Sunday, June 14, 2015

Who pays for mass care?

A good friend has a saying: "Whenever anyone says that it's not about the money, you better believe that it's all about the money."

At the Hot Wash discussion at the end of last week's 2015 National Mass Care Exercise in Austin, TX we started a discussion about how mass care responses in large or catastrophic events are paid for. Actually, I made some statements about the topic and this generated a discussion.

Chad Ostlund from Minnesota Emergency Management briefs Texas senior leadership during the National Mass Care Exercise in Austin, TC, June 2015.
I'm going to lay out what I said but first the general reader (i.e. one who isn't a mass care or emergency management professional) will need some explanation to provide context for the discussion. By mass care we mean the provision during disaster of food, shelter, emergency supplies and family reunification. By disaster we mean the range of natural and man made incidents from a house fire to a Category 5 hurricane.

Most of the time mass care resources are provided by the Voluntary Agencies Active in Disaster (VOAD) using funds that have been donated to them for that purpose. During blue skies the VOADs receive donations that they use to pay for salaries, training and exercises so that during gray skies they will have the capability to respond. When disasters happen the appeals go out to the public for donations to pay for the additional costs of the response. Big responses, with lots of exciting video footage of destroyed buildings and dazed survivors, generate a much broader and deeper response from the public than a smaller incident that may only make the  newspaper in their community. The result is that the VOADs often pay the mass care response costs for the smaller or less publicized disasters with blue sky money.

The old emergency management joke defines a disaster as when a tree falls on your neighbor's house and a catastrophe is when a tree falls on your house. Regardless of whether the disaster is federally declared or not, or whether the storm made good video for the Weather Channel, when the tree falls on your home and you're poor and uninsured you've got troubles. And if your county ended up on the list as declared for federal Individual Assistance, the maximum amount that FEMA can give you is $31,000. The average handed out by FEMA is only about $5,000. The VOADs are left with the task of matching the donated dollars they've received with the unmet needs of the survivors.

The gray sky money donated by the public, whether through the "Text $10" appeals or by other means, must pay for response costs as well as the unmet needs of individual families that are uncovered  through case management during recovery. One VOAD indicated that two thirds of the gray sky money that they receive arrives within 5 days of the event. The pot of money that each VOAD can devote to a disaster is therefore fixed and finite, and most of the donated dollars arrive early in the disaster.

Some state and local government aren't inclined to help out during the mass care response. In one of the many storms of my past a member of the Governor's staff, who shall remain nameless, asked me, "Why are we giving truckloads of bottled water to the Red Cross?"

"Because they're handing out the water to our citizens," I replied.

"They should buy their own water with the money the federal government gives them," said the staffer.

"The federal government isn't giving the Red Cross money."

"Oh, yes, they are."

"But really, they're not."

"Oh really, they are," said the staffer in a tone that was meant to conclude the conversation.

Fortunately, someone other than me was able to educate the staffer and the Red Cross got their truck of water.

In another state and another disaster I had an emergency manager question my request to send a truckload of water to the Salvation Army. "Why should we send them a truck of water?" he asked.

"Because they're handing out the water to your citizens," I replied.

The EM frowned. "That community already has ways to get their own water."

I nodded my head and walked away. Fortunately, someone other than me was able to educate the EM and the Salvation Army got their truck of water.

This sets the context for the statements that I made at the conclusion of the National Mass Care Exercise. My contention (and I am not alone in this belief) is that during a federally declared disaster the state government, to the extent responsible, should support the activities of the mass care VOAD agencies through the purchase of logistics and supplies. Examples of logistics that can be provided are forklifts, pallet jacks, portalets, dumpsters, bulk water, propane and diesel. Examples of supplies are bottled water, ice, shelf stable meals. baby supplies, shelter supplies and food for preparation at the field kitchens.

In a large disaster the costs for these items would be millions if not tens of millions of dollars. Whether the state purchases the resources or asks FEMA to do so 75% of the costs are a federal responsibility. And for every dollar of response costs absorbed by government there is another dollar available to the VOADs weeks later to help meet the unmet needs of the survivors.

"So why should the states help out the VOADs during the response?" you ask.

So that they can use the money they save to help the survivors when the government is not in a position to do anything more. And that's a good strategy for any government to follow.