Case Management

Draft

Definition

Case management is a key function and role of post-disaster recovery. 

 

If you're unfamiliar with the concept or practice of case management then here's a handy definiton from the National Association of Social Workers:

 

    The practice of case management varies greatly across social work settings and is even more diverse as applied by other professionals. Despite this diversity, several elements distinguish social work case management from other forms of case management.

 

    Social work case management is a method of providing services whereby a professional social worker assesses the needs of the client and the client’s family, when appropriate, and arranges, coordinates, monitors., evaluates, and advocates for a package of multiple services to meet the specific client’s complex needs. A professional social worker is the primary provider of social work case management. Distinct from other forms of case management, social work case management addresses both the individual client’s biopsychosocial status as well as the state of the social system in which case management operates. Social work case management is both micro and macro in nature: intervention occurs at both the client and system levels. It requires the social worker to develop and maintain a therapeutic relationship with the client, which may include linking the client with systems that provide him or her with needed services, resources, and opportunities. Services provided under the rubric of social work case management practice may be located in a single agency or may be spread across numerous agencies or organizations. (underline mine)

 

Case Management and Community Disaster Recovery

Case management is a critical component for community recovery.  An emergency that causes signifiant disruption to a community is most likely a rare or unknown occurance. Post-disaster recovery assistance is (often) unfamiliar territory for those affected by disasters. Case managers guide/prod disaster-affected clients through the recovery process.

 

The underlined portion of the quote is critical to understanding delay and confusion for affected individuals. Post-disaster case management has typically been organized and run by a collaborative group of non-governmental organizations.  These organizations have developed their case management expertise in non-disaster settings deailng with everyday emergencies like unemployment, child care, psychological or medical referrals, and housing (among many other emergency situations).

 

Like any disparate organizations working within the same general business space, there are different methods of approaching similar problems and different specialties within each of the agencies. So while the agencies have similar meta-needs their individual preferences may be slightly different. The case management ecosystem is relatively stable in non-disaster situation as everyone has a decent understanding of the strengths, weaknesses, personalities, and capabilities of each other.

 

 

Government, NGO's and informational assurance

A key point of understanding in this environment is that government programs and agencies are viewed as source of resources and money. Government is not viewed as an ally. Government is required to attach strings to the money it allocates to social services. It needs to know names, numbers, and the quality of the intervention (for performance indicators). Government would want to know the shoe sizes of the aid recipients if it could reliably capture that information.

 

Individuals and agencies in governmental social service agencies may not care or want any of this information. There may be an official, if unspoken, rule in a municipality that people are asked for their age rather than date of birth to avoid identiying information.  At some point, though, there's a justified fear that someone, somewhere in the mass of government someone will use information gathered through social service case management to target and persecute a vulnerable individual.

 

Non-governmental case management agencies work with the most vulnerable populations. The destitute, hungry, sick, physically or mentally impaired, undocumented, squatters, and unemployed are served by the non-governmental case management agencies. NGO case management agencies don't trust government with data about these vulnerable populations.

 

Responsibility to protect and recovery assistance

The nongovernmental sector ...to be continued

 

Case Management software

Social Worker- IT Disconnect
Open Source Alternative

 

 

Next topics:Coordinated Assistance Network (CAN) and other internal proprietary systems vs. open source CiviCase.

Technorati Tags     Open,Management,Case,Source

Distilled orientation

Draft

One of the most iteresting ideas to come out of this 2006 report from the National Defense University is the focus on intensive training to align orientations for complex/critical situations. I am only a few pages into the essay but this got me thinking about the current training methods for emergency management planners and coordinators. What is the overall strategy right now? I won't/can't answer that question because of job responsibilities and liabilities.

What should the focus for training, response and planninig efforts? Training, planning, and response should be coordinated to adapt and adopt to unkown circumstances and windfalls. Stealing from the computer world, disaster training and organiztion needs to be made more extensibile. Wikipeida defines extensibiliity to mean  "a system design principle where the implementation takes into consideration future growth."



Extensibility
Network input/output configurations
transparency as a method
Actively choosing intense training for the few over widespread overviews of the many

IT SECURITY: UR DOIN IT RONG

draft

I'm going to quote a blog post in its entirety (I'll try not to do this too often)

Just a quick hit on this Intel-sponsored survey: apparently, employers think millennials like me are good employees, but that we're a risk when it comes to IT security. (Believe me, the intersection between millennial and IT prompted me to title this post LOLCats style: IT SECURITY: UR DOIN IT RONG). I think this speaks to evolving norms of security and privacy. I would be that a lot of employers' perceptions are based on the fact that people my age post a lot of stuff on facebook, have, or had, personal blogs, etc. But I think that's not actually super-relevant for professional IT security. Just because people put stuff out there doesn't mean they don't care about information being secure; rather, their standards for what NEEDS to be secure are different. Just because Paris Hilton got her sidekick hacked doesn't mean she's careless with her information; it means the hardware she's using is vulnerable. In a world of telework, among other things, agencies are going to have to come up with new, goof-proof ways to keep information secure. But a more open, tech-savvy generation isn't inherently an IT security risk. (bolding mine)

I think that Alyssa contradicts herself here.  Immediately after saying that the millennial generation posts information everywhere, she says that it's not a security risk because of standards for security risk are different.  That's like saying it's OK to have one person playing tackle football when everyone else is playing soccer.  When there are two competing rule sets, the group that is out of power but trends to information openness is automatically viewed as a security risk.  Hell, I know much of the open source world is a security risk. I just happen to weigh the benefits of openness much greater than the benefits of total information security.

I don't doubt (well, I hope) that Alyssa has a more nuanced view of IT security vs. openness, I just think that the nuance is a necessary part of the discussion to further the cause of transparency into the security conscious older generation. I don't want to have to wait for the boomers to die off to live in a more transparent world.

Social Networking, Trust, and Disaster

Draft

I riffed a few days ago on Twitter and its potential uses in disaster. Fester, over at Newshoggers (thanks for the plug Fester!) responded to my post and added a bit of analysis at the bottom which I glossed over as a basic assumption for understanding the value and drive/cause of iterative improvements

Legitimacy in today's world is based upon trust.  Good information that is widely distributed through a variety of common channels improves trust.  It also relieves the responding agencies of a massive command and control problem of evacuation and crisis avoidance.

But what is trust in social networking, how is it established, and what does it mean in crisis situations where there will be many interactions based on trusting the reportage of strangers?  After all, there are millions of people in city like New York and no one person can remember all their names.

Trust can be established in many ways through social networking. The lowest barrier to trusting information is to know the person in real life.  That person is not likely to be useful for reporting on crisis or emergencies. Your friend simply isn't likely to be an eyewitness on the scene of a particular disaster you're wondering about (unless you care very intensely about the disaster because of the relationship).  The second lowest bar is the friend of the friend or friend of the colleague, colleague of the friend. You trust a person that a person you trust trusts --say that five times fast.  The next level of distance is the voice of demonstrable expertise. We have these in real life, Jane Jacobs called them the neighborhood characters that are the bedrock and enablers of any community. Their expertise, whether it be in astrophysics, the relative merits of deli egg sandwiches, or disaster technology, is widely acknowledged by the general public and are trusted based on their demonstrated expertise.

Now here is where technologically boosted networking becomes a bit disjointed from our flesh and blood reality; there are non-experts without immediate or secondary connections to you who you will be relying upon to ort their experiences during disaster. Why should you trust them?

You end up with an extended network of friends, friends of friends, experts and trusted strangers because there is an implicit trust that is built into the fabric of those connections.  Knowing a particular individual, and being on the same technological extension of a social network, and knowing about a topic and finding another interested person passionate about that topic become one and the same.  Because of each individuals orientation, training, religion, schooling, preference for smooth over crunchy peanut butter, they have found a level at which they can communicate across/through unfamiliarity. Strangers find common cause through parallel orientations.  Those parallel orientations, over time, build into a more cohesive trust that can be translated as if the referral were a friend of a friend.  

I read an interesting blog post about the different types of twitter users (I cannot find the link) where there were basically broadcasters and engagers, and the difference was readily apparent by calculating the ratio of followers to followed and by monitoring how many tweets were replies or question redirects (@'s and Retweets-RT in tweetspeak).  When you include this basic caluclation on top of hte multiple level orientations, as Fester mentions below in comments, you have a valid social network that can provide relatively good information in a rapid response time frame.  The information can be assumed to be as valid as any median person could establish in the same time frame.

Now to respond to the second sentence of Fester's quote above- how does Twitter relieve the command and control function of an emergency manager or central control point? Participation in Twitter- in building and maintaining the relationship, networks and trust- enables large movements of people to self regulate based on information being provided to them by people they trust they can trust (not a typo).  The quick updates of twitter allow frequent adjustments to be made by everyone in the network. Broadcasted disagreements with the initial reporting lead to a quickly resolved situation where the facts quickly win out (I know this anecdotally only).  Twitter was wisely designed as an impersonal social network. If someone provides bad feedback, their feed can be dumped without residual social implications in a way that facebook friends cannot.  In this way, Twitter is even more quickly the best stream of corrected information.  

Public safety agencies and personnel should learn to take advantage of the self-correcting mechanisms inherent in an  impersonal, but trust based social networking tool that increases the penetration of good information.  There may need to be legal caveats to the methods by which public safety agencies can participate, and there would need to be an experienced bullshit detector at the tweeting keyboard, but there is no reason to expect a net loss of utility and safety from twitter.  If Bin Laden hacked Oprah's account and started tweeting, the account would quickly be ignored and would lose influence.

I will soon have another post of my response to fester's double-edged sword argument.

Gadgets and Gizmos

Draft

This is a post about the recent attacks on Mumbai.

I thoroughly enjoy the work 37signals does promoting themselves and their products. I don't even need a disclaimer; Not only am I completely unaffiliated with any of the partners, I don't even use their products. I am, however, a rabid consumer of their blog and book. 

Their entire focus is on overperforming while un-delivering.  They take keep it simple stupid to its brilliant extreme.  Choose the most basic tool that does the job and make that tool the best damned widget imaginable but realize that the process is iterative.  To get to that end killer app you should throw together as many practical drafts as possible and make them live to real life conditions so as to expose the flaws. 

Like I said above, this is a post about Mumbai, in particular the tools that the terrorists used to create their mobile network that could keep inside the decision cycle of millions of minds.  John Robb at Global Guerillas has a post up called "Off the Shelter Leverage" where he gives a preliminary (final?) list of the off-the-shelf technologies that were fused with group cohesion to create a cascading system affect in a major metroplitan area.  My question is, where was the off the shelf response?

The terrorists didn't have to go through a year long RFP and procurement process.  They had the flexibility to shop, compare, buy, and modify their own tools. Compare that to the procurement process for a government agency, even (particularly?) in the security realm.  While the security forces probably had more advanced technology, or more "secure" technology, the terrorists didn't care.  The terrorists were able to take advantage of the ocean of masking signals to stay anonymous - official security relies on dedicated services.  Terrorists modify their equipment to meet changing needs. Government has standard issue supplies.


http://blog.wired.com/defense/2008/12/the-gagdets-of.html

Twitter

Draft

Twitter is a mobile social web application designed to allow the efficient sharing of micro-thoughts in 140 character bursts.  In normal times people use Twitter to answer some very basic questions:

• What are you doing now?
• What are you thinking now?
• What's got you puzzled/troubled?
• Where can I find homemade bagel bites in the East Village at 3 a.m on Thanksgiving?

One of the emerging focuses, particularly after the Mumbai terror attacks, is on the disaster or crisis applications of a service like Twitter. (Follow all the links in this post at Weblosky for a brief survey of the mixed opinions of Twitter's efficacy during crisis.  Those opinions range from (paraphrased)

1. "Of course distributed citizenry should be contributing on-scene reportage- it works! We rule!"
2. "There's an unhealthy signal to noise ratio coming out of the scene but Twitter helps because it usually self-corrects pretty darn quickly"
3. "Dirty Fucking Hippies - Leave the reporting to the pro's and go back to your commune"

As you might be able to tell, I disagree with the third way. I see no practical reason to ignore the large portion of the population that is on scene and reporting an incident, even if they might be wrong. I want to know what people are thinking, especially if they are wrong. Twitter is a tool where, if a public safety agency was quick and smart enough, they could correct public misconception quickly and relatively painless without relying the market penetration of traditional mass media. After all, who's going to go throw on a noisy TV or Radio when there's a mass murderers appearing out of no where and shooting into a crowd?

I also disagree with the first of these reactions, but only to a degree. I love the idea of an informed citizenry exercising their right to communicate in normal times but even more so during times of stress.  And so my support must go to the opinion smack dab in the middle at number two. There's a saying I've heard many times that, even through "official" channels that 90% of the information coming in the first couple hours from the scene of a large incident is gunk anyway.  All I want in the first few minutes, hours, of an incident is to know that there is buzz in the citizenry and that, yes, something is happening, stay alert.

Stay alert. That's half the battle right there.

Once people have been alerted to an incident, Twitter's quick iterative fact checking will win the day. These distributed information loops will be particularly effective with that enterprising public safety agency, calling LAFD/and halfheartedly LAPD, interjecting "official" news to aid the acceleration of correct information throughout the social network. 

The ideal Twitter-like tool would have to be location aware and be hosted on broadcasting mobile devices to be able to create low/no official network ad-hoc wireless mesh....but that's a post for another day.

Urban discrimination in the Stafford Act

Draft

Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act) is the law of the land for federal emergency management and disaster relief. The act not only authorizes FEMA's existence, but it also lays out the scope and particulars of the agency and how federal resource may be allocated for national, state, and local response.

There are many problems with FEMA. Some of them are due to personnel, others political, but today's FEMA rant is about policy.  When a disaster hits you and destroys a significant portion of your livelihood and home, the last thing you're really worried about is FEMA's paperwork. All you want to do is recover from the disaster as quickly and wholistically as possible. You don't care where the money comes from, all that matters is that you're able to afford a motel room, some gas for your car, and the plywood and contractors to fix your roof.  FEMA, through the Stafford Act, is even obligated to assist you in those efforts.

The immediate needs- things like food, water, baby formula, and medicine fall into the category of "critical needs" while the longer term fixes to your house, intermediate sheltering, and car repairs/replacements fall under FEMA's Individual and Households program.  The Stafford Act places a cap on combined aid (critical needs+Individuals and Households) going to households at a flat ceiling that is adjusted annually by the National Consumer Price Index (CPI-U) that is calculated by the United States Department of LaborBureau of Labor Statistics.

In 2000, FEMA's cap on individual assistance was set at $25,000 to be adjusted annually based on the National Consumer Price Index. This has resulted, in October 2008, to an adjustment for assistance to $30,300 per household. I have no argument with the base sum of money available via grant. That's not my complaint and it is a valid policy option to have a low grant total so as to incentivize the population to better insure themselves against risk. After more study of the issue, I may ask for a base increase to the funding amount.  That's neither here nor there.

FEMA is in the recovery service business.  By pegging the adjustment of the cap for individual assistance to the National CPI as opposed to the more local Regional or even more local Metropolitan Statistical Area CPI, FEMA is effectively providing more recovery for areas that had been lagging indicators for the CPI. They are able to afford moregoods and services with which to recover as compared to an urbanized environment.  For any absolute value enforced across the board, the urban dweller loses as they have less purchasing power.

FEMA should focus on providing equity in recovery services and stop focusing on dollar for dollar parity.

But I guess this is what happens when the Dakota's get four desks in the Senate.

NOTE - I am working on some calculations to show the disparity between the outliers taken into account by the CPI all urban areas vs. regional vs. Metropolitan Statistical Areas but I'm having some difficulties. I can't seem to recreate FEMA's accounting that created the new $30,300 threshold. The closest I've gotten is $30,494 assuming I perform the calculations using September to September as the base fiscal year.  I'll be re-examing this in the next few days to try to nail down the discrepancies.

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