An Evaluation of the Impact of the National Disability Rights Network Participation in the Katrina and Today Project (Stough)

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AN EVALUATION OF THE IMPACT OF

THE NATIONAL DISABILITY RIGHTS NETWORK

PARTICIPATION IN THE

KATRINA AID TODAY PROJECT

Submitted by

Laura M. Stough, Ph.D.

Amy N. Sharp, Ph.D.The Center on Disability and Development

Texas A&M University

to

The National Disability Rights Network

Washington, DC

March 2008

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TABLE OF CONTENTS

Introduction................................................................................................................................3Purpose of Evaluation.............................................................................................................3Design of Evaluation...............................................................................................................3

Evaluation Questions ..................................................................................................................5Primary Questions of Interest..................................................................................................6Secondary Questions of Interest.............................................................................................. 7

Evaluation Procedure..................................................................................................................8Participants.............................................................................................................................8Analysis of Evaluation Data....................................................................................................9Timeline of Evaluation..........................................................................................................12

Results......................................................................................................................................13Quantitative Results.............................................................................................................. 13

Demographic Focused Questions ......................................................................................14Case Management Focused Questions...............................................................................17Summary of Quantitative Results ......................................................................................30

Results from Surveys of Case Managers ...............................................................................31Results from Interviews of P&A and NDRN Administrators................................................. 39Results from Focus Groups...................................................................................................48

Summary of Focus Groups................................................................................................ 68

Summary of Evaluation ............................................................................................................70Primary Questions.................................................................................................................70Secondary Questions of Interest............................................................................................ 75

Appendix..................................................................................................................................78Open-Ended Telephone Case Manager Questions .................................................................78Survey Questions for Case Managers....................................................................................79Questions for Focus Group....................................................................................................81P&A Administrator Interview Questions...............................................................................82

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INTRODUCTION

Hurricane Katrina was the largest disaster in U.S. history. The effects from this hurricane

resulted in loss or destruction of housing for over 1.5 million individuals. It is estimated that 23

percent of those affected by this disaster were individuals with disabilities (National

Organization on Disability, 2006). The United Methodist Committee on Relief (UMCOR) and

the Voluntary Organizations Active in Disasters (VOAD) were awarded an unprecedented $66

million dollars in October 2005 through the Department of Homeland Security to provide case

management for evacuees affected by Hurricane Katrina. This initiative led to the formation of

the National Case Management Consortium (NCMC) and the Katrina Aid Today (KAT) project.

Recognizing the critical support needs of individuals with disabilities affected by

Hurricane Katrina, National Disability Rights Network (NDRN) proposed that it would provide

case management services targeted at those survivors with disabilities. NDRN set as its goal as a

consortium member to provide high quality, cost-effective nationwide case management services

for approximately 7,000 displaced individuals with disabilities and their families.

Purpose of Evaluation

The purpose of this evaluation design was to provide a mechanism through which NDRN

could obtain both formative and summative information on 1) the quality of case management

provided to people with disabilities, and 2) the impact of case management on the Protection and

Advocacy (P&A) Centers as legal services organizations.

Design of Evaluation

The evaluation of this project used two different methodological approaches and four

data collection methods in order to investigate the role of National Disability Rights Network

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(NDRN) in the Katrina Aid Today (KAT) project. A quantitative approach examined the

differences in the outcomes of case management provided by NDRN as compared to the other

KAT partners, while a qualitative approach was used to describe the nature of the participation of

NDRN in the KAT project. The strength of this dual approach to evaluation was that the

quantitative information in this report has been summarized and statistically analyzed while the

descriptive data obtained through the qualitative approach provides an in-depth analysis of case

management provided to individuals with disabilities.

Data resulting from the quantitative analysis, as will be seen in that section, is primarily

numerical and descriptive in nature. This data includes information on the quantifiable

performance of these agencies as part of case management, and compares data from the non-

NDRN case managers to the NDRN case managers who were part of the KAT project. This

analysis used group data and does not identify any other partner group as an individual. The data

needed to analyze these questions was submitted through the CAN database or through

documentation collected by the KAT monitoring and evaluation staff.

Data resulting from the qualitative analysis was primarily descriptive in nature but

provides a rich context for the quantitative data in that it includes quotes and a narrative

description of NDRN’s participation in the KAT project. This data was directly collected from

state P&A case workers and staff, as well as from NDRN administrative staff, by the

investigators. In our review of the research literature, we found few evaluations and very little

evidence-based research involving individuals with disabilities and disaster. The results from this

evaluation give NDRN both demographic and comparative statistics which will be helpful in

producing policy-related materials and position papers on case management for people with

disabilities. This evaluation thus provides NDRN data that is based on one of the few systematic

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studies on the effects of disaster, and perhaps the only available study on the long-term recovery

of individuals with disabilities.

EVALUATION QUESTIONS

The following two pages present the Primary Questions of Interest and Secondary

Questions of Interest . The Primary Questions are those that were identified by NDRN

administration as of greatest interest and the data associated with these questions are primarily

qualitative in nature. The Secondary Questions are those that consist of descriptive or

comparative statistics and are primarily quantitative in nature. As both categories of questions

serve important functions in the overall evaluation of this project, their designation as primary or

secondary questions are given as a the result of NDRN’s expressed areas of focus, rather than an

assessment by the evaluators of their relative importance.

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Primary Questions of Interest

Qualitative Evaluation Questions Hypothesis Major Themes Measured Impact Responsib

Party

1. What is the impact when a legal services

organization provides case management

to people with disabilities who are

evacuees?

NDRN case workers and staff have

access to legal knowledge that makes

a difference on both how cases are

managed and how they are resolved.

Legal Knowledge and Legal

Advocacy

The impact of legal

knowledge on outcomes

for evacuees

NDRN

Evaluator

2. What kind of impact does case

management provided by disability

service experts have on outcomes

experienced by people with disabilities?

NDRN-affiliated case managers are

disability subject-matter experts

whose knowledge makes a difference

in outcomes for evacuees.

Disability Knowledge and

Disability Services Knowledge

The impact of disability

knowledge and disability

services knowledge on

outcomes for evacuees

NDRN

Evaluator

3. What effect did NDRN participation

have on the delivery of services by the

Katrina Aid Today partner organizations

and on Katrina Aid Today organization?

NDRN staff and affiliate staff

educate their partner organizations

and KAT administration through

their actions as both a resources and

an instrument of systemic change

Advocacy for and Education

about individuals with disabilities

The impact of advocacy

and education on KAT

organizations

NDRN

Evaluator

4. What does case management look like

when the evacuee client is a person with

disabilities?

Case management with individuals

with disabilities differs, in part, along

the dimensions of time, intensity,

location of services, level of self-

determination, and topography

The effects of the Need for

Disability Supports on the process

of case management

Impact of the needs of

the individuals with

disability on the nature

of case management

provided.

NDRN

Evaluator

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Secondary Questions of Interest

Quantitative Evaluation Questions Type of Data and Analysis Data Source Responsible

Party

1. Were clients as satisfied or more satisfied

with the case management that they

received from the P&A case managers as

compared to clients who used other KatrinaAid case managers?

Comparison of groups: NDRN clients

vs. other clients. Quantitative tests of

equality: e.g., t-test, Chi-square.

Katrina Aid Today Client

Satisfaction Survey

UMCOR Evaluators/

NDRN Evaluators

2. Were P&A case managers rated as

knowledgeable or more knowledgeable

about the recovery process and resources

available as compared to other Katrina Aid

case managers?





Satisfaction Survey

UMCOR Evaluators/

NDRN Evaluators

3. Were individuals with disabilities referred

to LTRC/Unmet Needs Tables at a higher

or equal rate than were individuals without

disabilities?




CAN data base UMCOR Evaluators/

NDRN Evaluators

4. How were P&A case managers rated with

regards to providing information and

services that met the client’s needs as

compared to other Katrina Aid case

managers?





Satisfaction Survey

UMCOR Evaluators/

NDRN Evaluators

5. How did the primary needs reported by

individuals with disabilities differ fromthose without disabilities?

Descriptive statistics, measures of

association (correlations)

CAN database UMCOR Evaluators/

NDRN Evaluators

6. Were the individuals who were referred to

disability services listed in the CAN

database also referred to NDRN?

Descriptive statistics, measures of

association (correlations)

CAN database UMCOR Evaluators/

NDRN Evaluators

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EVALUATION PROCEDURE

To answer the Primary Questions of Interest, we used four methods of data collection:

1) quantitative analysis, 2) surveys, 3) semi-structured interviews of NDRN administrators and

P&A staff, and 4) focus groups of clients. Each of these methods is described below. For each of

these methods, we detail the participants, procedures, and instruments that were used.

Participants

To clarify the terms that we are using for the participants, we provide a guide to our

usage of labels in this document:

NDRN Administrators: Administrators working at NDRN headquarters in DC overseeing the

KAT project. These are the Tier 1 and Tier 2 contacts for UMCOR.

P&A Administrators: Administrators who oversee the state P&A offices.

KAT Administrators: KAT administrators at the state P&A offices. These are referred to by

UMCOR as Tier 3 contacts.

Case Managers: KAT case managers working at the P&A offices.

Evaluators of this project followed the requirements of an Institutional Review Board and

the guidelines of the Belmont Report for the Protection of Human Subjects. A copy of the

approval of these procedures can be obtained from the Texas A&M Institutional Review Board

or from one of the principal investigators. Data collected from the surveys, interviews, and focus

group parts of the evaluation was treated confidentially and any identifying information obtained

was changed or deleted to protect the confidentiality of the participants. The evaluators have

modified statements in this report so that they cannot be linked to any given individual

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participant and responses from case managers and KAT administrators have had their

geographical associations removed to protect the identity of these employees.

Analysis of Evaluation DataThe following section details how the evaluation data was collected for the purpose of

answering the Primary Questions and the Secondary Questions as well as how this data was

analyzed.

Quantitative Analysis. Data collected through the CAN database was analyzed to

answer several of the primary and secondary evaluation questions. Information from the CAN

database was extracted by UMCOR’s Measurement and Evaluation staff in July of 2007 and sent

to the investigators for analysis. In order to address the secondary questions, we extracted those

cases that were managed by NDRN and compared them to those cases managed by other KAT

partner agencies. A limitation with this comparison was that some individuals with disabilities

were not referred to KAT-NDRN for case management and were also represented in the partner

agency sample. However, this comparison did allow for analysis of demographic differences and

service delivery difference between the two groups of consortium members.

Surveys of case managers. Surveys were administered and collected by the

investigators. These surveys were structured, in that the questions were predetermined and the

method by which the survey was conducted was consistent across all case managers. All case

managers received the same survey questions (see Appendix A). These questions were piloted by

Drs. Laura Lein and Holly Bell, who were the evaluators for two other Katrina Aid Today

consortium partners, and were derived from focus groups that they conducted with case

managers for evaluation purposes.

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The Tier 3 KAT administrators in the four Gulf States affected by Katrina were asked to

distribute information about the survey to the case managers in their state and to schedule times

during which the investigators might contact them. Some KAT case managers were not included

in these schedules and in these cases they were directly contacted via email by the project

evaluators and asked to schedule a time to complete the survey. When these two methods did not

elicit an appointment time, then the project evaluators contacted the case manager by telephone

in order to set up an appointment. Each case manager was contacted at least three times in an

attempt to set an appointment time.

The surveys consisted of a set number of questions that elicited demographic and factual

information from each participant (see Appendix). In addition, the evaluators used a “Critical

Incident Procedure” to obtain specific information on case management of individuals with

disabilities. This procedure was used to obtain a description from the case managers about one

particular case that they had managed that they believed was successful, as well as about one

case which seemed to be more difficult to manage, as well as the factors that they attributed to

these descriptions.

Survey data was analyzed as whole group data. Descriptive statistics were generated and

the responses of the case managers were tallied for those questions in which the responses could

be tabulated. Qualitative responses were open coded to categorize the responses. These codes

were grouped to form overarching categories. These categories were then compared across case

managers to determine those that we most representative of these case manager responses.

Interviews with Administrators. Thirteen P&A administrators and three NDRN

administrators were interviewed. All interviews, with the exception of one, were conducted face-

to-face at the office at which the administrators were employed. Five questions were asked of

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each administrator (see Appendix) and follow up probes were used to elicit more specific or

elaborative information as needed. The interviews took from 20 to 40 minutes. Consent forms

are on file in Dr. Stough’s office at Texas A&M University.

Variance occurred across the interviews in that questions designed to elicit clarification

and elaboration were asked during the interview. Thus, these interviews were designated as

“semi-structured” rather than “structured.” Interviews and focus groups were analyzed following

the similar procedures. All sessions were audio taped and these audiotapes were transcribed for

analysis. Data analysis of interview and focus group information were performed using

Grounded Theory analysis (Glaser & Strauss, 1967; Strauss & Corbin, 1990), in which the

transcripts of the interviewees were analyzed using a line-by-line approach to collect and analyze

the data. Grounded Theory focuses upon the data that is elicited from the participants in a study

and produces an inductively derived conceptual model that is grounded in this data. This

methodology allows for the comparison of new data to previous cases so that the addition of new

information from additional interviewees allows the evaluator to iteratively gain more precise

information on the question of interest. Grounded Theory is a particularly appropriate method to

use when the area of interest has not been previously investigated, as is the case in this

evaluation of the experience of individuals with disabilities following disaster.

The outcome of the analyses of these of these two methods produced 1) categorization of

the results, 2) statements and quotes that exemplified and elaborated on each category, 3) text

descriptions of each category of interest, and 4) a text summary of how the result categories

interact and affect each other.

Focus Groups. Focus groups were the fourth data collection method used as part of this

evaluation. The focus groups provided an opportunity to ask participants to given elaborative

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responses and to obtain detailed information about particular survey items. Each focus group

consisted of three to eight participants who were asked a series of five questions (see Appendix)

over a period of one and a half hours.

Field Notes. Field notes were collected while gathering the data. They served to remind

the evaluator of contacts made with the participants in the evaluation, to note supplemental

information obtained during the data collection process, and to record initial analysis of the

phenomena under study. During this evaluation, field notes were collected during interactions

with NDRN staff and P&A staff. Field notes were also recorded following interviews and focus

groups. Field notes were collected at the same time as the other four methods of data collection.

For the purposes of this evaluation, it was not necessary that field notes be analyzed separately.

Timeline of Evaluation

The timeline of the data collection and analysis was as follows.

Evaluation Timeline

MAY

2007

JUNE

2007

JULY

2007

AUG

2007

SEPT

2007

OCT

2007PRIMARY QUESTIONS:

Contact and set up data collection schedulewith NDRN and State P&As

XX

Semi-structured interviews at P&As and at NDRN

XX XX XX XX

Survey of all case managers XX XX XX

Focus groups at P&As and NDRN XX XX

Analyze data from primary questions XX XX XX

SECONDARY QUESTIONS:Obtain permission for access to

quantitative data collected by KAT

XX

Meet with UMCOR evaluators XX XX

Obtain first year of group data fromUMCOR (Jan.–Dec. 2006)

XX

Input data and clean up database XX

Analyze data XX XX XX

Write up and report results XX

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RESULTS

Data collected from the procedures described above were analyzed separately and the

results of these analyses are reported in the following section.

Quantitative Results

Data sets extracted by program evaluation personnel at United Methodist Committee on

Relief/Katrina Aid Today (KAT) from the Coordinated Assistance Network (CAN) database in

July 2007 were analyzed to answer demographic-focused and case management-focused

questions about NDRN as compared to other KAT partners. These analyses were conducted after

consultation and discussion on their composition with Nachama Wilker at NDRN.

Most of the questions were answered by tally and cross-tabulation of data elements in

CAN records to analyze frequencies for NDRN as compared to all other KAT partners. A few of

the questions asked about continuous quantities (e.g., length of time that a case stays open) and

were answered by comparing means for NDRN with means across the other partners. Additional

questions were answered by comparison of numbers presented in built reports.

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Demographic Focused Questions

Is there a difference in age or gender of NDRN clients as compared to the other KAT

partners?

The majority of clients served by NDRN and across the other KAT partners were female

(66% and 73%, respectively). NDRN’s clients were older as compared to those served by the

other partners: 1 average age of NDRN clients was 53 compared with 45 for clients of the other

partners. Although the clients served by NDRN and across the other KAT partners most often

were Black/African American (64% and 79%, respectively), the proportion of White clients was

significantly greater for NDRN as compared to the other partners (34% and 14%, respectively).2

1 Proportion of clients ages 46-99 was slightly but significantly greater for NDRN than for the o ther partners (chi

square 8.37, p<.01). Average age of 53.17 + 16.01 for NDRN was slightly higher as compared to 44.82 + 15.43 for

clients of the other partners (F=1028.47, p<.001, eta squared = 0.02). These calculations are based on database

records for which age was recorded, 3794 or 83% of NDRN cases and 51376 or 98% of cases across the other

partners.

2Chi square=12.09, p<.001. The proportion of clients for whom no information about ethnicity was recorded was

significantly greater for NDRN compared to the other partners (chi square=5.99, p<.05): in nearly one-fourth of

cases (24%) no information about ethnicity was recorded for NDRN clients compared to 10% for the other partners.

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Is there a difference in the Katrina impact factors for NDRN clients as compared to

others?

Nearly all NDRN clients, like those of the other KAT partners, were displaced and had

experienced damage to their housing by Hurricane Katrina. NDRN clients were less likely

compared to the other partners to have been a mandatory evacuee (61% NDRN compared to

81% other partners) or to have experienced loss of income (17% NDRN, 57% other partners).3

NDRN clients were recorded to have slightly fewer numbers of impacts as compared to

clients of the other partners; the average numbers of impacts summed across the seven categories

were 2.75 + 1.00 NDRN as compared to 3.46 + 1.02 for other partners.4

3Chi square 8.56, p<.01; chi square = 32.62, p<.001 for NDRN as compared to other partners for mandatory

evacuee and loss of income, respectively.

4F=1012.25, p<.001, eta squared = .03

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Calculations and comparisons were based on the 2,260 NDRN clients and 34,271 clients

of other partners with at least one impact recorded in the database. The percent of cases with zero

impacts recorded were surprisingly large but not significantly different for NDRN and the other

partners (50% NDRN and 39% other partners).

Is there a difference in numbers of clients that lived in Section 8 or public housing pre-

disaster?

A minority of clients of NDRN and of the other partners were recorded in the database as

having resided in subsidized housing pre-Katrina (12% of NDRN clients and 15% of clients of

the other partners). For those clients who did reside in subsidized housing, Section 8 vouchers

was the most frequent type of subsidy (7% of NDRN clients and 9% of clients of the other

partners).

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A surprisingly large percentage of cases had no information recorded in response to the

question asking if the client’s pre-disaster housing was subsidized (53% NDRN and 41% other

partners). There were no significant differences for NDRN clients as compared to the other

partners in the presence of information or the type or frequency of pre-disaster housing subsidy.

Case Management Focused Questions

What is the length of time a case stays open?

Average number of months from the date the case opened to the date it closed for the

1,273 NDRN clients and the 20,039 clients of other partners with closed cases were 4.90 NDRN

and 6.03 other partners. The difference was not statistically significant. The range was less than

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one month (0.03) to nearly 3 years (30.44 months) for NDRN clients and 0.03 months to nearly 4

years (47.08 months) for the other partners.

What are the property-related needs of NDRN clients as compared to the other partner

agencies?

The majority of clients needed housing with NDRN clients more likely to need housing

as compared to the other partners (73% NDRN, 60% other partners).5

The next most frequent

property-related needs are furniture/appliances (30% NDRN, 39% other partners) and

utilities/services (23% NDRN, 32% others). Less than one-fourth of clients had need indicated

for transportation, clothing, or financial assistance.

5Chi square=4.40, p<.05.

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Average number of needs across the 6 types of property-related needs was trivially

smaller for NDRN clients as compared with others: 1.82 + 1.21 for NDRN, 2.00 + 1.21 others.6

These calculations are based on the 2,137 NDRN clients and 31,195 others with at least

one need recorded in the database. A surprisingly large number of records had no needs

indicated: 53% NDRN, 44% others. The proportion of NDRN cases with zero needs indicated

was not significantly different from that for the other partners.

What are the person-related needs of NDRN clients as compared to the other partner

agencies?

6F=43.79, p<.001, eta square=.001

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The most frequent personal need was health & well-being and was not significantly

different for NDRN as compared to the other KAT partners: 45% NDRN, 39% others. Less than

a third of clients had need indicated for food/nutrition, employment/job training, aged/disabled

services, and less than 10% had need for services for children & youth. NDRN clients were

notably less likely to need employment/job training as compared to others (12% NDRN, 29%

others)7and notably more likely to need aged/disabled services (23% NDRN, 8% others).

8

Average number across the 5 types of person-related needs was trivially smaller for

NDRN clients as compared to others: 1.09 + 1.06 NDRN, 1.17 + 1.06 others.9

7Chi square 7.85, p < .01

8Chi square 9.77, p < .01

9F=9.68, p < .01, eta square = .00

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What are the procedural needs of NDRN clients as compared to the other partner

agencies?

Only a few clients had procedural types of need indicated in their database records with

need for application assistance the most frequent type of procedural need: 8% NDRN, 11%

others. Less than 10% of clients had need indicated for legal assistance, benefits restoration, and

language assistance. There were no differences for NDRN clients as compared to the clients of

other partner agencies

Average number across the four types of procedural needs was trivially smaller for

NDRN as compared to others: 0.19 + 0.44 NDRN, 0.23 + 0.55 others.10

10F=10.71, p <.01, eta square = .00

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When number of needs was calculated across all 15 types of needs (6 types of property-

related needs, 5 types of person-related needs, and 4 types of procedural needs), the average for

NDRN clients was trivially smaller as compared to others: 3.10 + 2.01 NDRN, 3.39 + 2.10

others.11

What is the participation profile of NDRN clients as compared to the other partners?

Partners NDRN

Caseload

Total number of KAT cases in CAN database 55301 4825

# of Recovery Plans developed 43694 3502

% of cases with a developed Recovery Plan 79% 73%

ClientsEstimated number of people served 147635 11098

Average household size 2.67 2.30

Staffing

# of Paid Case Managers 565 71

# of Volunteer Case Managers 1323 7

Total number of Case Managers 1888 78

Case Management

# of opened cases 29383 2582

# of closed cases 24873 2093

# of Referrals provided 47511 3299

# of Referrals utilized 188308 10261

Estimated total value of services provided 77,077,222.00$ 3,583,307.00$

Average estimated value of services provided per case $1,393.78 $742.65

Inspection data presented in the 60% Benchmark Report for KAT and NDRN12 showed

NDRN serving 8% of cases and nearly 8% of people served through the KAT National Case

11F = 42.63, p < .001, eta square =.00

12Report supplied by United Methodist Committee on Relief (UMCOR) September 4, 2007 from CAN Built

Report.

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Management Consortium. Similar to those of the other KAT Partners, approximately three-

fourths of NDRN clients had a developed Recovery Plan. The proportion of closed to open cases

was similar for NDRN and the other Partners (43% and 45%, respectively).

The ratio of volunteer to paid case managers was notably less for NDRN as compared to

the other partners (approximately 1:10 versus 2:1). The ratio of total cases to total case managers

was notably greater for NDRN as compared to the other partners (approximately 62:1 versus

29:1).

The ratio of referrals provided to total cases appeared similar for NDRN as compared to

the other partners (approximately 1:10). Amount of referrals utilized and total value of services

provided as a ratio of total cases appeared to be less for NDRN as compared to the other

partners: referrals utilized approximately 2:1 NDRN versus 3:1 other partners and dollar value

of service provided approximately 743:1 NDRN versus 1394:1 other partners.

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Is there a difference in referral to long term recovery committees?

Less than five percent of clients are recorded as referral to Long Term Recovery

Committees (LTRC) with no difference for NDRN as compared to others: 3.8% NDRN, 4.8%

others.

The average value of services provided when presented to LTRC was approximately 6.5

to 6.9 thousand dollars with no difference for NDRN as compared to others: $6,478.84 +

$9,070.45 for NDRN, $6,979.40 + $16,134.34 for others. The calculation of average value of

services is based on those few cases for which the information was recorded in the database:

n=57 NDRN, n=1,772 others.

Combining cases across NDRN and the other partners, the average value of services

provided when presented to LTRC was greater when the client was indicated as needing

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aged/disabled service: $10,834.26 + $15,575.66 for clients needing aged/disabled services

compared to $7,894.90 + $17,355.86 for clients NOT indicated as needing aged/disabled

services.13

Is there a difference in reasons for case closure?

The most frequent reason for case closure for clients of NDRN and of the other KAT

partners was “primary needs met”. Thirty-five percent of NDRN closed cases and 35% of other

closed cases were indicated as closed by reason of primary needs met. Other reasons for case

closing included recovery plan achieved, client relocating, client withdrew, and case transferred

out of the KAT network. Substantial numbers of NDRN cases were closed with the reason

“Unable to resolve because of lack of resources”; 17% of NDRN cases compared to 5% for

13F = 4 .09, p < .05, eta squared = .00

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others.14 “Other” reasons for case closure included losing contact with the client, client refusal of

services offered (e.g., “refused to go to the unmet needs committee”), and needs are beyond the

services and resources of the program.

A surprisingly large number of case records with status “closed” indicated no reason for

case closure. NDRN was not significantly different from others in proportion of closed cases

without any reason recorded: 40% NDRN, 34% others.

Is there a difference in clients’ perception of extent to which needs are met at time of case

closure?

The majority of clients of NDRN and of other partners who answered the question about

their perception of extent to which needs were met indicated their needs were completely or

14Chi square = 6.37, p < .05

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mostly met, although NDRN clients were slightly less likely to report this level of positive

outcome: 62% NDRN, 77% others.15

The client’s perception of outcome is recorded in the database for only about one-fourth

of the closed cases and is not different for NDRN as compared to others: 72% NDRN, 74%

others.

How did clients rate their case managers on the client satisfaction survey?

Nearly all (i.e., more than 90%) of respondents to the client satisfaction survey indicated

satisfaction with their case managers. They agreed or strongly agreed the case worker was

“courteous and professional;” “knowledgeable about the recovery process and resources

available;” and “understanding of my challenges and concerns.” There were no differences in

proportions of satisfied clients for NDRN as compared with the other partners.

15Chi square = 5.97, p < .05

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The overall survey response rate was low. Stated as a proportion of all cases closed, only

6% of clients completed the satisfaction survey (i.e., the vast majority of clients eligible to the

complete the survey did not do so). The low rate of response was the same for NDRN and for the

other KAT partners.

Did clients indicate satisfaction with services?

Nearly all (i.e., more than 90%) of clients who responded to the satisfaction survey that

was made available to them at case closure indicated they agreed or strongly agreed they were

satisfied with almost all aspects of services that were queried on the satisfaction survey. Survey

respondents were slightly less likely to express satisfaction with “the way various agencies

assisting my recovery from Hurricane Katrina have responded.” Slightly less than 90% of survey

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respondents at the other KAT partners (88%) and only about half (63%) of NDRN survey

respondents agreed they were satisfied with the way the various agencies responded.16

Survey responses from clients of NDRN and those from the other Partners regarding

services within their respective case management agency indicated almost uniform satisfaction—

i.e., more than 90% agreed or strongly agreed the “Agency responded promptly after my case

was initiated;” “Overall, agency staff were courteous and professional;” “I am satisfied with

service I received from this agency;” “The Agency did everything it could to help me address my

needs;” and “I received information and services that met my needs.”

16Chi square = 15.57, p < .001

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Summary of Quantitative Results

Similar to clients of the other partners, NDRN clients were:

• Predominantly female and predominantly Black/African American;

• Nearly all displaced and had experienced damage to housing;

• Not likely to have lived in subsidized housing pre-disaster;

• Likely to have their case open an average of 4 to 6 months;

• Not likely to have their case referred to Long Term Recovery Committee;

• Likely to have “primary needs met” or “recovery plan achieved” as reason for case

closure; and

• If they answered the client satisfaction survey, likely to indicate satisfaction with their

case manager and with services received.

In contrast to clients of the other partners, NDRN clients were:

• Older;

• Less likely to have been a mandatory evacuee or to have experienced loss of income;

• More likely to need housing and services for aged/disabled but less likely to need

employment/job training;

• More likely to have case closed for the reason “unable to resolve because of lack of

resources;

• Less likely to report their needs were met; and

• If they answered the client satisfaction survey, were less likely to express satisfaction

with the various agencies assisting in their recovery had responded.

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Results from Surveys of Case Managers

Sixty-two case managers were submitted by the KAT administrators to be surveyed. Of

the list of 62, 68% (n=42) were surveyed. Three people on the list were actually administrative

personnel and not included in the case manager sample (5%). One of the people listed was

actually a Vista Volunteer and 13 of the case managers had left their positions (21%) and could

not be contacted. Three additional case managers were unable to be contacted and no interview

was conducted with these three (5%). At least three attempts were made to contact each case

manager.

All case managers were administered the same survey questions (see Appendix). Of the

42 case managers surveyed via telephone, 100% of them responded that they were employed as a

case manager. The case managers interviewed had been employed in their position an average of

12.6 months with the high being 96 months and the low being two months. The case manager

who had been employed for 96 months had been previously employed with her P&A as a case

manager in another capacity. Of the case managers interviewed, 14 were from Mississippi, 12

from Louisiana, four from Alabama, nine from Texas, and three from Georgia.

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Gender of case managers

female

83%

male

17%

female

male

Educational status of case managers

Some

college

6%

Bachelor's

65%

master's

23%

ph.D.

3%

J.D.

3%

Some college

Bachelor's

master's

ph.D.

J.D.

Of the case managers interviewed, 83% were female and 17% were male. Ethnicity broke

down to 47% African American and 53% White. Thirty-six percent were single, 50% married,

14% separated or divorced and there was a range of 0 to 4 children living in the homes. Six

percent of the respondents had ‘some college,’ 65% had a Bachelor’s degree, 23% had a

Master’s degree, 3% had a PhD, and 3% had a JD.

Of the case managers interviewed, 62% were working in a damaged area (n=26) and 64%

considered themselves to be a survivor. Twenty-seven percent of the interviewed case managers

volunteered during the immediate aftermath of the storm.

There were a total of 2,047 cases that were part of the case load of this population of case

managers with a high of 240 for one case manager and a low of seven for another case manager.

The average number of cases per case manager was 48. One hundred percent of cases were

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Katrina survivors. Of all the cases managed by these case managers, 1,046 had been closed with

a high of 100 closed cases for one case manager and a low of zero for another.

Case managers were asked a series of questions about their experiences with NDRN-

KAT clients and the factors that affected their recovery following Hurricane Katrina. When case

managers were asked about what made some cases successful in recovering following the storm,

the responses generally centered around the ability of the case manager to find appropriate

resources for the clients, the awareness of the disability-related systems in place, the ability to

coordinate amongst agencies, and client motivation.

Identifying and accessing available resources was the category of concern expressed most

often throughout the interviews: “Being disabled you are limited to when and where you can go

so if you aren’t there at a particular time you miss out.”17

The client then goes to the doctor and

to the store occasionally, and so has limited access to resources. The CM believed that providing

case management made the client aware of services available that otherwise would go

overlooked.

Several case managers mentioned that timing sometimes played a large role in how

successful they were as accessing resources––the timeliness of contacting the client, cooperation

from the client, collaboration from other agencies, and accessing resources. Another example of

timing and being able to find the appropriate resources:

Everything just came together. It had to do with the particular needs of the clientsand what I could offer. These clients just needed furniture but had obtained their own mobile home. They are older and disabled. What their needs were and what Icould provide matched up.

17Throughout this evaluation report consistent effort was made to respect the voice and expression of the

participants. As a result, in some cases, quotes in this report will appear ungrammatical or to have syntax errors.Each transcript was checked twice in order to render as accurately as possible the words of the participant. Quotes areincluded as intact as possible and only edited when it increased readability. In these cases, the format “…” was usedto indicate deleted words except in the case of repeated words or verbal fillers. When words were included for readability, brackets were used.

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Yet another case manager illustrated that having knowledge of the system by both the

client and the case manager is helpful in achieving success. The coordination of services between

the social worker, the client and the CM made the case successful and led one case manager to

remark, “It helps when the client is more interested in their recovery than you are.” The client

put a lot of effort into their recovery plan. The client followed up on paperwork, was patient, was

aware that some services are not given, and gave the CM the necessary paperwork to get the

additional funding and the services that they needed.

Case managers were also asked about challenges in providing case management. Lack of

resources was the primary response on this query. Many case managers communicated that their

ability to navigate the disability arena allowed them to access more services and resources for

their clients.

I had a client who was diabetic, he could not walk. Lived in a FEMA trailer andFEMA is closing the trailers soon. He found a place to live 300 miles away withfamily, but the local resources initially would not agree to support him if hemoved that far away.

The case manager was subsequently able to get the support needed to execute the move.

Knowledge of the disability system and knowledge of the needs of clients was also

identified as important by the case managers in being able to achieve success; not having this

knowledge was a perceived barrier.

An agency did not understand the needs of the clients and was very judgmentalabout the client’s situation. This agency has judged the client and made it difficultfor them to receive services. FEMA was not aware of the clients’ needs,especially the clients’ needs that had to do with the client’s disability status.

The CM had to help FEMA understand the client’s situation. This issue was with FEMA

in the housing department. It is an ongoing situation as the case is not yet closed.

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Another case manager gave an example of the limitation some people with disabilities

have when accessing social support services.

A young man was in a nursing home and needed to be moved to another city.

Medicaid, Medicare won’t pay for it because he isn’t going to hospital but to ahome to be closer to his family. Not a medical necessity, FEMA says it has beentoo long after the hurricane for them to assist. The ambulance service cut their costs but we still don’t have the means to pay $800 to move him. He is medicallyfragile.

The case managers interviewed perceived the biggest challenge faced by clients in their

area as housing. Other significant challenges include working through the system, transportation,

locating resources (both tangible and financial) and paperwork (amount of, literacy, and

organizational skills needed). One case manager summed it up by sharing that:

Everyday needs are more accessible in a small town such as food and clothing. Ina small town I can go to any Goodwill, Salvation Army, soup kitchen and in amatter of minutes get my daily needs met. In a place the size of Houston theyknow nothing about the lay of the land and it is so spread out, that getting your everyday needs getting met is an impossibility, you can’t go to your neighbor andget some soap or ramen noodles. The ability to advocate for their own selves isstunted when faced with a large city. Even with help it is kind of hard.

The focus on housing as the primary challenge was overwhelming supported by case

managers.

Housing, housing and housing [laughed]. That is a loaded question, they face so manychallenges. Clients who were living in low-income housing find that there is none leftnow. Even finding an apartment is difficult.

Housing. Living in the area a lot of things have changed, clients have difficulttime adapting to the new area and the new ways. Housing is big problem, noaffordable housing. Used to be able to get a 1br for $400, now if is $800 if youcan find it.

The prompt regarding the perception of cultural differences amongst clients and case

managers elicited a balance of responses. Forty-one percent of case managers did perceive a

difference and 59% did not. The primary perceived difference was focused around cultural and

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regional differences. These differences encompass many things including the way the social

services systems operate and the language used within each system, perceived client dependency,

and the perception of Katrina survivors as “being lazy” and “taking advantage of the system.”

Statements from case managers illustrating these differences included:

There is a cultural difference in the standpoint of services offered in differentareas. Some are used to one type of service and when they relocate the servicesare different. People that didn’t experience the storm don’t understand the gravity.

Another case manager noticed that in “New Orleans case managers were like Mama’s,

they did everything for you.” She shared that, in her area, case managers give the client the

information and they do it for themselves. “Transportation was another issue here. Clients were

used to public transportation. They became stranded because they no longer had that public

transportation.”

When asked about what advice they would give the KAT, the case managers surveyed

responded that all agencies needed in-house monies to meet client needs. As the system is now,

agencies must scramble to obtain resources; as one case manger said,

We are going out and doing the bulk of the work to get resources. We don’t havea backup, we have to convince other agencies of the value of what we are doing.We should be able to show who we are and get resources from other agencies for our clients. I feel triple worked.

Another case manager shared that,

Empower the case management organizations with some funds. [Our agency] hasa contract to help broker information to people with disabilities. Immediate needscould be dealt with effectively if we had some money to help them get back ontheir feet. Empower case managers with some money to disperse for immediateneeds. Not a Walmart card but some money that the case manager could helpimmediate needs. We try to raise money for this purpose and it goes outimmediately.

Other advice to KAT was to provide more resources, streamline paperwork process, and

to refine CAN and then leave it alone and to “stop making changes mid-stream.”

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The paperwork, input, and project evaluation rigors that centered around KAT, which

was not perceived to be a fully functional database that was user-friendly, were perceived to need

some streamlining. KAT was reported to undergo changes on a fairly regular basis causing some

confusion amongst users.

It [KAT] is a wonderful project but the expectations have been out of control.They have expected us to keep accurate data on a program that is not accuratelyworking. They take their information from this system but it is not working. Wedo quarterly report and ours does not compare to their report. CAN has the potential to be an awesome system but there are many kinks and it is not the toolthey expect it to be.

Another case manager shared that “the supervisors need to be people who are down here and

more visible with us, there is a huge disconnect that leads to miscommunication,

misunderstanding, etc.”

When asked if the P&A had influenced other KAT agencies, the response was 86%

positive. The P&A agencies were perceived as experts on resources for people with disabilities

and a group with specialized knowledge. One case manger noted that she believed that they

provided a service to the CM in the other agencies, “It makes their job easier because we are

doing the footwork for people with disabilities.”

When asked if cases of people with disabilities differed from cases of people without

disabilities 83% of the case managers agreed with this statement. The reasons given were that

people with disabilities had more specialized needs, their clients required more guidance, and the

cases required more specialized knowledge on the part of the case manager. As one case

manager explained,

Yes. It is like driving a standard versus an automatic. They both go straight, andturn and back up. But to accomplish that you have to have a little moreinvolvement and a little more knowledge.

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Another case manger shared how it is sometimes difficult to obtain resources and support

due to the involved nature of the cases.

I think that our clients bring a lot less [tangible efforts] to the table to contribute.

At the LTRC tables when asked “What they have they come with. What have theydone for themselves?” they come with a lot less. You have to look a lot harder toget the resources that they need, you have to be a lot more creative with donationsand volunteer labor.

Recovery was also perceived by this group as being more difficult for someone with a

disability (86%). Again, the specialized services and the need for a case manager with this

knowledge was the primary challenge. One case manager shared that,

Somewhere along the way if they don’t plug into some agency that can addresstheir needs they will miss out on services that they are entitled to and need. Casemangers need to have some knowledge of what is available for [IDD].

Other challenges to a successful recovery included having the knowledge to know how to

function within the social service system, mental health complications and transportation.

A person with disabilities has to navigate with in the typical system so a typicalcase manager cannot imagine if it is already hard for a non-disabled person tonavigate a typical environment, it is enhanced when you have a disability. Thereis so much more to deal with.

Upon conclusion of the interview, case managers were asked if they had anything else

they would like to share. Many of the case managers wanted to emphasize that while the work

was challenging, it is also very rewarding.

It is the most stressful job I have ever had and the same time the most rewarding.Being able to help someone who has lost all hope it does something to you thatyou can’t describe in words.

Another primary issue was that the case managers felt that to do a good job they needed

to be backed up by financial resources that they could pull from to meet the needs of the client.

Most of the other Katrina Aid Today partners had financial resources and donations that they

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could use to support the clients using case managers through their agency. The KAT affiliates

did not have such a mechanism in place before the storm, although some of the offices did have

short-term monies that they were able to distribute to some clients at the beginning of the project.

Results from Interviews of P&A and NDRN Administrators

After coding and categorization of the responses from the P&A administrators

and NDRN staff the responses were reviewed across the five questions that were used to solicit

responses. The results of this analysis are organized by question in the following section:

Question 1: What has been the impact of providing case management to Hurricane

Katrina/Rita evacuees on this organization?

Respondents overwhelmingly pointed out that participating in case management to

disaster survivors was a new role for the organization. Prior to Katrina, NDRN and the P&A had

been primarily a legal services organization and, as noted by more than one respondent, “P&As

don’t do case management.” Involvement with emergency management organizations was new

to the organization, as was involvement with the faith-based organizations that are the most

common provider of long-term disaster recovery resources.

P&A administrators pointed out a number of management challenges that were part of

the program. First, the start-up of the program was fast and the P&As were challenged to keep up

with the rapid ramp-up of the program. Second, the employment and supervision of the over 50

case managers who had been hired as part of the Katrina Aid Today program provided a special

challenge as the nature of the work of the case managers was markedly different from that of the

other employees working at the P&As. Sometimes this meant that the KAT employees worked at

offices at different locations than the other employees at the P&As or that the P&A had to find

temporary space in which to house them. Pay rate for the KAT case managers was shaped by the

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funds available from the larger KAT grant and sometimes differed from that of the P&A

colleagues. For most of the P&As, these factors made the integration of the KAT staff with the

other P&A staff challenging and several directors mentioned special efforts they had made at

helping the case managers feel as though they were part of the rest of the agency. Third, funding

from the larger KAT program was designated primarily for salaries for case managers and little

was allocated for administrative costs and support. All of the P&A administrators noted that their

agencies then needed to find funds in order to cover unanticipated costs, such as for additional

hours for the human resources or secretarial support, or for extra copying and telephone costs,

which had not been planned for in their original KAT budgets. These budgetary needs were also

impacted by the administrative oversight and reporting functions that were required by the KAT

Monitoring and Evaluation team––time and personnel were needed to comply with these

requirements and all the P&As reported on the challenges of providing such oversight given their

KAT budgets.

Data keeping and paperwork functions required by KAT were different than those used in

the past by the P&As for other programs and the KAT employees had to quickly learn these

functions. Especially during the first year of the program, reporting demands to KAT changed

often and learning new procedures on a short timeline was reported as stressful for all of the

P&As. P&A staff explained that implementing new procedures and activities while at the same

time developing the program and recruiting clients was a challenging task.

There were several positive impacts of participating in the KAT program that were

mentioned by the P&A administrators. One consistently mentioned positive impact was that the

P&As received higher visibility regarding their work with people with disabilities. Working

toward the shared goal of recovery of hurricane survivors also assisted with forming

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collaborations with agencies and organizations with whom the P&As had not previously had

relationships. Some of the agencies with whom they are collaborating were not agencies that

they had targeted previously for collaboration. For example, one administrator shared that, “we

now interact with other social service agencies like Catholic Charities that allows us to bring a

new perspective to these organizations. As a KAT partner, we have put a focus on disability

issues.” In other cases, the program strengthened relationships with existing partners.

In addition, the P&As had the opportunity to serve clients with characteristics that they

had not previously served. For example, elderly people with functional limitations who did not

typically consider themselves as having a disability, survivors who were Vietnamese, or those

with mental illness. P&A staff believed that individuals with disabilities in the community

became more aware of the P&As with the expanded role that the agency was playing in the

recovery process. The majority of the respondents mentioned that the experience with KAT

would make their organizations more prepared to serve survivors with disabilities in future

disasters.

Question 2: Some case managers and administrators have expressed that the management

of cases of evacuees with disabilities differs from the management of cases of evacuees

without disabilities. Do you agree with this statement? Why or why not?

The respondents overwhelmingly agreed that the management of cases of evacuees

differed from the management of evacuees without disabilities. In some cases, the respondents

stressed that the difference was not primarily in the types of services needed by these individuals,

but in the nature of the case management itself. The respondents characterized the case

management services needed by people with disabilities as requiring more frequent contacts,

more time, lasting longer, and being overall more intensive than that provided to individuals

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without disabilities. The multiplicity of issues of individuals with disabilities was seen as being

greater as was their knowledge about services that would meet those multiple needs. The end

goal, however, was the same in that the objective was to connect these individuals to needed

services.

Most people with disabilities have additional services that were disrupted to themin terms of what was required to live. The traditional case management model of putting people back into the same place they were does not understand theservices of people with disabilities.

Yes. That was our premise going and I have not been dissuaded since. There may be similarities, the loss or the lack of svc system is… no question that if you are

middle class you lose your roof, you put it back you go on. So many who wereliving in the community that are now in nursing homes, institutions, in morerestrictive settings. They don’t have the resources to get back to near where theywere. A huge reliance on social service systems is apparent. It is important for anorganization with disability awareness to be involved because they would haveknowledge of these factors.

Administrators also believed that individuals with disabilities as a group had

characteristics that made management more challenging. For example, as a group, individuals

with disabilities are less likely to be homeowners. This meant that some of the FEMA programs

were not of use to them or, in the case of FEMA trailers, were not accessible to them. Individuals

with disabilities were also seen as less likely to be employed, which affected their ability to pay

utility bills or to purchase furniture. It also impacted their ability to relocate after the storm as

they may not have the resources or transportation needed to relocate. Individuals with disabilities

were more likely to have medical needs and in some cases assistive devices or durable medical

equipment needed to be replaced. Most administrators mentioned that case management for

people with disabilities necessitated knowledge of how to communicate with the disability

community. Some administrators believed that the skill of working with people with disabilities

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was one that could be provided through training by the P&A and not a necessary prerequisite for

hiring as a case manager with the P&A.

Question 3: Some case managers report that recovery from disaster is more difficult for

individuals with disabilities and requires knowledge of disability services in order for a

successful recovery plan to be designed. Do you agree with this statement? Why or why

not?

In general, the administrators agreed that recovery from disaster was more difficult for

individuals with a disability. Case management with the survivors with disabilities was seen as

taking longer in part because multiple areas of support needed to be addressed. Needed

knowledge include information on disability resources and sources for durable medical

equipment. It was also noted that people with disabilities might be more at risk for depression or

anxiety. Another reported factor was that people with disabilities, on average, have more support

needs that those without disabilities. For those evacuees that were displaced, those natural

supports were seen as more difficult to reassemble as they had been developed to accommodate

the particular needs of these individuals and put place over time. Some administrators noted that

those accommodations that were in place before the storm might no longer function in the new

environment.

The respondents believed that case managers who had knowledge of disability services

would be more successful than those that did not. Essential to the success of these case managers

was understanding of disability services and eligibility for those services. Part of the reason it

was seen that people with disabilities were more reliant on public services such as public

transportation and social services, and that public infrastructure was seen as being particularly of

importance for individuals with disabilities.

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Clients have reliance on so many federal programs and the long term nature of thesystemic presence does affect how they access support. Special education, evenhousing requires access to federal programs. There is a broader array of servicesand systems for people with disabilities. It is not a question of getting roof repaired and sending them on their way, there are stiff bureaucracies to deal with.

In the beginning money is donated, people are helping; people with disabilitiesdon’t recover that quickly.

Finally, it was reported that case workers needed to be able to aware of the attitudes and

biases that society have against individuals with disabilities and be prepared to deal with those

attitudes when seeking resources for their clients.

Question 4: In our conversations and interviews with P&A staff we have heard stories

about the influence that the KAT-NDRN staff and case managers have had on the case

management and administrative practices of their colleagues in the other KAT agencies.

Do you think that the participation of your P&A as part of the KAT consortium within the

state had an influence on other KAT agencies? If so, how?

The response to this question was a guarded “yes.” The reservation of most of the

respondents was that they had yet to see the results of their advocacy and education activities-

which made the respondents unsure about the extent to which the P&As had concretely and

definitively influenced their partners. The respondents did believe that the partner agencies were

more aware of their services and that their participation in KAT had heightened their profile

among agencies, but that there was still some misunderstanding about what was the role of the

P&A. Partner agencies were likely to call the P&As when they needed disability-related

information, and appreciated that the P&As had disability-related expertise, but this did not

necessarily translate to the transfer of cases to the P&As. The involvement of the P&As was seen

as elevating awareness of disability-related issues among the partner agencies. In most cases, the

P&As took leadership among the KAT partners in hosting meetings at their offices,

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demonstrating best practices in case management, or providing training and information on

working with individuals with disabilities.

Statements regarding impact on partner agencies focused on the awareness that the

partner agencies now had about the role of the P&As. Despite this awareness, the concrete

impact that the P&A participation had had on the partner agencies was hard to see for most of the

respondents. While the partners provided much information and referral to disability-related

services the partner agencies, the reported impact was one of disability-awareness rather than an

increased knowledge of disability resources. As such, the influence that the P&As saw

themselves as being most valuable was in providing technical assistance.

More definitive change was seen as part of the legal actions that the legal side of the

P&As took regarding accessibility of services and information in accessible format. Some

respondents pointed out that these actions had influence outside of the KAT partnership, such as

legal actions taken on Red Cross and FEMA. In some cases, the administrative staff made a point

to communicate with other agencies about the rights of individuals with disabilities. All of the

respondents believed that they had influenced the other partners to at least think about disability

issues and the rights of individuals with disabilities.

On the national level, NDRN administrators pointed out the effect that NDRN and the

P&As had gained credibility among the emergency management organizations and this enabled

them to have a stronger voice and thus the potential to affect change. Perhaps the most

significant impact was on the Stafford Act, which legislates the accommodations that people

with disabilities who are receiving case management and sheltering have after a disaster. This

advocacy was seen as having long-term effects on recovery practices and as having changed the

legal requirements of agencies providing sheltering and services.

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In short, respondents believed that presence of the P&A partners at the “disaster recovery

table” made the partners think about disability issues in a way in which they had not done before.

Partners were seen as being more aware of the needs of people with disabilities, but respondents

did not know if this would ultimately affect practice and were unsure if this involvement would

substantially change how services would be delivered in the future.

Question 5: What advice would you give to Katrina Aid Today (KAT) in improving

services for the next disaster?

Among the P&As, and particularly among the Tier 3 supervisors, advice about changes

were fairly consistent. The strongest recommendation for change focused on the measurement of

outcomes of the program, specifically, the use of number of cases as being the primary and

almost exclusive outcome measure. . One Adminstrator commented that. “The administrative

structure did not work well, it set up competition. Lot of time was spent on numbers and not on

the quality of case management. That was set up by design, not purposefully but that was the

impact of the design.”

Case management of individuals with disabilities was presented as more intensive and time

consuming, which meant that fewer cases could be managed by each individual case manager.

Case management by the P&As was sometimes referred to as “holistic” or “deep case

management” as the support needs of individuals were seen as necessitating a more intensive

level of case management.

A related recommendation was that the expected time that survivors would need to

recover from the disaster should be modified. Time for recovery was seen as being particularly

important as individuals with disabilities were seen as needing an even more extended time for

recovery. Part of this time for recovery was linked to the need for the existing public

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infrastructure to be rebuilt or modified as an essential part of the supports that people with

disabilities are reliant upon. For example, for those individuals with disabilities with visual

impairments who were unable to drive, the public transportation system was an essential support

that needed to be in place before they could effectively mobilize within the city.

Paperwork and input into the CAN database were seen as excessive and taking time away

from assisting clients. Paperwork and procedures required by the KAT program were seen as

being a barrier to connecting clients to services, rather than facilitating the case manager’s work.

Many administrators commented on the changing requirements of paperwork, particularly during

the two quarters of the KAT program, and how these changes had been challenging to their case

managers because of the time involved in updating their records. In most cases, the P&As chose

to keep their own records of client services in addition to those required to be entered into CAN.

An administrator commented that “one state [received less than $18,000] and had four site visits”

illustrating the paperwork requirements.

Another area of improvement suggested by administrators was to make services available

through individual partners available to ALL the partners. This suggestion was particularly of

issue for the P&As who did not have access to additional disaster relief funds as did, for

example, Catholic Charities or the Salvation Army. The point was made that if the partners were

part of a consortium then the partner resources should be made available to all partners within

the consortium. The P&A did not have tradition of handling donations for distribution to clients.

Some administrators believed that, as a result, clients would seek out services from partner

agencies that could provide material resources in addition to case management.

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Results from Focus Groups

The five focus groups took place at five different locations, chosen in collaboration with

administrators at NDRN, at which a P&A was directing a Katrina Aid Today case management

program. The five focus group locations were in Houston, Baton Rouge, New Orleans, Gulfport,

and Atlanta. The Tier 3 administrator at each location collaborated in selecting a location in

which to hold these focus groups, as well as in contacting potential participants for this

evaluation study. The administrators were asked to invite eight participants that 1) had been in

contact with the P&A during the previous 60 days, 2) who had received at least six months of

case management services from Katrina Aid Today, 3) who were over 18 years of age as of the

date of the storm, and 4) who represented a wide range of disabilities. Case managers of potential

participants were given a brief description of the study to read to the potential participant as well

as a copy of the consent form that was approved by the Institutional Review Board at Texas

A&M University. Participants were told that their transportation to the focus group would be

paid for and, in the case that it was needed, accessible transportation could be provided by the

research team. Interested participants were informed that lunch would be served immediately

before the focus group took place and that they would receive a $25 stipend for their

participation in the focus group. Once the case managers had obtained a list of interested

participants, contact information for any participants needing transportation was then given to

the Principal Investigators. Six to nine interested participants were invited to each group.

Participants were called and reminded of the upcoming focus group 24-48 hours before each of

the groups were scheduled.

When they arrived at the focus group, participants were asked to complete a brief

demographic survey sheet. The demographic make up of the groups was as follows:

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Focus Group Educational Levels

High School, no

diploma

21%

High School diploma

28%Some college, no

degree

21%

Associate's degree

11%

Bachelor's degree

11%

3rd Grade education

4%J.D.

4%

High School, no

diploma

High School diploma

Some college, no

degree

Associate's degree

Bachelor's degree

3rd Grade education

J.D.

The focus group participants had a large range of educational levels. One participant had

completed a third grade education and another had a J.D. Graduates were almost equally

distributed among the educational levels of no diploma, (n=6), high school with diploma (n=8),

and some college with no degree (n=6).

Focus Group Disability Category

1 12

4

7

16

0

2

46

8

10

1214

16

18

VI LD Mobility MentalIllness

MedicalNeeds

Multiple

Focus group participants reported a range of disabilities. Most (n=16) participants

reported multiple disabilities. Of the 31 participants, 15 reported either mental illness or

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depression as a disability. Nineteen participants participated in the focus group and represented

themselves as person with a disability, four participated as a family member of a person with a

disability, and eight participated as both a person with a disability and as a having a family

member with a disability.

Open coding was completed on each focus group transcript. These codes were collapsed

into overarching categories. As the intent of this evaluation report is to report the responses to

predetermined focus group questions, these categories were then compared across transcripts to

determine those held in common across the five focus groups. In the following section, these

categories are presented and organized under the questions used by the investigator to elicit

responses:

Question 1: What have been things that prevented you from recovering?

This question, originally intended to be asked as the last of the series of five, was moved

to become the first in the list of questions. At our first focus group in Houston participants

insisted on starting their discussion by reporting on barriers to their recovery, rather than on the

supports that they had received post-disaster. In fact, they seemed unable to talk about their

recovery. As one focus group member in Houston stated “…you can’t really say that you have

actually recovered. It’s not easy…you’re not there yet, you’re still not there...” The investigators

moved the question about recovery to become the first in order to facilitate the flow of discussion

in the remaining four focus groups.

Of all the questions asked the groups, the question of barriers to recovery most easily

elicited responses, and without exception, participants were able to identify multiple factors that

had negatively affected their recovery. These factors were categorized and then consolidated so

that we could examine commonalities across the five groups. Some participants contributed

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narratives of their disaster or recovery experiences as part of their response to this question.

These brief narratives were then coded to identify categories of barriers that the participant

mentioned.

The first overarching category, one that was easily identified by the participants,

concerned the lack of the concrete resources they believed would help them recover. Participants

returned repeatedly to this theme during the focus groups, even in response to other questions.

They cited assistance that they had received soon after the storm had occurred but were aware

that resources had become substantially reduced by the time the focus groups were held, almost

two full years following the disaster.

With regard to the specific supports needed, the largest majority of respondents reported

housing or home repair as the primary need preventing their recovery. Most respondents had

received FEMA housing assistance at some time during the previous two years. However,

responses indicated that ongoing FEMA assistance was fraught with uncertainties, required

complicated and excessive recordkeeping, and was maintained only through repeated and

sometimes stressful interactions. One participant commented:

That’s like that’s how they do ya, they find all kinds of loopholes not to give youthe money, you know “You didn’t cross your T’s you didn’t dot your I…”…Youknow I’m in need––forget about that––give me what I need. “I need it,” that’swhat I say but they don’t see it like that. (New Orleans Focus Group)

Most participants expressed uncertainty and anxiety about the future of their housing and

over 90% were living in rental properties or with other families. Additionally, many participants

stated that rental properties that were affordable for them before Katrina were now much too

expensive. Further complicating their housing challenges was that most participants’ income

significantly decreased after Katrina. One participant stated:

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And then all of sudden apartment buildings I would see that were one bedroomthat might have been say $400 dollars [before Katrina] now its $700 dollars.(Mississippi Focus Group)

Another participant said:

In a two bedroom, one bathroom house. Six adults, five children. And that is because we are not making it, we just are not making it. We are paying twice therent and we not making half the money we was making (Georgia Focus Group)

In some cases, the housing provided to them was not appropriately accessible or was

located where there was limited or no public transportation. One participant remarked:

Praise God for [name of case worker]! And, um, they tore my house down justabout three weeks ago and she is going to use my insurance money to help get me

a handicap accessible home not the trailer I am in…You know, I have a trailer,and…I am uncomfortable in a way because the sofa is old. I am sleeping on top of a pillow because the back bedroom the bed is so high I cannot get into it. Andthey got one air conditioning unit in there and it does not cover the whole trailer.Certain parts of the day it gets hot.... (Mississippi Focus Group)

Anther participant related a similar experience:

I got a telephone call, “Oh…we have a trailer for you, you have to come on homeso you can inspect the trailer” and all this. I’m handicapped, she gives me a trailer as big as this room here, it’s not handicapped equipped. Ok, she promised mefaithfully, oh…that you’re here now, we gonna take care of this. Just give meabout two weeks and we’re gonna put you in a handicapped. So we spent twomonths, six months, eight months…now I’m getting ready to be kicked out of mytrailer, ok. (New Orleans Focus Group)

Employment was another primary category of need for these participants, most of whom

had been employed before the disaster. Some of the jobs that the participants had had pre-

disaster did not exist in their new location:

You know there is no professional doorman where you can just go and get another doorman job and then it is not going to pay as much as it did in New Orleans. Youknow what I mean, he was making $200–$300 dollars cash sometimes. You justcan’t replace that. And then I had my hustle. I had my little sewing businesswhere everyone in the school system wore uniforms so everyone needed their uniform altered and I had my little business going. Everything was just goingswell and lovely and…you’re back down to the bottom again. (Georgia FocusGroup)

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Transportation was another service need consistently identified by the participants.

Without transportation respondents were unable to seek employment, obtain medical services or

to search for more appropriate housing.

Most of the thing that I am really looking for right now is to get me sometransportation, some better transportation than what I got. Basically from there, Ithink I can make from there, but I know it is going to be a little rough up the road, but basically I just need transportation. (Mississippi Focus Group)

If I could just get a place, get my house fixed and get some transportation so mydaughter can carry me to where I need to go then I … She can drive, but I can’t soif I had some transportation where she could take me… (Mississippi FocusGroup)

Medical supports, including the need for durable medical equipment such as wheelchairs,

and prescriptions, were another category of need in this group.

…my baby needs medicine right now, but CVS will not take his Medicaid cardand he catch pneumonia. He has a respiratory disease, and he catch pneumonialike three times a year. And I got a prescription right now and they are like “weare not taking that” you know and it is just I am scared to transfer and then I amscared not to. (Georgia Focus Group)

Despite the desired concrete service needs, most of the participants agreed that most of

the needs identified above could be fulfilled by adequate financial support, either in the form of

compensation for employment or from some form of public assistance, which might include

support from FEMA, Social Security, disability benefits, or insurance payments.

Well, like with me I am just staying in an old trailer that was there. I had no helpto fix it, I am on low income, I am on disability. But I just don’t have money tofix it. But I have not had any help from nobody so I am just doing the best I can,what can I do about it? (Mississippi Focus Group)


…so we came to, it’ll be a year next week, to Houston and we’ve been reallyliving on my social security, which has been very difficult to make it and, um,FEMA just got to the point where I didn’t even know how to talk to them becauseI had a lot of medical issues as a result of Katrina…so we just do what we have todo to survive. (Houston Focus Group)

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The second overarching category that connected the narrative responses to this first

question was that of the difficulty in obtaining services. This category was exemplified by

participants’ comments about “getting the runaround,” gate-keeping in different forms, and

competition for resources.

…it is the most frustrating thing is to call a number and they tell you they’regoing to be able to help you but then when you call that number, “Right, but letme give you another number you can call” and then you call that number “Here’sanother number you can call,” and you’re sittin’ there with a list of numbers andyou call that whole page [but] you still have nothing. (Georgia Focus Group)


Nobody knows what’s going on and you’re right there in the middle of this…you’re already in all the confusion. You go there and guess what? They arelike “Oh, well, here’s the birth certificate, here that…” then they still need moreso I tell you what I’m out of here… (New Orleans Focus Group)

Paperwork and lack of information about services were other barriers to obtaining needed

resources. One woman, whose husband died during the storm, commented:

My husband was a 100% disabled veteran and his income is greatly missed. Andthe VA they denied me his benefits and now it is on appeal. The doctor said, “seeif you could have his file sent back to New Orleans.” So the VA here finallydecided to send the file back because at first it seemed like they didn’t want to doit for whatever reason. So the file is back in New Orleans and as far as I knowthey are looking into it. (Georgia Focus Group)

Some participants were quite candid about the psychological effects of the disaster and

how these had affected their ability to persist in seeking out services. In each group there were at

least two participants who self-identified that they were experiencing depression. In response to

the question about his biggest barrier, one participant replied;

…mentally, I guess. [Name of case manager] has helped a lot with getting a down payment of the mobile home and getting furniture, but you have got to deal withthe mental stuff. And you see all this stuff in the paper every day that Katrina isgone, get over it, and all this stuff. But it ain’t gone for everybody. (MississippiFocus Group)

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I don’t sleep. That was the first thing I have had to eat [referring to the lunch provided at the focus group] since yesterday. I don’t really have an appetite, I eatonce a day. I don’t know why, I guess the stress has got me gaining weight,

maybe the lupis is acting up, but I’m swelling. I don’t have no help whatsoever.But yet they say I want a handout. All I want to do is go to work. All I want to dois pay my bills, put food on my table, put gas in my car. I want to be able to comeand go like a human being. (Georgia Focus Group)

The reason for the experienced depression was not directly linked to a loss of resources

rather it was usually connected conversationally in the focus group to an increasingly limited

pool of options and the bureaucracy of applying for aid:

It is like we have lost our hope. No one answers our phone calls, no one calls us back, you know. We have been left out. By asking certain questions or asking for something that we need, desperately need, and it just “Call this number, well, callthis number, call this number.” I had six in one day, different ones to call andnobody had any answers for me. So that has been a very long drawn out thing.Getting the answers as to who do we talk to. (Mississippi Focus Group)

In some cases, depression became in of itself a barrier to the recovery of some individuals:

…see it’s not just a better job for me…I don’t know how to explain it but I havelike a sadness in me that comes out every night and I get really, really depressed, Ireally do. Sometimes I be like that for weeks on. And the other people they won’tknow that I just get in a rut and I just can’t get past it and… come home fromwork just go to sleep. (Houston Focus Group)


I was talking to a social worker because I was having a whole lot of issues as far as my thoughts were concerned, and at one point I was even thinking aboutsuicide. I was thinking that if I would take myself out then people wouldn’t haveto worry. (Georgia Focus Group)

When asked about the biggest barrier to recovery another participant replied,

The frustration of it all. I had quit smoking years ago, I started smoking again. I’mtaking pills for depression. Her hair’s falling out. I mean it’s, it’s… I don’t knowyou… I don’t know how to deal with it. (Mississippi Focus Group)

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Resources were seen as being unequally distributed or more available in other states. The

focus group in New Orleans consisted of participants who had lived in New Orleans before the

storm and who had returned. Several of the participants had been displaced and had returned

after living for several months in temporary housing in other states. The group believed that the

services that they had received in other states had been superior to those that they were being

provided in Louisiana and that financial delays and corruption in the state affected the aid that

they were receiving. The researcher then asked, “You know, I don’t get this though because you

guys are all glad to be back home.” The participants, as a group, replied, “There’s no place like

home” and one woman remarked,

We [are] like abused children. But still…you got that block that say, “I love mymom, I hate my momma, I love my mom” but you do get abused. (New OrleansFocus Group)

Question 2: What has helped you recover from Hurricane Katrina?

When this question was asked as the leading question to the first focus group in Houston,

participants quickly changed the topic from “what has helped” to “what things have prevented

your recovery.” Participants across all groups consistently reverted to talking about barriers to

recovery even when asked directly about factors supportive of their recovery. What became

apparent after interviewing all of the groups was that, without exception, every participant in

each of the focus groups was still recovering from the disaster––none saw themselves as having

“recovered.” Recovery was seen as an ongoing process in the midst of which the participants still

found themselves. As all of the participants in the focus groups were still receiving case

management, it is perhaps not surprising that these individuals presented themselves as still in

the recovery process, however, their responses emphasized that they were not satisfied with the

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conditions within they were now living and that they believed that their lives had been better

“before.” For example, when asked about recovery, one participant said:

It’s not really a recovery moment you can’t really say that you have actually

recovered. It’s not easy so it’s like your not there yet your still not there. (HoustonFocus Group)

When asked what had helped them during their recovery process, the groups

overwhelming responded, in order of importance, family, friends, and prayer/spiritual support. In

the cases that the participant was living apart from their family or friend before the storm, they

emphasized the support that they had received from their church or from their spiritual practice:

My family’s not here––I’m alone here and I went through a great deal. I had aheart attach and triple bypass surgery two weeks after the storm and it was just meand God. (Houston Focus Group)

Where you all have destruction [referring to others in the group] I had devastationand I did a lot of praying. My church kind of like stepped in a little…we stilltrying to rebuild that but, really and truthfully the prayers helped me. (NewOrleans Focus Group)

Um, I guess mainly the support from people here, from my church. Just fromfamily and friends…So basically it has been relationships that have been thestrongest piece, I think. Cause even with working with persons with some of theother agencies there have been relationships that have been developed from thatcommunication and that contact with persons from other agencies. That is basically what it has been, relationships. (Georgia Focus Group)

But its like you gotta help you know you got to reach out and help one another because if the, if the system kick in and try to help you its gonna take you a reallong time to get any help you know and they need help. (New Orleans FocusGroup)

Prayer and my people. My son and my sister. Out of thirteen of us I only have twoleft. So like, if I need something I call my sister. She needs something, if I got it Icall her. My mother and my father always teached us…nothin’ like your own.(Baton Rouge Focus Group)

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Question 3: What help or services have helped you get the things you need?

Responses to this question were closely linked to that of Question 2. In all of the focus

groups, however, participants had to be prompted to identify the formal supports or agencies that

had provided them with support. Most respondents reported getting assistance from FEMA or

Red Cross immediately or soon after the storm:

I didn’t get housing assistance until I got to Texas. When I was in Omaha Nebraska there was this church, I can’t recall the name of the church, but theywas a affiliated with the Red Cross as well they put me up in a hotel for a coupleof months. (New Orleans Focus Group)

Almost half of the participants identified, after prompting, a faith-based recovery group

such as Catholic Charities or Lutheran Social Services as helpful in connecting them to needed

resources. Some participants listed the P&A as an important support:

Disabilitylink has helped me tremendously and [KAT] has helped metremendously because I didn’t have any transportation even when Disablitylink got me into [a] Section 8 program I had no way to find a house because I had notransportation. So when I did get in touch with [KAT] they took me to look athouses, they took me for the inspection of the houses and just helpedme…Without them I don’t know what I would have done. The Disability Link

and [the P&A case worker]––she has been putting me in touch with CatholicCharities who assisted me in some other ways. So, it was like a network, I guessthey had between each other, and they found out what would best suit me and she[the case worker] referred me to them…They have been tremendous in helpingme, especially since I had my stroke, I don’t remember so good all the time.(Georgia Focus Group)

Although this question was designed to elicit naming of agencies and organizations that

had provided supports, participants commented that reliance upon these formal supports had not

been part of their life pre-disaster. Most reported relying on family and friends for needs in their

communities:

…you could make a phone call, you could call an aunt or an uncle, a cousin, aniece, a nephew, someone you grew up with, you know, a childhood friend, but just that connection you could that could be a last resort you say “well, look, I’m

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in need, can you, I’m stuck in traffic, can you pick up the kids for me, can youmake sure and that… (Georgia Focus Group)

…there’s a place here in New Orleans it’s the Ninth Ward it’s like a country, acountry, and I think it deals up from there because those people were country and

country people like they believe in really gellin together…you can’t depend onthe system. (New Orleans Focus Group)

…my neighbor’s really my big support system because like I said…he cut grassand if I need something I could, you know, I try to get with him and cut grass and,you know, get things situated. (Baton Rouge Focus Group)

Among the formal support agencies mentioned, Red Cross, Catholic Charities, St.

Vincent de Paul, Salvation Army, and Lutheran Social Services were mentioned most often, as

were local churches where the focus group members were attending. One participant had

financial support to rebuild his home but believed that compassion was also needed in supporting

him as a disaster survivor:

If I could have one or two maybe three or four workers that are hanging there with[me] and [being] very humanistic with [me]. But then you got this other peoplethat come along and they like, they just doing their job. You have to do your job but you have to have that compassion. You have to relate to what’s going on. No,you may not have been in that situation, but [it’s] kinda like step back and seewhat’s going on––put yourself in [my] shoes or something… (New Orleans FocusGroup)

In the Mississippi Focus Group participants talked about groups assisting them with

obtaining a new wheelchair, prescriptions, and presenting their case at the long-term recovery

table.

I did get a wheelchair through Medicaid. But what happened when I got it, it wasin my daddy van, in the back of the van, and he open it up and it fell…Medicaidcome back and picked it up and they tried to get it fixed and they couldn’t get itfixed and they told me that I can’t get another chair for five more years. And thischair is [broke] and I need another chair but I am dealing with this one here, youknow. (Mississippi Focus Group)

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Question 4: How has Katrina Aid Today (this Advocacy Center) helped you?

Most participants had not been in contact with the P&A before the disaster and had

contacted the agency to seek services during the recovery period:

I found out about this program here through a friend of mine…and she said TheAdvocacy. I had never heard of this program––I’m not going to lie––I had never heard of it before but I called... I wasn’t gonna call because I know the situationthat everybody’s going through and I said “Lord, I can’t go through this” butwhen I called it was a whole different thing, you know. (New Orleans FocusGroup)

Few participants spontaneously mentioned the case management services that they were being

provided through Katrina Aid Today as an important source of services as part of their responses.

Those that did were appreciative of the efforts of their case manager but some saw limitations in

what their case manager had provided to them.

I haven’t received anything from the agency––we just got all this process.(Houston Focus Group)


I think that I have given my case manager more resources than she’s given me

because I look for them. And I call so much with the resources that I got off theInternet, I called them so much they said, “Miss [name] you are already in thesystem, you need to wait. You have a case manager and if you would just let her do her job…” and I’m still waiting. (Houston Focus Group)

Another Houston Focus Group member said that the search for available resources from all the

different organizations “…was like going from having one pimp to having four or five pimps,

you just have to work extra hard.”

Most did not separate the services that Katrina Aid Today provided from the services that

their case manager had provided.

… you know how they have those FEMA meetings and I went there and I’d justgotten to Houston and everything they were telling me didn’t apply and it seemedlike only those people who received services was if it was for welfare were able toget help. So I stared crying cause I just couldn’t stand it and I was standing in the

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middle of the floor and this lady walked up to me…so they had a table for KatrinaAid. [Name of case manager] was there so he started talking to FEMA on my behalf…and Red Cross. (Houston Focus Group)

Another participant stated:

…I’m always been on my own since seventeen and I don’t believe in dependin’on charities and I wouldn’t have went there at that time if my checks would havecame on time but that’s the reason I went there and the reason I got a socialworker and I just got her and I been here two years. That’s the first time I ever asked her was last month and I don’t ask for nothin’ I don’t believe in askin’ for nothing because I say it like this, they got a lot of poor people out that really needit, I prefer them to get it…I only been here two years and I used her last month for the first time in two years and that’s it. (Baton Rouge Focus Group)

Other participants related these experiences:

So you know uh so now we down to eatin peanut butter and jelly you know fromtime to time just so so you can make it but I don’t know where there’s anyresources for anything. (Houston Focus Group)

Red Cross only gave three hundred and sixty dollars but this is what they did theygave me a voucher for medication for one hundred and eight dollars, they gaveme a voucher for clothes for I think for one hundred and thirty something dollarsand when they gave the checks for the cash they deducted the medicine and theclothes voucher from that so I got a grand total of one hundred and twenty twodollars that was tangible you understand (Houston Focus Group).

There are so many people devastated by this storm and there are not enough casemanagers to go around. They have got so many people. They are trying to help somany people. (Houston Focus Group)

Question 5: How has your case manager helped you?

When this question was asked, the overwhelming majority of the respondents agreed that

their case manager had been attentive and supportive during their recovery process. Three

categories of support were consistent across the focus groups; assistance with paperwork,

listening and emotional support, and information and referral services. A participant stated:

Housing. You know, just if [name of case worker] had not come along we probably would still be struggling, but she helped us along the way and weappreciate that. It is like I said, its hard to get…help…They forgot about theelderly and the poor. (Mississippi Focus Group)

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She assisted me to get furniture for my home and so I have furniture. I appreciatethat, that was going to be a big hurdle to jump if I didn’t get no furniture. She got

that for me so I appreciate that very much. At least I have a bed to sleep in and acouch to sit on and a dining room table. That was nice. (Mississippi Focus Group)

Some participants talked about the importance of having a personal relationship with

their case management that blurred the boundaries of the service provider-case dynamic. One

woman commented:

…She even went to church with me on Sunday and I really appreciate that and…Ithink that I knew that’s what a lot of people need because then when you have

somebody that’s in this program and know what’s going on and…you can getthem to understand what you need… (New Orleans Focus Group)


If it weren’t for [name of case worker] I would not be where I am at now, but shestill gave me the motivation. Because I felt like someone was still trying to helpme so I got up and tried to help myself. But before [name of case worker] I didn’tknow what to do. I just sit and just sit there until she came along. She gave mehope. (Mississippi Focus Group)

Another participant responded:

…it’s like a glass of cold, cold water when you deal with somebody who is therefor you and just…says “Well, look, let me go to my supervisor and get back toyou,” and get back to you even if they got to say “No” they have gotten back toyou. (New Orleans Focus Group)


…she helped me a lot, she was pointing out a lot of things to me about, you know,about getting myself situated back in, you know, working stuff, like that, and shealso pointed out things that helped me get around and she was kinda showing meabout the system how I take the bus so I can, you know, be from point A to pointB. (Baton Rouge Focus Group)

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Another stated:

I’ve had a good experience thus far and, like I said, he’s been, he listens. He’sgiven me a list of other resource to use so I have no complaint. (Houston FocusGroup)

Even when the resources were not forthcoming, the participants felt that they benefited

from their relationship with their case manager:

Mr. ____ he’s very helpful to me because even though I got to keep more papersmore papers…he calls me, he even calls me Sunday to let me know…how I getthrough this…Like I said, he also intervened between FEMA and I, because I hadgiven up with FEMA…I couldn’t emotionally I couldn’t deal with them…(Houston Focus Group)

Some clients did not have good responses from case workers, although when questioned

further these were usually not the P&A case managers that they were referring to:

No because they’re too busy to contact you. You have to contact them and thenwhen you try to contact them you gettin voice mails and you get this and that andthe other or you know it just ain’t happenin. (Houston Focus Group)

One participant from Houston who had been in a high-ranking human resources job

before the hurricane observed that many of the agencies and positions formed as a result of

emergency funding had limited experience in the human services arena:

In most cases what Katrina did it created a lot of jobs a lot of these agencies andyou got people working in these agencies who got crash courses on how to dohuman services have never worked in human services. [They] do not know how tocommunicate or relate to people and some are just there for the dollar and theycould care less how they talk to you and…just here to get this dollar and when the program ends “We’re gone.”

Context

Contextual categories provide the backdrop against which the other categories interact. In

other words, a contextual category does not fall within the overarching categories outlined above

but influences how these other categories were manifested or influenced each other. In the focus

group part of this study the context that influenced the results reported above was that of a sense

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of displacement. All of the participants from Houston, Baton Rouge, and Atlanta had been living

in the greater New Orleans area at the time of the disaster while the participants in Mississippi

had been living along the affected coast. Following the disaster, all had to shelter in different

locations. One participant did stay in his home during the storm, but then relocated to other states

for several months following the storm. The four participants in the New Orleans group had

returned to the city, however, they returned to a city and to neighborhoods that were unfamiliar

and irrevocably changed in its composition. The two participants who returned to their homes in

Mississippi were similarly unsettled and still waiting for assistance in repairing their homes.

What was striking was that not one of the focus group participants felt as if their current

living situation was settled or permanent, even those who had employment or who had returned

to their homes. One focus group participant stated:

I think it’s more then money––it’s you know where you live, the ground that youwalk on and when you wake up you know where you are and, you know, it’s justyour whole live has changed and I don’t think you’ll ever really recover becauseyou’ll never get back what you had. Everybody’s lost friends and family scatteredall around the country…

Another participant shared:

…it is like a record scratching, you feel like you keep jumping back to the same point. Wherever you was at in New Orleans once that happened it just puteverything on the halt, just stuck… (Houston Focus Group)

This group repeatedly expressed that they were unsure about the future, frustrated by the length

of time their recovery was taking, and unfavorably compared their current living situation with

that before the disaster. This context of uncertainty permeated their comments about recovery

and was reported as its own source of stress for these individuals. As one focus member in

Houston said, “I don’t know what recovery means––I don’t know if I’ll ever recover.” One

participant said,

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Having doubts for two years, just having doubts. And then our case worker comealong and she finally gave us a little bit of hope, you know. She has been the onlyhope we have had since the hurricane. (Mississippi Focus Group)

Another similar salient expression of displacement was the feeling of being cut off from

home and family. This separation was strongly expressed by a member of the Georgia Focus

Group; “I can relate to slaves (they were my ancestors) but all my family is like scattered.” Other

participants shared:

You had family there [New Orleans], you know and people don’t understand thatall of that is just gone, it is taken from you, it is jerked from you. We was pluckedout of that situation and put just anywhere. The first year that we were apart fromeach other I can’t listen to holiday songs, look at TV and commercials with the

family, I could not do none of that, I just couldn’t, it was just too emotional.(Georgia Focus Group)

I will say another barrier is not just FEMA, it is our resources like family. I havenone. They are from New York to Jersey to Texas to West Coast so no moregoing to big mama’s house on Sunday. We were very close. It is like I have noculture anymore it is like, I feel like, what did they call us? A refugee, yeah.(Georgia Focus Group).

Even when participants were able to return to their home, they were disturbed by the

damages to their homes and frustrated by the lack of resources to help them rebuild. These

factors contributed to make them feel unsettled even when living at home. One participant

reported,

I don’t have a home anymore. I mean, that’s the way I look at it. I mean, eventhough we just got a home you don’t feel like you’re home. I don’t know if thatmakes sense to anybody, but that is the way I feel. It’s lost. (Mississippi FocusGroup)

A participant from the New Orleans Focus Group said:

You know when that storm hit, my home is the only two story in that area. I had,what, thirteen, fifteen neighbors … over there at my house. Didn’t know them,didn’t know their names. Didn’t know they stayed around the corner, but I knowthat I was the only shelter that they had and I took them all in...About three dayslater, Coast Guard came and got everybody and I stayed…in that house over threeweeks.

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I been around the world at least six to seven times. Red Ocean, Pacific Ocean,Gulf War, Atlantic…I been around the world to Egypt––and they always trainedus for when the ship [might] sink. And since 1987 we never had one experience

where…I had to worry about ships sinking in the middle of the ocean…but here Iam in my own home, and I’m seeing water rise above me, trying to knock a ventout on the roof thinking I’m going to drown right there in my own home. (NewOrleans Focus Group)

These expressed feelings of displacement were heightened by the view that receiving

resources was seen negatively by others. Many participants that had been displaced to other

cities remarked on what they saw as unwelcoming attitudes in their new location and the

perception that they were undeserving of the level of support that they were receiving. Several

participants commented on how others in their new environments seemed to view them:

…as far as the money, when they start dishing out the money then people look atthat that “he got more than what I have” you know that when…that animositycomes in… (New Orleans Focus Group)

…it’s like a bunch of crabs in a basket––once you get to the top there’s alwayssomebody to pull you back down” (New Orleans Focus Group)

Everybody thought just because you came from New Orleans you didn’t work or you weren’t educated or whatever. That wasn’t the case they had like what sevenor eight universities out there that everybody came from all over the place youknow so people didn’t realize yeah we go to work a lot of people wereentrepreneurs. (Houston Focus Group)

…I go places sometimes and people see that I am from Louisiana and I havegetting a lot of nasty things said to me while I am driving. I just feel scared here, Idon’t feel secure or welcome… (Georgia Focus Group)

…even like in the barber shop seems like they angry at us for gettin’ certainthings but…they don’t realize that we lost practically everything... But they arelooking at 18 months free rent and they like “How did they get that?” and theylike “They get more than I get”, and I am like “What do you mean we get morethan you? We trying to get up to the ground level where everybody at!”… Whenyou have a group of people who are not used to that, when they see one person getthrowed the bone it is hard for them to sit there without salivating. But that is aracial thing, that is a cultural thing. (Houston Focus Group)

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A Houston focus group member commented “…at first everybody is nice to us, but now that we

are here everybody has flipped the switch, you know. You are not even wanted, that is what you

feel like, not wanted.” Indeed, two years following the storm, resources for hurricane survivors

have dissipated and competition for scare resources was evident throughout both the housing and

the employment sectors along the Gulf Coast. The sense of increasing community hostility was

seen by these participants as complicating their recovery process.

Summary of Focus Groups

The central phenomenon around which the discussions revolved was the clients’ lack of

recovery following Hurricane Katrina: Not one of the participants in these focus groups felt that

they had “recovered” from the disaster. The primary reason for the lack of recovery was

overwhelmingly, and yet simply, identified as a lack of the resources needed to return to

normalcy. Clients acknowledged that, for most of them, their recovery would be to a “new

normalcy” rather than a return to their former homes and neighborhoods. However, a lack of

basic services and supports, primarily housing, employment, transportation, and health care,

were barriers to their recovery. For those participants with mobility impairments or who had

chronic medical needs, disability supports and durable medical equipment were identified as

critical resource needs. While identified mental health issues, particularly depression, also were

mentioned as barriers (and a discernable level of depression was evidenced by several

participants in each group), these issues were usually discussed in conjunction with a lack of

resources or due to the challenging process of acquiring resources.

Not only was the lack of resources and services a barrier to recovery, but the difficulty in

obtaining these services was a barrier. Participants identified gatekeeping, “getting the run

around,” and excessive paperwork as being barriers to obtaining services. For some individuals

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the lack of information about services or conflicting information about services added another

level of difficulty in obtaining services. As this search for services often took place in an

unfamiliar city, this heightened the difficulty for the participants.

Agencies, organizations, and case managers were not identified as the most helpful in the

recovery process. Rather family, friends, and prayer/spiritual support were identified as most

helpful. When the groups were directly asked about formal supports, most reported getting

assistance from FEMA or Red Cross soon after the storm but were not receiving support from

these agencies at the time of the focus group. Similarly, participants did not mention disaster

recovery organizations or faith-based organizations unless directly prompted about receiving

support from these groups.

Participants did not usually mention the case management services that they had received

through Katrina Aid Today as a support, however the majority of those who did spoke positively

of them. Many times the emotional and social support that the case manager offered was

appreciated most by the participants, even when resources were not forthcoming.

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SUMMARY OF EVALUATION

The previous sections detail the results obtained from each procedural method used to

collect data. The following section provides an integrated summary of these results across these

methods. The summary is organized using the primary and secondary evaluation questions

developed in conjunction with NDRN at the beginning of the project.

Primary Questions

What is the impact when a legal services organization provides case management to people

with disabilities who are evacuees?

Participating in the Katrina Aid Today consortium was a new role for NDRN and its

P&A affiliates and these organizations were challenged to incorporate the new function of

disaster case management into their agency’s activities. In particular, the management of the

program and the reporting requirements were more time consuming and burdensome than the

P&As and NDRN had anticipated. As most of the funds used for the program were for direct

case management, the P&As and NDRN had to contribute staff and resources toward the project

beyond what they had anticipated when joining the program. A noted stressor across

administrators was the pressure to “meet their numbers” of cases handled, while still providing

what one administrator referred to as “deep casework” for individuals who had support needs in

addition to just disaster-related support needs. The origin of the pressure to “meet numbers” was

clearly top-down in that the UMCOR-KAT administrators communicated their concern to Tier I

administrators, who communicated it to Tier II administrators, and then was most felt by Tier III

administrators who were the direct supervisors of the case managers. Results from the surveys

obtained from the KAT case managers supported this finding in that the case managers were

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aware of the pressure to “meet numbers” but these same case managers verbalized their

commitment to providing quality case management to their clients rather than simply “touching

cases” in order to increase their number count. The top-down organization of Katrina Aid Today

also shifted the relationship between NDRN administrators and the P&A affiliates in that NDRN

was functioning as the contractor for a project within whose structures the P&As had to function,

rather than functioning as autonomous organizations.

What kind of impact does case management provided by disability service experts have on

outcomes experienced by people with disabilities?

Results from the case managers strongly suggested that disability-related expertise was

important in delivering quality case management to individuals with disabilities. This belief was

supported by them with examples of cases in which their knowledge of the disability service

system enabled them to provide better case management to their clients. These responses were

supported even more strongly by the administrators, who also believed that knowledge of

disability-related services was essential. Few participants in the focus groups, however, referred

to the disability-related knowledge of their case worker although most case workers were

regarded highly by their clients. For most clients, their involvement with KAT represented the

first experience they had had with a formalized social support agency and they therefore did not

have a basis for comparison with other case workers. In addition, participants in the focus groups

were overwhelmingly focused on their need for resources in order to aid their recovery rather

than on the disability-related knowledge of their case workers. The disability-related references

that were made by the participants were almost always made in connection to health-related

disabilities or to durable medical supports. Results from the case worker surveys and the

quantitative analysis suggest that NDRN-KAT clients represented more complex cases that

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involved multiple needs. Data from the focus groups seems to support this hypothesis as most

participants reported having more than one disability. Participants in the focus groups also rarely

mentioned a single support need rather they discussed a multiplicity of resource needs. These

resource needs were usually were compounded by reports of limited physical or mental well-

being.

No significant quantitative difference was found, however, in the length of time that

cases stayed open that were managed by the P&A case managers as compared to those managed

by the other KAT consortium members. This result was in direct contradiction to the results

obtained from the survey of the case managers and from the interviews conducted with the KAT

administrators, who overwhelmingly believed that cases managed required additional time and

effort in order to resolve. We believe that the inconsistency in these results is due to the nature of

the data obtained from CAN database: Data used for the purpose of this evaluation were

extracted in July of 2007 when just under 40,000 cases were part of the CAN database. Katrina

Aid Today administrators became aware of incomplete and sometimes inaccurate case

information that was in the CAN database and, during the Spring and Summer 2007, began

urging KAT administrators and case workers to completely fill out requested information in the

CAN database. For example, in the data analyzed for this evaluation, there were a number of

clients for whom the database recorded had been receiving case management for over three

years, despite the project having only been in place for 18 months. In addition, the number of

closed cases at the time of the data extraction for this study was only 21,312 (with just 1,273

from NDRN) and these cases were logically those that were able to be closed most quickly. We

recommend that this same analysis be rerun at the end of the project when a larger number and

variety of cases have been inputted into the CAN database. The resulting analysis will then give

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a more accurate measure of the differences between the lengths of time needed to manage

NDRN-KAT cases as compared to those of the other consortium members.

What effect did NDRN participation have on the delivery of services by the Katrina Aid

Today partner organizations and on the Katrina Aid Today organization?

The P&A administrators were unsure about the concrete affects of the participation of the

P&As on the practices of their KAT partners. They did believe that the primary effect of their

participation was one of awareness and that their consortium members knew more about both the

needs and rights of people with disabilities due to NDRN-KAT’s participation. However, to a

person, all of the administrators agreed that participating in Katrina Aid Today was the “right

thing to do,” regardless of the additional demands that participating in the project had placed on

their agencies. In reflecting on their participation in the program, however, the majority of

administrators suggested that there might be a more appropriate role, such as technical

assistance, that their agency could fill in disaster recovery rather than direct case management.

Another contribution that the P&A and NDRN administrators reported was that their

agencies assisted indirectly by impacting the recovery and emergency management system

overall through legal action. Through their advocacy for changes to the Stafford Act and through

their pursuit of equal access to services delivered through FEMA and Red Cross, NDRN and the

P&As provided leadership that affected the recovery system in a way, which while not visible to

clients, ultimately not only affected current case management, but will affect the design and

delivery of services to individuals with disabilities affected by future disasters.

What does case management look like when the evacuee client is a person with disabilities?

Case managers and administrators believed that case management was more complex and

expensive for individuals with disabilities. In fact, the average value of services provided to

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clients with aged or disability service needs was significantly greater then those who did not

need these services. The dollar amount of services provides was less for NDRN-KAT, however it

should be remembered that 1) NDRN did not have supplemental resources that it could

contribute to its clients, and 2) that individuals with disabilities were included in cases that other

agencies that were providing services, so using the “aged/disabled services” categorization may

be a more accurate marker to use for analysis.

Case managers and administrators strongly believed that case management for

individuals with disabilities took longer than did that of individuals without disabilities. Data

from the quantitative analysis, however, did not support this view. As the extraction of data took

place in July of 2007, and thus the project was still ongoing for most of the consortium partners,

a better measure can be obtained by repeating this analysis at the end of the Katrina Aid Today

program in 2008. The length of case management delivered by the P&A ranged from four to six

months, which did not significantly differ from the length of case management provided by the

other agencies. However, case managers also reported that type of case management provided

was more intensive and required more contacts from the case manager, which could not be

measured given data extracted from the CAN database.

The primary barrier that the hurricane survivors who participated in the focus groups

identified was a lack of concrete resources. The surveys of the case managers found that the case

managers continued to work on the behalf of their clients and were strongly committed to

assisting them in their recovery process. However, although they were positive in their

comments about the KAT program and appreciated the efforts of their case managers, not one

participant in the focus group believed that they had recovered from the disaster. Similarly,

results from the quantitative analysis of the CAN database found that they were more like to

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have had their case closed for the reason “unable to resolve because of lack of resources, and

were less likely to report that their post-disaster needs had been met. The premise of the Katrina

Aid Today case management program was that it would assist clients in connecting to needed

supports and services. In the absence of these resources, case management no longer fulfills this

purpose. NDRN-KAT was particularly affected by the diminishment of services in that it did not

have a non-profit arm, as did most of the other consortium members, for collecting donations or

contributions that could be given to their clients.

Secondary Questions of Interest

Were clients as satisfied or more satisfied with the case management that they received

from the P&A case managers as compared to clients who used other Katrina Aid case

managers?

Nearly all clients were satisfied with their P&A case managers, however, no significant

difference was found in the satisfaction rate with the P&A case managers as compared to the

case managers from the other partner agencies. As the satisfaction ratings with case managers for

both groups was high (over 93% of the clients replied “agree” or “strongly agree” to all of the

statements concerning satisfaction with case managers) a ceiling effect decreased the statistical

power of this analysis. It should also be noted that the overall client satisfaction survey response

rate was low: Less than 6% of the clients returned surveys, which, in turn, decreased the

statistical power needed to analyze this question.

Clients did seem to clearly distinguish between the support given to them by the case

worker and the reality that there were few resources available to them. Even though they were

frustrated by the lack of resources available to them they appreciated the psycho-emotional

support that they were given by their case managers:

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Well, she’s really mainly just being really kind, honestly. She’s just been kind andunderstanding, she’s kind of …”You know I hate to call and let you know but thefunds have been exhausted and this is what we can do…” I guess she’s just kinda just been supportive just with overall. But as far as actually getting anything ithasn’t come yet. (Houston Focus Group)

In many cases, the case manager themselves was used as a resource by clients and we

heard a number of examples of case managers who provided transportation to their clients or

who served as a compassionate listener for clients who were distraught or depressed.

Were P&A case managers rated as knowledgeable or more knowledgeable about the

recovery process and resources available as compared to other Katrina Aid case

managers?

A premise of the Katrina Aid Today consortium, and an argument for using the

Coordinated Assistance Network (CAN) database was that this network would better provide for

the coordination of services and decrease the amount of paperwork required of the client.

However, direct reports from clients who participated in the focus groups included numerous

examples of how paperwork and a seemingly endless circle of referrals functioned as barriers to

recovery. The P&A case managers assisted their clients in negotiating these barriers and clients

overwhelmingly appreciated the efforts of their P&A case managers. However, in light of the

lack of resources previously discussed, it is questionable the extent to which continuing to apply

for disaster recovery resources was contributing to the client’s recovery.

How were P&A case managers rated with regards to providing information and services

that met the client’s needs as compared to other Katrina Aid case managers?

In response to the client satisfaction survey, clients reported on their level of satisfaction

with services that they had received. Responses for both NDRN-KAT and the other agencies

were almost uniformly positive with the exception of the response to the statement “I am

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satisfied with the way the various agencies assisting my recovery from Hurricane Katrina have

responded. Only 63% of the individuals with disabilities served by NDRN-KAT were satisfied

with the way in which various other agencies had responded, in comparison with 88% of other

clients. The difference between the two groups was statistically significant. This difference is

particularly of note as it deviates from the pattern of response to all other questions on the client

satisfaction survey. The response also distinguishes between the level of satisfaction with

assistance received from NDRN-KAT and that received from other agencies: Individuals with

disabilities did not feel as well served by other agencies as did other individuals. Again, as the

number of Client Satisfaction Surveys returned was low we suggest that this analysis be

replicated at the end of the project period when more data has been inputted into the CAN

database.

Were individuals with disabilities referred to LTRC/Unmet Needs Tables at a higher or

equal rate than were individuals without disabilities?

Less than five percent of the clients were recorded as having been referred to a Long

Term Recovery Committees. Interestingly, a substantial and significant number of NDRN cases

were closed for the reason “Unable to resolve because of lack of resources” and were also

statistically less likely to report that their needs had been met at the time of case closure.

Together with data gathered from the interviews and surveys we believe that this is additional

evidence that individuals with disabilities experienced disproportionate difficulty in obtaining

resources and in recovering from the disaster.

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APPENDIX

Open-Ended Telephone Case Manager Questions

Interviewer: Hello, this is [name of interviewer ], from the Center on Disability and Development atTexas A&M University. It is our understanding that you are a case manager with Katrina Aid Today. TheCenter on Disability and Development, in collaboration with Katrina Aid Today National Case

Management Consortium and the National Disability Rights Network, is conducting research on casemanagement services for survivors of Hurricane Katrina.

We are interviewing over 50 case managers employed by the National Disability Rights Network.

Consent

Interviewer: Hello, this is [name of interviewer ], from the Center on Disability and Development at

Texas A&M University. It is our understanding that you are a case manager with Katrina Aid Today. TheCenter on Disability and Development, in collaboration with Katrina Aid Today National Case

Management Consortium and the National Disability Rights Network, is conducting research on casemanagement services for survivors of Hurricane Katrina.

We are interviewing over 50 case managers employed by the National Disability Rights Network.

Consent

Interviewer: The interview should take approximately _30-40_ minutes to complete. Your participationis voluntary. If you do not wish to participate, you may stop at any time. Information from this interviewwill be coded so that no personally identifying information is attached to it. Should the data resulting from

your participation be made available to other researchers in the future, the data will contain no identifyinginformation that could associate you with it, or with your participation in any study.

There are no personal benefits or compensation for participating in this study; however, the informationcollected in these interviews and from the online survey will lead to the development of a report designedto support future disaster planning.

If you have any questions or problems regarding the research, the names and contact information for theappropriate person to speak with is Amy Sharp at [email protected] OR 979-845-4612.

Do you have any questions about the purpose of this interview?

[if yes, answer them at this time.]

Are you willing to participate?Yes

No

[If no] Thanks for your time. Goodbye.

[If yes] Great, then we can begin.

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Survey Questions for Case Managers

These first questions are to get some basic information about your job and your previous experience.

1. What is your job title?

Are you an employee, intern or volunteer?

2. How long have you been at your current job? (in months)

3. What is the name of the agency where you are currently working?

4. What city and state is this agency located in?

5. Can you tell me a little bit about your previous work experience? (Probe for three most recent jobs. Ask about their job titles, basic job tasks, and how long they were employed in that

position.)

a. b. c.

6. Do you work for NDRN?

o Yeso No

The following questions have to do with your experience with Hurricane Katrina.

7. Are you working in an area damaged by Hurricane Katrina?

Yes

No .

8. Do you think of yourself as a survivor of Hurricane Katrina?

Yes .

No .Other (specify)

9. Did you volunteer with any organizations during the Katrina evacuation?Yes (go to 9b)

No (go to 10)

9b. If so, can you tell me a little bit about that experience?

10. How many Katrina survivor clients are you actively serving in your caseload?

11. What proportion of your case load is made up of Hurricane Katrina survivors?

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12. How many Katrina Aid Today (KAT) cases have you closed?

Examples from your experience can help us understand what your day-to-day work is like . . .

13. I’d like for you to think of a relatively recent case that you would consider a success. What do

you think made this case successful?

14. Now I’d like for you to think of a particularly challenging case. What do you think made this caseso challenging?

15. In your opinion, what are the three biggest challenges clients face in your area?

a.

b.

c.

16. Case managers working with Katrina survivors we have interviewed in other research have talked

about [cultural] differences they experience between themselves and their clients. Were theresituations where you have felt such differences? If so, can you tell me about them?

17. What advice would you give to Katrina Aid Today (KAT) in improving services for the nextdisaster?

18. In our conversations and interviews with P&A staff we have heard stories about the influence that

the KAT-NDRN staff and case managers have had on that case management and administrative practices of their colleagues in the other KAT agencies. Do you think that the participation of your P&A as part of the KAT consortium within the state had an influence on other KAT

agencies? If so, how?

19. Some case managers and administrators have expressed that the management of cases of evacuees with disabilities differs from the management of cases of evacuees without disabilities.Do you agree with this statement? Why or why not?

20. Some case managers report that recovery from disaster is more difficult for individuals withdisabilities and requires knowledge of disability services in order for a successful recovery plan to

be designed. Do you agree with this statement? Why or why not?

21. Is there anything else that you would like to tell us about your experience as a case manager?

Thank you so much for your participation. This has been very useful.

The results will be made available once the study is complete.

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Questions for Focus Group

Question 1: What have been things that prevented you from recovering?

Question 2:What has helped you recover from Hurricane Katrina?

Question 3:What help or services have helped you get the things you need?

Question 4:How has Katrina Aid Today helped you?

Question 5:How has your case manager helped you?

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P&A Administrator Interview Questions

Question 1: What has been the impact of providing case management to Hurricane

Katrina/Rita evacuees on this organization?

Question 2: Some case managers and administrators have expressed that the

management of cases of evacuees with disabilities differs from the management of cases

of evacuees without disabilities. Do you agree with this statement? Why or why not?

Question 3: Some case managers report that recovery from disaster is more difficult for

individuals with disabilities and requires knowledge of disability services in order for a

successful recovery plan to be designed. Do you agree with this statement? Why or why

not?

Question 4: In our conversations and interviews with P&A staff we have heard stories

about the influence that the KAT-NDRN staff and case managers have had on the case

management and administrative practices of their colleagues in the other KAT agencies.

Do you think that the participation of your P&A as part of the KAT consortium within

the state had an influence on other KAT agencies? If so, how?

Question 5: What advice would you give to Katrina Aid Today (KAT) in improving

services for the next disaster?

An Evaluation of the Impact of the National Disability Rights Network Participation in the Katrina and Today Project (Stough)

Documents