1. The Recovery of Individuals with Disabilities Following Hurricane Katrina Laura M. Stough Amy N. Sharp Center on Disability and Development Texas A&M University

2. Photos credit the Associated Press

3. http://www.gov.state.la.us/index.cfm?md=photogallery&tmp=home&navID=10&cpID=0&cfmID=0&catID=1

4. http://www.gov.state.la.us/assets/images/photogallery/Katrina/8.28.07.jpg

5. Photos from: http://www.nod.org/katrinaphotos/katrina9.jpg

6. A rescuer carries a young man who is unable to walk to safety. - Retrieved from FEMA Photo Library 2006.

7. Statistics on Individuals with Disabilities 12.6% of the working age population 16.7% of the total population 21.3% (almost 250,000) of the residents of the New Orleans metropolitan area described themselves as disabled in the 2000 Census.

8. Census of 2000 – New Orleans 107,883 people stated that they had a condition that substantially limits... basic physical activities such as walking, climbing stairs, reaching, lifting or carrying. 64,016 people were categorized as having a mental disability 54,014 people stated that because of a long-lasting condition they have difficulty dressing, bathing or getting around inside their home. 23,467 people stated that they had long-lasting conditions of blindness, deafness, or a severe vision or hearing impairment.

9. Katrina Aid Today A National Case Management Consortium Implemented by UMCOR and Consortium Partners to Assist Katrina-Displaced Persons KatrinaAidToday.org

10. Goal UMCOR, in cooperation with FEMA, formed a Consortium as lead agency The consortium, Katrina Aid Today, includes 9 members to provide case management Cost: $66 million Time: 24 months

11. National Disability Rights Network The goal of Katrina Aid for Individuals with Disabilities (KAID) is to provide high quality, cost-effective nation-wide case management services for displaced individuals with disabilities and their families.

12. Evaluation Questions 1.What does case management look like when the evacuee client is a person with disabilities? 2.What impact does case management provided by disability service experts have on outcomes experienced by people with disabilities? 3.What is the impact when a legal services organization provides case management to people with disabilities who are evacuees? 4.What effect did NDRN participation have on the delivery of services by the KAT partner organizations and on KAT organizations?

13. Design I.Survey of 50 case managers providing services as part of Katrina Aid Today II.Face-to-face interviews with 15 case management supervisors and administrators III.Quantitative analysis of types and costs of case management services received by 60,360 families affected by Hurricane Katrina IV.Five focus groups in Texas, Louisiana, Mississippi, and Georgia with 31 people with disabilities

14. Design I.Survey of 50 case managers providing services as part of Katrina Aid Today II.Face-to-face interviews with 15 case management supervisors and administrators III.Quantitative analysis of types and costs of case management services received by 60,360 families affected by Hurricane Katrina IV.Five focus groups in Texas, Louisiana, Mississippi, and Georgia with 31 people with disabilities

15. Analysis of Quantitative Data Extracted data on 60,360 families who had received case management services through Katrina Aid Today Database relied on input from case managers Descriptive statistics Between groups (KAID case managers versus KAT case managers) analyses

21. Similar to clients of the other partners, NDRN clients were 1 : Predominantly female and predominantly African American; Nearly all displaced and had experienced damage to housing; Likely to have primary needs met or recovery plan achieved as reason for case closure; and Likely to indicate satisfaction with their case manager and with services received. 1 X 2 analysis found no significant difference found between groups given p<.05

22. In contrast to clients of the other partners, NDRN clients were: Older (F=1028.47, p<.001, eta squared = 0.02); Less likely to have experienced loss of income (X 2 = 32.62, p<.001) ; Less likely to need employment/job training (X 2 = 7.85, p <.01); More likely to need housing and services for aged/disabled (X 2 =4.40, p<.05). More likely to have case closed for the reason unable to resolve because of lack of resources (X 2 = = 6.37, p <.05); Less likely to report their needs were met (X 2 = 5.97, p <.05) ; and Were less likely to express satisfaction in how other agencies assisting in their recovery had responded (X 2 = 15.57, p <.001).

23. Focus Groups of Individuals with Disabilities Five focus groups: Houston, Baton Rouge, New Orleans, Gulfport, and Atlanta Each group consisted of three to eight group members with disabilities Five questions presented to each group with follow-up probes

24. Focus Group Members 71% female, 29% male Average age 51 years (range 31-74 years) 26 (84%) were African American Of the 31 participants all reported disabilities –10 (32%) reported having more than one disability –21 (68%) reported the presence of more than one disability within their family –15 self-reported themselves as having some type of mental illness, usually depression

25. Procedures Each focus group lasted approximately 1.5 hours Lunch and explanation of the study proceeded the focus group Groups were recorded and produced over 12 hours of audiotape Transcription produced 302 pages of data

26. Analysis of Qualitative Data Used Grounded Theory (Glaser and Strauss, 1967) –Line-by-line analysis of qualitative data –Open coding –Axial coding –Relationship among the categories determined

27. Focus Group Questions 1.What have been things that prevented you from recovering? 2.What has helped you recover from Hurricane Katrina? 3.What help or services have helped you get the things you need? 4.How has Katrina Aid Today helped you? 5.How has your case manager helped you?

28. Focus Group Questions 1.What have been things that prevented you from recovering? 2.What has helped you recover from Hurricane Katrina? 3.What help or services have helped you get the things you need? 4.How has Katrina Aid Today helped you? 5.How has your case manager helped you?

29. What have been things that prevented you from recovering? Lack of concrete resources –Housing they tore my house down just about three weeks ago and she is going to use my insurance money to help get me a handicap accessible home not the trailer I am in…I am uncomfortable in a way because the sofa is old. I am sleeping on top of a pillow because the back bedroom the bed is so high I cannot get into it. And they got one air conditioning unit in there and it does not cover the whole trailer. Certain parts of the day it gets hot, but I still praise God that I have somewhere to be. (Mississippi Focus Group)

30. What have been things that prevented you from recovering –Housing I got a telephone call, Oh…we have a trailer for you, you have to come on home so you can inspect the trailer and all this. Im handicapped, she gives me a trailer as big as this room here, its not handicapped equipped. Ok, she promised me faithfully, oh…that youre here now, we gonna take care of this. Just give me about two weeks and were gonna put you in a handicapped. So we spent two months, six months, eight months…now Im getting ready to be kicked out of my trailer, ok. (New Orleans Focus Group)

31. What have been things that prevented you from recovering? –Employment Even though I was transported from one place to another I was always without transportation. I still had the bus system which was luckily running there and running all the way back to my job. It kept me working, which kept my mind together. And eventually I got on disability, it came along and its good. I am just trying to keep my mind steady going forward. I am not trying to look back to where I was, I am just trying to go forward. (Mississippi Focus Group).

32. Difficulty in Obtaining Services Paperwork and the runaround –My husband was a 100% disabled veteran and his income is greatly missed. And the VA they denied me his benefits and now it is on appeal. The doctor said, see if you could have his file sent back to New Orleans. So the VA here finally decided to send the file back because at first it seemed like they didnt want to do it for whatever reason. So the file is back in New Orleans and as far as I know they are looking into it. (Georgia Focus Group)

33. Difficulty in Obtaining Services Psychological status –It is like we have lost our hope. No one answers our phone calls, no one calls us back, you know. We have been left out. By asking certain questions or asking for something that we need, desperately need, and it just Call this number, well, call this number, call this number. I had six in one day, different ones to call and nobody had any answers for me. So that has been a very long drawn out thing. Getting the answers as to who do we talk to. (Mississippi Focus Group)

34. What has helped you recover from Hurricane Katrina? Um, I guess mainly the support from people here, from my church. Just from family and friends…So basically it has been relationships that have been the strongest piece, I think. Cause even with working with persons with some of the other agencies there have been relationships that have been developed from that communication and that contact with persons from other agencies. That is basically what it has been, relationships (Georgia Focus Group).

35. What has helped you recover from Hurricane Katrina? Prayer and my people. My son and my sister. Out of thirteen of us I only have two left. So like, if I need something I call my sister. She needs something, if I got it I call her. My mother and my father always teached us…nothin like your own. (Baton Rouge Focus Group)

36. Context of Displacement I will say another barrier is not just FEMA, it is our resources like family. I have none. They are from New York to Jersey to Texas to West Coast so no more going to big mamas house on Sunday. We were very close. It is like I have no culture anymore it is like, I feel like, what did they call us? A refugee, yeah. (Georgia Focus Group).

37. Context of Displacement I think its more then money, its …knowing where you live, the ground that you walk on and when you wake up you know where you are and, you know, its just your whole life has changed. I dont think youll ever really recover because youll never get back what you had. Everybodys lost- friends and family is scattered all around the country… (Houston Focus Group)

38. C0ntext of Displacement I been around the world at least six to seven times. Red Ocean, Pacific Ocean, Gulf War, Atlantic…I been around the world to Egypt- and they always trained us for when the ship [might] sink. And since 1987 we never had one experience where…I had to worry about ships sinking in the middle of the ocean…but here I am in my own home, and Im seeing water rise above me, trying to knock a vent out on the roof thinking Im going to drown right there in my own home. (New Orleans Focus Group)

39. Summary Concrete resources were reported as the primary need of these survivors Loss of a sense of place was as disturbing to the survivors as this lack of resources They described their situation in terms of the resources they needed, not in terms of their disability-related needs The majority of survivors talked about their psychological status and self-disclosed depressive symptoms Not one of these survivors saw themselves as having recovered

42. Acknowledgements National Disability Rights Network Center on Disability and Development Association of University Centers on Disability Research Education in Disaster Mental Health Program