1. Laura M. Stough, Ph.D. Amy N. Sharp, Ph.D. Center on Disability and Development at Texas A&M University Working with Long Term Recovery Groups and Voluntary Organizations: Lessons Learned

2. National Headlines http://www.editorandpublisher.com/eandp/photos/2006/01/W2/EyesOfTheStorm_XL.jpghttp://www.editorandpublisher.com/eandp/photos/2006/01/W2/EyesOfTheStorm_XL.jpg; http://img.timeinc.net/time/photoessays/hurricane_rita_eye/images/splash.jpg; http://www.geofffox.com/MT/images/times-picayune-sunday.jpg; http://www.brendanloy.com/blog/images/times- picayune-aug29.jpg; http://www.palmbeachpost.com/news/content/news/photos/nppa_2005q3/images/BUPq305x1hm5.jpg http://img.timeinc.net/time/photoessays/hurricane_rita_eye/images/splash.jpg http://www.geofffox.com/MT/images/times-picayune-sunday.jpghttp://www.brendanloy.com/blog/images/times- picayune-aug29.jpg

3. Images of the Aftermath

4. http://www.gov.state.la.us/assets/images/photogallery/Katrina/8.28.07.jpg; http://www.usace.army.mil/katrina-images/DSC_0006.JPG Images of the Aftermath

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

6. Images of the Aftermath A rescuer carries a young man who is unable to walk to safety.

7. Deaf section for Hurricane Katrina evacuees at the Houston Astrodome. (Houston, TX., 9/10/2005 -- FEMA photo/Andrea Booher)

8. What do we know about the experiences of people with cognitive disabilities in disaster situations?

9. Cognitive Disabilities Psychological issues Psychological issues Mental retardation Mental retardation Developmental disabilities Developmental disabilities Traumatic brain injury Traumatic brain injury Mental illness/emotional disturbance Mental illness/emotional disturbance Autism Autism Pervasive developmental delay Pervasive developmental delay Alzheimer’s Alzheimer’s

10. Research on Cognitive Disabilities Very few evidence-based studies on disaster and disability Very few evidence-based studies on disaster and disability Even less research on cognitive disabilities Even less research on cognitive disabilities Research on cognitive disabilities usually conducted by clinical psychologists or psychiatrists Research on cognitive disabilities usually conducted by clinical psychologists or psychiatrists Theoretical approach most often used is Post Traumatic Stress Disorder (PTSD) Theoretical approach most often used is Post Traumatic Stress Disorder (PTSD)

11. Research on Veterans Murdoch, M., Van Ryn, M., Hodges, J., & Cowper, D. (2005). Mitigating effect of department of veterans affairs disability benefits for post-traumatic stress disorder on low income. Military Medicine, 170(2), 137- 140. Murdoch, M., Van Ryn, M., Hodges, J., & Cowper, D. (2005). Mitigating effect of department of veterans affairs disability benefits for post-traumatic stress disorder on low income. Military Medicine, 170(2), 137- 140. Lopes Cardozo, B., Bilukha, O. O., Gotway Crawford, C. A., Shaikh, I., Wolfe, M. I., & Gerber, M. L. et al. (2004). Mental health, social functioning, and disability in postwar Afghanistan. Journal of the American Medical Association, 292(5), 575-584. Lopes Cardozo, B., Bilukha, O. O., Gotway Crawford, C. A., Shaikh, I., Wolfe, M. I., & Gerber, M. L. et al. (2004). Mental health, social functioning, and disability in postwar Afghanistan. Journal of the American Medical Association, 292(5), 575-584. Ismail, K., Kent, K., Brugha, T. S., Hotopf, M., Hull, L., & Seed, P. et al. (2002). The mental health of UK gulf war veterans: Phase 2 of a two phase cohort study. British Medical Journal, 325(7364), 576-579. Ismail, K., Kent, K., Brugha, T. S., Hotopf, M., Hull, L., & Seed, P. et al. (2002). The mental health of UK gulf war veterans: Phase 2 of a two phase cohort study. British Medical Journal, 325(7364), 576-579.

12. PTSD and Individuals with Acquired Disabilities Mona, L. R., Cameron, R. P., Lesondak, L. M., & Norris, F. H. (2000). Posttraumatic stress disorder symptomatology in men and women with spinal cord injury. Topics in Spinal Cord Injury Rehabilitation, 6(1), 76-86. Mona, L. R., Cameron, R. P., Lesondak, L. M., & Norris, F. H. (2000). Posttraumatic stress disorder symptomatology in men and women with spinal cord injury. Topics in Spinal Cord Injury Rehabilitation, 6(1), 76-86. Martz, E., & Cook, D. W. (2001). Physical impairments as risk factors for the development of posttraumatic stress disorder. Rehabilitation Counseling Bulletin, 44(4), 217-221. Martz, E., & Cook, D. W. (2001). Physical impairments as risk factors for the development of posttraumatic stress disorder. Rehabilitation Counseling Bulletin, 44(4), 217-221.

13. Abuse of Children with Disability Westcott, H. (1991). The abuse of disabled children: A review of the literature. Child: Care, Health and Development, 17(4), 243-258. Westcott, H. (1991). The abuse of disabled children: A review of the literature. Child: Care, Health and Development, 17(4), 243-258. Sullivan, P. M., Jones, D., Garfinkel, L., & Sobsey, D. (1993). Sexual abuse therapy for special children. Journal of Child Sexual Abuse, 2(2), 117-133. Sullivan, P. M., Jones, D., Garfinkel, L., & Sobsey, D. (1993). Sexual abuse therapy for special children. Journal of Child Sexual Abuse, 2(2), 117-133.

14. Research on Pre-existing Psychiatric Disabilities Silove, D. M. (2000). The rights of the severely mentally ill in post-conflict societies. Lancet, 355(9214), 1548-1549. Silove, D. M. (2000). The rights of the severely mentally ill in post-conflict societies. Lancet, 355(9214), 1548-1549. Pandya, A. A., & Weiden, P. J. (2001). Trauma and disaster in psychiatrically vulnerable populations. Journal of Psychiatric Practice, 7(6), 426-431. Pandya, A. A., & Weiden, P. J. (2001). Trauma and disaster in psychiatrically vulnerable populations. Journal of Psychiatric Practice, 7(6), 426-431. Pandiani, J. A., & Banks, S. M. (2002). Terrorism and people with mental illness [letter]. Psychiatric Services, 53(11), 1475. Pandiani, J. A., & Banks, S. M. (2002). Terrorism and people with mental illness [letter]. Psychiatric Services, 53(11), 1475.

15. Cognitive Disabilities and PTSD Mitchell, A. & Clegg, J. (2005) Is post-traumatic stress disorder a helpful concept for adults with intellectual disability. Journal of Intellectual Disability Research, 49(7), 552-559. Mitchell, A. & Clegg, J. (2005) Is post-traumatic stress disorder a helpful concept for adults with intellectual disability. Journal of Intellectual Disability Research, 49(7), 552-559. Doyle, C., & Mitchell, D. (2003). Post-traumatic stress disorder and people with learning disabilities: a literature based discussion. Journal of Learning Disabilities, 7(1), 23-33. Doyle, C., & Mitchell, D. (2003). Post-traumatic stress disorder and people with learning disabilities: a literature based discussion. Journal of Learning Disabilities, 7(1), 23-33.

16. Lessons Learned… Research on various cognitive disabilities is extremely limited Research on various cognitive disabilities is extremely limited Focuses on trauma following war, abuse, or disaster Focuses on trauma following war, abuse, or disaster Disability can be the result of war, abuse, or disaster Disability can be the result of war, abuse, or disaster Some work on preexisting mental illnesses and disaster (Carol North) Some work on preexisting mental illnesses and disaster (Carol North)

17. Evidence-Based Approaches from Natural Hazards Researchers Social vulnerabilities (e.g. Peacock, Lindell, & Phillips) on groups found to be at greater risk for affect and slower to recover from disaster including: Social vulnerabilities (e.g. Peacock, Lindell, & Phillips) on groups found to be at greater risk for affect and slower to recover from disaster including: –Families living in poverty –Ethnic minority groups –Female head of household families –Elderly families

18. Lesson Learned… Poverty heavily affects both what groups are affected by disaster and the extent to which they are affected Poverty heavily affects both what groups are affected by disaster and the extent to which they are affected

19. Other Approaches… Deterioration of social networks and resources (North & Kaniasty) Deterioration of social networks and resources (North & Kaniasty) –We can reframe this theory as a loss of formal and informal supports in the disability community Resurrection of the case management model as a proposed vehicle through which services are coordinated and provided Resurrection of the case management model as a proposed vehicle through which services are coordinated and provided

20. Lessons learned about what these bodies of research do not tell us… Pre and post data on the effects of disaster on individuals with disabilities and their families Pre and post data on the effects of disaster on individuals with disabilities and their families A psychosocial narrative of experiences of individuals with disabilities during and following disaster A psychosocial narrative of experiences of individuals with disabilities during and following disaster Epidemiology of mortality, survivability, and psychological affects of disaster Epidemiology of mortality, survivability, and psychological affects of disaster Evidence-based data on the supports that are most effective for individuals with disabilities Evidence-based data on the supports that are most effective for individuals with disabilities

22. CDD Partners

23. Disaster-Related Projects Evaluation design for the National Disability Rights Network as part of the Katrina Aid Today case management consortium Evaluation design for the National Disability Rights Network as part of the Katrina Aid Today case management consortium Project design for the Texas Interagency Interfaith Disaster Recovery Case Management Project Project design for the Texas Interagency Interfaith Disaster Recovery Case Management Project Evaluation design for UMCOR’s Katrina Aid Today mid-point evaluation Evaluation design for UMCOR’s Katrina Aid Today mid-point evaluation

24. From top left clockwise: http://www.completessl.com/images/other/katrina2.gif; http://www.disabilityfunders.org/images/logo04-500.gif; http://tvworldwide.com/events/nod/051005/images/press_image.jpg; http://www.democrats.org/files/img/20051003_katrinaRA-btn.jpg; http://www.dhh.louisiana.gov/offices/images/imgs-77/lagovkatrina.jpg; http://www.rescare.com/web/main/ResCareReliefSm.gif; http://katrinadisability.info/images/ideas.jpeg; background: http://www.michigan.gov/images/hurricane_135421_7.jpg.http://www.completessl.com/images/other/katrina2.gifhttp://www.disabilityfunders.org/images/logo04-500.gif http://tvworldwide.com/events/nod/051005/images/press_image.jpghttp://www.democrats.org/files/img/20051003_katrinaRA-btn.jpg http://www.dhh.louisiana.gov/offices/images/imgs-77/lagovkatrina.jpghttp://www.rescare.com/web/main/ResCareReliefSm.gif http://katrinadisability.info/images/ideas.jpeghttp://www.michigan.gov/images/hurricane_135421_7.jpg Recovery Efforts

25. Collaboration with Non Profits and other Organizations US Peace Corps / Crisis Corps US Peace Corps / Crisis Corps National VOAD Conference in North Carolina National VOAD Conference in North Carolina Central Texas VOAD Central Texas VOAD Texas Interagency-Interfaith Disaster Response Texas Interagency-Interfaith Disaster Response UMCOR Disaster Response UMCOR Disaster Response Katrina Aid Today Case Managers Katrina Aid Today Case Managers Working Conference on Emergency Preparedness for Individuals with Disabilities and the Elderly Working Conference on Emergency Preparedness for Individuals with Disabilities and the Elderly Protect Texas Volunteers Protect Texas Volunteers

26. Lesson learned… Infiltration!

30. Education and Training Provide expertise and resources for County Extension Agents Provide expertise and resources for County Extension Agents Online training through the Texas Extension Disaster Education Network Online training through the Texas Extension Disaster Education Network Develop modules for use in training of Emergency Managers at Texas A&M’s “Disaster City”, Texas Task Force One Develop modules for use in training of Emergency Managers at Texas A&M’s “Disaster City”, Texas Task Force One Center for Homeland Security Studies at Texas A&M Center for Homeland Security Studies at Texas A&M

31. Lesson learned… Translation! We must learn the language of the existing emergency management system including its- -organizational structure -positions and their functions -terminology

32. Long Term Recovery Led by Voluntary Organizations Active in Disaster (VOADs) Led by Voluntary Organizations Active in Disaster (VOADs) Part of the National Emergency Management Plan Part of the National Emergency Management Plan Lead agency for a particular disaster is appointed by the local VOAD Lead agency for a particular disaster is appointed by the local VOAD Most organizations are faith-based Most organizations are faith-based Organizations have traditions of specialization Organizations have traditions of specialization

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

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

36. Katrina Aid Today-National Case Management Consortium Summary Chart for KAT Members by State

40. Lesson Learned: The primary long term recovery goals are the same for families with and without disabilities… The Journey is Just a Little Different

41. Photo by Kendall Kessel; April 2006

43. Project REDD: Research and Education on Disability and Disaster At the Center for Disability and Development at Texas A&M University