EIIP Virtual Forum Presentation — October 14, 2009

The Role of Nongovernmental Organizations
in Long-Term Human Recovery After Disaster

Anita Chandra, Dr.P.H.
Behavioral Scientist
RAND Corporation

Amy Sebring
EIIP Moderator

The following has been prepared from a transcription of the recording. The complete report (Adobe PDF) may be downloaded from http://www.rand.org/pubs/occasional_papers/2009/RAND_OP277.pdf

[Welcome / Introduction]

Amy Sebring: Good morning/afternoon everyone. Welcome to EMforum.org. We are very glad you could be with us today. I am Amy Sebring and will serve as your Moderator today.

Today’s topic is based on a recently published research paper from the RAND Corporation titled The Role of Nongovernmental Organizations (NGOs) in Long-Term Human Recovery After Disaster: Reflections from Louisiana Four Years After Hurricane Katrina. Although the traditional bricks and mortar type recovery is obviously essential, this report brings attention to the human dimension, and how those needs can be better served, over the longer term.

A related survey on our home page asks, "Do you agree with the report finding that human recovery is not well-defined at the federal, state or local level? Agree, Disagree" Please take a moment to participate and review the results thus far.

Now it is my pleasure to introduce today’s guest: Dr. Anita Chandra is a Behavioral Scientist with the RAND Corporation and lead author of the study. She has a background in public health systems research, child and adolescent health, and community-based participatory research and evaluation.

In the area of public health systems research and preparedness, Dr. Chandra has been actively involved in a series of projects with the Department of Health and Human Services (DHHS). She currently co-leads a task on preparedness planning for special needs populations, and has been instrumental in developing the special needs and community resilience components of the draft National Health Security Strategy, due to Congress in December 2009.

Welcome Dr. Chandra, and thank you very much for being with us today. I now turn the floor over to you to start us off please.

[Presentation]

Anita Chandra: Thank you, Amy. I just wanted to give a little bit of context to why we pursued developing this short report, and then talk briefly about some of our findings from our conversations with NGOs as well as our suggested recommendations for next steps, both in terms of program and policy change, as well as future questions that need to be answered before we can move forward on long-term human recovery.

As Amy mentioned, Rand has been working with the Department of Health and Human Services for several years on issues related to emergency preparedness. In the past year, we’ve been developing the National Health Security Strategy, which is set to be introduced hopefully later this year, and then rolled out to states and local officials very soon after. A core component of that was engaging community stakeholders—to really understand their needs and interests and gaps and concerns around health security more broadly.

As part of that ongoing discussion, we decided to convene an extra group of people in Louisiana specifically to really understand (the 4 years post-period from hurricanes Katrina and Rita) how recovery had been going and to really explore this issue of the length of recovery as well as the longer length that people often attribute to human recovery, well beyond the buildings and roads getting back to functioning.

With that being said, we devised a facilitative discussion format to really delve more deeply into those areas for discussion.

One of the things that we did initially was to really think about the roles of NGOs, particularly in recovery. As many of you know, certainly NGOs play a critical role in recovery, but sometimes there are limitations in the policy and financial support that hinder or make their involvement more difficult.

In addition, we know from prior experience that there is sometimes a lack of clarity on how to better support their activities in long-term recovery, and less guidance about the recovery phase in terms of roles and responsibilities for NGOs and how that sequence of activities should happen, particularly in terms of the coordination between federal leaders and NGOs.

One of the things that is often overlooked, that we certainly heard from our participants in this facilitative discussion, was that long-term recovery may be longer and more complicated following multiple disasters. In the report, we have a figure trying to depict this, which really shows the overlapping nature of disaster recovery.

It’s not that one period of recovery is complete and then the next disaster hits, but rather a community that is in stress and recovery can often be hit once, twice, or even more. Certainly Louisiana was no exception, after Katrina and Rita, to be hit again by the outcomes of Ike as well as other kinds of disasters that hit in the last 4 years.

In addition, that further complicates the roles of NGOs in the recovery phase, because trying to figure out how to stretch limited resources becomes even more challenging, particularly when they have to go back to the same pot and there isn’t federal guidance that allows some creative thinking about multiple needs and multiple disasters.

As I mentioned earlier, as part of our national discussion to develop the National Health Security Strategy, we convened this extra group’s meetings in April of 2009 with a group of NGO leaders in Louisiana. These weren’t simply leaders in New Orleans, although that was the majority of the representation.

We did have other leaders from other parts of northern and southeastern Louisiana, really representing the range of NGOs, from CBOs, that provide social services or mental health support, to organizations that are more faith-based in orientation to try and represent the wide expanse of NGOs that are invested in the recovery period and are still supporting community residents in long-term recovery.

We posed a couple of questions to the group, and then let it unfold. Our key questions were these. We wanted to understand their roles in recovery, and understand the extent to which they felt they had been well-reflected to state and local planning.

In addition, we wanted to use the discussion to figure out where there were continued gaps in planning (what is working well, but also where there were gaps), and how can federal and state agencies better engage the NGOs in the long-term recovery period specifically.

Our conversation was really focused on NGOs and their orientation, and what they needed from federal and state entities. Certainly there is merit to revisiting this issue with the federal and state government arms, and thinking about their perspective on these issues, to really flush out where there are opportunities for improvement.

Here are some of the key challenges that we talked about in a bit more detail in the report. First, and not surprisingly, what we learned was that no one really found that there was a comprehensive system or operating plan for human recovery.

We know that FEMA right now is working on a national recovery framework, but certainly at the time of doing this analysis this past spring, there wasn’t really an operating recovery framework, nor was there a lot of focus on recovery beyond infrastructure recovery.

There wasn’t a working definition of human recovery. We used one in the report, but there wasn’t a clear understanding of what constitutes human recovery, what that looks like, and how that should be supported. In ESF (Emergency Support Functions) in terms of ESF 6 and ESF 14, which is long-term recovery), there is some conversation about providing support for mental, behavioral, and physical needs, but very little guidance on implementation. People found that guidance was inadequate.

Certainly, as part of a National Incident Management System, there is more focus on response and less on recovery. In addition, the NGOs that are providing long-term social services, health services, and so on to their constituents, found that there was limited support for long-term case management services.

When we talk about case management services, we’re talking about this collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy, both for an individual as well as a family. They felt like a real understanding of the long-term needs of individuals and families wasn’t really reflected in the models that were being supported, or the policies that were supporting investment in this long-term case management.

In addition, we talked a lot, perhaps not surprisingly, about the Stafford Act and concerns from the participants that it didn’t sufficiently support human recovery. One thing that was talked about was the lack of explicit coverage of case management services, particularly extended case management services, that weren’t put into eligibility criteria in terms of support.

People talked a lot about the difficulty to get state or local matching funds, particularly when they are hit over and over again by multiple disasters.

Another thing we talked about was the fact that recovery dollars are often focused on rebuilding the element of the community, or the institution or infrastructure that has been damaged, and there’s less incentive to rebuild smarter or try to find innovative ways to rethink community design and development. In that, rethink ways that we connect social groups, connect constituents to really support human recovery.

Finally, one of the things we heard a lot about, was that the delays in receiving financial support continue to be a problem. While there have been improvements, it’s still hard to get dollars in advance (and people talked a lot about pre-existing contracts, which we’ll talk about in a minute), as well as just the ongoing delays of reimbursement, which can really make it difficult for recovery in general.

Specifically for human recovery, when you have families that are potentially vulnerable to certain consequences if they don’t get their services in a timely way, in the proper sequence that really meets their needs, having those delays can be a significant problem.

In the report, we talk about some potential actions. Some of these came from the group. Some of these came from collective thinking at Rand, based on some other research and analysis that we’ve done.

If you really think about the operating plan and system for recovery, this recovery NIMS idea, that really has an element of the framework or guidance that focuses on human recovery explicitly, and acknowledges that the plan has to extend for much longer of a period than the acute recovery phase that we usually plan for.

In addition, thinking about ways to consider the length of time for case management and what’s eligible under Stafford Act is critical, and not surprisingly, to think a lot about the state matching fund requirement, which can be a significant barrier.

In addition, in finding ways to incentivize, particularly as we move toward thinking about community resilience, how to create stronger communities that can withstand disasters, or at the very least mitigate vulnerabilities that could be addressed in advance of a disaster.

While we definitely got some key recommendations that we think are important for federal and state policy leaders, there are some areas for which we really actually have no information. We still don’t really know what human recovery entails and what supports are needed. We have some understanding of the needs based on this retrospective analysis.

We don’t really know what are the models that are going to work, how long human recovery should be, when certain services should be activated or not, who should be doing what when—we have limited information. We also don’t know what is the best amount of dollars, fiscal sort of spending, as well as other kinds of costs associated with human recovery, and how much we should be resourcing these services.

Finally, one of the things that we make a point of in the report is that NGOs are not created equal and have different strengths and weaknesses, and often they are on the hook to respond in ways that maybe don’t make the most sense and don’t leverage their assets appropriately.

We talk a lot about the response reliability of NGOs and figuring out which NGO should be used for which types of activities, particularly in the human recovery phase, so that we can get the most impact and also be the most cost efficient.

That concludes a very brief overview of our short report. We had intended this report to be a springboard for discussion, because there are lots of questions that remain unanswered about human recovery. So I look forward to your questions and a robust discussion. Thanks.

Amy Sebring: Thank you very much Dr Chandra. Now, to proceed to our Q&A. We are also interested in hearing from you, our audience, about any specific experiences you may have had in this area.

[Audience Questions & Answers]

Question:
Eric Evans: Have you looked at any models that are existing in some states? For example COADs like those in Missouri?

Anita Chandra: We didn’t look explicitly at Missouri, but I will say that we talked a lot about this element of using COADs or VOADs or sort of coordinating councils. Those kinds of things came up when we talked about streamlining activities in a community around long-term human recovery, but we didn’t look at Missouri specifically. For this, we were really focused on Louisiana this time.

Question:
Amy Sebring: You briefly mentioned about going forward, and I’m wondering, do you have any ideas in terms of where might be a good focal point for these kinds of issues?

Anita Chandra: I think there are a couple of things. One is trying to nail down these elements of human recovery that we think are most critical. I’m trying to figure out what are the best models of supporting it. I think people have varying definitions, and right now the definition is pretty expansive, to think about daily and social routines, and physical and psychological health, but I think we need to drill down a little bit more to make that a little more operational.

As part of our work on the National Health Security Strategy, we’re going to be spending the next several months talking to community and national leaders on how you really get an operational definition of resilience, and identify strategies to enhance resilience. Similarly, where we’re at a loss is trying to figure out what is going to be the common operating definition of human recovery so that we know which programs make the most sense.

Right now, there are a lot of great models, but we don’t really have a set of best practices that have been robustly evaluated that are supporting of human recovery. It really starts with that commonly accepted and uniform definition that we don’t quite have yet. But Louisiana Family Recovery Corp has been doing some thinking, and they were a partner with us on this effort about human recovery, but it’s still a relatively new kind of concept.

Question:
Chuck: Did the study find that the relationship of FEMA to the NGO's (especially the American Red Cross) should /could be changed to improve the plan? Or do you categorize the efforts totally as no plan (as mentioned)?

Anita Chandra: I think there were definitely different sentiments in the room. Certainly, some people felt like the plans and the relationships were not there. Other people felt like it had to be strengthened. We certainly had leaders from Red Cross in the room. But I think the concern was that the support from the feds, including FEMA, wasn’t there and wasn’t adequate enough, particularly in terms of guidance on implementation.

Question:
Rey Thompson: Thanks for putting into words the issues that the State of Utah has been working through to create a more effective flow of activity through response into recovery. Louisiana presents a very different social scenario than many other states. Did any of the NGOs you surveyed represent national level or inland state perspectives?

Anita Chandra: We did have some national organizations that were there and represented both their national hat as well as their local chapters. I think the one that sticks out really is the Red Cross, as well as some of the faith-based organizations that had their leaders from the United Methodist Church and Lutheran Services.

But you’re absolutely right. That is a concern when we try to generalize and think about these findings, and we say at the end that we know this reflects the Louisiana experience, and the extent to which these lessons learned are transferable—I think there are some elements that are consistent across states that we need to think about.

What we hope is that it just galvanizes more discussion for other states and nationally to think about how these lessons learned would apply to other states, and to develop, as they are developing the national recovery framework, to think about that diversity in creating a framework that applies across the board, particularly to pre-existing socioeconomic conditions, different disasters that they would be most at risk for, as well as different infrastructures.

With respect to the government organization as well as to how NGOs interact, every state and every community is a little bit different. That is an important point. What we hope is that we can draw what we’ve learned from the other states to inform that framework that is being developed.

Comment:
Amy Sebring: I’m going to follow on that question a little bit, because what it brings to mind is that in further research you might possibly be able to get to the point of doing vulnerability assessments ahead of time in terms of the needs for those types of services.

Anita Chandra: We’ve talked a lot about this, and definitely different communities and different states have been using either risk assessment frameworks or hazards and vulnerability assessments (HVAs) and so on, and perhaps what needs to be added to those is a dimension or a set of dimensions that really gets at are you ready to go to support human recovery—the human element that might be missing sometimes from the existing assessments that some communities are doing.

To do a lot of that work on the front end, to not only figure out what support will need to be ready to go, but to also which NGOs are best-equipped, and has assets and capabilities to respond for particular needs, and make sure there is coordination among the NGOs (which is another theme that came out of our discussion—trying to stitch together the work of the NGOs in a more robust way).

Question:
Eric Evans: I may have missed it but are these findings published in a document that we can view and perhaps use for state-based legislation?

Anita Chandra: No, I don’t think they’re quite there yet. But given the fact that there are activities happening now (and I mentioned the National Health Security Strategy, which will effect everybody when it comes out, as well as the FEMA Recovery Framework)—getting some of these ideas and principles into that stage of development, I think is still important.

Certainly, there are additional opportunities to develop our evidence phase and get the research even more ready, but there is enough here that we’ve used it to inform the direction of the strategy for sure and certainly we hope FEMA will consider these elements in the National Recovery Framework.

Question:
Jordan Nelms: Have you had any interaction with the Evaluation and Modeling of the Emergency Preparedness and Response Services of Faith Based and Community Organizations (FBCO) project?

Anita Chandra: I have not. We have talked to some groups (I’m not familiar with that one), certainly a group at University of Southern Mississippi who is doing some work around faith-based organizations and disaster response, but we have not had a conversation with the group that you’ve referenced.

Certainly we know, particularly when we talk about psychological resilience, which is longer and never fully calculated in these recovery models, really benefit from the involvement of faith-based organizations. Exploring that and evaluating those models are important.

Question:
Cynthia Davidson: Have you looked at what it will take to support NGO personnel in the early recovery time? As an NGO after Katrina, I found that several things (housing, food, R&R) were put in place to support governmental staff, but while I worked side by side with them, I was not entitled to any support.

Anita Chandra: That’s a great question, and certainly a sentiment that came up in our data collection when we talked to the NGO leaders. It’s something that we would like to do. We are trying to find ways to support that more and to figure out what resources are needed for NGOs at all phases—before, during, after, and particularly the long-term after disaster period—and trying to assign some costs.

That’s one of the things from this analysis so that we can make a stronger case to federal entities about what resources should be set aside, particularly for NGO leaders who are doing the lion’s share of the work.

Question:
Avagene Moore: Anita, has anyone researched the impact of individual or family preparedness re: human recovery? I would think the more people know and take responsibility for related to preparedness AND recovery would help and should be part of an educational effort through NGOs, the ARC, or whatever means available.

Anita Chandra: I think that is absolutely an element to this. It shouldn’t just count for needs for services for the community or systems level to support those efforts. Certainly it’s part of the National Health Security Strategy and the orientation towards community resilience.

We talk about the importance of empowering families and individuals and making sure they have the resources they need for their particular circumstance, because that element is key to ultimately building the resilience of the community to respond and then recover as quickly as they can. Really evaluating that empirically has not truly been done. There are a lot of unanswered questions. We have a good sense that it matters, but to really put numbers or data behind it has been left common.

Comment:
Jean Peercy: We have heard about the impact of case management, but we have concerns about consistent construction management and what impact it has on the individual recovery plan and guidance of repairs and volunteer efforts.

Anita Chandra: That’s a good point. While we’ve focused on human recovery, it doesn’t mean to discount infrastructure recovery. In fact, we have a line in the report where we talk about how interdependent they are, because there is certainly psychological benefit to seeing your community rebuild, and having stops and starts and delays doesn’t help that.

What we are arguing for in this analysis is that we need to understand that interdependence, and know that they are so interrelated and we have to think more holistically about the larger recovery framework. Even if policy folks are not compelled by the human recovery element, they are compelled by the fact that getting infrastructure back up will get that work force back up, or get that community back up to be productive and viable.

They are inextricably linked; I agree with you.

Question:
Amy Sebring: I’m going to ask you to expand a little bit on the notion of pre-positioned contracts with these types of services. I think many of us in the business of emergency management are familiar with pre-positioned contracts for things such as debris removal. This may be a novel idea.

Anita Chandra: I think the pre-positioned contracts, and absolutely we’ve talked about it terms of debris removal or other kinds of more structural or building oriented kind of services—we’re talking about pre-positioned contracts for some of these first tier case management services that are kind of immediate and meet basic needs.

We’re also talking about pre-positioned contracts for organizations that can deploy relatively quickly when it comes to mental health services, whether it’s psychological first aid or other kinds of trauma based services. I don’t know that we’ve really had the full expanse of contracts available that really acknowledge that human end of things. Certainly, they could be improved on the other end.

Thinking about what are the resources of an individual or family going through a disaster, and bringing to bear all we know about trauma and disaster response, and then thinking about the organizations that are best equipped in a community to have the contracts ready to go so that there is no delay in terms of getting the professionals or paraprofessionals, or whoever, out the door to provide those services.

Amy Sebring: That’s going to depend somewhat on eligibility criteria in the Stafford Act, is it not?

Anita Chandra: Yes, when we talk about the current definition of case management services and what’s eligible, it’s not fully expansive enough to acknowledge that. The other thing that we talked a lot about, it came up a lot in our discussion but certainly something to consider (and a lot of organizations are doing this really well) is that case management needs to apply to the needs of families at the stage that they are at.

There are stages of readiness for different services, particularly mental health services, and to have some flexibility, in the Stafford Act as well as in the types of models that are available, to really acknowledge not only the length of time but the fact that service needs change as families and individuals move through the recovery period. There is really no definition or guidance that acknowledges that right now.

Question:
Amy Sebring: Another thing that I think we saw with Katrina was that the policies changed over time and would go in fits and starts, things were scheduled to end and they would extend it—so this type of advance acknowledgement of the length of time it takes would help, don’t you think?

Anita Chandra: I agree. I think what we argued about, we certainly had this opportunity uniquely to think about how a community is doing four years out; but certainly we have other models nationally and globally. That probably gives us a start of an evidence phase to know what people need. It’s now time to translate that science and that experience in to actual policy change. I think there is some inconsistency that people felt between the two.

Question:
Avagene Moore: What do you envision as the next step to expand the dialogue on long term human recovery on a national scale? Are plans underway that you can share with us?

Anita Chandra: As I mentioned earlier, we are continuing our work with HHS and the National Health Security Strategy is certainly a broad effort that focuses on lots of elements around health security and making sure that the population has the resources they need for health and safety. A large piece of it will be community resilience. I see the resilience and recovery are pretty linked.

For the next several months, we will probably be talking and going across the country and hopefully engaging some of the folks who are participating today and talk about what does resilience mean, and what investments need to happen both before an event, as well as in recovery. That is definitely a piece that Rand is having a large role in.

Additionally, we’re trying to get the information from the stakeholders that we’ve talked to up to folks, including folks who are working on the National Recovery Framework. We thinks that is the key national or federal lever, but we’d like to do some more work at a community level to try and think about whether there are demonstration communities that have lessons learned that we can pull together to inform our definition of human recovery. That would be great.

Definitely, the Health Security Strategy and the National Recovery Framework seem to me, right now, to be the most important things to get right when it comes to human recovery.

Question:
Amy Sebring: I think it’s definitely coming out very well at the end of the report, the research opportunities. I’m assuming you are not planning on doing all that research yourself; it would be nice to engage our research community?

Anita Chandra: I absolutely think that. We hope to always do these things in partnership, not only with the sort of traditional research community, but what we’ve done in the last several years with the HHS projects is try to think about how we’re always engaging practitioners and people on the ground to make sure that we have both sides represented.

We’re going to need to pursue this research. Now it’s about the logistics of getting it going. We’re definitely committed to partnering with others to get this going.

Amy Sebring: It did look like from the references that you had at the end of the report that at least you are familiar with the recent literature that’s out there (I’m sure you wouldn’t characterize it as an exhaustive literature review) but there is some basis for [the report recommendations].

Anita Chandra: There is some basis for it. The literature that we cited in this document (and this is relatively short, and we wanted to keep it that way) certainly, we’ve been looking at the literature quite a bit as we’ve been thinking about resilience and thinking about special needs and vulnerable populations, we’re starting to cull all of that research. But there are still gaps. Some of the key gaps are articulated at the end of the report.

Question:
Deon Pfenning: I got pulled away mid-presentation, so I apologize if this question has already been addressed: You spoke of FEMA putting together a "National Recovery Framework." Is there an established timeline on when this Framework will be available and is there a draft document accessible to view?

Anita Chandra: I don’t believe there is a draft document. We have actually been trying to get our hands on it as well. I think the process is just underway, so I don’t have information about the timetable. I think we’re all working on getting that information. I’m happy if I find something out, if there’s a listserv or a participant list, I’m happy to share what I find out. I only know the timetable on the Health Security Strategy, not the National Recovery Framework.

This is the time for people to try to the extent possible to inform that process of how they’re developing it. I know for the National Health Security Strategy we had regional meetings with local stakeholders and that was very important to us. I hope FEMA is doing something similar, but I don’t know.

Comment:
Eric Evans: In Missouri we have a state level partnership with NGOs, major religious denominations and state agencies. This has been in place since the great Midwest Floods of 1993. This system has been tested many times over the last few years as MO has been hit repeatedly with disaster declarations. This state-level body coordinates and facilitates cooperation at the state and local levels - thus the [previous] COAD comment. We are currently trying to engage the faith community to become involved at the state and local level to become resources at the local and regional level. Response has been fantastic - almost too good.

Anita Chandra: I know Missouri was involved in one of our regional meetings for the National Health Security Strategy, and the extent to which you are (I don’t know which public health district or region you are in) but they have that information. I think a lot of this is also sharing those innovative practices and lessons learned across state lines and pushing out things that are evidence based. I’m not sure how well that has gotten out to lots of folks, but hopefully that seems to be part of what you’re doing—moving forward, that’s great.

Comment:
Rey Thompson: While I support the idea of guidance being provided by the federal government, I find it difficult to imagine the issuance of guidance that is flexible enough to adapt to so many scenarios. Fortunately, training is available from FEMA and DHS to get local entities started thinking about recovery processes, such as community and economic development and individual assistance programs. I think the key is involving NGOs and emergency managers in those training opportunities.

Anita Chandra: I couldn’t agree more—I think that’s right. I think it is a challenge to write thing that are flexible. We definitely attempted to do that in some of the other work, the strategy development, to make sure that we have some guidance in there, but certainly allowed to be adapted for different contexts and different risk profiles that different states and communities are confronted with.

Question:
J.R. Jones: My most difficult challenge in casework in Katrina was the lack of secure housing (non-trailer) available to mid-to-low socio-income clients put in storm/disaster proof locations. Does FEMA or any other government organizations advise communities to put these in place?

Anita Chandra: We hear that in our work in the Gulf States. It might exist, but I’m not aware of it. I don’t think there is that sort of focus, from what I understand, from FEMA in respect to housing of that type. We are still trying to understand what the impacts of those housing situations have been on people in the Gulf States region.

Question:
Amy Sebring: Did anybody, as part of your process, share any anecdotes that illustrate (and you don’t have to name names)? I just wondered if there were some examples you could share?

Anita Chandra: I will say one of the things that people talked on and on about was even the difficulty with the NGO government coordination with the NGO- NGO coordination. That they didn’t have necessarily worked out, that certainly sounds as if Missouri and other places are may be further along.

It was because there wasn’t a commonly accepted centralized database on who was getting what services, people talked and gave examples with people’s names and so on about people who would either miss whole services or whole sets of services or there would be unnecessary redundancy. People would either fall through the cracks in terms of getting those kinds of recovery services, because they’re getting social services over here and mental health services over here.

People talked a lot about those kinds of family stories quite a bit. They felt like even a flexible framework with some guidance would help create better coordination and streamlining. A lot of times it was because they were waiting for some funding and maybe a family had to go to the next agency or the next NGO and then they would be lost. They wouldn’t know what would happen to that family. That was a lot of dialog that we had in that meeting.

The concerns that people have when they are trying to do a lot and obviously donating a lot of time for families because they care about these families, and having services not cover the full duration, knowing that the family is still in need and not being able to cover that length of recovery. That is the other frustration, and that’s probably the main motivation of pursuing this question.

Comment:
Avagene Moore: I heard a fascinating report given to the NEMA Response & Recovery committee this week in Ohio. David Miller, IA State Director, spoke on "The Road Back - Long-Term Recovery and the 2008 Iowa Floods." He spoke briefly about lessons learned and he will be speaking in the EMForum.org in the near future. You may want to listen in Anita, or you may wish to contact David and get his official report.

Anita Chandra: Great, thank you.

Comment:
Amy Sebring: The report is rather brief, especially when you get through all the front matter.

Anita Chandra: We kept it as sort of a thought piece. We wanted to talk about this meeting that we pulled together, but we really wanted the discussion, so it’s great to have this discussion today. There’s a lot of work ahead, for sure, not only through the national efforts but hopefully some local projects moving forward.

[Closing]

Amy Sebring: Time to wrap for today. Thank you very much Dr. Chandra for an excellent job, and taking the time to share these ideas with us. We also wish best in your future efforts in this area. Please stand by just a moment while we make a couple of quick announcements.

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