Work Context of Case Management with Hurricane Katrina Survivors

Background and Purpose: In the 2.5 years since Hurricane Katrina dispersed hundreds of thousands of Gulf Coast residents throughout the U.S., little research has focused on the long-term recovery of survivors and efforts of case managers to assist them (Appleseed, 2006; Kromm & Sturgis, 2008). However, many survivors of Hurricane Katrina continue to experience complex and long-term needs (Appleseed, 2006). This study examines the work context in which case managers attempt to meet those needs. Methods: The data presented are drawn from a telephone survey of Katrina Aid Today (KAT) case managers and supervisors (N=170) working with survivors of Hurricane Katrina in 32 states in both host and disaster-affected areas. Brief telephone interviews were conducted with respondents (predominantly African American and European American females). The interviews focused on a series of open-ended questions about the respondent's experience with Hurricane Katrina, work area, caseload, and aspects of a “successful” case and a “challenging” case. Respondents were also asked to describe the three biggest challenges facing clients, cultural differences they experienced between themselves and clients, and advice they had for improving the program. Interviewers used Computer Assisted Telephone Interviewing (CATI) to summarize responses. The summaries were then transferred into Microsoft Excel. Each interview summary was double coded and differences were reconciled to increase reliability. Working in Excel allowed us to generate counts of open-ended responses in a tabular format and to identify trends. Illustrative stories and quotes were selected to further highlight these trends. Results: While the emphasis was somewhat different in disaster-affected and host communities, client motivation and the availability of resources were key factors in successful cases. Conversely, lack of client motivation or resources were key factors in challenging cases. Housing, employment and transportation were the greatest needs cited by respondents. Half of the respondents reported that they did not experience cultural differences. However, cultural differences that were noted included clients' attitude or lifestyle, language or communication, and a range of “other” differences, such as food, socioeconomic differences, education, work experiences, and family/social networks. Finally, respondents recommended that KAT increase and improve distribution of resources, increase training and preparation of case managers, and reduce the amount and type of paperwork required. Respondents also suggested that KAT should improve its ability to implement a disaster plan, increase communication and collaboration among agencies, and improve the quality and quantity of staff. Conclusions and Implications: This research contributes to our understanding of disaster case management by examining factors identified by KAT case managers and supervisors as either helpful or a hindrance to their success in working with clients. Adequate resources, particularly affordable housing, were identified as essential to successful case management. Despite concerted efforts by NGOs in host and disaster-affected communities, affordable housing continues to be a critical problem for survivors. While half of the respondents did not identify cultural differences as important, case managers' frustration with survivors' lack of “motivation,” particularly in culturally different host communities, raises issues about culturally appropriate assessment and intervention for disadvantaged clients.