Chapter Appendix A - Recommendations
Section Human Services
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Critical Challenge: Human Services
Lesson Learned: The Department of Health and Human Services should coordinate with other departments of the Executive Branch, as well as State governments and non-governmental organizations, to develop a robust, comprehensive, and integrated system to deliver human services during disasters so that victims are able to receive Federal and State assistance in a simple and seamless manner. In particular, this system should be designed to provide victims a consumer oriented, simple, effective, and single encounter from which they can receive assistance.
Recommendations:
63. AssignHHS the responsibility for coordinating the provision of human services during disasters. HHS should serve as the single Federal coordinating agency, with full situational awareness across agencies, and manage the delivery of services by other Federal departments. HHS working with DHS should review and, as appropriate, amend the NRP to ensure a single point of contact for victims to access all applicable Federal human services in an emergency and a capable deployment plan to enable this effort.
a. Federal agencies with an ongoing role in delivering human services should be prepared to do so in a disaster environment. In addition to HHS, other Federal agencies have responsibility for providing human services. All Federal agencies responsible for the administration of human service programs should plan and prepare for the delivery of services in a disaster environment, with HHS coordinating and authorizing reimbursement for their respective disaster-related expenditures. Federal agencies that routinely deliver human services should build on established relationships with State and local agencies and private sector organizations, but also create contingency plans to assure the independent delivery of Federal assistance when necessary.
64. HHS should inventory all Federal human services. As part of this effort HHS should:
a. Inventory the range of human services programs of the Federal government. There are thousands of human service programs across the interagency, many of which are jointly administered by State and local agencies. A catalogue of available programs will facilitate the prioritization and delivery of services, especially during emergency situations.
b. Identify current statutory authorities that permit the waiver of impediments to the delivery of services during an emergency. Knowing which regulations can be waived will help responding agencies to more efficiently deliver services in emergency settings when speed is a high priority. Agencies should identify current waiver authority and impediments to service delivery and should provide HHS with suggested threshold criteria for triggering waiver authority. Agencies should also identify current authority for reimbursing disaster-related administrative costs and related impediments to reimbursing service providers for legitimate costs.
65. HHS should develop a simple, comprehensive, and efficient means for disaster victims to enroll for all available human services at a single encounter. Many important human service programs have wide variation in eligibility requirements. HHS’ coordination and integration role is vital in helping to simplify access to complex and varied human service programs. Upon completion of the inventory of programs and available Federal facilities, HHS should prioritize the delivery of human service programs and develop plans to establish “one-stop” centers where disaster victims would enroll in Federal, State, local, and non-governmental human assistance programs. These “one stop” centers should complement the continued and expanded use of simplified telephone and internet-based registration modalities. The goal should be for the victim to go to one physical location, encounter one person who gathers all the necessary data and inputs it into a database that is shared and transparent among all human service providers at the Federal, State and local level as required. This will likely increase efficiency, reduce frustration of evacuees and expedite the delivery of services for eligible recipients.
a. Task the appropriate Federal agencies to develop processes to assess disaster victims’ needs and process their applications for assistance within consolidated “one-stop” centers. These processes should avoid duplication of effort, employ streamlined in-take and case management strategies and foster the interagency administration of human services in a disaster area.
b. HHS working with DHS should work to include faith-based, community, and non-profit organizations in the emergency planning, preparedness, and delivery of human services. These private sector organizations contributed greatly to the Hurricane Katrina response. They should actively participate in all phases of a Federal disaster response and HHS should specifically facilitate access to their services in all “one-stop” centers.
c. HHS in coordination with DHS should oversee the development of deployable interagency teams to assess human service needs and deliver assistance. Created before the disaster, these teams can be deployed immediately to the disaster area to begin coordinating access to human services. These teams should be composed of knowledgeable and experienced Federal employees as well as personnel from State and local agencies and the private sector, as appropriate. They should serve in the “one stop” centers and also visit shelters and other locations necessary to facilitate the deliver of human services.
d. HHS working with DHS and the Department of Labor should inventory existing Federal infrastructure and resources which could be utilized for provisions of consolidated services to affected areas. Contingency plans should be developed for the utilization of Federal facilities, equipment such as phones, computers, and personnel on short-notice to provide consolidated services in response to a crisis. These plans should be exercised and evaluated on a routine basis.
66. HHS and DHS should jointly work with the private sector to encourage the development of a capacity to voluntarily store and retrieve personal identifying information. Encourage the private sector development of a capability for individuals to voluntarily submit their personal identifying information for virtual storage that citizens and their families could access during emergencies. The capability is best thought of as a 21st century version of a bank vault, with virtual safe deposit boxes for information. Disaster victims could access the virtually stored data to apply for Federal assistance, medical treatment, or insurance benefits. Because of the sensitivity of the personal data stored, strict privacy limitations and protections would be required. HHS should consider how their experience with Electronic Health Records (EHR) might inform such an effort.
67. Existing Federal sources of information should be identified which might assist Federal authorities upon an emergency or disaster declaration by the President. While numerous current Federal information sources exist (such as those maintained by SSA, DHS, VA, Treasury and the Department of Defense), they are not designed to identify or track individuals. Limited emergency access to existing Federal information sources should be considered and evaluated for their potential value in improving the Federal response. The development and deployment process must account for privacy, security, scalability, and compatibility
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