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Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery (2015)

Chapter: Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?

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Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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B

Disaster Recovery Funding: Achieving a Resilient Future?
1

June 21, 2014

Gavin Smith, Ph.D., AICP
Executive Director, Department of Homeland Security Coastal Hazards Center of Excellence
Associate Professor
Department of City and Regional Planning
University of North Carolina at Chapel Hill

PURPOSE OF REPORT

The Institute of Medicine (IOM) Committee on Post-Disaster Recovery of a Community’s Public Health, Medical, and Social Services has been tasked with providing practical guidance on recovery practices that, if implemented, can improve short-, intermediate- and long-term health outcomes in a disaster-affected community. The committee has commissioned this paper to inform its deliberations regarding opportunities to leverage resources that become available in the post-disaster environment to improve the health and social welfare of community members by meeting short- and long-term public health, medical, and social service needs. Specifically, this paper seeks to describe the major governmental and nongovernmental funding sources for disaster recovery, delineate the complex pathways by which those funds reach affected communities and are allocated for recovery activities, and identify key decision makers at state and local levels responsible for directing the dissemination of recovery funds.

INTRODUCTION

Disaster recovery can be defined as “the differential process of restoring, rebuilding, and reshaping the physical, social, economic, and natural environment through pre-event planning and post-event actions”

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1 A white paper prepared for the National Academy of Sciences, Institute of Medicine Committee on Post-Disaster Recovery of a Community’s Public Health, Medical, and Social Services. The author is responsible for the content of this article, which does not necessarily represent the views of the Institute of Medicine.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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(Smith and Wenger, 2006, p. 237). Disaster recovery is a complex process comprised of many interrelated elements and the means by which it is achieved varies across individuals, organizations, institutions, and communities based on a series of pre- and post-event actions. Disaster recovery is shaped by a combination of pre-disaster investments and post-disaster funding, policies, and technical assistance strategies. The overemphasis on post-event aid versus investing in pre-event capacity building and collaborative decision making can hinder recovery outcomes. Similarly, a focus on what amount to narrowly defined federal post-disaster funding streams disproportionately drives the trajectory of recovery, thereby hindering a community’s ability to achieve a more resilient and sustainable future.

Sustainable development, and more recently, the concept of resilience have been used to help frame disaster recovery (Berke and Beatley, 1997; Berke and Campanella, 2006; Berke et al., 1993; Campanella, 2006; NRC, 2012). Both have important practical applications and can be used to help guide improved policies and funding strategies, if they are effectively operationalized (Smith and Wenger, 2006). Significant challenges remain as both concepts are elusive in practice, as evidenced by the lack of tangible, coordinated policies and funding mechanisms focused on these aims that are guided by a national resilience strategy. Researchers suggest that a locally-focused capacity-building effort, supported by a broad governance network is needed (NRC, 2012, pp. 3-9). While many federal, state, and local units of government suggest that their organizations rely on sustainability and resilience-based concepts to help drive disaster recovery funding programs, these endeavors are often undertaken in isolation, which undermines resilience (Smith, 2011).

Disaster Recovery Assistance Network

Accessing post-disaster funding is a critical part of recovery (Bates and Peacock, 1987; Friesema, 1979; Olshansky and Johnson, 2010, pp. 227-230; Platt, 1999). Additional resources include policy and technical assistance in the form of education, outreach, and training initiatives. Each of these interconnected resources are delivered by a host of actors collectively defined as the disaster recovery assistance network (see Figure B-1). The network is characterized as a loosely coupled set of organizations whose

image

FIGURE B-1 Disaster recovery assistance network.

SOURCE: Smith, 2011, p. 14.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

level of interaction varies over time and space and the degree to which the resources delivered by these organizations is coordinated temporally or meets local needs is also highly variable.

The three resources (funding, policy, and technical assistance) and the rules associated with their distribution differ across the network as Figure B-1 indicates. While the graphic represents a hypothetical assistance network that is subject to change over time, the notion that the rules used to manage the resources can range from highly prescriptive (e.g., those administered by nations and federal agencies) to highly flexible (e.g., emergent groups and individuals) has important implications. For instance, the highly prescriptive rules delivered by federal agencies post-disaster have been found to disproportionately drive recovery outcomes, as substantial attention is placed on the management of these resources even though they may not reflect local needs at the community or individual level (Smith, 2011, pp. 35-36). Conversely, those who may possess a deep understanding of local needs are often excluded from participating in the development of national recovery policy, including those shaping the distribution of funding. Further exacerbating the ability to develop a coherent recovery strategy driven by collaboration and the coordinated distribution of assistance is the large number of actors who fall within what can be called “the zone of uncertainty” as both practitioners often fail to involve them in pre-event planning for post-disaster recovery and researchers know less about their roles in recovery (Smith, 2011, p. 15).

TIMING OF ASSISTANCE

The timing of disaster recovery assistance includes pre- and post-event activities. As noted in the definition of disaster recovery, pre-event planning and post-event actions assume an ideal condition as the United States does not have in place a robust pre-event planning policy nor do most states or local governments maintain pre-disaster recovery plans that address the coordinated timing of assistance. For example, the National Disaster Recovery Framework, developed due to a congressional mandate established following Hurricane Katrina, has not been fully codified nor is there sufficient attention tied to pre-event planning.2 Even with the advent of the NDRF, the vast majority of attention remains placed on the administration of the often substantial influx of post-disaster funding rather than a meaningful commitment to pre-event investments in capacity building and the modification of policies dominated by a response or post-disaster orientation.3 A focus on response and post-disaster funding has limited the development of a thoughtful set of procedures, put in place before a disaster and agreed to by stakeholders, to coordinate the timing of that assistance across members of the assistance network.

The lack of investments in pre-event planning is particularly troubling given the strong post-disaster forces at work, namely, the post-disaster problems that Olshansky (2006) refers to as speed versus deliberation and time compression (Olshansky and Johnson, 2010, pp. 225-226). Following disasters there is an intense pressure to return to a sense of normalcy, even if pre-event conditions include inequitable housing, poor public health, sprawling development and high hazard vulnerability (Smith, 2011). Attempts to alter pre-event conditions through post-disaster deliberation followed by a thoughtful implementation strategy is hard to achieve in practice (Campanella, 2006; Vale and Campanella, 2005). Taking the time needed to contemplate changes in long-standing human settlement patterns or identifying those who can assist the disenfranchised when traditional aid programs like loans cannot achieve this end requires a long-term commitment that can run headlong into public pressures to rebuild as quickly as possible and make policy choices that do not necessarily represent the public good, including those that are shaped by

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2 Prior to Hurricane Katrina, the U.S. government did not have in place a national disaster recovery strategy. Rather, guidance on recovery activities, which focused entirely on the distribution of post-disaster federal grant programs, was located in an appendix of the National Response Framework. This condition provides a powerful indicator of the strong response orientation of Federal Emergency Management Agency (FEMA) and the emergency management profession across the United States.

3 A common refrain among local government officials who have experienced a major disaster is the difficulty of financially managing the large sums of money that flow into their community, which can dramatically exceed annual operating budgets and the ability of existing staff to administer new and unfamiliar programs in addition to their day-to-day responsibilities associated with typical government operations.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

development interests (Freudenburg et al., 2009) or those that influence the distribution of post-disaster aid. Promises of “building back better” often ring hollow for those who were among the most vulnerable and least powerful in a community.

Understood relative to the disaster recovery assistance network, the timing of assistance varies across each member of the network, in part, because of the lack of good pre-event planning and collaborative problem solving (Smith, 2011, pp. 18-22). The resources delivered by most actors (disproportionately in the post-disaster timeframe) remain uncoordinated, duplicative, and in many cases counterproductive. If one assumes that each member of the assistance network is delivering funding; creating, influencing, or implementing policies; and delivering technical assistance across a temporally defined disaster recovery continuum, the complexities of disaster recovery become more apparent.

Take, for instance, two sets of actors (e.g., nonprofits and local governments), both of whom implement post-disaster housing-related policies. Following disasters, nonprofit organizations often offer assistance to low-income homeowners through the repair or reconstruction of damaged housing. If done before local governments have considered strengthening building codes and standards, or re-mapped hazardous locations in accordance with the latest technology or tools used to assess risk, homes may be built back to standards that were in place at the time of the event, rather than in accordance with the best available information. The rapid repair or rebuilding of housing can also precede access to federal funding that could be used to incorporate a range of risk reduction measures such as the relocation or elevation of flood and storm-surge prone housing, the use of fire resistant building materials, and the retrofitting of homes to better withstand earthquake-induced ground motion. The failure to incorporate these measures into recovery has the effect of perpetuating social vulnerability. The lack of coordination horizontally (e.g., between local government and nonprofits) and vertically (between federal, state, and local government actors) is another problematic characteristic of the disaster assistance framework.

HORIZONTAL AND VERTICAL INTEGRATION

The concept of horizontal and vertical integration is a useful way to help to understand the interaction of governmental and non-governmental actors and has been applied to disaster recovery as a way to help explain the benefits of inter-organizational cooperation and the implications of failing to do so (Berke and Beatley, 1997; Berke et al., 1993; Smith, 2011) (see Figure B-2).

A Type 1 community, which is characterized by strong horizontal and vertical connectivity, is able to recover more quickly and in a manner that addresses local needs, controlling for other factors such as size of the disaster and its impacts, wealth, and disaster experience. A Type 1 community has strong ties among locally-based organizations as well as established relationships with state and federal organizations involved in disaster recovery. This condition fosters a good understanding of local needs and external sources of assistance, including the degree to which state and federal resources meet identified needs.

Type 2 communities possess strong horizontal but weak vertical integration. Rural locales often possess the characteristics of a Type 2 community as they tend to be tight-knit and yet may not maintain strong relationships with state and federal organizations. This means that while they may have a good understanding of local conditions and needs, their ability to assess the types of external assistance available, including the degree to which it will meet local needs, may be limited.

Type 3 communities have weak horizontal but strong vertical integration. Since these communities have a good understanding of federal and state assistance programs and their associated funding mechanisms, but weak horizontal connectivity, recovery is strongly influenced by narrowly defined federal and state programs rather than a locally-developed and grounded vision for recovery.

Type 4 communities are characterized by weak horizontal and vertical integration. As such, they are likely to be the most ill-equipped to deal with the complexities of disaster recovery. Their ability to seek external assistance or coordinate locally available resources is limited.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

image

FIGURE B-2 Horizontal and vertical integration typology.

SOURCE: Smith, 2011, p. 25.

PRE- AND POST-DISASTER RECOVERY FUNDING ACROSS THE DISASTER RECOVERY ASSISTANCE NETWORK

The remainder of this paper will focus on the role of disaster recovery funding, including how it affects the three dimensions of the assistance framework (resources and local needs, timing of assistance and horizontal and vertical integration). The pre- and post-disaster funding mechanisms in place in the United States have a strong effect on the use of available resources and the degree to which they meet local needs. This is most evident among federal assistance as many of these programs are delivered in the aftermath of a disaster, rather than pre-event; they are narrow in scope and highly prescriptive in nature; and local governments struggle to implement these federal programs, and may not be able to muster the additional resources needed to effectively address larger policy and planning issues such as developing a broader vision of what they want their community to be in the aftermath of an extreme event.

The lack of pre-disaster funding investments in capacity building efforts like training and the hiring of on-call local staff (either contractors or temporary government officials) to support the effective management of post-disaster grant programs often results in overwhelmed local government staff, whose day-to-day roles may become consumed by the search for or implementation of grants rather than addressing other key issues like case management, building code enforcement, public health concerns, and the implementation of pre-existing plans and policies that were in place at the local level before the disaster struck.

The timing of funding delivery across the network of aid providers also has a significant effect on recovery outcomes. Ill-timed and/or uncoordinated funding strategies can lead to suboptimal results among members of the assistance network, as the housing example suggests. The failure to coordinate the timing of funding disbursements across all members of the disaster recovery assistance network is exceedingly difficult and requires a commitment to build a robust and sustained pledge to pre-event planning and post-event actions that are maintained over the life of the often lengthy recovery process. The lack of commitment to this effort, while troubling, is not surprising given the episodic nature of extreme events.

The ability to build on established relationships and strengthen those that remain nascent, non-existent or emergent in the aftermath of a disaster can be expressed through the horizontal and vertical integration typology. While varied organizations provide recovery-related funding before and after disasters,

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

their effective coordination remains elusive. Further, the use of these funds once received by communities of differing types can vary significantly. In both cases, the level of horizontal and vertical integration can help to understand these relationships. For instance, the ability of local governments to effectively manage the receipt of government-based funding that is provided by external state and federal agencies is often incumbent on their awareness and understanding of varied eligibility requirements and the timing of their distribution. It is also shaped by relationships established over time, often in the throes of the disaster recovery process. Thus local governments that have experienced past disasters can learn the myriad sources of funding and how they can be stitched together to address local conditions and available local assets. Inexperienced communities must rapidly assimilate substantial amounts of information regarding grant and loan eligibility criteria while they struggle to address a range of new duties that many local officials are unprepared to address in a comprehensive, integrated manner. Strong inter-organizational relationships at the community level are also critically important. The ability to effectively manage limited resources that will rapidly become overtaxed while assessing local post-disaster needs benefits from a cohesive set of local actors.

Types of Funding and Eligibility

Pre- and post-disaster recovery funding is comprised of several types, including direct assistance in the form of grants and loans and assistance targeting capacity building initiatives like planning. Direct assistance may be provided to individuals, institutions, and organizations as well as communities to fund a range of activities, many of which focus on projects tied to the physical reconstruction or repair of housing, damaged infrastructure, and public facilities like hospitals, police, and fire stations. The nature of assistance received by individuals, including insurance payouts, grants or loans can influence not only individuals and family outcomes, but also community-level recovery. Likewise, the type of funds received by communities can shape options and associated outcomes among individuals and families. The nature of housing assistance is a powerful case in point as the majority of federal funding targets homeowners and not renters, who are disproportionately low income. For instance, insurance payments or post-disaster grants that pay for housing repairs increase the likelihood that these residents will stay in a given area, even if it is subject to repeated hazard events, whereas the limited funding available for renters post-disaster may exacerbate the loss of affordable housing, sometimes resulting in the “disaster gentrification” of low-income areas hit by disaster (Smith, 2014).4

Another problematic issue involves the rebuilding of communities to their pre-event condition rather than the systematic incorporation of risk reduction measures into the repair of damaged housing, infrastructure, and public facilities. The Hazard Mitigation Grant Program (HMGP) can be used to fund a series of risk reduction measures such as the acquisition or elevation of flood-prone housing and the strengthening of homes and buildings to withstand the forces of nature (e.g., ground motion associated with earthquakes, high wind tied to hurricanes or tornadoes, or storm surge tied to coastal storms).

The amount of HMGP available following a federally declared disaster is predicated on 15 percent of

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4 While post-disaster assistance following federally declared disasters tends to receive the most attention from researchers and practitioners, the cumulative amount of damages sustained from non-declared events exceeds that recorded for large scale disasters (National Emergency Management Association and the Council on State Governments, 1998). This has important implications for state and local officials tasked with the provision of assistance following localized emergencies when federal assets are not available and the value of proactively applying existing, locally-based resources, tools, and techniques—such as long-standing partnerships, an in-depth knowledge of local conditions and capabilities, and land use measures—are often unrecognized. The preponderance of smaller localized events also highlights the important role insurance plays in recovery as access to insurance proceeds are not tied to a disaster declaration, per se, but rather to incurring damages that are covered by the policy. Significant challenges remain, however, on both counts. The failure to involve key stakeholders at the local level, like land use planners in pre-event recovery planning, has been shown to limit the use of readily available tools and techniques, while disaster-based insurance (e.g., flood and earthquake) is less likely to be maintained by low-income individuals and families, nor is it likely to be maintained over time when it is a required criterion for accessing post-disaster housing assistance grant programs.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

total disaster costs, and as such, is still a modest amount of funding committed to risk reduction.5 Further, since the funds are made available after a disaster, they are typically used to address at-risk properties that have been damaged by the event in question. Conversely, the Pre-Disaster Mitigation (PDM) grant program, which is a component of the Disaster Mitigation Act of 2000, recognizes that hazard mitigation is best initiated prior to a disaster and therefore represents an important advancement in the larger policy dialogue surrounding disaster resilience. In order to remain eligible for PDM funding, states and local governments are required to develop pre-disaster hazard mitigation plans. Linking pre- and post-disaster assistance to engaging in pre-disaster hazard mitigation planning is a step in the right direction. However, a 6-year study of the quality of state and local hazard mitigation plans uncovers several key problems. First, plans did not do a good job linking the results of the risk assessment and the development of risk reduction policies and projects. Second, many plans did not address land use as a key aspect of a larger risk reduction strategy. Third, very few plans made the link between hazard risk reduction and climate change adaptation (Lyles et al., 2014).

The Public Assistance (PA) program typically represents the largest allocation of funding following federally-declared disasters. PA funds are used to pay for post-disaster debris removal, the funding of the additional time required of local and state officials to address recovery-related tasks, and the repair or reconstruction of damaged public facilities. The PA 406 program represents an important, albeit underutilized, means to incorporate hazard mitigation into the repair of damaged infrastructure. Eligibility determinants of the 406 program, namely, cost effectiveness, requires collecting additional data and conducting benefit cost analyses. The additional time required to perform the analysis can deter the pursuit of the funds used to repair damaged infrastructure, like hospitals, fire and police stations, and roads in a manner that makes them less susceptible to future damages. As noted earlier, local elected officials are under intense pressure to return communities to “normal” as quickly as possible and the additional time needed to rebuild the community in a safer manner may be met with heated opposition. Similarly, FEMA PA staff are trained in disaster-based cost containment procedures and the expenditure of additional post-disaster funding (even if it is cost-effective in the long run) can sometimes manifest itself in a general reluctance to aggressively pursue hazard mitigation measures (Smith, 2011, pp. 61-62).

Following major federally-declared disasters, Congress may deem it necessary to provide additional assistance beyond that offered under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act), which is the traditional federal vehicle through which post-disaster assistance is delivered. Among the largest single sources of “supplemental assistance” is the Community Development Block Grant for Disaster Recovery (CDBG-DR). Administered by the U.S. Department of Housing and Urban Development (HUD), the CDBG-DR can be used to fund a variety of disaster recovery activities, including (1) the acquisition and relocation of flood-damaged housing; (2) relocation payments for people and businesses displaced by a disaster; (3) debris removal not covered by FEMA; (4) rehabilitation of homes and buildings damaged by a disaster; (5) buying, constructing, or rehabilitating public facilities such as streets, neighborhood centers, and water, sewer, and drainage systems; (6) code enforcement; (7) homeownership activities such as down payment assistance, interest rate subsidies, and loan guarantees; (8) public services; (9) helping businesses retain or create jobs in disaster impacted areas; and (10) planning and administration costs (HUD, 2015]).

The CDBG-DR funds target those communities that have demonstrated significant unmet needs not addressed by other grant programs. At least half of CDBG-DR funds must be used to assist low and moderate income persons. The HUD criteria help to address three important shortfalls described in the larger disaster recovery assistance network: grant flexibility, the ability to address unmet needs, and assistance provided to socially vulnerable populations. The effective delivery of post-disaster assistance

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5 States that develop an enhanced hazard mitigation plan are allotted HMGP funds that represent 20 percent of total federal disaster costs. Enhanced state hazard mitigation plan status is based on a state’s demonstrated ability to manage HMGP funds, not necessarily an enhanced ability to build local capacity or commitment to reduce hazard risk. The enhanced status criteria further demonstrates the federal emphasis on grants management and the processing of grant funds rather than a more comprehensive approach to state-wide risk reduction.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

also benefits from a high level of engagement with local governments tasked with the implementation of disaster recovery funding. Historically, HUD staff charged with CDBG-DR program administration have not provided the same level of daily face-to-face interaction and dialogue with local governments and individual post-disaster aid recipients as other FEMA and state grant program managers typically do. The ability to draw lessons from the more flexible CDBG program and apply them to other more narrowly defined post-disaster recovery grant programs described in this paper while developing an enhanced and enduring CDBG-DR engagement strategy with future grant recipients (to include pre- and post-disaster training and capacity building initiatives) could conceivable improve both approaches.6

Direct assistance to local governments can take many forms, including grants, loans, and insurance proceeds. Funds may include federal grants to provide the financial capital needed to continue governmental operations and services, loans obtained through lending companies to finance reconstruction activities not covered by public sector programs, insurance payouts for insured facilities, and the incorporation of risk reduction measures into the recovery and reconstruction process. At the individual and family level, funds may include federal funding to make temporary repairs to damaged housing; individual loans procured through local banks, lending institutions, relatives, or the Small Business Administration; and insurance proceeds.7 Challenges remain, particularly for poor families that may not qualify for a grant or loan.

The financial investment in pre- and post-event disaster recovery capacity building efforts in the United States remains woefully inadequate, particularly when compared to the massive, albeit episodic expenditures made after a federally-declared disaster occurs. The overemphasis on post-disaster assistance has had several negative effects. One, because communities do not receive significant assistance unless they have been impacted by a major disaster, their capacity to recover from an extreme event when it does occur remains low. Thus, it should not be surprising that recovery outcomes are often suboptimal, lengthy processes that may leave the community in worse shape than it was before the disaster. Two, there is little incentive for communities to be proactive and adopt forward-looking strategies that embrace hazard mitigation measures, for instance, when they believe that sufficient post-disaster aid is available regardless of the pre-disaster choices made by them.8

Pre- and post-disaster planning grants have the potential to positively influence disaster recovery outcomes if specific changes to existing guidance and requirements are made. Grants that are most relevant to disaster recovery include comprehensive local planning grants, hazard mitigation planning grants, and post-disaster recovery planning grants. In many states, funds are provided to local governments to develop comprehensive land use plans. These plans are intended to serve as a means to develop a common vision of the future and the steps needed to achieve it. Given that these plans should be developed through an extensive participatory process and possess regulatory and legal standing they should provide a good way to help chart the recovery process should a disaster strike. However, many communities have not incorpo-

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6 Options to improve the delivery of CDBG-DR include the hiring of additional HUD field staff that are committed to work more closely (and for an extended period of time in the field) with states, communities, and individual grant recipients on a pre- and post-disaster basis and enhancing the existing working relationship with FEMA’s Community Planning and Capacity Building (CPCB) teams. Each FEMA regional office now includes CPCB officials tasked with assisting states and communities develop disaster recovery plans and build local recovery capacity. Addressing the initial option will require an organizational change at HUD to become more committed to placing staff in the field for long periods of time after disasters rather than simply releasing funds and expecting states and local governments to possess the capacity to implement them with little support. The ability to more effectively use the latter approach to disseminate HUD CDBG-DR information through the CPCB will require the development of clear messaging agreed to by both HUD and FEMA as grant administrators may be reticent to have “non-experts” deliver what amounts to highly technical and nuanced information to potential grant recipients.

7 Insurance coverage varies by income and race. Low-income minorities are less likely to obtain and maintain insurance than middle income non-minority populations. Similarly, renters, which are disproportionately comprised of lower-income tenants, are less likely to maintain insurance relative to homeowners, in part because of mortgage-based requirements. Of those that live in and adjacent to flood-prone areas, low-income residents are less likely to maintain flood insurance and may be unaware that homeowners insurance does not cover flood-related losses.

8 Hazard mitigation planning research has shown that many local governments have developed plans that meet minimal requirements in order to remain eligible for pre- and post-disaster funding rather than as a means to reduce hazard risk (Smith, 2009).

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

rated recovery actions in the comprehensive plan. In most cases, if disaster recovery has been addressed at all, it is located in an annex to their local emergency management plan, which like the National Response Framework, places a strong emphasis on response, not disaster recovery goals. While there are federal funds that can be used to pay for the development of pre-disaster recovery plans, like Hazard Mitigation Assistance (HMA) program, Emergency Management Performance Grants (EMPG), and the Homeland Security Grant Program (HSGP), local governments have to make the development of recovery plans a priority as the noted grant programs have historically been used to fund hazard mitigation projects (HMA) and response-related activities (EMPG and HSGP).9

The disconnect between plans developed by land use planners and emergency managers is a real problem. The disaster recovery process involves a myriad set of challenges tied to grants administration, building code regulations and permitting, the reconstruction of damaged infrastructure and housing, environmental restoration, economic development, and the reconstitution of social networks. In many ways, these issues are the purview of the land use planner. Yet many of the major funding streams that flow from federal and state agencies are associated with the Stafford Act, the federal legislation that governs FEMA’s roles and responsibilities in the aftermath of a disaster. The more recent passage of the Disaster Mitigation Act of 2000 and the Post-Katrina Emergency Management Reform Act also serve to clarify and expand these roles. Thus, much of post-disaster federal funding assistance flows through FEMA and is managed by state and local emergency management offices. Yet, the development of a community’s future-oriented vision is largely the responsibility of land use planners. The ability to link post-disaster funding, which serves as a key implementation vehicle for recovery and the community’s vision of recovery is not always clear as few communities have actually developed a recovery plan in advance of a disaster (Smith, 2010).

The Disaster Mitigation Act of 2000 has the potential to play an important role in shaping post-disaster recovery outcomes that are more resilient. These plans are intended to identify ways to reduce future risk through specific projects (e.g., relocation of flood-prone homes out of the flood plain, the strengthening of infrastructure to better withstand the forces of earthquakes) and policies (e.g., the adoption of more stringent building codes and the disinvestment of capital improvements in high hazard areas) based on their assessment of risk. The plans also provide a means to implement identified projects post-disaster as a federally-declared disaster triggers the release of Hazard Mitigation Grant Program funding. A 6-year study assessing the quality of state and local hazard mitigation plans has found, however, that many of the plans represent a means to an end, namely, ensuring access to post-disaster hazard mitigation funds rather than serving as a future-oriented vehicle to help guide future development away from known hazard areas (Berke and Smith, 2009, p. 7; Lyles et al., 2014; Smith, 2010).

The passage of the Post-Katrina Emergency Management Reform Act has sought to place greater emphasis on disaster recovery, to include planning. While several congressional investigations following Hurricane Katrina have led to the development of the National Disaster Recovery Framework (NDRF),10 the NDRF is still being operationalized almost 10 years after Katrina struck. Specific tasks currently underway include the development of state and local recovery planning guidance, the hiring of federal recovery coordinators in each FEMA region, and the provision of post-disaster planning assistance through the

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9 A number of programs that have a distinct response orientation could be modified to address pre-disaster recovery needs, including local planning and other key capacity building initiatives. Examples of specific actions include: (1) a shift in FEMA’s Community Planning and Capacity Building group to include a greater commitment to pre-event disaster recovery planning; (2) the modification of the Emergency Management Assistance Compact to include a greater emphasis on the sharing of resources that are focused on disaster recovery (rather than just response); (3) the modification of emergency management accreditation programs to include a greater emphasis on recovery; (4) the expansion of the roles associated with the members of National Volunteer Organizations Active in Disasters; and (5) the expansion of the Community Emergency Response Teams to include preparing for disaster recovery (see Smith, 2011, pp. 345-361). Similar challenges remain in the health profession as the Hospital Preparedness Program (HPP), Public Health Emergency Preparedness (PHEP) performance measures focus on disaster preparedness and not disaster recovery.

10 FEMA has developed a series of frameworks addressing response, hazard mitigation, and disaster recovery. The reluctance to refer to these documents as plans stems, in part, because of their general reluctance to be overly prescriptive regarding the guidance provided to states and local governments. However, the frameworks can be vague and offer limited direction for states and local governments.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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Community Planning and Capacity Building team. While planning guidance encourages states and local governments to develop pre-disaster recovery plans, they are not required. Nor is significant pre-event assistance (e.g., capacity building) provided. Rather, emphasis remains on the provision of assistance following a federally-declared disaster where CPCB staff assist communities develop post-disaster recovery plans.

The Sandy Recovery Improvement Act of 2013 represents another piece of legislation crafted after a major disaster that strives to address long-standing problems associated with disaster recovery.11 Broad aims include efforts to improve the quality and efficiency of recovery through a number of amendments to the Stafford Act. More specific provisions include: (1) streamlining HMGP and PA grant procedures and emphasizing greater flexibility in order to speed the disbursement of funds; (2) expanding rental housing assistance options; (3) expanding the use of Alternative Dispute Resolution techniques to resolve grant disputes; and (4) creating a national strategy for reducing future risk (Brown et al., 2013). The improvements in funding, to include specific changes in grant rules that enhance flexibility and streamline procedural requirements (which have the potential to better address local needs and enhance the speed of disaster assistance) represent important advances in federal grant programs. The overriding emphasis on grants administration in the Sandy Recovery Act of 2013 provides another example of a government-centric approach focused on the post-disaster release of funding, without a similar commitment to pre-event planning, to include how good pre-event plans engage the larger network of resource providers in the collaborative development of coordinated funding strategies that better meet local needs and are appropriately timed.

The last proposed measure in the Sandy Recovery Improvement Act (creating a national strategy for reducing risk) is also significant in that it points out a gap in the capacity of federal agencies to craft national policy in a timely, yet thoughtful manner. The action proposed in the Sandy Recovery Improvement Act, for instance, is very similar to the existing National Mitigation Framework, which at the time the post-Sandy legislation was written, was more than a year overdue (Brown et al., 2013, p. 22). The National Mitigation Framework has since been approved as part of Presidential Policy Directive 8: National Preparedness (PPD-8). As evidenced by PKEMRA and the Sandy Recovery Improvement Act of 2013, much of our national disaster policymaking remains reactionary, piecemeal, and slow to implement. Further evidence of this problem is the fact that much of the Sandy Improvement Act of 2013 was proposed several years ago as part of the Disaster Recovery Act (Brown et al., 2013, pp. 25-26).12 While we often associate capacity building initiatives with states and local governments, it is evident that additional resources (perhaps drawn from the more active engagement of the larger network) are needed to build the capacity of federal agencies to craft and implement sound national policy, including those policies that link planning and the provision of disaster recovery funding.

DISASTER RECOVERY FUNDING PROVIDERS AND RECIPIENTS

There are a number of entities that provide and receive pre- and post-disaster recovery funding across the disaster recovery assistance network as shown in Figure B-1. One of the great challenges in disaster recovery is to effectively coordinate the distribution and timing of these funds. Members of the public sector, including federal, state, and local government agencies disburse, manage, and receive monetary

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11 The history of national disaster policymaking in the United States is highly reactionary, as policy shifts tend to occur following major disasters (Rubin and Renda-Tanali, 2001).

12 Many of the proposed changes to disaster recovery approved following Hurricane Sandy were initially part of the Disaster Recovery Act of 2012 which was passed by the Senate in the 112th Congress (H.R. 1) but never ratified. The Disaster Recovery Act of 2012 was part of the Senate-passed Disaster Relief Appropriations Act, 2013 that was not taken up for a vote in the 112th House. Key provisions of the proposed Disaster Recovery Act were drawn from Smith (2011, pp. 321-376). Broad actions proposed by Smith include (1) Conduct an audit of state and local disaster recovery plans; (2) Mandate state and local recovery planning; (3) Mandate the use of Alternative Dispute Resolution to address pre- and post-disaster recovery conflicts; (4) Establish collaborative leadership initiatives; (5) Develop an education, training, and outreach agenda; (6) Establish a national recovery coalition through improved planning practices; (7) Assess and modify emergency management programs and the scope of plans; and (8) Enhance local self-reliance and accountability: Create a culture of planning for recovery.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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assistance in the form of grants and loans. The distribution of federal post-disaster funds following a presidentially declared disaster tends to overwhelm state and local governments who are often ill-prepared to manage budgets of this size. Focusing on the administration of these funds at the state and local level tends to shift attention away from a thoughtful discourse surrounding other issues such as achieving preexisting state and community goals, coordinating federal assistance with other types of aid that comes from the larger assistance network, and ensuring that socially vulnerable populations are receiving the help they need (Smith, 2011).

The manner in which post-disaster federal assistance flows to states, local governments, and individuals necessitates close attention by recipients and further complicates the recovery process, including the ability to “plan” in the aftermath of a disaster. Among the most difficult issues for local governments to address is the uncertainty associated with when they will receive varied grant program funding to implement recovery and reconstruction efforts. Considering the interconnected elements of recovery, such as the clearing of debris, the repair of damaged infrastructure, and the reconstitution of affected neighborhoods, the inability to easily determine when differing funds will be available to implement identified projects in a logical manner often results in recovery outcomes being driven by these ambiguous timelines rather than a more coherent, integrative approach.

Each governmental layer involved in this process adds complexity and uncertainty. Federal programs have varied rules that affect the timing of its delivery. For instance, HMGP funds are extremely difficult to administer. It is not uncommon for an individual grant recipient like a homeowner who is slated to have their home acquired to wait for more than a year to receive these funds.13 Federal programs, which are administered through a number of agencies in regional offices located across the United States, possess widely differing levels of capacity to manage these programs due to staffing levels and post-disaster experience.

States, which often serve as “pass through” organizations responsible for administering federal grants like HMGP, PA, and CDBG, in coordination with local governments, have differing levels of disaster experience and staffing capacity, which can dramatically affect the speed with which federal funds ultimately reach local governments and individuals (Smith, 2011; Smith et al., 2013). State officials in various agencies work with federal agency representatives and local government officials to assess post-disaster needs and determine if damages sustained to infrastructure, critical facilities, and housing are eligible for assistance. State responsibilities also include creating prioritization plans for certain grants like HMGP and CDBG, whereby the state establishes the types of projects that can be funded, recognizing broader federal guidelines such as “cost-effectiveness” in the case of HMGP and assisting a determined percentage of low-income disaster recipients as prescribed under HUD CDBG guidelines. Additional restrictions can be placed on the receipt of federal assistance, although this is uncommon. Evidence suggests that this is due to concerns about further slowing down a process that is already mired in bureaucracy (Smith et al., 2013). State restrictions on federal grant programs may require receiving jurisdictions to adopt higher codes and standards than currently exist or requiring the development of plans or policies as a precursor to the release of funds.14

Some states create disaster recovery programs tied to ongoing revenue sources or “rainy day” funds. State programs are developed to address needs that are unmet by federal assistance. In the case of state

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13 The development of a pre-disaster hazard mitigation project, linked to a disaster recovery plan which establishes a framework for post-disaster decision making, can significantly speed up this process. A comparison between two disasters that struck the same community provides a powerful case in point. Following Hurricane Fran, which struck North Carolina in 1996, it took 1 year to develop and approve the acquisition of approximately 360 flood-damaged homes using HMGP funds. After all of the available HMGP funds were expended, Kinston, North Carolina, developed a HMGP application in anticipation of a future disaster and the release of additional funding. The grant was developed in close coordination with state and federal officials, all of whom had gained valuable knowledge in the development of an eligible grant application following Hurricane Fran. Three years later, Hurricane Floyd struck, devastating the town again. This time, it took approximately 1 week to have a grant approved for the acquisition of more than 300 homes and funds began to flow into the community shortly thereafter (Smith, 2011, p. 65).

14 In North Carolina following Hurricane Fran, the state required communities receiving HMGP funds to develop hazard mitigation plans. This requirement pre-dated the similar stipulation adopted by FEMA under the Disaster Mitigation Act of 2000.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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funds, local governments apply for these resources through a grant application process created by the administering agency. State agencies responsible for the administration of these funds tend to align with the nature of the grant and may include state emergency management, community development, environmental management, and social services.

Local government departments often represent the recipients of post-disaster federal and state assistance. For instance, public works departments, working closely with the jurisdictions financial management department, may be responsible for the administration of Public Assistance funds used to repair damaged infrastructure, whereas the housing and economic development department may assume responsibility for the management of an HMGP grant to acquire flood-prone properties. In many cases, local governments contract with consultants to assist in the writing of grant proposals as well as their implementation once approved.

While nonprofits, volunteer organizations, and foundations often seek to assist those whose needs are not met by federal and state assistance programs, and their ability to act is not as constrained by bureaucratic rules that slow monetary assistance, the very organizational culture that makes them more nimble can hinder overall recovery efforts. Nonprofits can grow impatient with more bureaucratic organizations and provide assistance without coordinating with government agencies. It is also important to recognize that nonprofits and foundations vary in terms of the speed with which they can assist others. For instance, the Salvation Army has proven more adept at identifying local needs and delivering targeted assistance more rapidly than the Red Cross, which has proven less organizationally responsive (GAO, 2006; Smith, 2011, pp. 131-132).15 Foundations, which may assume public or private characteristics, provide grants directly to individuals or local organizations tasked with recovery-related activities. The actions of foundations can prove critically important as local nonprofits are often over taxed after disasters and benefit from post-disaster funding which can be used to augment their capacity to assist their constituents or serve as a pass through for targeted disaster assistance funding.16

Quasi-governmental organizations, which include regional planning organizations, community development corporations, and homeowners associations perform many of the duties assumed by governments, including those following disasters. Examples include land use plan-making, code development and enforcement, grants management, and other contracted services as assigned. Regional planning organizations, for instance, are often contracted by local governments to write pre- and post-disaster recovery plans as well as write and administer post-disaster grants received by communities. Community development corporations may seek funds to repair or reconstruct damaged affordable housing as private sector developers may not view this as a profitable venture.

A host of private-sector organizations strongly influence recovery outcomes, including corporations, businesses, insurance companies, investment firms, and consultants. Corporations may provide financial assistance to communities or employees that reside in an affected area. In other cases, corporation may provide donations to a foundation or non-profit to distribute as they see fit. The return of businesses to an area affected by disaster can signal an important part of the overall recovery process as they can begin to provide needed goods and services needed by those who seek to return to their communities. Examples include home improvement retailers who provide building materials and white goods that are needed to repair damaged housing as well as small businesses who offer specialized services unique to the area. The distribution of insurance claims are vital to community and household recovery and provide an economic stimulus as these funds are re-injected into the community. Investment firms, developers, and construction

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15 The Red Cross has a congressional mandate to provide assistance and is thus encumbered by rules established in Washington, DC. The Salvation Army is a more decentralized organization that allows for more local autonomy and improvisation (Smith, 2011, p. 138).

16 Foundation-based funding is driven by the makeup and orientation of board members who ultimately shape the distribution of monetary aid. In some cases this may not match local needs. Foundations, like other organizations that provide funding, want to be able to demonstrate their relevance and this can manifest itself in the quick rather than thoughtful distribution of funding or the release of funds to address an issue highlighted by the media rather than one explicitly needed by underrepresented groups (Smith, 2011, pp. 140-141, 171).

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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firms provide the capital, plans, and manpower to physically rebuild damaged housing, businesses, public facilities, and infrastructure. Consultants, many of whom specialize in post-disaster recovery activities, assist local governments in writing and implementing grants, picking up disaster-generated debris, and writing plans. The practice of post-disaster recovery, like emergency management as a whole, is becoming increasingly privatized which has important implications. Some research suggests that private sector firms are more nimble and able to specialize in post-disaster recovery whereas other research suggests that private contractors may not have the best interests of a community in mind and are influenced by profit motive, leading to shoddy construction, price gouging, and unscrupulous business practices.

Following major disasters like Hurricane Katrina, international aid organizations and nations attempted to provide a range of resources, including monetary donations to U.S. based foundations and technical assistance (e.g., search and rescue crews, medical teams, and engineering-based assistance tied to the repair of damaged levee infrastructure). Much of the assistance was not accepted as the United States did not have in place clear international protocols to accept disaster aid from other nations or the aid was offered by nations in which the United States does not maintain positive diplomatic relationships. In the case of the former, the concept of “absorptive capacity,” which is typically applied to developing nations (Harrell-Bond, 1986) can be applied to the United States which did not have in place the means to accept and use the external assistance offered (Smith, 2011, pp. 198-199). In the case of the later example, the establishment of conditions under which the assistance will be accepted is referred to as “conditionality,” (Susskind, 1994, pp. 18-24) and can hinder the likelihood that a receiving nation will accept that assistance. In the case of the United States, President Bush was reticent to accept offers from other nations, stating the United States had the capacity to address recovery needs.

In Ilan Kelman’s concept of disaster diplomacy, nations that view themselves as “enemies,” can in fact work together collaboratively after disaster through the sending and willing receipt of assistance. Following Katrina several examples exist in which disaster diplomacy failed. For instance, the offer of Cuban physicians was met by a response from the White House that effectively said the United States would not accept this aid until Fidel Castro was no longer in power (Smith, 2011, p. 201). Additional examples include Argentina’s offer of physicians, the willingness of the British to deliver meals ready to eat (which were destroyed due to fears of mad cow disease), and the use of Greek cruise ships for use as hotels or hospitals (which were ultimately turned down once it was realized that it would take over a month to process the needed paperwork) (Smith, 2011, p. 203).

The difficulties experienced by the United States in accepting international assistance is troubling considering that international aid is routinely delivered to other nations as part of the missions of several U.S. organizations like the United States Agency for International Development (USAID) and the Office of Foreign Disaster Assistance (OFDA). The ability to draw lessons from these experiences, including concepts like absorptive capacity, conditionality, and disaster diplomacy, was seemingly ignored, nor was it used to critically assess our own ability to accept aid from other nations and make necessary changes in international relief protocols. Hurricane Katrina has led to a further examination of this issue, which merits increased attention, particularly in light of the global ramifications of a changing climate and how this affects weather patterns both in the United States and abroad. Significant concerns remain as the United States has largely failed to effectively incorporate lessons from developing nations regarding post-disaster recovery, including the value of investing in pre-event capacity building measures (which is a long-standing approach used in international development strategies) and the importance of drawing on deeply held indigenous knowledge as a means to better understand local needs.

The creation of emergent groups after disasters is well documented in the response literature, as groups form in reaction to an issue that is perceived to merit increased attention and such group tends to dissolve once the problem is addressed. Much less attention has been placed on emergent groups in disaster recovery as evidenced both in the existing academic literature on recovery as well as in practice. Members of emergent groups are lacking in most pre-disaster recovery plans (in part because they do not exist prior to a disaster), nor do emergent groups tend to be adequately involved in post-disaster decision making, even though they play important roles in filling gaps in disaster recovery assistance networks (Smith,

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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2011, pp. 244-245). The involvement of these groups in recovery can be planned for and incorporated into policy making and resource distribution processes when a disaster occurs. The rapid identification of these groups post-disaster and their meaningful involvement in recovery operations provides another example of the value of pre-disaster planning and adaptive post-disaster actions. Examples of emergent group actions include assisting non-English speaking individuals [to] apply for assistance, advocating for limited post-disaster redevelopment in flood-prone areas, promoting the construction of low-income post-disaster housing and providing free bicycles for those without an automobile following Hurricane Katrina (Smith, 2011, p. 243).

Individuals, including their social networks, possess a vital awareness of local conditions in a community, yet these resources are often underutilized by larger disaster recovery assistance networks. In some ways this is manifest in the labeling of individuals as “disaster victims,” implying a helplessness and an inability to act to confront the challenges following a disaster. The discounting of their importance in recovery can be seen in limited engagement and empowerment strategies in which individuals are actively involved in conveying needs and developing or modifying existing policies and funding strategies provided by others. In the immediate aftermath of a disaster, individuals are typically the first providers of assistance through search and rescue activities, sheltering, and provision of food. In long-term recovery, individuals, who may experience an initial psychological shock, often feel a higher purpose which drives more self-directed actions (Hoffman, 1999; Smith, 2011, p. 241). Research has shown that individuals and households recovering from a disaster rely on a mix of autonomous, kinship, and institutional resources. Autonomous resources include personally held financial, material, and individual skills. Kinship resources include those delivered by family, friends, and associates which vary according to the level of damage sustained to the provider’s property, distance from one another, and the potential harm faced during the delivery process. Institutional resources include that delivered by others in the larger disaster assistance network. The ability to make sense of the myriad funding programs and their confusing rules can prove overwhelming and the ability to decipher them benefits from past disaster experience as well as boundary-spanning organizations like nonprofit organizations who may serve as case managers.

A TEMPORAL REVIEW OF DISASTER RECOVERY FUNDING

Next, we discuss the timing of funding across the disaster recovery assistance network, emphasizing pre- and post-disaster timeframes. Pre-event recovery activities that influence the access to funding involve preparedness, planning, and capacity-building initiatives. An important reality remains in that many local and state governments invest little funding in disaster recovery preparedness, planning, and capacity-building initiatives, often resulting in significant hardships when, in fact, they must confront the many challenges of disaster recovery after an extreme event. Pre-event preparedness activities may include the identification of members of their disaster recovery assistance network, including those that are local as well as external providers of assistance (e.g., state, federal, and international). Planning efforts include developing, exercising, monitoring, implementing, and updating disaster recovery plan over time. It is critically important to involve members of the disaster recovery assistance network (identified as part of preparedness activities) to include the development of mutually agreeable goals, objectives, and policies that drive the temporally coordinated use of the resources they possess. Capacity-building actions, ideally delivered prior to a disaster, involve education, training, and outreach efforts, of which planning can play an important role. The act of planning serves as a capacity building process achieved through learning about one another’s roles and capabilities and enhancing the collective capacity of the group through the optimization of resources (e.g., limiting duplicative or contradictory funding strategies) that are undergirded by a common set of goals identified in the recovery plan. Another approach used to optimize resources could involve the reprogramming of existing funds already awarded to communities. Reprogramming already distributed funding may prove difficult to achieve in practice due to rules governing their use after being awarded. An alternative involves the creation of a pre-disaster collaborative process spanning funding providers to establish a funding eligibility matrix tied to agreeable goals. For instance, CDBG funds can

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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be used to assist with the repair of low-income housing. The degree to which these funds also increase disaster resilience varies because federal rules do not require it and state agencies responsible for crafting eligibility rules in their respective states may not have considered it an important criterion. Good pre-disaster recovery planning, including the creation of committees tasked with addressing the coordination of pre- and post-disaster funding streams, should embrace this responsibility.

Post-disaster recovery activities are described in three temporally-defined phases: (1) response and the transition to short-term recovery, (2) mid-term, and (3) long-term recovery. It is important to note that the characterization of the recovery process as a simple linear process discounts the reality that recovery is achieved at different speeds and through differing pathways at the community and individual level (Smith, 2011, pp. 19-22). While there is not a clear line of demarcation separating the initial response and short-term recovery, the actions taken immediately after a disaster can shape what follows.

Response and short-term recovery activities include the provision of feeding operations (e.g., feeding stations provided by the Salvation Army, Red Cross, and other nonprofit and emergent groups); sheltering (e.g., evacuation shelters like those provided by the Red Cross, hotels, or staying with family and friends); preliminary mental health interventions (e.g., psychological first aid); non-emergency medical care and prescription access; early debris clearing efforts (e.g., clearing roadways for emergency access to hospitals and other critical facilities); and the provision of generators and early restoration of power. The funding of these emergency services are typically reimbursable by state and federal emergency management agencies if a state or federal disaster declaration has occurred. Depending on the scale (breadth of impact) and type (e.g., Tohoku earthquake and tsunami and resulting damages to the Fukushima Daiichi nuclear plant) of disaster and the capacity of local, state, and federal agencies (and the larger disaster recovery assistance network), this phase of the disaster can take days or even months to achieve. These characteristics can also differentially shape the temporal distribution of recovery as those communities and networks with fewer resources may be much slower to recover than others and these variations occur at multiple scales, including neighborhoods, households, and individuals. Further, response-related funds often carry over into the intermediate phase of recovery.

Specific actions undertaken during the intermediate phase of recovery include the provision of transitional housing (e.g., FEMA-provided trailers and rental assistance), temporary education and public services facilities; provision of monetary aid to allow for normal governmental operations (e.g., meeting payroll, hiring of additional staff, meeting existing and new financial obligations); continued mental health interventions; access to medical and social services, the restoration of public infrastructure (e.g., the complete restoration of power, water, and sewer services); the repair and reconstruction of damaged public infrastructure; the provision of economic redevelopment assistance (e.g., post-disaster employment, delivery of economic development grants and loans); and post-disaster planning for long-term recovery.17

During the long-term phase of disaster recovery, communities must confront a number of complex issues tied to rebuilding and reconstruction, including decisions surrounding the degree to which hazard mitigation is incorporated into recovery; the restoration of environmental systems; economic redevelopment; and the reconstitution of social networks. Hazard mitigation, or the adoption of policies and projects intended to reduce future hazard risk and exposure, is often achieved in the aftermath of a disaster when funds are available for this purpose. Specific measures may include the relocation or elevation of flood-prone housing, the strengthening (retrofit) of public facilities and infrastructure, the adoption of new or modified codes and standards, the use of hazards-based insurance (e.g., flood, wind, fire or earthquake), and the proactive application of land use tools and techniques (e.g., capital improvements planning, cluster development, open space preservation, transfer of development rights). During the recovery process this may include the disinvestment of public and private assets (e.g., infrastructure, housing, public facilities)

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17 While the development of disaster recovery plans are ideally developed before a disaster occurs, thereby providing the time needed for disaster recovery committees and the larger public to discuss the complexities of recovery and develop coordinative strategies to address them, recovery plans are often developed in the aftermath of a disaster. The development of these plans often begins as communities transition out of the immediate response and into the early phase of recovery as a number of pressing issues limit the time that can be devoted to a thoughtful planning process.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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in high hazard areas and the resettlement in less vulnerable locations. The application of hazard mitigation techniques to housing-related issues, including relocation provides an interesting case in point. The choices made by federal, state, and local governments regarding the use of post-disaster mitigation funds can powerfully influence the choices made by individuals. For instance, hazard mitigation funds are disproportionately used for owner-occupied housing versus rental properties. This can have the effect of assisting homeowners who may be more wealthy (on average) than renters.

The adoption of new or strengthened codes and standards can play an important role in reducing future losses. The adoption of new standards may be influenced by the real or perceived additional costs and the ability of proponents to adequately convey their benefits. Developing higher standards post-disaster may be opposed by some who see these additional requirements as restraining the pace of reconstruction or adding to the costs of repairs and new development in the affected area.

Additional factors shaping the adoption of new standards include the ability to collect and analyze the data required to select “appropriate” code standards. The analysis and re-mapping of such areas takes time and may result in the development of initial maps that depict an assessment that may need to be refined over time but can be used to help inform post-disaster reconstruction. Challenges remain when using this approach as communities must decide whether to adopt these new standards and associated maps in lieu of existing codes. In addition, new temporary standards require the vigilant enforcement of these advisory maps during a time when building code officials are overtaxed reviewing the influx of permits that invariably follow a major disaster.

The determination of appropriate codes and standards can be problematic as they are designed to withstand the hazard forces (e.g., high water, storm surge, ground motion, wind speed) associated a given “return period” event (e.g., 100-year flood or 1-percent annual chance event). The development of standards to a set return period event does not effectively account for the dynamism of hazards and the effects of growth in hazardous areas and adjacent locales. For instance, barrier islands are inexorably moving toward the mainland as part of a natural process. The construction of homes, infrastructure, and businesses, which are placed in a fixed location, must regularly confront this dynamism. Options include building protective measures like levees and seawalls, implementing beach re-nourishment and dune restoration projects, elevating structures, or limiting development in vulnerable locations. Researchers have coined the term “safe development paradox” to describe the false sense of security that protective measures can provide. The funding of these types of measures has the effect of encouraging development in these areas, leading to even larger disasters when the design parameters of levees and seawalls are exceeded, leading to increasing post-disaster payouts (Burby and French, 1981; Burby et al., 2006).

Growth in and adjacent to hazardous areas can also exacerbate risk as new development in floodplains, for instance, results in an increase in impervious surface, which speeds rainfall runoff, leading to increased flood elevations relative to what may be reflected on Flood Insurance Rate Maps developed in the past. Structures built to what amount to outdated codes and standards suffer the consequences. Upstream development and development adjacent to the floodplain can also increase flood hazard vulnerability as the cumulative effects are realized.

The adroit use of pre- and post-disaster funding can be used to address may of the shortfalls addressed in this paper, including the development and implementation of a strategy emphasizing sustainability and disaster resilience (Burby and Dalton, 1994; Burby, 1998). Ideally this involves drawing on pre-existing goals and incorporating them into post-disaster “opportunities” identified through a robust community engagement effort. The integration of physical, social, economic, and environmental dimensions, achieved through the implementation of complementary policies and projects, requires gaining access to the funds needed to realize these aspirations.

A Hypothetical Disaster Recovery Scenario

While drawing on the myriad resources of the disaster recovery assistance network is critically important, it is equally important to develop a strategy or plan to help shape the integration and temporal dis-

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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tribution of these assets. The development and implementation of an agreed upon plan greatly increases a community’s chances of successfully achieving this aim. The following hypothetical example provides a simplified explanation of this process. Following a major flood, a community begins to assess the effects of the event. Based on the assessment, the disaster merits a presidential disaster declaration, which triggers the release of federal aid as well as the assistance of the larger disaster recovery assistance network. As part of the recovery process, the community assesses its needs and forms a disaster recovery committee.

The committee identifies existing local policies and plans that pre-date the disaster and assesses how these documents can inform the development of a disaster recovery plan. As part of this assessment, those policies that contradict the aims of the recovery plan’s goals (as developed by the committee and citizen involvement) may be modified to reflect the recovery plan’s vision. One of the plans that should be assessed is their hazard mitigation plan, which should identify the hazards prevalent in their community as well as the vulnerability of their assets (e.g., housing, infrastructure, critical public facilities) to these hazards. The policy and plan review, commonly referred to as a capability assessment, and the risk assessment form the fact base upon which recovery policies are developed.

If we assume a primary vision of the recovery plan is to achieve a more resilient future, a set of goals are developed that address physical, economic, social, and environmental themes. Each of these goals are supported by policies and projects that include established implementation timelines. Careful attention should be placed on the development of policies and projects that are complimentary in nature to both individual goals as well as the larger plan’s vision.

For instance, let’s assume the community and its citizens decide to relocate a flood damaged community out of the flood plain. Once the land is acquired and the properties removed, the area might become a greenway, thereby reducing future flood-related damages, improving water quality, and enhancing public health and recreational opportunities. In addition, the property adjacent to the greenway may increase in value. Thus this one measure achieves multiple, integrated benefits for the community. If we assume the area was comprised of low-income residents, care must be taken to identify the means to relocate these residents to safe and decent housing. In addition, thoughtful consideration should be given to relocating the entire neighborhood to another area, thereby maintaining social networks, or identifying scattered housing sites throughout the community to avoid the aggregation of low-income housing.

Achieving a resilient future means more than taking steps to make a community less vulnerable to future disasters, as this brief hypothetical scenario suggests. As descried earlier in this paper, recovery also involves the clearing of debris; the restoration of damaged infrastructure; the provision of temporary and permanent housing solutions; the reconstruction of damaged public facilities, businesses, and housing; the repair of damaged ecosystems; and the reconstitution of disrupted social networks. It also means drawing on the resources held by members of the assistance network to achieve these aims. It also means collectively learning from past events and developing a sustained approach that is incorporated into the day-to-day activities of all members of the disaster assistance network.

KEY CHALLENGES AND OPPORTUNITIES TO ACHIEVING DISASTER RESILIENT OUTCOMES

Achieving disaster resilient outcomes following disasters is challenging, and is closely tied to the way in which funding assistance is provided across a network of stakeholders. Among the most problematic issues are the delivery of funding in isolation, narrowly defined programs that do not address local needs, creating and maintaining issue salience surrounding disaster recovery, and the timing of assistance. Most members of the assistance network provide funding in a way that is not coordinated with others, leading to duplication, contradicting results, and ill-timed aid that often hinders the ability of communities to achieve disaster resilient outcomes. Addressing the issues common to disaster recovery remains difficult as pre-disaster recovery planning is less salient to local officials, particularly when compared to pressing day-to-day activities.

In the aftermath of a disaster there is an intense pressure to return to a sense of normalcy, even though it may take more time in the short run to inject resilience measures into recovery. The common refrain

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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among locally elected as well as state and federal government officials denote a disaster as “an opportunity” to address long-standing pre-event conditions and human settlement patterns should be carefully evaluated and questioned. Critically reflecting on this statement requires asking the question: opportunities for whom and at what cost? Disasters provide a powerful means to expose pre-event conditions, including inequity, high risk, and the existence (or not) of a collaborative planning culture.

Improving resilience across physical, social, economic, and environmental domains means adopting an integrative, long-term strategy. In today’s era of climate change, this means expanding our assistance network and a suite of temporally-defined strategies to include those that are engaged in understanding the linkage between our changing climate and its effects on natural hazards and disasters as well as the rapidly emerging collection of social scientists, planners, activists, engineers, and medical professionals who are developing adaptive strategies to our still emerging understanding of these episodic and long-term threats. Developing clear linkages between pre- and post-disaster recovery funding allocations and the incorporation of adaptation measures during the recovery process provide a unique “opportunity” that merits increased attention.

RECOMMENDATIONS

The following recommendations result from a distillation of the disaster recovery research and a critical assessment of existing national policy. The proposed changes, which are significant and require changes in national policy, represent a set of actions that are much needed and could be incorporated into the still emerging national dialogue surrounding disaster recovery and resilience. Two important venues provide a means through which to inject the recommendations that follow: the National Disaster Recovery Framework and Hurricane Sandy-related initiatives.

Increase the Pre-Event Investments in Capacity Building and Planning. The reluctance of federal, state, and local governments to invest the resources in pre-event capacity building and the closely associated means by which this can be achieved and ultimately acted upon through the policies and public investments identified in plans, is perhaps the single greatest problem facing those who seek to systematically address disaster resilience in a meaningful way. Today’s disaster recovery policy milieu is dominated by a post-disaster orientation as evidenced by the large-scale investments in monetary assistance after a disaster strikes with a proportionately low expenditure of funds, pre-emptive policies, or training before an event occurs. Nor is there meaningful attention paid to pre-event planning for post-disaster recovery. In a recent study of local disaster recovery plans in the southeastern United States (an area highly prone to disasters) researchers found that using a liberal definition of recovery plans, less than one-third of communities had a disaster recovery plan in place and among those that did, the plans were of poor quality (Berke et al., 2014). While this is slowly changing per the National Disaster Recovery Framework, state and local pre-event recovery plans are not required in order to gain access to post-disaster assistance. Smith has suggested that while the development of recovery plans should be required, an incremental policy approach should be undertaken in tandem with an increased investment in pre-event capacity building that targets measureable improvements in the quality of those plans over time. The ultimate aim of this strategy would be to hold communities more accountable by linking the creation of high quality plans to post-disaster funding access (Smith, 2011).

Improve the Coordinated Management of Pre- and Post-Disaster Funding. Planning provides one way to improve the coordination of funding across the disaster recovery assistance network. This holds true, however, only if all members participate in a meaningful process that fosters collective action over time. Current federal initiatives to further improve governance strategies, namely the “whole of community” concept, have yet to be effectively realized through clear and actionable policies. In its current state, it is more reflective of a desired end state without guidance, rules, and a mix of incentives and sanctions furthering compliance with what still remains a broad and elusive term. Further complicating matters is

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

the varied funding sources provided from non-governmental actors (e.g., nonprofits, businesses, quasi-governmental organizations, emergent groups, and individuals), whose compliance with governmental mandates is highly variable. Facilitating the coordinated expenditure of pre- and post-disaster funding across the assistance network, first requires gaining a depth of understanding among all providers of assistance as to the resources each provides and when they provide it. It also means identifying the underlying interests of each provider of assistance and how this is manifest in specific funding strategies. Gaining an understanding of underlying interests provides an opportunity to seek mutually compatible policies that can guide resource distribution in a cooperative manner while also identifying and modifying duplicative or counterproductive actions. One indicator of the degree to which this has occurred may be the willingness of organizations to reprogram pre-disaster funding criteria to include key disaster recovery goals such as disaster resilience.

Hold States and Local Governments More Accountable. It is incumbent on governmental actors to lead the development of clear policies that encourage—and, in some cases, require—compliance with disaster recovery program goals like achieving a more disaster resilient future if in fact post-disaster aid is an expectation following extreme events. Any shift in policy that increases accountability should be balanced with a concerted effort to build capacity both within organizations and across the larger network. Otherwise, increasing standards will likely lead to the creation of non-compliant plans or the abandonment of the process altogether.

Examples of this approach could include requiring communities and states to develop pre-disaster recovery plans that meet increasingly higher standards of practice over time, while investing in training, education, outreach, as well as providing the financial resources needed to develop these plans. Good recovery plans include strong inter-organizational coordination and implementation mechanisms, among other principles.18

Operationalize Broad Concepts Found in National Disaster Recovery Framework Through Coordinated Actions Implemented by Identified Members of the Disaster Recovery Assistance Network and the Passage of the Disaster Recovery Act. The good news is that attention has been placed on operationalizing the elements found in the NDRF. Examples include the national roll out of the NDRF through public meetings and conference calls, hiring of regional FEMA recovery coordinators, designation of state counterparts (state recovery coordinators), and development of FEMA committees comprised of state and local officials tasked with the development of training materials and guidance documents. However, the CPCB team has not begun a sincere effort to engage in a robust pre-disaster capacity building initiative to assist states and communities in developing and exercising recovery plans in advance of extreme events. Several factors are contributing to this still somewhat reactive approach: (1) limited federal resources and agency support to advance the aims of the NDRF, (2) the lack of a clear mandate to require the development of state and local pre-disaster recovery plans, and (3) insufficient authority to act in pre- and post-disaster plan-making settings (GAO, 2010; Smith 2011, pp. 321-323).

Following Hurricane Sandy, the CPCB team offered assistance after the disaster occurred. This has become the standard approach to recovery planning. It is incumbent on FEMA and the larger disaster recovery assistance network to engage in a more concerted pre-disaster recovery planning process, applying the tenets of good recovery planning, including in particular an emphasis on pre-event planning for post-disaster recovery. States like Florida have begun developing pre-disaster disaster recovery plans and lessons should be drawn from this process.

The adoption and more focused operationalization of the NDRF can provide the venue through which many of the problems noted in this paper can be addressed. In order for this to occur, a greater empha-

________________

18 A discussion of disaster recovery planning principles can be found in Planning for Post-Disaster Recovery: A Review of the United States Disaster Assistance Framework (Smith, 2011, pp. 275-292). See Sandler and Smith (2013) for a discussion of plan quality principles applied to state disaster recovery plans.

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

sis needs to be placed on the three previous policy recommendations, including (1) increasing pre-event investments in capacity building and planning; (2) improving the coordinated management of pre- and post-disaster funding; and (3) holding states and local governmental more accountable for their actions (and lack thereof). Any serious policy discussion should discuss the realities of funding as a motivator for action, including the need to invest substantial pre-disaster resources in planning and capacity building while gradually withholding funding from those states and local governments that do not agree to develop, adopt, exercise, and implement robust, inclusively created recovery plans. Federal legislation like the proposed Disaster Recovery Act should be passed to provide the federal government the resources they need to carry out the intent of the NDRF.

ENHANCE THE INTEGRATION OF HEALTH CARE ORGANIZATIONS AND PROVIDERS IN THE DISASTER RECOVERY ASSISTANCE NETWORK

A review of the NDRF suggests that it focuses primarily on the repair of infrastructure and places inadequate attention on “human recovery,” including the psychological effects of disasters as well as acute and chronic health issues faced during recovery (Chandra and Acosta, 2010). Chandra and Acosta suggest that in order to achieve more resilient health outcomes, a clear definition of health and human recovery should be developed, benchmarks established, and a vulnerability index created to help identify pre-disaster health and social service needs in order to identify and evaluate the resources required to address them, manage expectations, and track outcomes (Chandra and Acosta, 2010, p. 1609). The broader issues (e.g., social vulnerability, resilience, and recovery metrics/indicators and outcomes) have been discussed by a number of researchers and practitioners in other disciplines, including geography, psychology, planning, emergency management, and sociology, and a growing number have begun to develop, apply, and track indices of social vulnerability, recovery, and resilience. In fact, “wellness” has been used to as an indicator of resilience and a measure by which adaptation to a stressor (e.g., disaster) has occurred (Norris et al., 2008). Yet, like many such efforts, the degree to which health-related measures are integrated into a holistic system remains unattained (NRC, 2012, p. 5). Rather, like a central challenge in recovery, medical and public health groups have tended to act in isolation, rather than as part of a larger multidisciplinary group (Shoaf and Rottman, 2000). There are existing post-disaster grant programs focused on social, health, and mental health services. For instance, the Social Services Block Grant (SSBG) program targets health care and other human service providers, including community-based organizations. Eligible costs include paying for the provision of social, health, and mental health services and the repair and reconstruction of health care facilities, child care facilities, and other social services buildings and associated infrastructure. The degree to which these programs are connected with other post-disaster grant programs varies significantly across states and local governments.

Not surprisingly, the development of indicators do not necessarily span the broad network of aid providers and recipients to include medical and public health care providers. Additional research has shown, for instance, the valued, but underutilized or misunderstood, roles in recovery of several stakeholders in health-related fields, including nongovernmental organizations (Acosta et al., 2013) and local and regional public health providers (Koh et al., 2008). The ability to include them in the disaster recovery assistance network is increasingly prescient given the additional public health threats associated with increased disasters and the inexorable shift in climate-borne health impacts, including those tied to ecological, social, and physical disruption (Greenough et al., 2001).

DISASTER RECOVERY IN THE AGE OF CLIMATE CHANGE

Disaster recovery is a complex process, affected by a number of pre- and post-disaster conditions. The effects of a changing climate and adapting to these emerging conditions represents another issue that must be addressed in a thoughtful manner, recognizing that it adds an additional layer of complexity to disaster recovery. Like disaster recovery, adaptation has been framed in the context of sustainability and

Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
×

resilience (Godschalk, 2003; Peacock et al., 2008). Disaster recovery in the age of climate change means planning for uncertainty. One way to confront this challenge is through the development of a flexible suite of robust and contingent adaptation strategies (Berke, 2014, p. 187). Robust strategies are often referred to as “no-regrets” actions that address a range of scenarios. Contingent strategies are designed to address specific scenarios, including worst case conditions. In some ways, disaster recovery in this new era provides an opportunity for positive change, expanded networks, and complimentary aims linking risk reduction and adaptation, both of which can be framed and acted upon in a way that advances resilience. The future sustainability and resilience of our communities depend on it.

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Suggested Citation:"Appendix B: Disaster Recovery Funding: Achieving a Resilient Future?." Institute of Medicine. 2015. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press. doi: 10.17226/18996.
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In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges.

Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery.

Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.

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