By Dr. Monteic A. Sizer, Louisiana Family Recovery Corps

Once again, Louisiana residents impacted by disaster stand to be the losers in an ongoing stalemate between the state and the federal government.

The state of Louisiana has yet to secure any of the $32 million originally set aside by FEMA in 2008 for case management and other services intended for Louisiana citizens moving out of FEMA travel trailers and into more permanent living situations. These funds would have supported case management programs designed to assess the needs of those residents and aid them in accessing healthcare, social services, job training, employment, and other services which could ultimately push those being served toward self-sufficiency.  

The program, known as the Disaster Case Management Pilot (DCMP), never launched in Louisiana for a plethora of reasons, some of which included FEMA outright rejecting at least one of the state's applications that included means to capture data that state agencies wanted captured; a non-profit organization that the state partnered with dropping out of the process twice; and the state adopting Mississippi's case management model in an effort to more quickly move the application through FEMA's approval process. It should be noted that Mississippi was able to quickly access the nearly $25 million it was allocated for the program, prompting Louisiana's decision to change course and adopt Mississippi's model.  

Ultimately, each of these delays forced Louisiana to resubmit its application to FEMA. Eventually, time ran out for the successful implementation of the nine-month DCMP program.

On February 11, 2009, FEMA finally presented an award letter to the state that would provide up to $8,372,992 for a revised three-month program focused on transitioning the state's remaining 3,944 households in FEMA trailers into more permanent housing. The state also requested the Louisiana Family Recovery Corps, which had been a part of the application process from the start, to provide case management services to these households. That request was not made until March 17, 2009, more than a month after the state received the award letter and just 75 days before the scheduled end of the program.

At that time, the Recovery Corps asked the Louisiana Recovery Authority ("LRA"), the agency that the governor's office tapped to execute this program, to provide it with specific information related to the execution and set-up of the program. As of April 2, 2009, just 60 days prior to the scheduled closeout of the services portion of the program, the LRA had yet to fully assess the needs of the households it aims to serve; develop a software platform for executing and tracking the case management services; fund the Recovery Corps and its partner agencies to carry out many of the case management services needed; or allow partner agencies to hire and train case managers based on the Mississippi case management model that the LRA chose to utilize.

Suffice to say, this truncated program has the earmarks of a final attempt to secure at least a portion of the $32 million before it totally disappears. But, in the end, any version of the DCMP program with a quickly-approaching May 31, 2009, deadline for services rendered to clients is likely to be nothing more than a chaotic, bureaucratic mess that will lead disaster victims down the path of hoping to be served, only to be let down once again.

These political maneuverings with unknown outcomes for our citizens are not what the Recovery Corps sees as being helpful to the people of Louisiana. Further, we have been told directly by a FEMA official that under no circumstances will this program be extended again. With the state having only 60 days in which to build out the case management model, build out the software platform, identify partner agencies to provide services, allow partner agencies to create budgets and hire staff, train partner agencies and their staffs, provide case management services, and identify and secure housing for those residents leaving the FEMA trailers, it is implausible to believe that a successful program for our citizens can be properly implemented and executed.

Additionally, the Recovery Corps has already incurred nearly $200,000 in expenses associated with DCMP, expenses which have yet to be reimbursed by FEMA. FEMA and the state also refuse to provide upfront funds to the Recovery Corps and its non-profit partner agencies to hire the proper staff and make preparations to serve the program's clients.

The Recovery Corps cannot commit additional resources to the program without being certain that they will have a positive impact on the lives of Louisiana citizens. Nor can we, with a clear conscious, ask potential partner non-profit agencies who are already strapped for cash to incur any additional upfront expenses after also previously incurring yet-to-be-reimbursed expenses in ramping up for the DCMP program in 2008, only to learn that the state was forced to re-submit its application, causing further delays and leading to the conundrum in which the state now finds itself.

Thus, for these reasons and more, the Recovery Corps has notified the LRA that it cannot participate in this program that is doomed to fail. Excellent programs with specific outcomes for our citizens are what Louisianians deserve. We fear this rushed program will not meet those standards.

And that is extremely unfortunate, because there is a very real chance that thousands of people will go unserved yet again and Louisiana will lose out on all of the $32 million originally allocated to help transition its impacted residents toward self-sufficiency.

Many of these remaining citizens yet to be served represent some of the most difficult to serve. It should be noted that 3,528 of the 3,944 households are in trailers on their own private property. With no direct service dollars being offered to provide repairs to these residents' private homes and very little affordable housing stock available, the likelihood of them giving up their trailers or immediately becoming self-sufficient prior to the May 31, 2009, FEMA-mandated end of the program is minimal.

Just as unfortunate is the fact that the DCMP program could have been a real success in Louisiana. Instead, we have let slip through the cracks thousands of households with major needs by not providing them with the proper support and assistance.

Many of those underserved include minors, the elderly, and households with special needs. The most recent data available to the Recovery Corps, dated February 21, 2008, showed that 3,305 minors and 810 elderly residents (over 60) existed in the population to be served at that time by DCMP, along with 586 households with special needs residents. All but 44 of those households left their FEMA trailers and today remain largely unaccounted for and underserved. 

Additionally, according to data provided by the Southern University School of Nursing (SUSON) and analyzed by the Recovery Corps, these trailer populations were prone to mental and physical illness. The data found that in Renaissance Village, the second-largest of the trailer populations, 24.3% of the population served by SUSON suffered from chronic high blood pressure.As well, 15% of those examined exhibited some form of mental condition, 18% suffered from respiratory illness, 18% required prescription medication, 10.7% exhibited allergies, and 10.5% were diabetic. 

Of the children treated, 26% suffered from a respiratory illness, of which 17% were under age 10. Twelve percent of the children exhibited a dermatological condition which has been subsequently linked to formaldehyde exposure. Other medical conditions existed for these children, ranging from short-term conditions such as minor injuries and dehydration to more long-term conditions such as chronic diabetes. Overall, 10% required some form of regular medication. 

This information aligns closely with the data recently released by the Children's Health Fund which described how Louisiana's "on-going recovery is continuing to fail in ways that are clearly harmful to the health and well-being of children and their families." It is also plausible to believe that many in the aforementioned FEMA trailer population have yet to have follow-up medical exams.

All of this information is particularly disheartening because the Recovery Corps, at the state's behest, designed a rapid deployment plan that targeted families with minors, the elderly, or special needs members and was ready to remove these families from their FEMA trailers, work closely with them to resolve their specific needs, and place them in more permanent living situations to be determined by the state and FEMA. Due to the numerous application submissions to FEMA by the state and changes made within the state's application, however, this was never funded or implemented. Therefore, a population that should have been tracked cannot be accounted for and it is impossible to know their continuing medical needs. 

But DCMP isn't the only example of a program struggling to get off the ground. The state of Louisiana, through the Louisiana Housing Finance Agency, contracted with FEMA to execute a program commonly known as Katrina Cottages. The program, which was contracted in 2007 and was to be initiated in 2008, has been mired in red tape over contracts, permits, and zoning and has undergone widespread scrutiny for its overall lack of organization and execution.

While the state of Mississippi has been able to build thousands of these structures and even transition people into and out of the program, the state of Louisiana, to date, has built one Katrina Cottage and has yet to publicly identify the selection process for participants in this nearly $75 million program. The state now could lose much of this money if it does not meet specific FEMA-mandated benchmarks by September 1, 2009.

What is most concerning is the fact that, despite all that has been said about how the state continues to operate this program, there has been very little mention of the case management aspect of the program. 

If the original intent of the program is applied, the case management aspect will be of utmost importance. Many families selected to participate will become homeowners for the first time. Consequently, these residents will require financial literacy and job training so that they will be able to work and eventually pay the note if they elect to purchase their home. All of this is in addition to the case management that must occur around healthcare for these struggling families, including access to state social service programs to assist with mental health issues and the like.

If case management is not fully incorporated within the program as it was originally designed, the end of the Katrina Cottage program is likely to have a similar fate as the closing of HUD's Disaster Housing Assistance Program (DHAP). Prior to the eleventh-hour extension of that program, nearly 17,000 Louisiana residents whose housing was being subsidized by the government faced homelessness because they were not properly case managed toward becoming more self-sufficient. A severe shortage of affordable and available housing left many without options.

And while DHAP has been briefly extended for those who entered the program following Katrina and Rita, it appears as if proper case management is still not taking place for a vast majority of the program's families, setting the stage for a further humanitarian crisis when DHAP ultimately concludes. Additionally, those who entered the DHAP program after Gustav and Ike will likely face the same challenges when that program reaches its conclusion.

These various populations of Louisiana citizens scattered in the numerous FEMA and HUD programs still do not take into account the thousands of residents who were rightly or wrongly deemed ineligible for government programs or who simply did not sign up for government assistance. Many of those residents also continue to seek assistance in restoring their lives and will continue to turn to the state in order to advance the recovery process.

These concerns and many more remain on the minds of many across the state and the nation. The inability to effectively and efficiently initiate and properly execute programs for people has crippled the state of Louisiana for generations. That tradition appears to be as powerful as ever.

Now is the time for change. While it is too late for some, many can still be saved. But immediate action is required. Louisiana's residents cannot afford to lose potentially more than $100 million specifically intended for case management and housing assistance aimed at transitioning citizens impacted by unprecedented disaster toward self-sufficiency.

Rightfully so, many inside and outside the state ask why our residents are still suffering more than three years after Katrina and Rita. They ask why our people cannot yet stand on their own. One reply, in short, is that there are more than 100 million reasons why.

Dr. Monteic A. Sizer is President and CEO of the Louisiana Family Recovery Corps. For more information about the Recovery Corps, please visit www.recoverycorps.org.