Attachment 7

Disaster Case Management

Implementation Guide

December 10, 2008

Administration for Children and Families

U.S. Department of Health and Human Services

Contents

4Introduction

4Definition of Disaster Case Management and Guiding Principles

6Disaster Case Management Teams

7Program Activation, Enrollment, Service Delivery and Deactivation

9The Disaster Case Management Team and Staff Responsibilities

9Staffing

9Surge

14Identification and Screening of Staff

16Training

18Deploy to Disaster Site

19Staff In-Processing

19Coordination with Federal, State, Local and Voluntary Disaster Response Agencies

19Assessment of Community’s Unmet Disaster-Related Needs

20Initiate Disaster Case Management Services

20DCM Steps

26Collect and Enter Data

26Forms

27IT Platform

28During Remainder of Deployment

28Identify, Screen, and Train Local Agency Staff for Case Management Service Delivery

28Transfer Disaster Case Management Responsibilities to Local Agencies

28Continue Providing Case Management Services

29Performance Monitoring of Local Agencies

30Deactivation

30Close-Out Of Client Cases

31Staff Out-Processing

31Lessons Learned Activities

31Reporting to ACF, FEMA, National and Local Partners

39Annex I Job Descriptions

39National Partner Coordinator

40Training Coordinator

42IT Coordinator

43Community Coordinator

44Compliance/Finance Team Leader

45Administrative and Logistics Coordinator

46Healthcare and Human Services Consultant(s)

47RDCMRT Team Leader

48Disaster Case Management Supervisor

49Disaster Case Managers

49Regional Team Administrative and Logistics Coordinator

50Local DCM Agency Coordinator

51Local Agency Administrative Assistant

52Disaster Case Manager Assistants/Technicians

52Client Assistants/Navigators

53Volunteer Coordinator

54DCM Organization Charts

60National / Regional / Local Framework Staffing

List of Acronyms

ACF:

Administration for Children and Families

CAN:

Coordinated Assistance Network

CAS:

Client Assistance System

COA:

Council on Accreditation

DCM:

Disaster Case Management

EMA:

Emergency Management Agency

FEMA:

Federal Emergency Management Agency

HHS:

U.S. Department of Health and Human Services I&R:

Information and Referral

IT:

Information Technology

JFO:

Joint Field Office

LTRO:

Long-Term Recovery Organization

NDCMCT:

National Disaster Case Management Coordination Team

NEMIS:

National Emergency Management Information System

NGO:

Non-Governmental Organization

NVOAD:

National Voluntary Organizations Active in Disaster

RDCMRT:

Regional Disaster Case Management Response Team

SS:

Social Security

SSI:

Supplemental Security Income

TANF:

Temporary Assistance for Needy Families

VAL:

Voluntary Agency Liaison

VOAD:

Voluntary Organizations Active in Disaster

Introduction

This document serves as an implementation guide for the Disaster Case Management program. It provides an overview of the program and specifies team member roles and responsibilities at different time periods. This document is not intended to replace standard operating procedures.

Definition of Disaster Case Management and Guiding Principles Disaster case management is the process of organizing and providing a timely, coordinated approach to assess disaster-related needs as well as existing healthcare, mental health and human services needs that may adversely impact an individual’s recovery if not addressed. Disaster case management facilitates the delivery of appropriate resources and services, works with a client to implement a recovery plan and advocates for the client’s needs to assist him/her in returning to a pre-disaster status while respecting human dignity. If necessary, disaster case management helps transition the client with pre-existing needs to existing case management providers after disaster-related needs are addressed. This is facilitated through the provision of a single point of contact for disaster assistance applicants who need a wide variety of services that may be provided by many different organizations.

The purpose of disaster case management is to rapidly return individuals and families who have survived a disaster to a state of self-sufficiency. This is accomplished by ensuring that each individual has access to a case manager who will capture information about the individual’s situation and then serve as his/her advocate and help him/her organize and access disaster-related resources, human services, healthcare and mental healthcare that will help him/her achieve pre-disaster levels of functioning and equilibrium. The service is particularly critical in situations where large-scale mortality, injuries, or personal property damage have occurred.

Disaster case management is based on the principles of self-determination, self-sufficiency, federalism, flexibility and speed, and support to states.

1. Self-Determination: Individuals and families impacted by a disaster have the same rights and responsibilities as everybody else. Government aid to persons adversely impacted by a disaster should therefore seek to support the self-determination of persons adversely impacted by a disaster as they seek access to public benefits and consider relocation opportunities. Individuals and families focusing on their own needs, resources, and interests are more likely to achieve favorable results for themselves and for the broader society than when government restricts or directs their choices.

2. Self-Sufficiency: The object of any public welfare program, including efforts targeted toward persons adversely impacted by a disaster, should be individual and family self-sufficiency. As we seek to provide every necessary benefit to help persons adversely impacted by a disaster recover from the disaster and restart their lives, the measure of our success should not be the number of new entrants into public welfare systems or dollars expended. Rather, our success should be measured by how quickly and successfully persons adversely impacted by a disaster are able to become economically self-sufficient and socially integrated. These new lives may be either in the homes and communities held before the disaster or in new locations selected based on the individual’s or family’s best judgment of where their goals and aspirations may best be fulfilled.

3. Federalism: Our Federal system is designed so that states and local governments are often the primary means for administering and delivering public benefits and services to those eligible for them. For efficiency, speed, and to take maximum advantage of existing expertise in matching persons adversely impacted by a disaster with benefits and services, aid should be delivered—to the maximum extent possible—through existing state and local governments, rather than through the creation of new Federal institutions or programs. The role of the Federal government should be to enhance and support existing mechanisms, taking action when possible to eliminate unnecessary impediments to the delivery of assistance to persons adversely impacted by a disaster.

4. Flexibility and Speed: Persons adversely impacted by a disaster need immediate access to benefits wherever they present, even if they have lost their documentation or just arrived in a new state. Previous eligibility should continue without interruption and new eligibility should be established quickly. Hence, the Federal government should endeavor to provide states and local governments with as much latitude as possible in delivering benefits.

5. Support for States: States and localities endeavoring to deliver needed benefits and services to persons adversely impacted by a disaster should not be financially disadvantaged by their compassion and generosity. The Federal government, to the extent possible, should endeavor to reduce disaster impact on existing service delivery to citizens by helping connect persons adversely impacted by a disaster to human and medical services. Quickly linking persons adversely impacted by a disaster to appropriate assistance will reduce the likelihood that they will require more intensive healthcare and social service benefits, thus reducing the impact on states and existing systems.

The disaster case management process includes the following key elements necessary to respond to disasters of all sizes:

1. Following a disaster declaration, work with state/local stakeholders to identify existing public and private services and resources, and identify gaps in resources needed for disaster-related response.

2. Conduct outreach to identify vulnerable populations and people who have unmet disaster-caused needs.

3. Screen individuals to identify unmet disaster-caused needs that could benefit from case management services, as opposed to identifying only immediate short-term needs that can be addressed by other service providers in the affected area.

4. Triage clients’ unmet disaster-caused needs to identify any immediate crisis needs (e.g., emergency healthcare, mental health issues, medication management). Provide information and immediate referral for individuals with urgent needs.

5. For individuals seeking case management services (clients), complete comprehensive assessments of clients’ unmet disaster-caused needs to ensure that healthcare, mental health, and human services needs that may impede recovery are addressed.

6. Develop individual disaster recovery plans with clients. Include specific goals and timeframes that link with the client’s disaster-caused needs and any healthcare, mental health, and human services needs that may impede recovery.

7. Use a tracking system to monitor and track progress on clients entering and exiting the disaster case management system, including when they transition to other case management providers. Identify how information will be shared with other stakeholders

8. Advocate for clients, particularly by helping them meet their individual disaster recovery plan goals through referrals to agencies and organizations that provide direct services.

9. Continue to advocate for clients until either the goals of the plan are met and they either return to their pre-disaster status, are transitioned to another case management provider or their state’s social service system, they elect to discontinue services, or the designated maximum service delivery period is reached.

Disaster Case Management Teams A three-tiered system of national, regional and local teams comprise the disaster case management model. The teams at all three levels are designed to be scalable to the size and complexity of the disaster (see National/Regional/Local Team Framework).

The National Disaster Case Management Response Team (NDCMRT) is comprised of personnel from Federal agencies and representatives of the National Partner. The National Partner is an organization selected to partner with ACF through a formal full and open competition. The National Partner’s role is to provide leadership in both the planning process and the delivery of disaster case management as part of a contract with ACF. The NDCMRT is the first of the case management teams to be deployed following a disaster and is responsible for the initial analysis to determine the need for case management. The National Partner also serves as the advance team for case management and provides general oversight throughout the case management cycle.

RDCMRTs are comprised of volunteers (paid or unpaid) identified, trained, equipped, and coordinated by the National Partner. This team is comprised of case management supervisors, case managers and support personnel. Multiple Regional Teams are necessary to meet needs in the immediate aftermath of a disaster. Regional teams are supplemented with U.S. Public Health Service officers that are either social workers or nurses with case management experience. These officers are generally available for 30 days following a disaster to help fill gaps until the RDCMRT or local affiliates can assume responsibility. The primary responsibility of the RDCMRT is to provide initial triage and case management services for the first three to six months, allowing time for the local teams to take over.

The Local Teams are comprised of individuals or affiliates from local communities with experience in disaster case management. Ideally, a pre-identified state or local system for providing disaster case management exists to which all cases can be referred when the RDCMRT is no longer needed. Depending on the structure of the state, there are two possible options for transition to local teams: 1) if no state structure exists, the National Partner will identify voluntary and human services organizations that can be subcontracted to provide case management services; or 2) if a state has an established case management structure, the Federal Emergency Management Agency (FEMA) may provide a grant may the state or ACF for continuation of services. The RDCMRT will remain in place until the grant is awarded and the local teams are ready to receive clients.

Program Activation, Enrollment, Service Delivery and Deactivation Any direct or indirect assistance to disaster clients requires Stafford Act funds. To receive Stafford Act funds for disaster case management (DCM) services, a Federal individual assistance declaration, a request from the state for DCM services, and FEMA’s approval of that request are required. ACF then contacts the National Partner to begin service activation and implementation.

Following notification by ACF, the following steps begin the DCM service delivery activation process. All steps begin within 72 hours following the activation:

1. Deployment of the National and Regional Teams. Upon Presidential disaster declaration, the receipt of the state’s DCM request, and FEMA authorization of that request, ACF initiates deployment activities with the National team. This includes, but is not limited to:

a. Setting up communications, phones and computers

b. Identifying space within the Joint Field Office (JFO)

c. If additional office space is needed, making arrangements for this space and notifying ACF, FEMA, and other stakeholders about its location

d. Rostering the Regional Teams

e. Handling personnel and equipment logistics

2. Basic service identification from the Alliance of Information and Referral Systems (AIRS) taxonomy. Identification of sources for basic services.

a. Basic needs: emergency food

b. Basic needs: emergency shelter

c. Basic needs: housing/shelter

d. Basic needs: material goods

e. Basic needs: temporary financial assistance

f. Basic needs: transportation

g. Consumer assistance and protection

h. Legal assistance modalities

i. Domestic animal services

j. Healthcare

k. Mental healthcare and counseling

l. Employment

m. Public assistance programs

n. Social insurance programs

o. Individual and family support services

p. Post-disaster child care

3. Creation of a disaster-specific service delivery plan. The size and scope of the DCM program is scalable to meet the requirements the disaster. Some elements will always be included in the DCM service delivery plan following a disaster: a) a training plan: all deployments will provide training for staff on the FEMA sequence of delivery and special needs populations; b) information on available local human services and specialized case management programs; and c) applicable components of the state’s disaster recovery plan and other information regarding the local Long-Term Recovery Organizations (LTROs).

4. Staff in-processing. Staff in-processing includes orientation to the local community, including the introduction of key emergency management personnel, key Federal, state, and local officials, local human service agency leaders, and leaders of the state and local Voluntary Organizations Active in Disaster (VOADs) and LTROs. All staff will be issued proper credentials.

5. Public information functions. All information requests from the media or other entities related to DCM operations will be referred to ACF and vetted through the U.S. Department of Health and Human Services (HHS) and FEMA.

6. Liaison function (Federal, state, local and voluntary agencies coordination). At the time of activation, the National Team will identify the contacts and functions for the appropriate Federal, state, local and voluntary agencies and networks to be involved in the disaster response. Liaison with these entities will be accomplished through networking within the Emergency Management Agency (EMA) facilities and attending VOAD and LTRO meetings once they are established. The National Team will provide information necessary to carry out outreach functions, including obtaining FEMA Individual Assistance applicant lists for direct mailing and active outreach to places where large numbers of people congregate (i.e. places of worship, shelters, community centers, schools).

7. Coordination with local public and non-profit service provider systems and networks. Beginning with initial deployment and continuing throughout the case management process, DCM teams will communicate and collaborate with agencies providing disaster-related services to the community.

8. Coordination with other local disaster recovery providers. Recognizing that duplicative case management efforts may exist within a community, DCM teams will identify overlapping service organizations and discuss best practices, including use of the DCM program’s client tracking / IT platform to avoid duplication of services and ensure that individuals do not “fall through the cracks” among the various providers.

9. Assessment of community’s unmet disaster-related needs. Beginning in the first few hours following the Presidential disaster declaration, receipt of the state’s request, and FEMA authorization of that request, the National Team will communicate and coordinate with local emergency management personnel to ascertain correct information regarding overall damage estimates. The National Team will determine the number of affected households, geographic area of damage, initial number of anticipated Individual Assistance applicants, and work with state human services and FEMA Voluntary Agency Liaisons (VALs) to identify the capacity of local human service providers following the disaster.

The Disaster Case Management Team and Staff Responsibilities

Staffing

The DCM model utilizes staff at the national, regional, and local levels that are a combination of Federal, voluntary agency and local staff. When the program is activated, the number of staff required is based on the size and nature of the disaster. The target client to case manager ratio is 35 to 1 (this means a total of 35 cases – a case manager cannot have 35 DCM cases and other cases not covered in this program in excess of 35).

The target ratio of Disaster Case Managers to case management supervisors during the initial response phase of the deployment is 5 to 1. The 5 to 1 ratio should be reevaluated and adjusted during the recovery phase, based on factors such as the size and scope of the disaster, formal processes implemented during recovery that affect the supervisor’s workload (e.g., if case management supervisors are responsible for presenting cases to a Long-Term Recovery Committee), and the complexity of the cases assigned to the case managers. The ratio should never exceed 15 to 1.

For any disaster, the number of Disaster Case Managers necessary to provide services to clients will vary as the number of clients enrolled in the program varies. Clients must enroll in the program within a 6-month period following the disaster declaration, and then are provided case management services for a variable time period of up to 12 months, depending on the client’s needs and the availability of services and resources to which the Disaster Case Manager can refer the client. Once the enrollment period ends (after six months), the total number of clients will decrease continuously through the end of the program, as clients’ needs are met or are transitioned to other service providers. During this period, the National Partner will ensure that the target client to case manager ratio remains at approximately 35 to 1 by monitoring the total number of active clients at each local affiliate The National Partner and ACF will assemble the NDCMCT and coordinate the assembly of the Regional Response Teams. This program is meant to be inclusive of as many organizations with capacity to provide personnel for participation in the initial deployment efforts as possible, as well as of those with the capacity to deliver disaster case management services for the duration of the program service period. In particular, National and Regional Teams will be a mix of Federal and voluntary agency personnel to ensure the program can provide the necessary onsite staff to both meet client demand and conduct active outreach. Additionally, response teams should include staff with a mix of backgrounds, skills, and areas of expertise. The availability of disaster case management team members with a healthcare background and expertise addressing long-term human service problems is particularly important, therefore Regional Teams should include U.S. Public Health Service nurses and social workers. Regional Teams should also ideally include case management staff from all states in the region so that at least one member of the Team can assist other Team members in navigating and accessing state-level agencies and services.

Local DCM agencies continue providing disaster case management services under the supervision and/or contract with the National Partner throughout the remainder of the deployment.

Surge

Based on the size and nature of the disaster, National, Regional, and local teams will surge to meet the needs of clients. The number of Disaster Case Managers will vary by month as the number of clients enrolled in the program varies. If the disaster affects multiple regions, teams will be deployed within each affected region. RDCMRTs will deploy for two weeks and require backfill for three to six months. The National Partner will carefully monitor the factors that determine when and how many additional RDCMRTs must be deployed. These factors include progress in identifying local affiliate teams, current and expected client case loads, and the extent to which outreach has been conducted in the disaster area.

At the local level, surge requires having multiple Local DCM Team Coordinators and DCM Supervisors sufficient to meet the needs of the disaster. To maintain the desired supervisor to Disaster Case Manager ratio, additional DCM teams will be established (i.e., including a DCM Supervisor overseeing Disaster Case Managers and, if available, Disaster Case Manager Assistants/Technicians and Client Assistants/Navigators).

Pre-identified case management staff helps ensure that client demand can be quickly met. These include members of the U.S. Public Health Service (beyond those that may be members of the National or Regional Teams) to supplement existing staff and fill gaps.

Clients enroll in the program within a 6-month period following the disaster declaration (Chart 1), and receive case management services for a period of up to 12 months (see Length of Service) depending on the client’s needs and the availability of services and resources to which the Disaster Case Manager can refer the client. Data obtained from Katrina Aid Today demonstrates that the length of time clients received case management services varied from less than 1 month to 19 months.

Chart 1: Katrina Aid Today Case Management Service Time Distribution

Chart 2 shows the monthly demand for Disaster Case Managers for a disaster in which 10,000 households seek DCM. Of particular note is the “peak demand” for case managers, occurring at the end of the enrollment period. The table assumes that 10,000 households will seek DCM services, and the peak demand for Disaster Case Managers will be roughly 230.

Chart 2. Number of Required Disaster Case Managers, By Month, For a Disaster with 10,000 Households Seeking Case Management Services

The model was applied to each of the 15 National Planning Scenarios to estimate the demand for Disaster Case Managers for each scenario. Each estimate is in turn based on an estimate of the number of households likely to seek DCM services for each scenario. This is necessarily a subjective exercise, inasmuch as there have been only two large-scale disasters for which data exist on the demand for case management services—Hurricane Katrina and the New York City attacks of September 11,, 2001. For these two disasters, an estimated 100,000 and 10,000 households, respectively, sought DCM services.

Qualitative comparisons of these two disasters to the 15 National Planning Scenarios were then made. The estimated peak demand for disaster case managers shows the estimated number of households likely to seek DCM services and the resulting peak demand for Disaster Case Managers, which varies from 0 (i.e., no case management required) to thousands for each scenario.

Table 1. Estimated Peak Demand for Disaster Case Managers for the National Planning Scenarios

Estimated Peak Demand for Disaster Case Managers

# seeking shelter: 100,000

# evacuating area: > 1 million

# homes destroyed: unspecified economic impact: $100s of billions

# seeking shelter: 25,000

# evacuating area: > 100,000

# homes destroyed: none economic impact: $billions

# hospitalized: 865K – 9.9M

# seeking shelter: unspecified

# evacuating area: none

# homes destroyed: none economic impact: $100s of billions

# hospitalized: 28,383

# seeking shelter: unspecified

# evacuating area: unspecified

# homes destroyed: none economic impact: $millions

# hospitalized: 70,000

# seeking shelter: 15,000

# evacuating area: > 100,000

# homes destroyed: minimal economic impact: $500 million

# hospitalized: 1,000

# seeking shelter: 1,000

# evacuating area: 110,000

# homes destroyed: unspecified economic impact: $billions

# hospitalized: 300

# seeking shelter: 50,000

# evacuating area: unspecified

# homes destroyed: minimal economic impact: $300 million

# hospitalized: 100,000

# seeking shelter: 50,000

# evacuating area: 500,000

# homes destroyed: minimal economic impact: $millions

# hospitalized: 18,000

# seeking shelter: 250,000

# evacuating area: 250,000

# homes destroyed: 300,000 economic impact: $100s of billions

# hospitalized: 5,000

# seeking shelter: 150,000

# evacuating area: 1 million # homes destroyed: 200,000 economic impact: $billions

# hospitalized: 270

# seeking shelter: 10,000

# evacuating area: 100s of thousands

# homes destroyed: unspecified economic impact: $billions

# hospitalized: 450

# seeking shelter: 5,000

# shelter in place: none

# evacuating area: unspecified

# homes destroyed: unspecified economic impact: $millions

# hospitalized: 650

# seeking shelter: none

# evacuating area: none

# homes destroyed: none economic impact: $millions

# hospitalized: none

# seeking shelter: none

# evacuating area: none

# homes destroyed: none economic impact: 100s of millions Minimal (if any) disaster case management required

# hospitalized: none

# seeking shelter: none

# evacuating area: none

# homes destroyed: none economic impact: 100s of millions No disaster case management required

Identification and Screening of Staff

Prior to any client interactions or deployment, staff must be screened based on their interaction with and financial responsibility for clients. A basic pre-employment screening and reference check is required for all program staff. This basic screening includes: a) completion and review of an application form (name, contact information, date of birth, Social Security Number (SSN), education, experience, and professional references); b) criminal record and sex offender registry checks; c) professional and educational credentials; d) driving records for persons transporting clients; e) drug testing and credit checks based on position and responsibilities. Rescreening must be completed every five years.

As noted in Table 2, case management supervisors and Disaster Case Managers must undergo the same type of screening. Criminal background and registry checks must be performed at both the Federal and state levels, using a multi-jurisdictional approach depending on where the DCM service center is located, the applicant’s current state of residence, and the states in which s/he lived and worked in the past. The National Sex Offender Public Website (nsopr.gov) will be checked, in addition to state-based sex offender registries. Pre-employment screening vendors maintain a variety of multi-state, state, and regional databases that allow for name and SSN-based background checks and searches. Credit checks should be performed using at least one of the three national credit bureaus (Experian, Equifax, TransUnion). Driving and auto insurance records should be checked through state motor vehicle departments and verification of auto insurance.

Case manager assistants/Technicians must undergo basic screening and verification of references, previous work experience, as well as state-based criminal record checks and national sex offender registry and credit checks upon hire. Since case manager assistants register clients (involving the collection of personal identification information such as name, date of birth, SSN, etc.) and may potentially view case files and documents at the discretion of their supervisor, it is important to adopt these precautionary measures. Depending on office and program needs, case manager assistants may be given additional responsibilities. Thus, the extent and frequency of staff members’ unsupervised contact with clients, as well as whether they will be required to drive as part of their job, must be taken into consideration when determining whether to require additional screening.

For Client Assistants/Navigators/others with client contact, basic screening, verification of previous work experience, reference checks, state-based criminal record checks and national sex offender registry checks are mandatory prior to program assignments due to the potential for extensive client contact. While Client Assistants may not have access to case files or clients’ personal identifying information, there are times when volunteers perform a variety of tasks ranging from unsupervised home visits, to attending children during meetings with Disaster Case Managers, to distribution of donated goods. As with case manager assistants, additional screening mechanisms for Client Assistants may used at the discretion of the program manager (if, for instance, the Client Assistant is responsible for disbursement of debit cards), as well as driving record and auto insurance checks should they be asked to drive clients to and from appointments.

Table 2: Screening Requirements M= Mandatory; D= Discretionary

Case Management

Supervisor Disaster

Case

Manager Case Manager

Assistants Client

Assistants

* Driving records and auto insurance records will be mandatory for anyone driving agency vehicles, transporting clients in either agency or personal vehicles, or operating personal vehicles on official business. If a staff member will not be operating agency or personal vehicle on official business, then screening of driving records and auto insurance records would be discretionary.

** Credit checks will only be mandatory for case manager assistants or Client Assistants if they have access to funds for clients or access to client personal identifying or financial information (e.g., SSNs, banking and credit information).

Training

The National Partner’s Training Coordinator will ensure that all members of the case management team are trained using the ACF DCM Training Curriculum. The Curriculum focuses on the DCM model and principles of disaster case management, with an emphasis on providing services to persons with disabilities and other special needs populations. The Training Coordinator will ensure that Regional Teams are trained prior to deployment and will coordinate with Regional Team Coordinators to schedule trainings (either in-person or online) once teams are formed. Regional Team trainings will be tailored to the experience level of the trainees (e.g., extensive vs. no disaster case management experience). Training the Regional Team prior to deployment is critical. The onsite training on the third day following activation focuses on disaster-specific issues, including local conditions, resources, key state and local agencies, and likely client population characteristics. The Training Coordinator will include representatives of Federal, state and local agencies (e.g., representatives from state human service agencies, FEMA state and Regional VALs, local voluntary organizations, and HHS officials) at the Day 3 training when possible.

Once disaster case management services are initiated, the Training Coordinator, working with the Regional Team Coordinator and Disaster Case Management Supervisors, will monitor the work of the case management team and assess whether additional training is needed (e.g., how to address common issues) and schedule training accordingly.

The Training Coordinator must ensure that local affiliates are trained using the ACF DCM Curriculum prior to client interactions and essential training and knowledge (see Table 3) of team members at all levels. The Training Coordinator must work closely with the National Team’s Community Coordinator and local affiliate leaders to schedule training. Supplemental training must be provided to local affiliates throughout the service delivery period.

Table 3. Essential Training and Knowledge for the Disaster Case Management Team

Training Curriculum 1:

DCM Program Administration Disaster Case Management

Team Positions Timing of Training

Super-visor Disaster

Case

Manager Case

Manager

Asst.

Client

Asst.

Pre-

Disaster

Phase After

Deploy-ment

Training Curriculum 2:

DCM Program Coordination Disaster Case Management

Timing of Training

Super-

Disaster

Case

Manager Case

Manager

Asst.

Client

Asst.

Pre-

Disaster

Phase After

Deploy-ment

Training Curriculum 3:

DCM Program Process Disaster Case Management

Timing of Training

Super-

Disaster

Case

Manager Case

Manager

Asst.

Client

Asst.

Pre-

Disaster

Phase After

Deploy-ment

Deploy to Disaster Site

Within 24 hours of notification by ACF, all members of the NDCMCT will be at the disaster site; all members of the RDCMRT will be at the disaster site within 48 hours of notification. Deployment procedures will be initiated by the NDCMCT Team Leader in conjunction with any task order or other directive issued by ACF. All directives will include contact information for key personnel charged with coordinating Federal disaster response activities. The NDCMCT Team Leader will coordinate the deployment of the NDCMCT and RDCMRT with the HHS Incident Response Coordination Team (ACF Human Services Branch Chief) Federal and State Emergency Management procedures so as not to impede the efforts of rescue and other first response personnel. Individuals to be included in immediate communication(s) include but are not limited to: the ACF Human Services lead, FEMA VALs (HQ, Regional), and state emergency management officials or other state-designated point(s) of contact, and representatives of the local (impacted) community if available.

The NDCMCT Administrative and Logistics Coordinator plays a key role during this period (e.g., arranging for air transportation for NDCMRT and RDCMRT members to the disaster site, identifying work space onsite for the RDCMT, and securing housing for NDCMRT and RDCMRT members). In addition, the NDCMCT Administrative and Logistics Coordinator is responsible for delivering program equipment and supplies to the disaster site (e.g., laptops, air cards, computer hardware, lockboxes, track phones with pre-purchased minutes, credentials for team members, program signs, case folders and case management forms, and basic office supplies).

On Day 3 following notification (i.e., the 48 to 72 hour period), training will be provided to the RDCMRT (see Training).

Staff In-Processing

Staff in-processing will include orientation to the local community, including the introduction of key emergency management personnel, key Federal, state, and local officials, local social service agency leaders, and leaders of state and local VOADs and LTROs. Further, all staff, including ACF, NDCMCT, RDCMRT and local DCM agency personnel, will need to be issued necessary identification. These will include access badges (as necessary) into the FEMA JFO and other emergency management agency facilities for the purposes of community assessment and liaising/networking, as well as photo credentials identifying them as members of the ACF DCM team.

Coordination with Federal, State, Local and Voluntary Disaster Response Agencies

Coordination with Federal, state, local, voluntary and other disaster response agencies is vital for the successful implementation of the DCM model and to minimize duplication of effort. Effective communication with local public and non-profit agencies providing disaster-related services to the community builds trust and rapport with the local community, and ensures a productive environment that will provide the best possible service to clients. Upon deployment, NDCMCT and RDCMRT staff will initiate efforts to liaise and coordinate with disaster-related entities on the ground at the affected area. This coordination will build on the partnerships established prior to notification. In addition, locating the DCM team offices within close proximity to the local emergency management agency operations (for example, collocated with the JFO) enables the DCM team to establish a visible presence.

An important element of coordination is familiarizing local partners with DCM best practices, including the use of the DCM client tracking / IT platform to avoid service duplication and ensure individuals do not “fall through the cracks” among various providers.

Assessment of Community’s Unmet Disaster-Related Needs

Beginning in the first few hours of notification, the NDCMCT will communicate and coordinate its efforts with local EMA (or as designated by the state) personnel to facilitate the obtaining of correct information with regard to overall damage estimates. Key information to gather within these first few hours of notification includes the number of affected households, the location of Disaster Recovery Centers (DRCs), geographic area of damage, and initial number of anticipated Individual Assistance applicants. This information will help the NDCMCT begin estimating the number of additional Regional Team members and local DCM teams needed to meet client needs. Upon arrival at the disaster-affected area, the NDCMCT will continue this assessment, revising initial estimates as more accurate information is obtained.

Initiate Disaster Case Management Services

DCM Steps

Within 72 hours of notification, RDCMRT staff, supported by the NDCMCT, will initiate the provision of DCM services to clients in disaster-affected areas. RDCMRT staff will have primary responsibility for providing initial services, including active outreach, intake, assessment and the development of a preliminary recovery plan. If local disaster case management teams have already been identified, screened, and trained, they will work with RDCMRT staff to initiate DCM services. If local teams have not been identified, is it the responsibility of the Regional Teams to initiate case management service delivery. The following describes steps and procedures associated with DCM service delivery:

1. Eligibility—To receive services, clients must be determined to be eligible.

a. Eligibility requirements: All persons adversely impacted by a disaster in a Federally declared disaster area can apply for disaster case management services by requesting an intake interview. In addition, any person adversely impacted by a disaster in the disaster area can receive information and referral services from program staff. To receive additional case management services beyond the intake interview, clients must sign a confidentiality waiver and demonstrate disaster-related needs within a specified timeframe (e.g., 120 days).

b. Policies and procedures for confirming eligibility: The National Partner will have written policies that outline procedures for National, Regional, and local-level DCM staff to follow to verify eligibility. For instance, it may be necessary, based on the disaster variables, for clients to show proof of residency within the declared disaster area for a certain time period prior to the disaster event. In this instance, the Disaster Case Manager will secure copies of documents necessary to prove residency, like a utility bill for the claimed address, etc.

c. Referral process for ineligible clients: The National Partner will have written policies for Disaster Case Managers to follow for applicants determined to be ineligible for DCM services.

2. Call Center—The National Partner is responsible for establishing a call center within 72 hours of activation that persons adversely impacted by a disaster can call to inquire about and enroll in DCM. The National Partner will collaborate with the existing 2-1-1 system, if available, to establish and operate the call center. The call center must be able to identify urgent versus routine cases and provide the appropriate referral in a timely manner. The National Partner, in coordination with ACF, will develop policies and procedures to address the following call center operations:

· Specific intake questions required

· Marketing plans

· Referral requirements

· Interface with IT platform

· Training of call center specialists

· Reporting

3. Outreach—A well coordinated outreach effort is critical to the success of the DCM model’s goal of ensuring as many affected persons as possible receive, and are positively impacted by, DCM services. In particular, program staff and volunteers will conduct a variety of outreach activities focusing on reaching persons with disabilities and other special needs populations. Additionally, the RDCMRT Coordinator will ensure that RDCMRT case managers and other staff participate in outreach activities until their client case loads require them to work full time on existing cases.

Outreach activities include door-to-door canvassing, distribution of program flyers at disaster assistance centers and other locations, and seeking out locations where potential clients gather (e.g., community centers, houses of worship, American Red Cross shelters, FEMA Disaster Recovery Centers, and other emergency assistance centers) and presenting program information at the locations. Specifically, to ensure that the outreach effort is successful, the following steps will be included in implementation:

a. Coordinated outreach: The RDCMRT will coordinate its outreach efforts with other local disaster relief and social services providers, including but not limited to: department(s) of mental health, houses of worship, faith-based and non-profit groups providing disaster relief services, FEMA JFOs, local LTROs, and local/state voluntary organizations. Information shared with these groups will include the name and contact information of the National Partner and/or local affiliates as well as a description of services available. NDCMCT and RDCMRT staff must recognize that individuals impacted by disasters often “shop” for services from many organizations in the community, therefore it is imperative that information provided by the NDCMCT is consistent, current, and shared with as many relief organizations as possible to ensure the broadest area of coverage.

b. Visibility in the community: A primary goal is to have DCM staff visible in the community. Gaining access to LTROs and VOAD meetings is a top priority as these are generally highly effective for networking with other groups who may also be providing services to impacted individuals, including reconstruction assistance and direct financial help. Satellite offices that are disability-accessible and adjacent or in close proximity to FEMA offices increase the likelihood of reaching the largest number of potential clients in the shortest period of time. Further, coordination with state systems and agencies is crucial to prevent service duplication and the unnecessary expenditure of limited resources. For example, if a state agency exists that provides mental health counseling for persons adversely impacted by a disaster, local DCM agencies should utilize this agency as a referral source rather than hiring its own counseling staff. This staffing resource could then be used to hire case managers, data entry specialists or consultants with particular expertise in areas with critical client need. Finally, all offices will have a process for receiving walk-in applicants as well as scheduled appointments.

c. Supporting special circumstances: The National Partner will work directly with local agencies to determine what special circumstances may exist with the impacted population that may require additional resources to support outreach efforts. Examples of special circumstances may include: population groups with limited English proficiency; large numbers of elderly or citizens with special needs; persons with disabilities such as the hearing- or vision-impaired; large numbers of people with emergency healthcare needs; individuals living in relative isolation with no television, newspapers, or direct mail service (e.g., mail delivered to a post office rather than home delivery).

d. Public announcements: The National Partner must consider public service announcements through local television and radio stations and the Internet. The information broadcast must be consistent and current.

4. Triaging—The primary purpose for triage is to assign a priority level to a case. The three priority levels will be emergent (requires case management action within 48 hours from time of case opening), urgent (requires case management action within 5 days from time of case opening), and routine (requires action within 7 days from time of opening). This triage process is used by the case manager to determine his/her approach to the case load. Cases with the highest priority level receive the greatest amount of the case manager’s energy. The triage process helps define the case manager’s workload management.

a. Triage indicators: Triage indicators are based on a risk inventory conducted at intake. Indicators include those that identify potentially vulnerable populations, such as infants, children, the elderly, single parent households, persons with disabilities (including those with mental or medical illnesses), the homeless or pending homeless, people with limited English proficiency, households whose income is below the Federal poverty line, and other special needs populations.

b. Process for triaging case loads: The National Partner will have written policies regarding supervision activities, including the regular triage…