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
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-
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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