On June 16, the day after Father's Day, a simple e-mail was sent from central headquarters in Des Moines to local leaders of the Iowa Department of Human Services. "Immediate attention," read the subject line.
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The one-paragraph message asked help in identifying DHS employees willing to drive 100 or 200 miles from relatively dry areas of the state to soggy portions of eastern Iowa that were inundated with high water. It was a natural disaster that Gov. Chet Culver ranked among the top 10 worst in U.S. history, the result of biblical rains and horrific tornadoes.
The Iowa DHS was still functioning statewide that day but the strain was building.
Late the previous week, the Cedar River overwhelmed Cedar Rapids and all of its government functions, including regional offices of the DHS, thought to be safe on the upper floors of a sturdy downtown building that had never seen high water. The building was hastily abandoned as the angry Cedar barged through downtown.
Within hours, Marc Baty, the top DHS administrator for the 14-county Cedar Rapids region, and his staff found temporary offices in widely scattered public places, such as schools.
In a flurry of urgent after-hours calls to the phone company and internal IT staff, Baty arranged for the county office's main telephone number to roll to manned office locations and to patch together a computer network. Employees in the regional child abuse and neglect intake unit were instructed to report to DHS offices in a nearby county.
It all occurred without a break in service, and the phone never went unanswered.
But the enormity of the damage--and the damage yet to come as the crest moved southeast toward the Mississippi River--was becoming evident.
"Our first job was to preserve service for the 800,000 who depend on us everyday," said DHS Director Kevin Concannon, a 40-year veteran administrator in Iowa and elsewhere who postponed retirement plans by a month to help steer the recovery.
In Iowa, the DHS administers Medicaid, the state children's health insurance program, food stamps (known in Iowa as food assistance), welfare, subsidized child care, collection of child support payments, licensing of child-care centers, and child welfare. Half of the agency's 5,900 employees administer those programs. The other half staff nine institutions and the central office, none of them significantly damaged by floods.
"Our second job was to aggressively administer additional emergency programs for people who would not normally be eligible for our help, specifically disaster food assistance, crisis mental health counseling, and disaster grant assistance," Concannon said.
"When you're dealing with a crisis, government agencies can't wait for the fire trucks. Don't wait for FEMA to arrive. Start making calls to your federal partners to get things moving. Build your capacity and do it as much as possible from within," he said.
Hence the e-mail message on June 16 from LaVerne Armstrong, head of the agency's field office support unit. Expenses and salary for traveling workers would be covered, the note explained. Interested people would have to be ready to travel as soon as possible, some within two days.
He soon had a long list of people not only willing to deploy elsewhere, but others willing to put in extended hours to fill the shifts of traveling colleagues.
For several weeks, between 120 and 150 eligibility-determination staff--20 percent of the total statewide employees who do this work--volunteered to work three-to five-day shifts in FEMA disaster recovery offices that were hastily set up around the state. The traveling workers also provided respite in the hardest-hit local DHS offices.
Since most FEMA disaster recovery centers did not have Internet access for DHS workers to use, Armstrong also ordered 100 wireless Internet access cards for employees to plug into their laptops.
With the internal staff response being quick and mobile, there was no need to accept offers of staff assistance from other states.
"We appreciate those gestures, and there's no doubt we would have accepted them if our own employees hadn't stepped up so energetically," said Concannon.
Iowa, a state of some 3 million, is carved into 99 counties, and the DHS has offices in each one. Two-thirds of them have regular business hours while those in the most rural areas are open only a couple of days a week. Day-today management is provided in eight service area headquarters, includingone in Cedar Rapids, the state's second largest city at 124,000.
So far, an astonishing two-thirds of the state, 63 counties, have been declared a presidential disaster for individual assistance, meaning homeowners and renters may apply for up to $28,800 in FEMA disaster grants. Almost the entire remainder of the state was declared a disaster by the governor, meaning residents there may apply for Iowa's low-income disaster grant program administered by the DHS.
As the disaster deepened, Concannon ordered daily meetings of top administrators--normally a weekly event--plus a written detailed memo prepared every afternoon for all staff, legislators and anyone interested.
Among early decisions were those to lay eyes on all foster children, both relative and nonrelative (all were found safe, although some were in displaced families); to arrange for the post office to hold DHS mail that was undeliverable in flood areas (giving recipients time to collect it); to rapidly expand the food assistance call center (which fielded 500 calls a day, five times the normal rate); to host a displaced substance abuse shelter in one of the DHS-operated mental health institutes; to permit displaced people receiving subsidized childcare to remain eligible (normal requirements are to be employed or a full-time student); and to provide quick replacement for Medicaid-paid drugs or equipment lost or damaged in high water.
Administrators were aggressive in protecting state assets. With a flood surge heading for Des Moines on June 16, Child Support Administrator Jeanne Nesbit ordered 150 employees to abandon their low-lying offices and to take their computers home with them, monitors and all.
Essential to the Iowa DHS flood response was close communication with federal partners. Concannon said the Food and Nutrition Service was particularly helpful. As soon as the president declared a batch of counties to be disaster areas eligible for individual assistance, DHS officials asked permission of FNS to launch the disaster food assistance program. Approval came quickly each time, and DHS workers were dispatched to the affected areas almost immediately.
"Keep in mind, this program is completely separate from the regular food assistance program," said Ann Wiebers, lead administrator for DHS financial support programs.
"We're talking about a one-time, nonrenewable grant that provides quick help at a time when families are dealing with crises. Income and resources are taken into account, but the program works in a different way as most of the recipients are people who are not eligible for the regular program.
Customers got their food assistance debit-like cards before leaving the county office or the FEMA site, Wiebers said. In most cases, the cards were activated immediately.
Through the middle of July, about 13,000 households (34,000 plus people) received disaster food benefits. Eighty-two percent of recipients were new food stamp customers, with an average benefit of $357. The other 18 percent of recipients were already receiving regular benefits. They qualified for additional benefits averaging about $200.
Since many disaster victims have little or no access to cooking facilities, the FNS also approved Iowa's request allowing food stamp customers to purchase prepared hot food with their benefits. The rule applied only to previously approved food assistance vendors, not to restaurants.
Another federal waiver was more unusual.
As neighborhood after neighborhood became overwhelmed, disproportionately affecting low-income Iowans, DHS administrators searched for a plan to prevent automatic disqualifications in Medicaid and food assistance, among other programs.
About 35,000 Medicaid annual reviews were scheduled for July and August, and another 32,000 food stamp reviews were scheduled. Wiebers said the first part of the process--mailing recertification forms--was problematic because many recipients didn't have an address anymore, or lived in a place where mail was not delivered.
While the flood has left the state, the disaster lingers. With uncertainty about the future and pain from the losses, many Iowans needed--and will likely continue to need--crisis mental health counseling. Officials in the Mental Health and Disabilities Service division secured FEMA grants to provide free crisis counseling in the hardest-hit counties.
The DHS response wasn't entirely seamless.
Cedar Rapids officials were frustrated when inaccurate news reports or documents couldn't be squelched quickly enough. In one flyer that was widely distributed, disaster victims were told that they would get emergency food stamps if they simply showed up at the DHS office, no questions asked.
It was also difficult getting the word out about the location of temporary DHS offices and FEMA sites.
The initial supply of electronic benefits transfer food stamp cards did not meet the growing demand, and there were problems with printing and delivering new ones. In the end, all sites had an adequate supply.
Concannon said his agency's response was nimble and forceful.
"At some point there will be a formal debriefing and we'll make recommendations on lessons learned. Overall, I think the DHS can be proud of its service in a crisis. The takeaway for me is; don't wait, take action early, and engage the federal agencies from the outset," he said.
Roger Munns is the public information officer at the Iowa Department of Human Services.
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