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Case Management With Displaced Survivors of Hurricane Katrina, A Case Study of One Host Community (Bell)

Case Management With Displaced Survivors of Hurricane Katrina, A Case Study of One Host Community (Bell)

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Published by: Alabama Possible on Jul 21, 2011
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This article was downloaded by:
[Oklahoma State University] 
14 July 2010 
Access details:
Access Details: [subscription number 784375628] 
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Social Service Research
Publication details, including instructions for authors and subscription information:http://www.informaworld.com/smpp/title~content=t792306968
Case Management with Displaced Survivors of Hurricane Katrina
Holly Bell
the Center for Social Work Research, The University of Texas, Austin, USA
To cite this Article
Bell, Holly(2008) 'Case Management with Displaced Survivors of Hurricane Katrina', Journal of SocialService Research, 34: 3, 15 — 27
To link to this Article: DOI:
Full terms and conditions of use:http://www.informaworld.com/terms-and-conditions-of-access.pdfThis article may be used for research, teaching and private study purposes. Any substantial orsystematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply ordistribution in any form to anyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contentswill be complete or accurate or up to date. The accuracy of any instructions, formulae and drug dosesshould be independently verified with primary sources. The publisher shall not be liable for any loss,actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directlyor indirectly in connection with or arising out of the use of this material.
Case Managementwith Displaced Survivors of Hurricane Katrina:A Case Study of One Host Community
Holly Bell
Case management is a staple of post-disaster recovery, but there is limited re-search on this topic. Utilizing in-depth interviews, observations, and document analysis, basedon 78 interviews and attendance at approximately 50 public meetings, this longitudinal casestudy examined case management with displaced hurricane Katrina survivors in one host com-munity between December 2005 and December 2006. Case managers identified, assessed,planned,linked,monitored,andadvocatedforsurvivors.Theydescribedengagingsurvivorsandunderstanding their backgrounds and experiences as challenging. Lack of jobs, transportation,and affordable housing coupled with survivors’ trauma and preexisting needs presented barrierstolong-termrecovery.Despitethesedifficulties,casemanagersfeltpositivelyabouttheireffortsand identified coordination as a critical element for successful human/social services responsesto natural disasters.
[Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com>Website: <http://www.HaworthPress.com> © 2008 by The Haworth Press. All rights reserved.]
Disaster, case management, qualitative methods, case study
Hurricane Katrina and the flooding that fol-loweddisplacedmanypoorAfrican-AmericanresidentsofNewOrleansandsouthernMissis-sippi.Manyofthosemostaffectedbythisdisas-ter had lived in communities of concentratedand persistent poverty for generations. Hostcommunities,themajorityoftheminneighbor-ing southern states, were faced with helpingtomeetthesefamiliesneeds.Theywereparticu-larly ill suited to this task. Southern states his-toricallyhavehadfewstateandfederalsafety-netservicesandreliedmoreheavilyonfamily,church, and non-governmental organizationsfor these functions. Texas and Louisiana, forexample, were among the 10 poorest states(Dalaker,2001),andtheyhadamongthelowestwelfare payments and use (U.S. Ways andMeans Committee, 2000), highest rates of childhood poverty (U.S. Census Bureau,2002), and lowest levels of health insurance(U.S. Census, 2002). The infrastructure of so-cialservicedeliverywithinthesecommunitiesgreatlyaffectedthecommunity’sabilitytocarefor its most vulnerable citizens.
HollyBell,PhD,LCSW,isResearchAssociateattheCenterfor SocialWorkResearch,TheUniversityofTexasat Austin. Address correspondence to her at: Center for Social Work Research, School of Social Work, the Univer-sity of Texas at Austin, 1 University Station, D3510, Austin, TX 78712-0359 (E-mail: hbell@mail. utexas.edu).Theauthorgratefully acknowledgesLaura Lein,RonAngel,andJulieBeausoleilfor theirassistanceintheprep-aration of this manuscript.This research was funded by National Science Foundation grant number 0555113.Journal of Social Service Research, Vol. 34(3) 2008Available online at http://jssr.haworthpress.com
2008 by The Haworth Press. All rights reserved.doi:
 D o w nl o ad ed  B y : [ Okl ah o m a  S t a t e  U ni v e r si t y]  A t : 02 :57 14  J ul y 2010
Thisstudyfocusedonthefunctionsandchal-lenges of providing long-term disaster casemanagementtohurricanesurvivorsbyexamin-ing the experience of one southern host city.Despite the coordinated efforts of local casemanagers in identifying, assessing, planning,linking, monitoring, and advocating for dis-placed hurricane survivors, the combined ef-fectsoftheirlong-standingdisadvantage,trau-matic loss, and limited resources in the hostcommunitypresentednumerousbarrierstosur-vivors’ long-term recovery.
Casemanagementisastapleofpost-disasterrecovery.Basedonearlymodelsofsocialcase-work(Hall,Walsh,Huber,&Jampoler,2002),social workers, other professionals, or para-professionalsmayprovidetheseservices(Rose&Moore,1995).Thegoalofcasemanagementis the provision of high quality cost-effectiveserviceswiththeultimategoalofimprovingthequality of clients’ lives (Hall et al., 2002). Intheirreviewofthehistoryofcasemanagement,Hall et al. (2002) noted six generally acceptedfunctions of case management.
oroutreachtoclientsisthefirststep.Next,casemanagers conduct an
of clients’needs
with the client about addressing his or her par-ticular needs. An additional function of casemanagement involves
clients withneeded services.
the outcomes of their interventions is important, to insure thatclients actually receive the needed services. Incaseswheretheydonot,casemanagersengagein
atboththemezzoandmacrolevels.While the focus of case management is assist-ing clients to deal with fragmented services,casemanagersoftenfindthemselvesunabletohelpclientssuccessfullynavigateabrokensys-tem(Rose&Moore,1995).Thereareanumberof models of case management (Hall et al.,2002), making comparison and evaluation of casemanagementproblematic.Researchontheeffectiveness and cost-effectiveness of casemanagementhasbeenequivocal,althoughpre-vious research has indicated that it improvedclient outcomes (e.g., Gorey, Leslie, Morris,Carruthers,John,&Chacko,1998)buthasnotalways been cost effective (e.g., Saleh, Vaughn,Levey,Fuortes,Uden-Holmen,&Hall,2006).Casemanagementindisasterrecoverytakesa slightly different form. Disasters destroy oralternormalsocialorganization,andneworgani-zational structures emerge in disaster responseand recovery (e.g., Dynes, 1970; Drabek &McEntire, 2003; Quarantelli, 2003; Scanlon,1999),requiringthatserviceprovidersrespondflexiblytoachangingservicedeliverysystem.Examplesdrawnfromsocialserviceprovisionafterthe1993GreatFloodinIllinois(Poulin&Soliman, 1999), Hurricane Mitch in Honduras(Puig&Glynn,2003),theSeptember21,1999earthquakeinTaiwan(Yueh-Ching,2003),ter-roristattacksinIsrael(Itzhaky&York, 2005),and the 1997 Red River of the North Flood(Heitkamp, 1997) indicated the need for re-sponderstobeflexible,toactivelyseekoutsur-vivors,coordinateserviceswithmultipleagen-cies, work with limited information, andintervene at the micro, mezzo, and macro lev-els. Advocacy for survivors was an especiallyimportant part of disaster response. In cross-culturalsituations,serviceprovidersneededtobe sensitive to the cultural, political, andsocioeconomic differences that inhibited rap-port building (Puig & Glynn, 2003). Collabo-rating with multiple agencies under stressmeantthatservice provision was hamperedbytheuncertaintyandlackofintegrationofpublicsystemsandwaspronetoconflictsbetweencli-ent needs and government instructions, creat-ing conflicts for social workers (Yueh-Ching,2003).Culturaldifferences(suchasvalues,jar-gon,andworkstyles)betweenthevariouspro-fessionals and between professionals and vol-unteerscausedfriction(Itzhaky&York,2005).However,therequiredcollaborationimprovedboth agencies’ relationships with each otherandservicesprovidedtoclientsafteradisaster(Heitkamp, 1997).The focus of disaster case management hasbeen the development of a “Recovery Plan,”which identified survivors’ resources andneeds(UMCOR,2001;NVOAD,2004).Inthisplan, the case manager and survivor identifiedthe survivors’ “unmet needs,” which must bedisaster-related, as opposed to pre-disasterconditions or ongoing social issues. BothNVOADandUMCORstressedtheimportanceof survivor responsibility for their own recov-
 D o w nl o ad ed  B y : [ Okl ah o m a  S t a t e  U ni v e r si t y]  A t : 02 :57 14  J ul y 2010

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