Flirting With Disaster: A Case Study

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Flirting with Disaster: A Case Study Author(s): Joan E. Pynes and Pauline Tracy Source: Public Performance & Management Review, Vol. 31, No. 1 (Sep., 2007), pp. 101-117Published by: M.E. Sharpe, Inc.Stable URL: http://www.jstor.org/stable/20447663Accessed: 21-08-2014 16:01 UTC

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CASE STUDY

FLIRTING WITH DISASTER A Case Study

JOAN E. PYNES University of South Florida

PAULINE TRACY Sarasota County Health and Human Services, Sarasota, Florida

ABSTRACT: When natural disasters such as hurricanes, tornadoes, and levee breaks occur; the focus tends to be on taking care of the immediate physical needs of residents, such as shelter; water and food, and acute medical services. The availability of power and water services, the removal of debris, and the availability of gasoline are the next concerns. Behavioral/mental health services, although criticalfor the victims 'recovery, tend to be lower on the emergency services list. This case describes the realization by community organizations in Sarasota County, Florida, of the need to be more inclusive and to include behavioral and mental health services agencies in developing service plans in the aftermath of natural disasters. The collaborative strategy they employed is discussed.

KEYWORDS: behavioral health and human services, emergency health services, hurricanes, mental health, tornadoes

In 2004, four major hurricanes hit the state of Florida with the force of winds at 111 miles per hour or higher. Hurricanes Charley and Frances were Category 4s,

and Ivan and Jeanne were Category 3s. Hurricanes are placed in five categories:

Category 1: winds of 74-95 miles per hour (mph); Category 2: 96-110 mph;

Category 3: 111-130 mph, Category 4: 131-155 mph; and Category 5: 155+

mph. The last time four hurricanes hit a state in one season was in 1886, when

Texas was pummeled. The 2004 storms destroyed 25,000 homes, and approxi mately 40,000 more were damaged. Damage was estimated at more than $17

billion. One hundred and twenty-six persons lost their lives.

Public Performance & Management Review, Vol. 31, No. 1, September 2007, pp. 101-1 17. C 2007 M.E. Sharpe, Inc. All rights reserved. 1530-9576/2007 $9.50 + 0.00. DOI 10.2753/PMR1530-9576310105 101



102 PPMR / September 2007

The Importance of Providing Behavioral/Mental Health Services

When natural disasters such as hurricanes, tornadoes and floods occur, the focus

tends to be on taking care of the immediate physical needs of residents, such as

shelter, water and food, and acute medical services. The availability of power and

water services, the removal of debris, and the availability of gasoline are the next

concerns. Behavioral/mental health services, although critical to the victims re covery, tend to get neglected, as they are lower on the emergency services list of

priorities.

Research indicates the importance of immediate behavioral health services following a disaster (ACT Recovery Centre, 2003; Cohen, 1998; March, Amaya Jackson, Murray, & Schulte, 1998; McCaslin, Jacobs, Meyer, Johnson-Jimenez,

Metzler, & Marmar, 2005; Redlener & Schang, 2006; United Way Success By 6,

2005). Although most stress-related behavioral health issues are not long term, immediate crisis counseling can make a difference for those who have been af

fected (ACT Recovery Centre, 2003). However, there has been only limited research regarding an integrated and

coordinated effort to address the health and human services needs during the disaster recovery period. The typical standard operating procedure is that each individual agency takes care of the service for which it is funded and then passes

the clients on to the next agency that takes care of another issue, until the clients

have been to several different human service agencies to meet all of their needs even then only if they are fortunate.

After Hurricane Charley hit Charlotte and DeSoto counties on August 13, 2004,

members of the Community Alliance of Sarasota County, an alliance of commu

nity organizations and individuals concerned with addressing health and human

services in Sarasota County, realized that there was not a coordinated and com

prehensive system in Sarasota County to address health and human service disas

ter issues. The Alliance's mission is:

To provide a focal point for community participation, guidance and oversight of health and human services in Sarasota County by establishing a framework for the optimum achievement of an integrated health and human services delivery system which will enable citizens to achieve their maximum potential and improve their overall quality of life. (Community Alliance of Sarasota County, 2002)

The governing authority of the Alliance is vested in its Steering Committee, which is comprised of representatives from various organizations. Table 1 identi

fies each organization represented on the Steering Committee. Each organization

decides who will serve as the organization's representative.

The health department and the major hospitals were working together; yet,

some key public agencies such as Florida Department of Children and Families,

Agency for Health Care Administration, Department of Juvenile Justice, and



Pynes and Tracy / FLIRTING WITH DISASTER 103

Table 1. Community Alliance of Sarasota County Steering Committee

Participant Types No. of Seats Organizations

Funders 12 Local foundations 2 * Community Foundation of Sarasota County

* Gulf Coast Community Foundation of Venice Local govemment 5 * City of Long Boat Key (vacant)

* City of North Port * City of Sarasota (vacant) * City of Venice * Sarasota Board of County Commissioners

State agencies 3 * Department of Children and Families, Sun Coast Region * Department of Juvenile Justice * Sarasota County Health Department

United Ways 2 * United Way of Sarasota County * United Way of South Sarasota County

Human/community service providers 23 Aging services 2 * Seniors Advisory Council

* Senior Friendship Centers Children/youth 2 * Community Youth Development service orgs. * Manasota Safe Children Coalition Advisory Council Court system 2 * Public Defender (Twelfth Judicial Circuit)

* 12th Judicial Circuit Court Criminal justice 2 * Juvenile Justice Council

* Sarasota County Sheriff's Office Developmental 2 * Florida Center for Child and Family Development disabilities * Loveland Center Education 2 * Sarasota Early Learning Coalition

* School Board of Sarasota County Health 3 * Community Health Improvement Partnership (CHIP)

* Healthy Start Coalition of Sarasota County * Sarasota Memorial Health Care System

Homeless persons 2 * Salvation Army (vacant) * Suncoast Partnership to End Homelessness

Housing 2 * Office of Housing and Community Development * (vacant)

Mental health 2 * Coastal Behavioral Healthcare * Mental Health Community Centers

Substance abuse 2 * First Step of Sarasota * Sarasota Coalition on Substance Abuse

General community 16 Business/economic 4 * Young Professionals Group development * Economic Development Corporation of Sarasota County

* Sarasota Chamber of Commerce * Suncoast Workforce Development Board

Client/consumer 2 * National Alliance for the Mentally Ill, Sarasota County representatives * Vocational Interagency Council Community plan- 3 * Friendship Volunteer Center ing and resources * Individual Citizen

* SCOPE

(continued)




Table 1. (Continued)

Participant Types No. of Seats Organizations

Community 4 * Hispanic Latino Coalition representatives * Manasota 2-1-1

* NAACP (vacant) * Students Taking Active Roles in Sarasota County (STAR)

Faith-based 3 * Diocese of Venice community * Jewish Federation of Sarasota and Manatee Counties

* Sarasota United for Responsibility and Equity (SURE)

Department of Elder Affairs were not included in the County's emergency man

agement plan. Also missing were community mental health service providers such as Coastal Behavioral Healthcare, Jewish Family and Children's Services, and Bayside Center for Behavioral Health; substance abuse treatment providers;

children and families at risk service providers such as the Sarasota Family YMCA

and the Boys and Girls Club; providers of developmental disability services such

as the Florida Center for Child and Family Development, the Loveland Center,

Easter Seals, and the School Readiness Coalition; and elder service providers. After Hurricane Charley, almost all human service and many faith-based organi

zations worked independently to deliver services to Charlotte and DeSoto coun ties without a coordinated effort by the entire system.

The health and human services response in Sarasota County was splintered

with different agencies providing the service they were funded to provide, but

there was no one looking at the entire array of services, including basic living

essentials such as housing, food, employment, and transportation. The behav

ioral health support systems were in place and working well, but independent of

elder care services, faith-based efforts, and other critical services. As a result, case managers from one of the mental health centers would work with individu

als and conduct crises counseling but were not necessarily providing case man

agement to the entire family and addressing unemployment, housing, food, or

transportation needs. There was no general case management for families to as

sist with all of their needs. For example, a child may have received crises coun

seling but her parents may have been out of work due to a damaged vehicle and

inadequate funds to pay for repairs.

The lack of general case management became obvious when the Federal Emer

gency Management Administration (FEMA) used the Stay-n-Play RV campground in Venice, Florida, as a relocation site for displaced persons. FEMA initially placed

over 250 displaced families from Charlotte County at the Stay-n-Play site in FEMA

trailers without providing any support services such as public transportation, health

services, or human services. Almost immediately, the issues rose to the attention

of the local law enforcement agencies, the public health department, the school




system, and local human service agencies. Displaced persons from Charlotte County who were moved into the Stay-n-Play campground became isolated be cause the RV campground was not located on the Sarasota County Area Transit

bus line (the only public transportation system), which presented a hardship be cause many of the residents had lost their vehicles in the hurricane. Without trans portation, they were unable to enroll their children in school, go to the grocery store, go to the FEMA site to apply for financial assistance, or go to the Depart

ment of Children and Families office to apply for food stamps and financial aid. They were also unable to go to the doctor or the local health department, seek crisis mental health and substance abuse services that are typically needed after a traumatic event, or seek other human services. Compounding the problem, many of the residents spoke little or no English and did not know where to seek help. The need for a coordinated, integrated, effective disaster response system for health and human services became readily apparent.

There were also dangers in the environment. At the campground was a lake with several alligators that were no longer used to people being in their habitat. The placement of the trailers in the previously vacant site also disturbed the nesting grounds for insects and other wildlife. The school system did provide transportation for the children enrolled in school but there were no after-school activities when they re turned home to the RV park. This resulted in some criminal mischief around the site including destruction of the laundromat. The Stay-n-Play management staff put the laundromat under lock and key, leaving the residents who did not have their

own transportation without the ability to wash their clothes. Residents, in turn, left soiled clothing piled up outside the facility, which became a health hazard.

Bill Little, the executive director of the Health and Human Services Center, called an emergency meeting of all human service agencies in Sarasota County to develop a plan to address the Stay-n-Play residents' issues. Although FEMA initially was reluctant to designate the site as a group site versus individual sites, it did so in response to the health and human services community's overwhelm ing concern. Designation as a group site allowed FEMA to provide on-location support services and resources, including financial assistance directly to the resi dents of the Stay-n-Play. Once all the key players were on board, services were brought to the displaced people in the Stay-n-Play site, which improved the situ ation. The health and human services community established a strong network that opened the lines of communication, not just among agencies, but also to the residents of the FEMA site. By forming this strong network, the health and hu

man services providers who knew and worked in the community were better able

to assist the FEMA support staff in providing much needed services. The Stay-n Play issues were addressed by multiple partners united in one coordinated effort.

As a result of the Stay-n-Play incident and discussions by the Community Alli

ance Steering Committee, additional gaps in the health and human service deliv




ery system were identified. The Community Alliance and the Sarasota County Health and Human Business Center worked together during 2005 to coordinate the health and human services response by establishing the Community Disaster Preparedness Committee (CDPC), which brought agencies together to develop a coordinated plan. The first meeting of the CDPC was held on March 11, 2005. The main purposes of establishing the CDPC were to (a) bring agencies together to coordinate services in the county, (b) demonstrate how community organiza tions can connect to the county emergency management system, (c) assist agencies in developing their own plans, and (d) work with surrounding counties to develop linkages in the event a regional response is needed (CDPC, 2005, Appendix A).

Their efforts resulted in the concept of a Health and Human Services Opera tions (HHS-OPS) Center, which would operate separate from, but in concert with, the County's Emergency Operations Center. HHS-OPS is staffed by community partners and focuses primarily on providing a coordinated response to citizens on health and human service issues following a disaster.

The Health and Medical Emergency Support Function was expanded to included human services. Through the CDPC, a framework was developed that grouped services into four areas: volunteers, elderly, children and families, and substance abuse and mental health services. A subcommittee of each of these four groups met throughout 2005 to develop coordinated disaster preparedness and recovery plans for their areas. When the HHS-OPS is activated, one or more representatives of

each of the four groups are present in the HHS-OPS Center. HHS-OPS was acti

vated twice in the 2005 hurricane season. The first activation was in anticipation of Hurricane Wilma, and the second activation resulted in the establishment of the Katrina Assistance Center. Neither was a full activation that warranted all CDPC members to be at the HHS-OPS for more than briefings before each event; how ever, this did seem to clarify roles and identify areas that needed improvement.

A significant amount of effort was put into reaching out to the faith-based

community to utilize their congregations as volunteers. In the past, the Friend ship Volunteer Center registered all unaffiliated volunteers and would have to call each one individually when they were needed. After Hurricane Charley, Vol unteer Reception Centers were set up in Sarasota, and over 2,000 individuals were registered as volunteers. By collaborating with the faith-based organiza tions in 2005, a system was established so one contact person was established for

each organization, but that one person had access to two, ten, fifty or hundreds of

volunteers and resources. Several breakfast meetings were sponsored by the Com munity Foundation of Sarasota and the Gulf Coast Community Foundation of Venice and were held to introduce the faith leaders to the concept. The response was positive as faith-based organizations had been trying to find a way to help

their community during a disaster. These new volunteers have already been called

on to assist with several disaster-related activities. (See Table 2.)




Table 2. Sarasota Community Organizations Active in Disaster Committee

Agency

1st Brethren Church (Sarasota Police Department Chaplain) Agency for Health Care Administration All Faiths Food Bank American Red Cross (volunteer) Bayside Center-Sarasota Memorial Hospital Board of County Commissioners Catholic Charities Coastal Behavioral Healthcare Community Foundation of Sarasota County Community Services Administration Department of Children and Families Department of Children and Families-Suncoast Region DHS Emergency Management FEMA-VAL Region First Step Friendship Volunteer Center Glasser/Schoenbaum Human Services Center Goodwill Industries Gulf Coast Community Foundation of Venice Healthy Start Herald Hospice Jewish Family and Children's Services Pine Shores Presbyterian-Long Term Recovery Organization Pinebrook Rehab & Nursing Center Sarasota County Health and Human Services Sarasota County School Board Sarasota Family YMCA Sarasota YMCA Senior Friendship Centers State Emergency Response Team Southwest FL American Red Cross Salvation Army Sarasota Sheriff's Office Tidwell Hospice United Way 2-1-1 of Manasota United Way of Sarasota University of Southern Florida Volunteer Organizations Active in Disasters-Emergency Management YMCA

Note: Current roster as of November 2, 2007.




In August 2006, the CDPC was renamed the Sarasota Community Organiza tions Active in Disasters (COAD). Most communities have a Volunteer Organiza tions Active in Disasters (VOAD) group, which is largely made up of faith-based and volunteer organizations that are activated if necessary during a disaster. Each VOAD is different, and some are much more active than others. The Sarasota VOAD was not very active, and many of their members were part of the CDPC, so a decision was made by the Community Alliance of Sarasota County and

Sarasota VOAD to merge the two groups. Because nonprofits, government repre sentatives, foundations, and other partners including the faith-based and volun teer agencies were involved, the Community Alliance members thought COAD was a more accurate term. Nationally, COADs are beginning to replace VOADs because members from a variety of organizations need to be involved in planning for and the execution of services after a disaster. As a COAD, more resources from the national, state, and regional agencies will be available if needed. The Community Alliance is also considering incorporating the existing Citizens Corps into the Community Alliance as well.

Importance of an Organized Local Response

During the 2004 hurricane season, there was no presence in the Sarasota County Emergency Operations Center of human service agencies or the faith-based com munity and, therefore, no formal linkages. People (e.g., volunteers, the faith based organizations, and human service agency staff) who did not already have a

disaster-related role wanted to get involved, but they did not know how, and the system was not set up to utilize them effectively. Many of the organizations that

provided services ended up delivering the service they thought was needed with out coordinating with other groups often leading to duplicate efforts.

Local public agencies play a critical role in the preparedness and recovery phase of a disaster and must ensure the health and safety of their citizens imme

diately after a disaster occurs. While state and federal assistance may be forth

coming, local governments must be prepared to have an immediate, effective community response until these additional resources arrive. Public officials have a responsibility to address the basic needs of their constituents. These needs are met through various methods. Some communities rely on existing social workers to provide case management to persons displaced as a result of a disaster; how

ever, this can overload the system, depending on the magnitude of the event. In

addition, an increase in the number of government entities that have privatized

social service provisions often means they no longer have social workers to pro

vide general case management. Instead, contract agencies are relied on to provide

those services. The public and private health care sectors have become increasingly

interdependent. For these two sectors to come together effectively, government




agencies need to develop networks and serve as the main link among organizations (Ford, Wells, & Capper, 2002). In the last two decades, the relationship between health agencies and other stakeholders has become increasingly complex.

Although the proponents of networks note they provide government with the flexibility to tackle problems that are beyond the scope of any single organiza tion, others caution about "dark networks" (i.e., networks engaged in illegal ac tivities that escape scrutiny [Raab & Milward, 2003]), and other researchers have noted that the use of networks can be a way of distancing state actors from con

troversial policy effects (O'Toole & Meier, 2004). Lasker and Weiss (2003) found that when public and private organizations involved in health and human ser vices have created partnerships with community stakeholders, the partnerships generate frustration more often than results. They found that it is difficult to build a productive working partnership among people and organizations from different backgrounds. Many partnerships do not survive their first year, and others falter in the development of planned interventions. When partnerships get beyond the planning phase, collaborative actions are often time limited, ceasing when exter nal funding ends (Lasker & Weiss, 2003, pp. 119-120). Competition among the stakeholders can lead to conflict during a critical time when cooperation is re quired. Unfortunately, coordination and the common interest can be thrown into a state of flux as coalitions regroup as a result of responding to a crisis.

Through the CDPC, health and human services agencies established relation ships that enhanced the coordination of disaster-related services. A plan was de veloped that outlined four areas of concentration: volunteers, elderly services, children and family services, and substance abuse and mental health services. Training sessions were held for health and human service agencies, neighbor hood associations, and the faith-based community regarding the County's emer gency management system and how these agencies can become more involved in the disaster recovery phase. Engaging the health and human service organiza tions and the public allowed Sarasota County to expand its capacity to respond to

a disaster by utilizing the relationships established among organizations as well as volunteers through the CDPC.

One Year Later-Providing Assistance After Katrina

Following Hurricane Katrina in 2005, Sarasota County, like many other counties in the South, had an influx of displaced persons from Mississippi and Louisiana.

Until that time, the need to include plans to assist persons who were displaced

from other states had not been included in local emergency plans. As the dis placed families came to Sarasota and attempted to access the health and human

service agencies independently, some found it difficult because they were new to the community. Many went to faith-based organizations for help or relied on




family or friends for support. Sarasota County Health and Human Services staff began receiving information from community partners involved in the CDPC, such as Manasota 2-1-1, the health department, and faith-based leaders, that there were displaced families in the area that needed generic case management ser vices. After assessing the situation with key partners, it was determined on a Friday to partially activate the HHS-OPS and implement the plan to establish a Katrina Assistance Center the following Monday. Due to the strong networks established through the CDPC process, the Sarasota community was able to acti vate a one-stop center to provide information and referral, some direct services, and, most important, a real person who would sit down with the family and listen, in less than 24 working hours.

Initially, the Katrina Assistance Center operated as a one-stop center with agen cies such as Jobs Etc., Department of Children and Families, All Faiths Food Bank, Sarasota County Area Transit, and the American Red Cross providing ser vices. Sarasota County staff and volunteers from several local agencies were used as case managers. Other human service agencies were notified of the opening of

the center and agreed to provide expedited services to the displaced persons. On Monday morning, the center was opened with few resources available. As word

spread in the health and human service community about the center, human ser

vice agencies, local faith organizations, the Community Foundation of Sarasota, and individuals donated gift cards, food, housing, clothing, and support. First Step of Sarasota, which had recently received a grant to provide disaster-related crisis counseling, provided immediate behavioral health services either at the one-stop center or at another location, depending on the needs of the displaced person. The Katrina Assistance Center was located at the main health department so there was immediate access to medical appointments and, most important,

medications that may have been left behind or had run out.

Most of the planning process focused on responding to a disaster in Sarasota

County. However, it became apparent that despite not being directly hit by a

hurricane, resources are still needed to assist other local governments or even other states. The community came together through the relationships that were strengthened through the CDPC process and provided an integrated, coordinated health and human service delivery system.

Lessons Learned

Disasters can have a significant impact on the service delivery system in a com

munity where existing services may already be stretched thin. The impact on

behavioral health following a disaster is documented in a report by the Florida

American Red Cross (Situation Report #39, 2005), which stated that the number of mental health contacts in Florida following Hurricane Wilma was 45,671 as of




November 28, 2005. This number is in addition to persons who were already receiving mental health treatment prior to the hurricane. A recent study conducted by the Mailman School of Public Health at Columbia University and the Children's Health Fund found that after Hurricane Katrina, mental health became a signifi cant issue for the victims. A significant number of children have emotional or behavioral problems that developed after the hurricane.

Parents, mothers in particular, scored very low on a standardized mental health screen ing tool-over half of the women caregivers scored levels consistent with clinically diagnosed psychiatric problems such as depression or anxiety disorders. (Redlener & Schang, 2006, p. 2)

Children whose parents scored very low on the mental health survey were two

and a half times as likely to have experienced emotional or behavioral problems after the hurricane; and several parents and caregivers reported difficulties in finding appropriate and accessible mental health services (Redlener & Schang, 2006, pp. 2-3). However, it is not clear whether most communities understand the importance of these services in addition to the basic safety and living issues that arise after a disaster.

The most effective response to a disaster is one that begins at the local level; devolution from the federal to the state to the local level only reinforces the im portance of establishing a health and human services plan to address disasters. With the greater emphasis on governing by networks, government often relies less on public employees in traditional roles and more on partnerships, contracts, and alliances to do the public's work (Agranoff & McGuire, 2003; Goldsmith & Eggers, 2004). As more and more health and human services are privatized, the agencies that participate in networks are seen as the public sector and are major stakeholders in the process. The network must work together to provide a seam less array of services to the general public. The expectations of citizens are that problems will be solved. It does not matter who solves them. There are different types of public management strategies, and public managers must understand

what type of network they are managing and what its purpose is before it can be

managed effectively (Milward & Provan, 2006, p. 1 1). To mitigate a disaster takes more than the County Emergency Operations Cen

ter and the traditional disaster-response agencies to be effective. Yearly commu nication and planning is required for community partnerships to be effective. When CDPC members were surveyed in November 2005 and asked whether time spent by attending meetings was a good investment, the response was posi tive. One member stated he wished he had spent more time participating in meet

ings. Another member stated that his involvement in the process prompted him to prepare an extensive disaster plan for his organization, which reduced the stress

level of staff in the days prior to Hurricane Wilma because they all knew their




individual post-disaster assignments (Tracy, 2005). Several members expressed their appreciation for the support given by the Gulf Coast Community Founda tion of Venice, the Community Foundation of Sarasota, the Community Alli ance of Sarasota, Sarasota County Government, and Sarasota County Health and Human Services for supporting the CDPC and providing leadership with out taking over the group. CDPC members believed the community greatly improved its use of volunteers over the past year, most significantly by inviting the faith-based leaders and their organizations to become a part of the planning process (Tracy, 2005).

The CDPC partnership was effective because it focused on resolving prob lems. Citizens and community organizations were involved in identifying prob lems, offering solutions, making decisions, and delivering services rather than relying on a hierarchical bureaucratic structure (Kettl, 2005). Training and the assignment of roles predisaster improved the community's use of volunteers. Vol unteers involved throughout the year are less inclined to lose interest. Experi enced volunteers recruited additional volunteers when they felt their time and efforts were appreciated and needed. A community that provides an immediate system of care to victims of disasters will enable them to stabilize their lives, physically and emotionally, which allows the victims to regain a sense of control that may have been lost during the disaster. Disaster recovery services provided by existing trusted agencies in the community are more readily accepted by di saster victims whose social support systems are no longer in place.

The Community Alliance of Sarasota County deserves credit for recognizing potential problems in its behavioral and mental health services delivery system prior to a disaster hitting the county. It initiated the formation of the CDPC, now Sarasota COAD, almost two years before a report by the U.S. House Bipartisan

Committee to Investigate the Preparation for and Response to Hurricane Katrina found the following government failures: adverse weather warnings were not heeded, despite 56 hours of notice; communication failures due to a lack of ad vance planning; information gaps, where information did not move between ju risdictions and within individual agencies; a lack of coordination across federal, state, and local units of government; a lack of training among a range of organi

zations at all levels; medical shortcomings, characterized by many problems in the field such as deployment, confusion, uncertainty about mission assignments, and red tape; government failure to plan for the role of the private sector, a lack of

shelter and temporary housing; a failure to execute plans; and the most basic

concepts of public administration were frequently applied either late or not at all

(Ink, 2006, pp. 801-802; Menzel, 2006). The Community Alliance of Sarasota County recognized voids in its behav

ioral and mental health delivery systems and invited new partners to be part of its

planning and service delivery system. The agencies that comprise Sarasota COAD




are linked to the county's comprehensive emergency management plan. With this foresight, should a disaster occur, behavioral and mental health services will be delivered.

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Raphael, B. (1986). When disaster strikes. New York: Basic Books. Redlener, I., & Schang, G. (2006, April 17). Responding to an emerging humanitarian

crisis in Louisiana and Mississippi: Urgent need for a health care i( Marshall Plan."

New York: Columbia University Mailman School of Public Health and the Children's Health Fund. Available at http://ncdp.mailman.columbia.edu/files/marshall_plan.pdf, accessed April 24, 2006.

Tracy, P. (2005). An integrated and coordinated health and human services approach to disasters. Public Administration Program. University of South Florida.

United Way Success By 6. (2005, September 29). Special Edition SB6 Newsletter: Chil dren & long-term hurricane rebuilding. Available at http://national.unitedway.org/sb6/, accessed August 4, 2007.

Appendix

COMMUNITY ALLIANCE OF SARASOTA COUNTY Community Disaster Preparedness Committee

MEETING SUMMARY March 11, 2005

Invited Committee Members Present: Alex Young United Way of Sarasota County Bill Little Sarasota County Health Department Bob Carter Senior Friendship Centers Diana French Volunteer Connections David Harrawood Sarasota County Emergency Services Major Bert Tanner Salvation Army-Sarasota Corps Bryan Pope Salvation Army-Sarasota Corps Inaki Rezola American Red Cross Dr. Carrie Springer Coastal Behavioral Healthcare, Inc. Stewart Steams Community Foundation of Sarasota County Chris Stewart First Step of Sarasota-FE MA Region 4 Linda Wagner Hospice of Southwest Florida Kim Kutch DCF-Suncoast Region Alberto Suarez United Way 2-1-1 of Manasota Rev. Dr. Tom Pfaff Goodwill Industries Dr. Kay Glasser Human Services Advisory Council

Invited Committee Members Not Present: Bob Bems VOAD Ken Alexander Sarasota Memorial Hospital Shannon Staub Sarasota Board of County Commissioners Vanessa Carusone City of North Port Lois Natiello DCF-Suncoast Region Dave Beesley First Step of Sarasota Carl Weinrich Sarasota YMCA Mike Bigner Gulf Coast Community Foundation of Venice




Others Present: David Turner FEMA Region IV Voluntary Agencies Liaison Aleda Kleckauskas Hospice of Southwest Florida Roy McBean United Way 2-1-1 of Manasota

Staff Present: Chip Taylor Sarasota County Health and Human Services Jeanne Hodaian Sarasota County Health and Human Services

The first official meeting of the Community Alliance's Community Disaster Prepared ness Committee (CDPC) was held on March 11, 2005, at the Community Foundation of Sarasota County, 2635 Fruitville Road, at 9:00 A.M.

Alex Young, Committee Chair, welcomed the invited members and guests and introductions were made. Alex confirmed the proposed name of the new committee being formed-Community Disaster Preparedness Committee-and provided a general overview of the committee's purpose.

Overview and Purpose of the Community-Based Disaster Preparedness and Response Initiative

Bill Little provided an introduction of the community-based preparedness concept and introduced Jeanne Hodaian. Jeanne offered a brief overview and purpose of the proposed Community-Based Disaster Preparedness and Response Initiative and provided a handout of the presentation information. Members also were provided a copy of the Gulf Coast Community Foundation of Venice's Interim Report (Dec. 2004): Lessons Learned, which is a review of the regional disaster response. The following points were highlighted in the presentation:

1) The community-based initiative will create a framework for disaster preparedness for Sarasota's human services delivery system, ensuring coordinated preparedness, response and recovery plans that are linked with the county's emergency manage ment plan.

2) The initiative will broaden the scope of the County's Emergency Support Function 8 (ESF 8) from just health/medical to include human services as well.

3) The plan addresses key problems identified during the 2004 hurricane response activities, increasing agencies' response and recovery capacities and improving coordination of volunteers at multiple levels.

4) The initiative will reduce and/or eliminate duplication of activities and improve coordination and communication through planned processes and procedures outlined in standardized disaster plans.

5) The plan takes a three-pronged approach to partnership building. Core human service agencies that serve vulnerable populations throughout the county are targeted first. These are designated as "Tier 1" agencies and will be the focus for initial partnership-building activities. Agencies in this category would include Senior Friendship Centers, Coastal Behavioral Healthcare, First Step of Sarasota, DCF, YMCA, the Salvation Army, and others of a similar size and scope. "Tier 2" agencies would include smaller community-based, non-governmental human service providers. "Tier 3" agencies include faith-based organizations, assisted living facilities (ALF) and skilled nursing facilities (SNF), and other organizations or businesses to be identified.

6) A model disaster plan format based on the state/national disaster response plan (NPR) will be developed. The model plan will not replace existing agency plans, but




provide guidance to agencies for the enhancement and expansion of their plans, ensuring that an all-hazards approach, interagency linkages, and communication and coordination procedures are standardized across plans and linked to the local comprehensive emergency management plan (CEMP).

7) Disaster preparedness education and training activities will provide target audiences with core competencies and operations skills relevant for effective disaster prepared ness, response and recovery activities for staff functioning at the Command Post level.

The timeframe calls for Tier 1 partnership development and training activities to be completed by the beginning of the 2005 hurricane season (June).

Discussion

Bill Little clarified the concept of the county Emergency Operations Center (EOC) and its emergency support functions (ESE), with particular reference to ESF-8 (Medical! Public Health) and ESF-15 (Volunteers & Donations), explaining how these functions would be expanded and enhanced through this proposed initiative. Additionally, Chip Taylor added that part of the plan is to use the Health Department auditorium as an ESF 8 Command Post, where the key human service agencies would be located during a disaster response and recovery event, and for pre-event staging and training area.

Linda Wagner (Hospice of SW Florida) stated that hospices and larger ALFs and SNFs should perhaps be added to the Tier- I category.

Training issues were broached by various participants. Linda Wagner noted that the USF School of Social Work has a Trauma Training Program that may be worth review ing with regard to mental health issues in disaster response and recovery. Several individuals also pointed to the importance of integrating spiritual care with mental health care activities that should be included in training curricula. Bill Little announced that the University of Miami's Department of Epidemiology and Emergency Prepared ness Center (DEEP) will make a presentation at the Community Alliance meeting on March 21 to describe their behavioral health curriculum in disaster response and how they could be of assistance in meeting the behavioral health training needs of agencies in the community. David Turner of FEMA noted that there are a variety of training courses on the FEMA Web site (www.fema.gov).

Dr. Carrie Springer emphasized the need to consider a system for pie-identification and/or pre-credentialing of behavioral health volunteers in order to decrease problems encountered by her agency's staff when volunteering at various organizations, where agency policy required re-credentialing.

Bill and others noted that a variety of subcommittees may need to be created to facilitate planning activities for different agency types and populations, such as behav ioral/mental health and related agencies, faith-based agencies, elderly and others to be identified in future meetings.

Dave Harrawood highlighted the importance of having a clear understanding of all of the resources available from each agency in the collaborative. It was noted that a matrix of agencies and resources will be developed.

Roy McBean and Alberto Surarez discussed the capacity of the United Way's 2-1-1 database as an importance resource in registering agencies and creating a database of collaborative agency resources. Alberta said the 2-1-1 database technology offers the capacity to collect and utilize all of the agency resource information needed for the community-based effort (www.uw2 1 manasota.net).

David Turner observed that other counties have very active VOADs and other agencies that we can coordinate with in our plans for inter-county preparedness activi




ties. Bill Little and Bob Carter both reinforced the importance of the inter-county coordination.

Chip Taylor asked if there are other agencies that we should include in the commit tee, requesting that members inform us of other stakeholders we may want to invite to participate on the committee. Suggestions should be sent to Jeanne Hodaian at the Health Department.

David Harrawood stated that the State Emergency Management Office may be transferring responsibility for the persons with special needs (PSN) shelters, placing this under the Department of Health.

Linda Wagner said that the recovery component in agency plans is essential; this is an area where many plans were lacking and/or hugely inadequate last year.

Rev. Dr. Tom Pfaff broached the issue of how best to integrate faith-based organiza tions into the disaster preparedness planning process. He suggested that the tiered approach may be a good one that can be adapted to the multiple levels within the faith based community. It was pointed out that creating a subcommittee of the Community Alliance's faith-based members and charging them with planning this process and developing standardized, coordinated plans for the faith-based agencies might be a good way to approach this.

Inaki Rezola and others raised the issue of Sarasota County's VOAD and the importance of working with VOAD to build their capacity in disaster preparedness response and recovery activities, using this collaborative forum.

Stewart Stearns stated that we may want to consider having a subcommittee of local funders as well, ensuring funder perspectives and involvement in preparedness planning and response.

Next Steps

Jeanne requested that agencies complete the questionnaire sent with the agenda and return this to her by email. This will start the process of identifying strengths and weakness in agency plans that may be a focus for the plan revisions and also begin self identifying resources and activities that they have to offer in future disaster events.

Alex requested that each agency share its current disaster plan with us, so that we can start identifying the best way to fit the model plan with current agency plans, without asking agencies to create new disaster preparedness plans.

Jeanne agreed to send participants the contact information from the Committee Roster. She also will develop a "glossary of terms" for disaster preparedness and response to assist individuals/agencies unfamiliar with the various acronyms and provide definitions of core concepts in the emergency preparedness field.

Joan E. Pynes is a professor of public administration at the University of South Florida. She is the author of Human Resources Management for Public and Non profit Organizations (Jossey-Bass, 2004). Her interests are public and nonprofit management.

Pauline Tracy received herMPAfrom the University of South Florida. She began her

employment with the Department of Children and Families and served in multiple positionsfrom public assistant specialist to deputy district administrator She is pres ently the human services policy coordinator for Sarasota County, responsible for managing the administrative functions of the Human Services Department.



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