disaster case management

Disaster Case Management
Best Practices and Lessons Learned

Alyssa Pollock/Disaster Case Management Committee Chair
Sondra Hayes/Disaster Case Management Supervisor
12-16-15

Successes: The case management process promoted a long-term, quality relationship between the case manager and the client. Although we experienced some limited turnover in case management staff, overall the longevity of the case managers allowed for positive working relationships with clients. The stability in the case manager-client relationship provided numerous benefits to the client, including emotional support and mutual trust. Case managers were able to develop a thorough knowledge of client circumstances in each case that enabled them to advocate appropriately on the clients' behalf.

Utilization of the Coordinated Assistance Network (CAN) enabled information-sharing across agencies. Since the points of contact at each agency participating in case management agreed to utilize CAN, all case managers had access to the detailed electronic case file for each client with a signed release. Paper files were also shared across agencies with a signed release. This sharing of information allowed a seamless continuum of care for the client when working with multiple agencies and in some cases, transitioning from one case manager to another.

Consistent training and case management supervision across agencies provided clients with uniform service across agencies. Initially, the first case managers attended joint training provided by UMCOR and were all provided with the same guidance during training. The case managers who joined Tri-County LTR later in the process were provided with a standard orientation. This uniformity in training led to more consistent service delivery. Since all agencies agreed that the appointed Case Management Supervisor would provide daily direction and clarification to all case managers, this consistency in supervision also led to consistency of service.

The Long-Term Recovery Center office provided an agency-neutral shared workspace for case managers and was conveniently located for clients. When the LTR Center opened and the case managers relocated to the Center from their various agency offices, the case management team experienced an increase in collaboration, communication, and teamwork. The workspace was neutral and also allowed Tri-County LTR to develop its own public identity. In addition, the Center was conveniently located to the highest concentration of clients in Washington and East Peoria, which allowed for walk-ins and easy access for case managers to make client home visits.

Staffing levels for case managers and support staff were appropriate for the caseload throughout the recovery efforts. Although the total number of case managers grew, peaked, and declined throughout the recovery process, this progression closely mirrored the caseload. Consequently, our staffing levels were appropriate for our caseload at any given point in the process. The addition of a part-time Admin support position to manage Funders' Forum paperwork was greatly needed, and our efficiency improved after that position was put in place. Throughout the busy months in the office when client walk-ins and phone calls to the main phone line were frequent, the addition of a paid or volunteer receptionist was extremely beneficial. Initially, one of the paid case managers fulfilled this function until some volunteer receptionists were found to fill this role.

Challenges and Recommendations: Accountability for the Case Management Supervisor was challenging in a matrix-management environment. According to the Disaster Case Management organizational structure adopted by the DCM agency points of contact, the Case Management Supervisor had a reporting relationship to the Disaster Case Management Committee Chair, who provided direction on the committee's goals. However, as each agency needed to retain its own human resource practices to comply with HR laws, it was difficult for the DCM Committee Chair to hold the Case Management Supervisor accountable. Additionally, the Case Management Supervisor experienced similar accountability challenges in supervising case managers who came from other agencies. This issue became even more challenging because the agency who was the employer of record for the Case Management Supervisor was located in another part of the state and therefore had only limited participation on the DCM committee. Our recommendation is that in the future, the Case Management Supervisor position needs to be employed by one of the local agencies who are closely involved in the entire DCM process.

Technology resources are needed to support the work of the case managers and to provide continuity in case of personnel changes. After the turnover in the Case Management Supervisor position, it was discovered that many of the Funders' Forum and procedural documents had been located on a personal laptop. Our recommendation is that file storage on a central server, cloud, or external hard drive should be secured from the beginning to prevent loss of knowledge during personnel changes. Also, for this recovery operation, the computers and phones were provided by one of the local agencies participating in disaster case management. On the next disaster, consideration should be given to whether computers and phones will be available from one of the agencies or whether LTR may need to procure these items.

Longevity of volunteer case managers was improved after the volunteers became paid disaster case managers. Although volunteer case managers can and did provide excellent service to clients, their availability long-term over the entire recovery process was challenging. Retention of case managers was greatly improved after some of the case managers who began initially as volunteers were converted to temporary employees. Our recommendation is that recruitment of volunteer case managers may need to become a function of the Volunteer Management subcommittee to ensure adequate volunteer staff. The recruitment and retention of volunteer case managers may become even more crucial during the next disaster if funds do not allow an adequate paid case manager workforce.

Case Management Supervisor and Funders' Forum Moderator are two separate and distinct roles, and keeping track of the status of Funders' Forum payments was confusing and time-consuming. During the peak months when dozens of cases were presented and funded, the workload for the Case Management Supervisor was not manageable and forced her to divide her attentions between providing adequate support to the case managers and keeping track of the Funders' Forum. Our recommendation is to identify a Funders' Forum lead or temporary employee who can manage the Funders' Forum process. By keeping the roles separate, LTR would also maintain better separation of duties and fiscal controls to avoid the potential for fraud. We also recommend that the Steering Committee refine the process for generating payments in collaboration with the members of the Funders' Forum in order to streamline the process. Some funders preferred different methods of receiving documentation (e-mails vs paper copies), which was confusing.

Availability of the UMCOR Case Management Training was limited, and we had no alternative. The in-depth, multiple-day training provided by UMCOR was very beneficial for the case managers who started early in our recovery operation. However, the case managers who began their positions later did not have access to the UMCOR training because UMCOR has limited capacity to deliver the training in Illinois. Our recommendation is that we work with UMCOR or another provider to identify opportunities for a œtrain-the-trainer program so that we could have local instructors in the Tri-County area. Alternatively, we could develop our own local, formalized training.

Meetings for the Agency Points of Contact were very beneficial but very time-consuming. For about the first 18 months of the recovery operation, the points of contact from each participating disaster case management agency met every two weeks to discuss and agree on procedures, to check progress, and to resolve problems. The meetings were productive, necessary, and generated collaboration and teamwork, but finding time to meet every two weeks for 18 months was challenging. Our recommendation is to find a way to reduce the frequency of meetings as early in the recovery operation as possible.