans; 
St. Vincent de Paul, Baton Rouge; 
Volunteers of America, New Orleans. 

Case management providers: By state; Mississippi; 
Biloxi Housing Authority; 
Boat People SOS; 
Catholic Charities, Biloxi; 
International Relief and Development; 
Jackson County Civic Action Committee; 
Lutheran Episcopal Services Ministry; 
Mississippi Case Management Consortium; 
Mississippi Protection and Advocacy Agency; 
Mississippi Regional Housing Authority VI; Pilgrim Rest; 
Recover, Rebuild, Restore Southeast Mississippi; 
Salvation Army, Jackson. 

Academic organizations: 
Louisiana State University; 
The Urban Institute. 

Source: GAO. 

[End of table] 

To determine what steps the federal government took to support disaster 
case management programs after Hurricanes Katrina and Rita, we reviewed 
the roles and responsibilities of the federal government for disaster 
recovery services. We also reviewed federal laws, regulations, and 
guidance related to the federally funded disaster case management 
programs established to assist victims of Hurricanes Katrina and Rita, 
including the federal government's authority to establish or fund post- 
disaster case management programs. We interviewed officials from the 
Federal Emergency Management Agency (FEMA), the Department of Health 
and Human Services (HHS), and the Department of Housing and Urban 
Development (HUD), as FEMA and HHS funds were used for disaster case 
management programs to assist victims of Hurricanes of Katrina and 
Rita, and HUD administered one of these programs. We also interviewed 
disaster case management providers to determine what impact breaks in 
federal funding had on their agencies and on the disaster victims. 

To determine how federal agencies oversaw the implementation of 
federally funded disaster case management programs, we reviewed program 
guidance for federally funded disaster case management programs for 
victims of Hurricanes Katrina and Rita and interviewed officials from 
FEMA and HUD regarding their oversight responsibilities, including 
their review of disaster case management data. We also analyzed the 
reliability and completeness of data on KAT clients from the 
Coordinated Assistance Network database, and we spoke to officials who 
were knowledgeable about the database. We reviewed FEMA's National 
Response Plan and National Response Framework to determine what role 
the federal government had in coordinating the delivery of human 
services following a disaster. We also reviewed previous GAO work to 
identify best practices for coordination among federal agencies, 
practices to sustain coordination, and the importance of information 
sharing. We interviewed officials from federal agencies and case 
management providers to determine whether they adhered to best 
practices and what challenges they faced in coordinating and sharing 
information. 

To determine what challenges case management agencies experienced in 
delivering federally funded disaster case management services, we 
conducted a content analysis of interviews with federal agencies, case 
management providers, and academic organizations regarding disaster 
case management services for victims of Hurricanes Katrina and Rita. 
Some interviews were conducted by other GAO teams doing work related to 
Hurricanes Katrina and Rita. Through an iterative process we developed 
a general list of challenges, grouped them, and assigned them a 
specific category of challenge such as agency resource constraint or 
community resource constraint. We reported on commonly identified 
challenges and provided relevant examples of each. We also reviewed 
evaluations of the federally funded disaster case management programs, 
relevant federal laws, and previous GAO work to support our findings. 
In addition, to obtain information on the needs of disaster case 
management clients, we obtained summary level data on KAT clients from 
the Coordinated Assistance Network database maintained by the American 
Red Cross, and we received record-level data on DHAP case management 
clients from HUD's Tracking-at-a-Glance database. To assess the 
reliability of the data needed to address this objective, we checked 
the data for obvious errors in accuracy and completeness, reviewed 
existing information about these data, and interviewed officials 
knowledgeable about the data. We determined that the data we used for 
this objective were sufficiently reliable. 

To determine how previous or existing federally funded case management 
programs will be used to inform the development of a federal case 
management program for future disasters, we interviewed officials from 
FEMA, HUD, HHS, and case management providers regarding the evaluations 
of disaster case management programs. We also spoke with officials from 
the contractor hired by FEMA for its evaluation of disaster case 
management pilot programs. We reviewed documentation, such as program 
guidance and statements of work on agencies' evaluations of disaster 
case management programs. 

We conducted this performance audit from May 2008 to July 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 based on our audit objectives. 

[End of section] 

Appendix II: Comments from the Department of Homeland Security: 

U.S. Department of Homeland Security: 
Washington, DC 20528: 

June 22, 2009: 

Kay E. Brown, Director: 
Education, Workforce,and Income Security Issues: 
Government Accountability Office: 
Washington, D.C. 20548 

Dear Ms. Brown: 

Thank you for the opportunity to comment on the draft report GAO-09-561 
"Disaster Assistance: Greater Coordination and an Evaluation of 
Programs' Outcomes Could Improve Disaster Case Management." The 
Department of Homeland Security appreciates the work in planning and 
conducting and issuing this report. 

The following is our response to the recommendations. 

Recommendation: Create a timeline for the establishment of the Disaster 
Case Management (DCM) Program. 

Response: Concur. The report states that FEMA should create a timeline 
for the establishment of the DCM Program. Even prior to the GAO's draft 
report, FEMA's program office has been working closely with the FEMA 
Grant Programs Directorate and Office of Chief Counsel to actively 
pursue all program development requirements. Once those requirements 
are identified, FEMA will create a program development work plan to 
assist in addressing the challenges identified in the draft report and 
identify a timeline for the establishment of the DCM Program. 

Recommendation: Ensure that the program includes practices to enhance 
and sustain coordination among federal and nonfederal stakeholders. 

Response: Concur. In regards to ensuring that the DCM Program includes 
practices to enhance and sustain coordination among federal and non- 
federal stakeholders, FEMA is working closely with the U.S. Department 
of Health and Human Services' Administration for Children and Families 
(ACF) to establish a DCM Program management team. The team intends to 
meet bi-weekly to further develop plans for a proposed DCM Program 
model that is a hybrid between the FEMA State-managed DCMP and the 
pilot implemented by ACF. Additionally, once evaluation results from 
each pilot are completed, FEMA intends to host DCM stakeholder 
meetings, with both federal and non-federal partners, to discuss the 
pilot evaluation results and long range program planning. 

Recommendation: Conduct an outcome evaluation to determine the results 
of the DCM-P Programs that have assisted victims of Hurricanes Katrina 
and Rita as well as pilot programs for victims of subsequent disasters. 

Response: Concur. FEMA is working to complete all appropriate 
documentation to modify the existing DCM-P evaluation project. The 
modification includes a detailed review of the evaluation results 
collected by each DCM-P. In addition, the modification will expand to 
include an evaluation of the Texas DCM-P and the U.S. Housing and Urban 
Development's Disaster Housing Assistance Program's case management 
component. It is also FEMA's intent that the pilot evaluation project 
will establish common data collection points for future reporting and 
provide FEMA with evaluation tools that will become the standard data 
collection information for the DCM Program. 

Thank you for the opportunity to provide comments to the draft report. 

Sincerely, 

Signed by: 

Jerald E. Levine: 
Director: 
Departmental GAO/OIG Liaison Office: 

[End of section] 

Appendix III: Comments from the Department of Housing and Urban 
Development: 

U.S. Department Of Housing And Urban Development: Office Of Public And 
Indian Housing: 
Washington, DC 20410-5000: 
[hyperlink, http://www.hud.gov] 	
[hyperlink, http://www.espanol.hud.gov] 

June 2, 2009: 

Ms. Kay E. Brown: 
Director: 
Education, Workforce, and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street, NW: 
Washington, DC 20548: 

Dear Ms. Brown: 

The Office of Public and Indian Housing has reviewed the draft report 
on Disaster Assistance: Greater Coordination and an Evaluation of 
Programs' Outcomes Could Improve Disaster Case Management (GAO-09-561). 
Enclosed are my written comments concerning your report. 

Please contact Tony Hebert at (202) 402-7387, if you have any 
questions. 

Sincerely, 

Signed by: 

Deborah Hernand, for: 

Paula O. Blunt: 
General Deputy Assistant Secretary for Public and Indian Housing: 

Enclosure: 

[End of letter] 

Office of Public Housing and Voucher Programs: Disaster Housing 
Programs: 

Comments on GAO 09-561: 

1. Highlights Page: The second paragraph states that HUD's initial 
monitoring of case management services was limited. The Department 
disagrees with this characterization. HUD closely monitored grantees 
throughout the duration of case management services under the Disaster 
Housing Assistance Program - Katrina/Gustav (DHAP-Katrina). Programs 
were monitored through a case management tracking system, program 
assessments, on-site monitoring visits and on-site training visits. 
Monitoring was done by HUD headquarters staff, HUD field staff, and 
HUD's case management contractor. The case management contractor 
provided technical assistance staff for both on-site and remote 
monitoring of grantees across the entire DHAP-Katrina portfolio. In 
addition, contract staff based in Gulf Coast states conducted regular 
on-site monitoring across large and low performing grantees, 
particularly at the front end of the program to ensure that grantees 
were effectively implementing case management programs. GAO indicates 
that HUD and FEMA both provided only minimal initial monitoring, yet in 
subsequent sentences GAO states that HUD provided additional 
monitoring. The statements in this section regarding HUD's monitoring 
efforts are inconsistent with other information provided by GAO within 
the report and HUD's standard operating procedures under DHAP-Katrina. 

2. Highlights Page Recommendation: GAO recommends that FEMA "evaluate 
outcomes of disaster case management pilot programs to inform the 
development of this program." The U.S. Department of the Housing and 
Urban Development (HUD) agrees in part with this recommendation and 
will investigate the effectiveness of its case management to date as 
part of a study of DHAP. HUD's Office of Policy Development and 
Research (PD&R) is conducting a Disaster Housing Assistance Program 
(DHAP) Incremental Rent Transition Study. This study will compare 
families transitioning from stepped-up rents (i.e., Phase I families) 
and $0 rent (i.e., Phase II/Phase III families) to market rate or 
assisted housing and measure their outcomes over time. This Information 
Collection would enable the Department to answer the question of how do 
you transition people most effectively from rental assistance to market 
rate housing after a disaster. Additionally, since DHAP differs from 
the regular Housing Choice Voucher (HCV) program, this study will 
enable HUD to see if DHAP vouchers and their differential rents are 
having a different effect on housing, employment, education, health, 
and other outcomes after DHAP ends February 28, 2009. See Notice of 
Submission of Proposed Information Collection to OMB, FR-5187-N-69. 
Further, the report provides recommendations for FEMA, but doesn't 
provide adequate details on the recommendation for coordination of 
other stakeholders such as HUD and HHS with FEMA. It would be 
informative for HUD if the report were revised to provide specific 
desired outcomes for HUD in disaster planning as it relates to the 
challenges described in the report. 

3. Page 9, Paragraph 3: The Mississippi Case Management Consortium 
(MCMC) under FEMA's DCM-P only provided case management services to 
DHAP-Katrina families newly referred after August 5, 2008 in the state 
of Mississippi. The total number of DHAP-Katrina families served by the 
MCMC through the DCM-P in Mississippi was 459 families. This paragraph 
overstates the role MCMC played in providing case management services 
to DHAP-Katrina families. 

4. Page 9, Paragraph 3: GAO states that most DHAP-Katrina clients will 
receive rental assistance under the DHAP-Katrina Transitional Closeout 
Plan through August 31, 2009. While rental assistance will be provided 
until August 2009, not all families will receive this assistance 
through the end of the closeout program. Many families will convert to 
the Housing Choice Voucher (HCV) program through HUD's DHAP to HCV 
conversion process. Others will transition off of the program through 
HUD's Incremental Rent Transition (IRT). Under this process, the amount 
of housing assistance provided to each family is reduced by $100 each 
month. If at any point the housing assistance payment is zero, the 
family transitions off of the program. Since the start of the DHAP- 
Katrina Transitional Closeout Plan, thousands of families have either 
converted to the HCV program or transitioned off of DHAP assistance 
through the IRT process. 

5. Page 11 (sub-title) and Page 13, Paragraph 2: HUD's approach to 
monitoring DHAP-Katrina sites focused on intensive initial monitoring 
of all sites to ensure proper implementation and follow-up monitoring 
with large and low performing sites over the life of the program. The 
data reported by DHAP-Katrina grantees through the case management 
tracking software (Tracking-at-a-Glance) allowed HUD to develop program 
assessments which enabled the Department to target both technical 
assistance and monitoring to low performing sites. HUD's monitoring of 
case management programs under DHAP-Katrina was both strategic and 
sustained. In addition, the Department organized roundtable discussions 
and regional training sessions in Louisiana and Texas to provide 
program updates, policy reviews, and additional technical assistance. 
Ongoing training was also provided for case managers through a variety 
of methods: on-site, telephone, webinars, and via email until the end 
of the program. 

6. Page 14, Paragraph 2 and Page 15, Paragraph 1: GAO states that a 
Mississippi housing agency received short notice to process housing 
payments for DHAP-Katrina clients. Under the standard DHAP-Katrina 
protocols for Phase I and Phase 11 families, DHAP-Katrina grantees had 
ample time to process a family and make housing assistance payments by 
the lease effective date of the Disaster Rent Subsidy Contract (DRSC). 
For Phase III families, housing agencies were provided completed DHAP 
participant packets, and the agency merely had to process the housing 
payment. If the housing authority received the packet at a time that 
made it difficult to make a rental payment based on the agency schedule 
or lease effective date, the landlord was made well aware and fully 
understood that the rental payment could be late due to the nature of 
the process. 

7. Page 18, paragraph 1: HUD's initial estimate was that approximately 
12,000 DHAP-Katrina families may ultimately need and be eligible for 
HCVs provided under a special $85 million appropriation of HCVs 
targeting DHAP-Katrina families. The conversion of these families from 
the DHAP-Katrina Transitional Closeout Program to the HCV program is 
currently in process. 

8. Page 23, Chart: HUD plans to conduct two evaluations of the DHAP-Ike 
case management program. One will focus on process and lessons learned. 
The second will analyze program data and family outcomes. HUD's Office 
of Policy Development and Research (PD&R) is working with program staff 
on these efforts to ensure that both evaluations provide comprehensive 
assessments of the DHAP-Ike case management program. 

9. Page 24, Paragraph 1: GAO notes that HUD was unable to derive 
substantial conclusions from its initial evaluation of the DHAP-Katrina 
case management data. Presently, the Department is utilizing additional 
approaches to reach conclusions about client outcomes and the 
effectiveness of the DHAP-Katrina case management program. GAO states 
that current evaluations provide limited information on outcomes and 
program elements that need improvement. However, the Department 
conducted structured interviews with housing agencies and case 
management providers to determine their perspectives on DHAP-Katrina 
case management and service provision to persons with disabilities. 
This qualitative data provided useful information regarding challenges 
associated with DHAP-Katrina case management. Data from these process 
interviews is being used to develop lessons learned and case management 
best practices. 

10. Page 26: GAO recommends that federal agencies conduct outcome based 
evaluations on future disaster case management programs. The Department 
agrees with this recommendation, and has already engaged evaluation 
partners to evaluate DHAP-Ike family outcomes and implementation 
processes. 

[End of section] 

Appendix IV: GAO Contacts and Acknowledgments: 

GAO Contact: 

Kay E. Brown, (202) 512-7215 or brownke@gao.gov: 

Staff Acknowledgments: 

Kathryn A. Larin, Assistant Director; Melinda Bowman; Nisha R. Hazra; 
and Charlene M. Johnson made significant contributions to this report. 
Molly Traci also made key contributions. In addition, Doreen Feldman 
and Sheila McCoy provided legal assistance; Cynthia L. Grant and Walter 
K. Vance analyzed and assessed the reliability of data; Susan Aschoff 
assisted in report development; Mimi Nguyen developed the report's 
graphics; and Carolyn Blocker, Beth Faraguna, Lise Levie, Suneeti Shah, 
Barbara Steel-Lowney, and Nyree Ryder Tee verified our findings. 

[End of section] 

Related GAO Products: 

Gulf Coast Disaster Recovery: Community Development Block Grant Program 
Guidance to States Needs to Be Improved. [hyperlink, 
http://www.gao.gov/products/GAO-09-541]. Washington, D.C.: June 19, 
2009. 

Hurricanes Gustav and Ike Disaster Assistance: FEMA Strengthened Its 
Fraud Prevention Controls, but Customer Service Needs Improvement. 
[hyperlink, http://www.gao.gov/products/GAO-09-671]. Washington, D.C.: 
June 19, 2009. 

National Preparedness: FEMA Has Made Progress, but Needs to Complete 
and Integrate Planning, Exercise, and Assessment Efforts. [hyperlink, 
http://www.gao.gov/products/GAO-09-369]. Washington, D.C.: May 7, 2009. 

Office of the Federal Coordinator for Gulf Coast Rebuilding: 
Perspectives and Observations. [hyperlink, 
http://www.gao.gov/products/GAO-09-411R]. Washington, D.C.: April 10, 
2009. 

Emergency Management: Actions to Implement Select Provisions of the 
Post-Katrina Emergency Management Reform Act. [hyperlink, 
http://www.gao.gov/products/GAO-09-433T]. Washington, D.C.: March 17, 
2009. 

Disaster Recovery: Past Experiences Offer Recovery Lessons for 
Hurricanes Ike and Gustav and Future Disasters. [hyperlink, 
http://www.gao.gov/products/GAO-09-437T]. Washington, D.C.: March 3, 
2009. 

Disaster Recovery: FEMA's Public Assistance Grant Program Experienced 
Challenges with Gulf Coast Rebuilding. [hyperlink, 
http://www.gao.gov/products/GAO-09-129]. Washington, D.C.: December 18, 
2008. 

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. 

Actions Taken to Implement the Post-Katrina Emergency Management Reform 
Act of 2006. [hyperlink, http://www.gao.gov/products/GAO-09-59R]. 
Washington, D.C.: November 21, 2008. 

Disaster Recovery: Past Experiences Offer Insights for Recovering from 
Hurricanes Ike and Gustav and Other Recent Natural Disasters. 
[hyperlink, http://www.gao.gov/products/GAO-08-1120]. Washington, D.C.: 
September 26, 2008. 

Mass Care in Disasters: FEMA Should Update the Red Cross Role in 
Catastrophic Events and More Fully Assess Voluntary Organizations' Mass 
Care Capabilities. [hyperlink, 
http://www.gao.gov/products/GAO-08-1175T]. Washington, D.C.: September 
23, 2008. 

Voluntary Organizations: FEMA Should More Fully Assess Organization's 
Mass Care Capabilities and Update the Red Cross Role in Catastrophic 
Events. [hyperlink, http://www.gao.gov/products/GAO-08-823]. 
Washington, D.C.: September 18, 2008. 

Gulf Opportunity Zone: States Are Allocating Federal Tax Incentives to 
Finance Low-Income Housing and a Wide Range of Private Facilities. 
[hyperlink, http://www.gao.gov/products/GAO-08-913]. Washington, D.C.: 
July 16, 2008. 

National Response Framework: FEMA Needs Policies and Procedures to 
Better Integrate Non-Federal Stakeholders in the Revision Process. 
[hyperlink, http://www.gao.gov/products/GAO-08-768]. Washington, D.C.: 
June 11, 2008. 

Catastrophic Disasters: Federal Efforts Help States Prepare for and 
Respond to Psychological Consequences, but FEMA's Crisis Counseling 
Program Needs Improvements. [hyperlink, http://www.gao.gov/products/GAO-
08-22]. Washington, D.C.: February 29, 2008. 

National Disaster Response: FEMA Should Take Action to Improve Capacity 
and Coordination between Government and Voluntary Sectors. [hyperlink, 
http://www.gao.gov/products/GAO-08-369]. Washington, D.C.: February 27, 
2008. 

Emergency Transit Assistance: Federal Funding for Recent Disasters, and 
Options for the Future. [hyperlink, 
http://www.gao.gov/products/GAO-08-243]. Washington, D.C.: February 15, 
2008. 

Gulf Coast Rebuilding: Observations on Federal Financial Implications. 
[hyperlink, http://www.gao.gov/products/GAO-07-1079T]. Washington, 
D.C.: August 2, 2007. 

Homeland Security: Observations on DHS and FEMA Efforts to Prepare for 
and Respond to Major and Catastrophic Disasters and Address Related 
Recommendations and Legislation. [hyperlink, 
http://www.gao.gov/products/GAO-07-1142T]. Washington, D.C.: July 31, 
2007. 

For more GAO products related to disaster preparedness, response, and 
reconstruction visit the Topic Collections page on GAO's Web site, 
[hyperlink, http://www.gao.gov]. 

[End of section] 

Footnotes: 

[1] For a listing of reports, please see the related GAO products at 
the end of this report. 

[2] GAO, Long-Term Care Reform: States' Views on Key Elements of Well- 
Designed Programs for the Elderly, [hyperlink, 
http://www.gao.gov/products/GAO/HEHS-94-227] (Washington, D.C.: Sept. 
6, 1994). 

[3] The Council on Accreditation is an international, independent, not- 
for-profit, child-and family-service and behavioral healthcare 
accrediting organization. It was founded in 1977 by the Child Welfare 
League of America and Family Service America (now the Alliance for 
Children and Families). Originally known as an accrediting body for 
family and children's agencies, the Council on Accreditation currently 
accredits 45 different service areas. Among its service areas are 
substance abuse treatment, adult day care, services for the homeless, 
foster care, and inter-country adoption. 

[4] Council on Accreditation. Council on Accreditation Standards: 8th 
Edition /Private (August 2008). [hyperlink, 
http://www.coastandards.org] (accessed Oct. 17, 2008). 

[5] ibid. 

[6] Pub. L. No. 109-295, title VI, §689f, codified at 42 U.S.C. §5189d. 
The Post-Katrina Act was passed in October 2006. 

[7] Pub. L. No. 93-288, 88 Stat. 143 (1974). 

[8] 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 is necessary. 

[9] GAO, National Disaster Response: FEMA Should Take Action to Improve 
Capacity and Coordination between Government and Voluntary Sectors, 
[hyperlink, http://www.gao.gov/products/GAO-08-369] (Washington, D.C.: 
Feb. 27, 2008). 

[10] 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. 

[11] UMCOR, formed in 1940, is the humanitarian relief agency of the 
United Methodist Church. UMCOR provides immediate and long-term relief 
to people around the world, and uses case management as a vehicle to 
provide long-term recovery. 

[12] For more information on the use and management of the 
international donations see GAO, Hurricane Katrina: Comprehensive 
Policies and Procedures Are Needed to Ensure Appropriate Use of and 
Accountability for International Assistance, [hyperlink, 
http://www.gao.gov/products/GAO-06-460] (Washington, D.C.: Apr. 6, 
2006). Because these international donations were distributed through 
federal agencies, we refer to them as federal funds for the purposes of 
this report. 

[13] 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. 

[14] FEMA's Disaster Relief Fund is the major source of federal 
disaster recovery assistance for state and local governments when a 
disaster occurs. 

[15] According to guidance for the DCM-P program, the funding period 
for the program began on June 1, 2008, and tentative awards were to be 
made to states on June 16, 2008. 

[16] Emergency TANF funds were authorized under the TANF Emergency 
Response and Recovery Act of 2005, Pub. L. No. 109-68. Emergency SSBG 
funds were authorized under the Department of Defense, Emergency 
Supplemental Appropriations to Address Hurricanes in the Gulf of Mexico 
and Pandemic Influenza Act of 2006, Pub. L. No. 109-148. 

[17] HUD had responsibility for supporting FEMA in providing shelter 
and housing assistance to victims of disasters under Emergency Support 
Function 6 of the National Response Plan in place at the time of 
Hurricanes Katrina and Rita and maintained that responsibility under 
the subsequent National Response Framework. 

[18] HUD has also administered a DHAP program for victims of subsequent 
disasters. In this report, DHAP refers to programs for victims of 
Hurricanes Katrina and Rita. 

[19] After the FEMA state-managed DCM-P program in Mississippi became 
operational in August 2008, it assumed case management responsibilities 
for new DHAP clients. Clients that received DHAP assistance before the 
DCM-P program became operational continued to receive case management 
from DHAP case management providers. 

[20] The Mississippi Case Management Consortium did not provide case 
management services for clients who moved to Mississippi from out of 
state. According to HUD officials, the Mississippi DCM-P program 
provided disaster case management services to 459 families 
participating in DHAP. 

[21] According to HUD officials, not all DHAP clients will receive 
housing assistance through the end of the transitional program. Some 
may convert to HUD's Housing Choice Voucher Program and others may 
leave the program when they are no longer eligible to receive 
assistance. 

[22] As stated previously, FEMA awarded a conditional grant for the 
Mississippi DCM-P program in July 2008. 

[23] Some of the 5,456 clients that were referred by FEMA did not 
receive services through the Mississippi DCM-P program for a variety of 
reasons. For example, in March 2009, Mississippi reported that 1,078 
clients had incorrect or no contact information and 949 clients refused 
services. 

[24] Prior to Hurricane Katrina, the U.S. government had neither asked 
for nor accepted disaster assistance directly from foreign countries. 
See GAO, Hurricane Katrina: Comprehensive Policies and Procedures Are 
Needed to Ensure Appropriate Use of and Accountability for 
International Assistance, [hyperlink, http://www.gao.gov/products/GAO-
06-460] (Washington, D.C.: April 6, 2006). The Department of Homeland 
Security and Department of State have since developed policies, 
procedures, and plans to help ensure international cash donations for 
disaster relief and assistance are accepted and used appropriately as 
needed. 

[25] Coordinated Assistance Network is a partnership among several 
national disaster relief nonprofit organizations. After September 11, 
GAO recommended that FEMA convene a working group to encourage 
voluntary organizations involved in disaster response to integrate 
several lessons learned from the attacks, including easing access to 
aid for those eligible and enhancing coordination among charities and 
with FEMA. See GAO, September 11: More Effective Collaboration Could 
Enhance Charitable Organizations' Contributions in Disasters, 
[hyperlink, http://www.gao.gov/products/GAO-03-259] (Washington, D.C.: 
Dec. 19, 2002). Following our report, seven of the largest disaster 
response organizations--including the Red Cross, The Salvation Army, 
and the United Way--in partnership with FEMA, formed the Coordinated 
Assistance Network to ease collaboration and facilitate data sharing. 

[26] At the Coordinated Assistance Network's inception, the founding 
agencies recognized that pursuant to various privacy laws, there was no 
mechanism that allowed government agencies to partition relief 
information from law enforcement particularly in cases of undocumented 
persons. Thus, government agencies are not allowed access to the 
database because there would be no way to ensure that government 
agencies would limit their use of the database to service delivery. 

[27] According to a FEMA official, the Coordinated Assistance Network 
Steering Committee--which includes two FEMA representatives--oversees 
changes or enhancements to the database. 

[28] 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). 

[29] 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). 

[30] 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"--a use compatible with the purpose for which it 
was collected. FEMA has published a routine use notice outlining the 
instances where it may share data from its Disaster Recovery Assistance 
Files. According to its routine use policy, FEMA can disclose 
application information as necessary, to prevent duplication of efforts 
or benefits in determining eligibility for disaster assistance. This 
could include releasing information to federal, state, and voluntary 
organizations. This policy does not allow FEMA to provide FEMA 
registration numbers to organizations that request information. FEMA 
registration numbers are assigned to victims that apply for FEMA 
assistance and are used to track claims. FEMA will, however, provide 
contact information once an appropriate request in writing has been 
approved. FEMA requires that the organization obtain the FEMA 
identification number directly from the client before any specific 
information about FEMA assistance to an individual can be released. 

[31] According to HUD officials, the standard DHAP protocols for Phase 
I and Phase II families would have provided ample time to process a 
family and make housing assistance payments. For Phase III families, if 
the housing authority did not receive client information with enough 
time to make a rental payment by the required date, the landlord was 
made aware that the payment could be late. 

[32] It was ultimately determined that victims of Hurricanes Katrina 
and Rita would not be served under the HHS pilot. 

[33] [hyperlink, http://www.gao.gov/products/GAO-06-15]. 

[34] According to FEMA, the agency hopes to obtain information 
concerning the use of compatible tracking systems from their evaluation 
of pilot programs, which we discuss later in this report. In addition, 
FEMA officials said that efforts are underway to develop methods for 
two-way information sharing among various database systems, including 
those used by FEMA and HUD. 

[35] [hyperlink, http://www.gao.gov/products/GAO-06-15]. 

[36] 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.: Dec. 11, 2008). 

[37] Group site residents may have received these services, but data 
generally do not distinguish group site residents from other 
recipients. See [hyperlink, http://www.gao.gov/products/GAO-09-81]. 

[38] FEMA employs housing advisors who recertify disaster victims for 
continued housing assistance from FEMA. Housing advisors are not case 
managers. However, they provide housing resource information to 
disaster victims to assist them in securing permanent housing. 

[39] Jacqueline Berman and Yasuyo Abe, They are Thinking of Today, Not 
Tomorrow: Evaluation of the Louisiana Family Recovery Corps' Case 
Management Program and Human Recovery Coordination: Final Report 
(Berkeley Policy Associates, Oakland, CA: August 2007). 

[40] [hyperlink, http://www.gao.gov/products/GAO-09-81]. 

[41] GAO, Gulf Opportunity Zone: States are Allocating Federal Tax 
Incentives to Finance Low-Income Housing and a Wide Range of Private 
Facilities, [hyperlink, http://www.gao.gov/products/GAO-08-913] 
(Washington, D.C.: July 16, 2008). 

[42] GAO, Gulf Coast Rebuilding: Observations on Federal Financial 
Implications, [hyperlink, http://www.gao.gov/products/GAO-07-1079T] 
(Washington, D.C.: Aug. 2, 2007). 

[43] [hyperlink, http://www.gao.gov/products/GAO-08-913]. 

[44] While there were more than 30,000 DHAP clients receiving housing 
assistance as of January 2009, HUD officials said some clients may not 
be eligible for long-term housing assistance due to program rules based 
on income or criminal background, among other factors. 

[45] Harry Holzer and Robert Lerman, Employment Issues and Challenges 
in Post-Katrina New Orleans, (Washington, D.C.: The Urban Institute, 
February 2006). 

[46] [hyperlink, http://www.gao.gov/products/GAO-09-81]. 

[47] As we previously reported, FEMA officials stated that given the 
level of destruction and, in some cases, opposition from communities, 
FEMA was not always able to locate temporary housing in places with 
easy access to existing infrastructure. See GAO-09-81. 

[48] [hyperlink, http://www.gao.gov/products/GAO-09-81]. 

[49] Jennifer Claire Auer and Linda M. Lampkin, After Katrina: Open and 
Operating? An Assessment of Louisiana Nonprofit Health and Human 
Services after Hurricanes Katrina and Rita, (Washington, D.C.: The 
Urban Institute, February 2006). 

[50] Berman, 2007. 

[51] See 42 U.S.C. §5174 and 44 C.F.R. §206.110. 

[52] The Housing Assistance program provides assistance for such things 
as rental housing, home repair, and home replacement. The Other Needs 
Assistance program includes financial assistance for medical, dental, 
funeral, personal property, transportation, and other disaster-related 
expenses not compensated by other means. In 2005, the maximum amount an 
individual or household could receive through these programs was 
$26,200. 

[53] Eric Jenner, Lynne W. Jenner, Eva Silvestre, and Maya Matthews- 
Sterling, Final Evaluation of the United Methodist Committee of Relief 
Katrina Aid Today National Case Management Consortium (New Orleans, LA: 
The Policy and Research Group, March 2008). 

[54] Ibid. 

[55] The money used to fund KAT came from international donations for 
Hurricane Katrina victims. 

[56] Berman, 2007. 

[57] According to agency officials, HUD is also conducting a study 
related to the housing assistance provided under the DHAP program. The 
goal of this study is to determine how to transition people most 
effectively from rental assistance to market rate housing following a 
disaster. 

[58] GAO, Performance Measurement and Evaluation: Definitions and 
Relationships, [hyperlink, http://www.gao.gov/products/GAO-05-739SP] 
(Washington, D.C.: May 2005). 

[59] According to agency officials, HUD is currently utilizing 
additional approaches to reach conclusions about client outcomes and 
the effectiveness of the DHAP case management program for victims of 
Hurricanes Katrina and Rita. In addition, HUD said the department 
collected qualitative information regarding challenges associated with 
DHAP-Katrina case management, which is being used to develop lessons 
learned and case management best practices. 

[End of section] 

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