DEPARTMENT OF HOMELAND SECURITY 

Office of Inspector General 

FEMA’s Crisis Counseling Assistance 

and Training Program 

State of Florida’s 

Project H.O.P.E. 

OIG-08-96 September 2008 
 

Office of Inspector General 

U.S. Department of Homeland Security 

Washington, DC 20528 

September 26, 2008 

Preface 

The Department of Homeland Security (DHS) Office of Inspector General (OIG) was established 

by the Homeland Security Act of 2002 (Public Law 107-296) by amendment to the Inspector 

General Act of 1978. This is one of a series of audit, inspection, and special reports prepared as 

part of our oversight responsibilities to promote economy, efficiency, and effectiveness within 

the department. 

This report addresses the strengths and weaknesses of the Federal Emergency Management 

Agency’s (FEMA’s) Crisis Counseling Assistance and Training Program (Crisis Counseling 

Program), as implemented by the state of Florida’s Project H.O.P.E. (Helping Our People in 

Emergencies). It is based on interviews with employees and officials of relevant agencies and 

institutions, direct observations, and a review of applicable documents. 

The recommendations herein have been developed to the best knowledge available to our office, 

and have been discussed in draft with those responsible for implementation. It is our hope that 

this report will result in more effective, efficient, and economical operations. We express our 

appreciation to all of those who contributed to the preparation of this report. 

Richard L. Skinner 

Inspector General 
Table of Contents/Abbreviations 

Executive Summary.......................................................................................................................1
 

Background ....................................................................................................................................3
 

FEMA’s Disaster Crisis Counseling..........................................................................................3 

Program Administration.......................................................................................................3 

Program Design ...................................................................................................................4 

Florida’s Project H.O.P.E. .........................................................................................................6 

Results of Review ...........................................................................................................................8
 

Coordination of Outreach Activities..........................................................................................8 

Services Provided.................................................................................................................9 

Presentations and Engagement Strategies..........................................................................10 

Publicity .............................................................................................................................12 

Integrated Efforts ...............................................................................................................13 

Information Sharing to Locate Disaster Survivors ..................................................................14 

Managerial Oversight and Project Monitoring ........................................................................15 

Methodologies to Assess Effectiveness...................................................................................17 

Program Evaluation and Measurement..............................................................................18 

Consistency in Grant Project Framework................................................................................19 

Staffing.....................................................................................................................................21 

Qualifications of Counselors and Project Managers..........................................................21 

Training..............................................................................................................................24 

Management Response and OIG Analysis.............................................................26 

Appendices 

Appendix A: Objectives, Scope, and Methodology................................................................27 

Appendix B: Recommendations .............................................................................................29 

Appendix C: Congressional Inquiry .......................................................................................30 

Appendix D: Management Comments to the Draft Report ....................................................31 

Appendix E: Major Contributors to this Report .....................................................................38 

Appendix F: Report Distribution ............................................................................................39 
Table of Contents/Abbreviations 

Abbreviations 

FEMA Federal Emergency Management Agency 

CMHS Center for Mental Health Services 

HHS U.S. Department of Health and Human Services 
 

OIG
 Department of Homeland Security 

Office of Inspector General 

Executive Summary 

Disasters are events that are out of the realm of the normal human experience and, 

from a psychological standpoint, are traumatic enough to induce stress in anyone, 

regardless of previous experience. Catastrophic disasters often have impacts on 

tens of thousands of people and disrupt entire communities, having widespread 

physical and emotional consequences. The emotional impact of a disaster often 

persists well after the physical impact. Children may show evidence of symptoms 

related to the disaster years later.1

 Most people who are coping with the aftermath 

of a disaster have normal reactions as they struggle with the abnormal situation of 

disruption and loss caused by the disaster. They do not see themselves as needing 

mental health services and are unlikely to request them. Community outreach is 

frequently necessary to seek out and provide mental health services or 

interventions to individuals who may be affected by a disaster.2 The Federal 

Emergency Management Agency’s (FEMA’s) Crisis Counseling Training and 

Assistance Program (Crisis Counseling Program) is designed to address those 

needs. 

We initiated a review in response to Congressional concerns about the use of 

funds by the state of Florida’s Project H.O.P.E. (Helping Our People in 

Emergencies) through a Crisis Counseling Program grant. During the course of 

our initial inquiry, we performed additional work to encompass an assessment of 

the elements of the Crisis Counseling Program, in addition to its implementation 

by Florida, including project management and oversight, reporting, effectiveness 

evaluation, and methods used to evaluate grant projects. 

In our December 2006 response to Senator Susan M. Collins, we reported that 

Project H.O.P.E. used federal grant funds on reasonable and approved items and 

activities according to Crisis Counseling Program guidance. These project 

expenditures were consistent with federally approved budgets, and were used to 

fund eligible activities under the existing Crisis Counseling Program guidelines. 

1

 “Psychosocial Issues for Children and Families in Disasters: A Guide for the Primary Care Physician”; American 

Academy of Pediatrics Work Group on Disasters; U.S. Department of Health and Human Services, 1995 (DHHS 

Publication SMA95-3022) 

2

 “Emergency Mental Health and Traumatic Stress”, Crisis Counseling Assistance and Training Program guidance, 

Center for Mental Health Services/Federal Emergency Management Agency 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 1 
We determined that Project H.O.P.E provided a wide range of crisis counseling 

services, reached a substantial portion of the Florida survivors of Hurricanes 

Wilma and Katrina, and used a variety of accepted, long standing and 

professionally approved methods and activities to reach the populace in need of 

counseling and related services. 

With respect to the Crisis Counseling Program, we identified five areas that could 

be strengthened including: (1) better coordination of outreach and publicity 

activities among FEMA, other responding agencies, and the state implementing 

the Crisis Counseling Program grant project; (2) improved information sharing 

among FEMA and state agencies to locate disaster survivors needing counseling; 

(3) improved managerial oversight and project monitoring; (4) improved 

methodologies to measure project effectiveness; and (5) better planning for 

consistent project design implementation within the grantee state. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 2 
 

 

 

 

Background 

FEMA’s Disaster Crisis Counseling 

The Crisis Counseling Assistance and Training Program (Crisis Counseling 

Program) is funded by the Federal Emergency Management Agency (FEMA). 

The program was originally authorized by the Disaster Relief Act of 1974 

(P.L. 93-288), and was re-codified in Section 416 (42 USC § 5183) of the Robert 

T. Stafford Disaster Relief and Emergency Assistance Act (P.L. 101-707). FEMA 

offers two separate grant programs under the Crisis Counseling Program to 

provide assistance to states that need additional resources to fully provide the 

short-term mental health or crisis counseling services needed following a disaster. 

These programs are the Immediate Services Program and the Regular Services 

Program. States can apply for either or both of these programs, depending on 

their needs. The Immediate Services Program provides funding for counseling 

that can be applied to meet mental health needs immediately following a disaster, 

and services may be provided for two months following the disaster declaration 

date, with a possible extension of one month or more if the Regular Services 

Program application is pending within that same period of time, or if the state can 

justify a continuing need for the Immediate Services Program. The Regular 

Services Program funds services up to nine months from the date of award notice, 

and provides for extensions, contingent upon ongoing need. 

Program Administration 

The Center for Mental Health Services (CMHS), Emergency Mental Health and 

Traumatic Stress Services Branch — a component of the U.S. Department of 

Health and Human Services’ (HHS) Substance Abuse and Mental Health Services 

Administration — works with FEMA through an interagency agreement to 

provide technical assistance and consultation, Crisis Counseling Program 

guidance, training for state and local mental health personnel, grant 

administration, and Crisis Counseling Program oversight.3 CMHS and 

FEMA review the Regular Services Program grant application from the state and 

3

 HHS formally transferred the delegation and responsibility for disaster-related services to CMHS from the 

National Institute of Mental Health (NIMH), which was originally identified in the Disaster Relief Act of 1974 as the 

delegated authority. P.L. 100-707 (11/23/88), the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 

formally amended the delegation to remove the reference to NIMH. FEMA did not change this information in their 

regulation issued March 21, 1989 (54 FR 11610), nor later in the amendment issued on March 3, 2003 (68 FR 

9899). This obsolete reference to NIMH continues to exist in the current (10/1/06) regulations (44 CFR § 206.171) 

“for disasters declared on or after Nov. 3, 1988.” 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 3 
work collaboratively to award the grant. A grant application exceeding $1.5 

million is also reviewed by CMHS-approved external reviewers. Based on the 

results from these reviews, the FEMA Regional Office and CMHS forward a 

recommendation to FEMA Headquarters for a final decision. If funding is 

approved, FEMA Headquarters transfers funds to HHS’ Substance Abuse and 

Mental Health Services Administration, which awards the grant to the State 

Mental Health Authority. Because the grant is administered by CMHS, the State 

Mental Health Authority and subgrantee, such as Project H.O.P.E. (Helping Our 

People in Emergencies), must adhere to grant guidelines and regulations 

promulgated by HHS. 

FEMA’s regulations (44 CFR § 206.171) provide general guidance on the Crisis 

Counseling Program and outlines specific requirements for grant funding, 

reporting on grant activities, and the roles and responsibilities of grantee and 

grantor. Regulations promulgated by HHS (42 CFR and 45 CFR Part 50) on 

grants management and accountability are also incorporated by reference. Further 

detailed guidance is found on CMHS’ website that explains the differences 

between crisis counseling, mental health treatment, and case management, as well 

as appropriate and inappropriate activities and services under the Crisis 

Counseling Program. Additionally, CMHS’ website describes project staffing 

under the Crisis Counseling Program, the fiscal management of Crisis Counseling 

Program grants, and refers to numerous scientifically based publications on 

disaster-related topics such as effective dealings with children and recognizing 

stress or trauma reactions. Guidance specific to the Crisis Counseling Program 

was developed by CMHS in coordination with FEMA Headquarters. 

Program Design 

The Immediate Services Program typically covers the early phase of response and 

recovery, and crisis counselors generally work in the Disaster Recovery Centers 

or other locations where survivors and emergency workers gather in order to 

provide information and support, and to identify needs. Crisis counselors also 

canvass the local areas to assess the disaster impact and seek out survivors in the 

community. At this stage, counselors often listen to survivors tell their stories and 

vent their frustrations, and provide information about available disaster assistance 

programs. 

The Regular Services Program follows the Immediate Services Program and 

includes continuation of individual counseling and expanded services at 

community-based sites, group encounters, and educational contacts that included 

presentations and discussions with various groups and organizations. Individuals 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 4 
often receive face-to-face personal counseling at regular intervals in their homes 

or at a community-based site. Counselors also provide community education 

services and address various organizations to provide education on disaster mental 

health or coping issues. The final phase emphasizes assisting the community in 

planning anniversary or memorial events and creating a plan for ongoing 

community support, including referrals as needed for further assistance and 

preparing survivors for program termination. 

The scope of the Crisis Counseling Program is immediate, short-term, incidentspecific, intervention-style crisis counseling services and support for emotional 

recovery to individuals adversely affected by major disasters. The Crisis 

Counseling Program is intended to supplement state and local mental health 

resources, both public and private, for the specific incident-related need, and is 

not meant to replace or fund existing services. Individuals identified as having 

needs that fall outside the scope and duration of the Crisis Counseling Program 

are referred to other agencies that provide mental health treatment or other 

appropriate types of assistance on a permanent, long-term, and regular basis. The 

criteria and methodology for referral is expected to be constantly reinforced by 

supervisors throughout the project period and monitored to ensure consistent 

application by the project’s crisis counseling staff. 

Individual crisis counseling is defined as providing various support services in 

personal contact with survivors at their places of residence or other locations 

where they are comfortable. Group crisis counseling offers more informal 

support services in a small group format with the additional goal of enabling 

people to normalize and support each other through the recovery process. Public 

information (outreach) and education contacts offer community-based 

information on resources and active disaster services, along with general 

information on disaster stress, coping tips, and awareness issues, and brief 

educational contacts are individual contacts with survivors lasting less than 15 

minutes. Crisis Counseling Program guidelines identify education, referral, and 

outreach as critical elements of crisis counseling activities that are designed to 

ameliorate emotional difficulties or assist in identifying such reactions in others 

who may not be seeking help. A key concept of the Crisis Counseling Program is 

that most people experiencing a reaction after a major disaster are responding 

normally to an abnormal life situation, which can be addressed early in the 

process through basic, straightforward supportive methods in order to preclude 

possible damaging physical, psychological, and behavioral effects and the costs 

associated with sustained, more serious mental health or emotional situations as a 

result of the trauma. HHS’ Substance Abuse and Mental Health Services 

Administration generally makes funding, which is not restricted to incidentFEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 5 
specific circumstances, available to the state for professional, more intensive, 

formal mental health services and longer-term needs. 

These interventions involve understanding the disaster survivors’ current situation 

and reactions, identifying and mitigating additional stressors, assisting them in 

reviewing their options, providing emotional support and encouraging linkages 

with other individuals and agencies that may help survivors recover to their predisaster level of functioning. Assistance is focused on helping survivors 

understand and cope with their current situation and reactions, and is premised on 

the assumption that the individual is capable of resuming a productive and 

fulfilling life following a disaster if given support, assistance, and information at a 

time and in a manner appropriate to his or her experience, education, development 

stage, and culture. 

Survivors generally do not walk into a mental health office and ask for 

counseling. Door-to-door outreach and group informational and educational 

presentations are techniques for letting people know services are available and for 

identifying individuals who need such services. They also can be a useful 

strategy for gauging community-wide needs. 

Florida’s Project H.O.P.E. 

Crisis Counseling Program grant funds were provided to the Florida Department 

of Children and Families, Substance Abuse and Mental Health Program Offices, 

which submitted the grant applications and was responsible for implementing the 

Crisis Counseling Program grant according to FEMA guidelines and procedures. 

Project H.O.P.E. initiated the Immediate Services Program grants for Hurricane 

Katrina on September 7, 2005, and for Hurricane Wilma on October 25, 2005, 

and provided primarily face-to-face individual counseling and services to 

survivors who visited the FEMA Disaster Recovery Centers throughout Florida. 

The Regular Services Program grants covered the period March 15, 2006, to 

December 14, 2006, and expanded services to include additional contacts and 

presentations to groups including special needs populations such as children and 

senior citizens. The Hurricane Katrina services were provided to survivors who 

relocated to Florida from Louisiana and Mississippi, and the Hurricane Wilma 

services were primarily provided to survivors residing in Florida. 

FEMA awarded a total of $22,664,669 to Florida for the Immediate Services 

Programs and the Regular Services Programs to provide counseling services to 

survivors of Hurricanes Katrina and Wilma. This included $9,612,552 for 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 6 
services to Hurricane Katrina survivors and $13,052,117 for services to Hurricane 

Wilma survivors. The Immediate Services Program grant was awarded for 

$6,023,835 and the Regular Services Program grant was awarded for 

$16,640,834. State reports showed that, as of March 14, 2007, expenditures of 

$16,442,269 had been recorded, and it was estimated that final project costs 

would approximate $16.6 million. This included about $4.4 million for the 

Immediate Services Program grants and $12.2 million for the Regular Services 

Program grants; and $6.3 million for Hurricane Katrina-related services and $10.3 

for Hurricane Wilma-related services, with unspent balances estimated at $6 

million, or about 27% of the grant unused. The breakdown of overall expenses 

was 85% for personnel costs, 6% primarily for counselor travel, 2% for materials 

and supplies, and 3% for closeout audits. 

For the Immediate Services Program period from September 7, 2005, through 

March 14, 2006, key elements of services included more than 40,000 individual 

crisis counseling sessions including repeat contacts, more than 750 group 

sessions, and educational/informational contacts in excess of 100,000. More than 

150,000 persons were reported as served, referrals to survivors for assistance by 

other agencies exceeded 35,000, and direct referrals for mental health treatment 

approximated 3,900. Key issues raised by survivors included the need for 

information and assistance, anxiety and agitation, disaster and displacement fears, 

confusion and disorientation, and depression. 

Reports for the Regular Services Program period from March 15, 2006, through 

December 14, 2006, noted major activities including 30,889 individual crisiscounseling contacts, 12,996 group crisis-counseling contacts, and 148,625 public 

education contacts with an additional large number of brief educational contact 

and materials distributed. Also, community-networking contacts in excess of 

77,000 were noted and over 27,000 referrals were provided to survivors. The 

approximated percentages of services provided to the Hurricanes Wilma and 

Katrina survivors correlated to the reported expenditures of 62% for Hurricane 

Wilma services and 38% for Hurricane Katrina services. 

HHS’ Substance Abuse and Mental Health Services Administration, through an 

$11 million appropriation by the legislature, funded a longer-term disaster relief 

grant program in Florida called Project Recovery, which served as the follow-on 

or expanded services phase to the Crisis Counseling Program in seven state 

districts. Project Recovery literature described it as providing “mental health and 

substance abuse supports for Florida residents who continue to experience 

hurricane-related emotional or addictive distress.” Team members are trained to 

treat eligible individuals and families in 8-12 sessions by providing psychoFEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 7 
education, anxiety management techniques or coping strategies, and cognitive 

restructuring. Project Recovery was not designed to replace crisis counseling or 

community mental health centers, which may have been more appropriate for 

individuals with persistent or long-term needs. 

Results of Review 

Coordination of Outreach Activities 

FEMA’s Crisis Counseling Program guidelines define outreach as a service 

method for providing face-to-face individual services to disaster survivors in their 

own homes or at businesses, schools, churches, shelters, community centers, 

nursing homes, or similar environments. Crisis Counseling Program guidelines 

refer to “outreach workers” and “crisis counselors” as the same, using the same 

method of service delivery, though often regarded differently by certain 

communities merely because of the title and its implied role or meaning. 

Outreach is initially conducted at the Disaster Recovery Centers, with counselors 

delivering immediate support to survivors searching for assistance. The crisis 

counselor provides a supportive resource to: (1) validate a disaster survivor’s 

feelings and reactions as normal, expected, and appropriate to the situation; (2) 

educate them about ways to manage their distress; (3) assist them in determining 

their priorities for disaster recovery and to develop plans for meeting them; and 

(4) refer them to other available disaster assistance, human services, and 

governmental and community organizations to address ongoing needs. 

Counselors often listen to survivors tell their stories and vent their frustrations and 

provide information about the disaster assistance programs available. Counselors 

are often comprised of retirees, students, community volunteers, or even disaster 

survivors themselves. 

Functions normally identified as case management are not included under the 

Crisis Counseling Program. These would be activities such as creating or 

implementing emergency preparedness activities; advocating for specific 

treatments, methods, therapies, or services; engaging in fundraising to assist 

disaster survivors with financial problems; or providing child care or 

transportation services. Door-to-door outreach and group informational and 

educational presentations are used as methods to also identify survivors needing 

services and to provide counseling. Project H.O.P.E. crisis counselors spoke 

various languages and knew neighborhood characteristics needed to effectively 

address the diverse needs of the local population. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 8 
 

 

 

 

Services Provided 

The Crisis Counseling Program guidelines identify education, referral, and 

outreach, as critical elements of crisis counseling activities that may serve to 

ameliorate emotional difficulties or assist in identifying such reactions in others 

who may not be seeking needed help. 

Florida’s grant applications for Project H.O.P.E. identified the target populations, 

estimated the numbers of persons who needed counseling, and described the range 

of services to be provided under the Immediate Services Program and Regular 

Services Program. This included individual and group counseling and assistance, 

referrals for additional service, community outreach and public education, and 

information regarding available services. Although the services provided under 

Project H.O.P.E. to Hurricane Wilma survivors were typical of services generally 

provided to people directly impacted by the disaster in their state, the Hurricane 

Katrina grant provided to Project H.O.P.E. was unique, as it was the first time the 

Crisis Counseling Program was used to deliver services for displaced families and 

relocated evacuees from outside the normal service area.4 Many Gulf Coast 

residents were evacuated to various states across the country during the response 

to Hurricane Katrina. FEMA granted separate emergency declarations to 43 

states which hosted the majority of the relocated survivors to enable the host 

states to independently provide disaster relief assistance that normally would have 

only been available from their directly-impacted home states. Under normal 

circumstances, the state directly impacted by the disaster is the only eligible 

applicant for Crisis Counseling Program funds, and the service areas must be 

within the boundaries established by the Presidential disaster declaration. 

Florida summary reports and district weekly reports identified a wide range of 

counseling services and several hundred thousand contacts related to individual 

and group counseling and educational activities, and thousands of referrals 

whereby survivors were provided information about other agencies that could 

provide services determined as appropriate, including additional mental health 

counseling or treatment. Our interviews with Project H.O.P.E. managers and 

4

 In the aftermath of the September 11, 2001 terrorist attacks, the state of New York requested that the undeclared 

border states receive Crisis Counseling Program funding in order to address the disaster impacts on families, 

relatives, and friends of both the survivors and victims who worked within or nearby the declared areas of New 

York City, but lived just outside the attacked areas. These residents did not become evacuees, but were impacted 

due to proximity. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 9 
local government and voluntary organization officials corroborated the extent and 

type of services reported. Individual counseling contacts and services exceeded 

190,000 and direct referrals for additional mental health treatment exceeded 

20,000. 

Conclusion: The counseling, outreach, educational, and referral services 

provided by Project H.O.P.E. were consistent with Crisis Counseling Program 

guidelines and with Florida’s grant applications. 

Presentations and Engagement Strategies 

During the Regular Services Program, increased emphasis was placed on group 

encounters targeted at specific risk population segments, including children and 

senior citizens who were particularly impacted by the hurricanes. Group outreach 

or education to children and senior citizens was often introduced by presentations 

or exercises, such as a puppet show with a hurricane theme, a skit dealing with 

wind impacts, or other similar activities, such as books or singing for children, 

and a form of Bingo using hurricane terminology for seniors. These introductory 

activities are known as “engagement” strategies and techniques for approaching a 

group of individuals in such a way that information presented is non-threatening, 

and generate audience interest as a precursor for discussion of disaster-related 

issues, including fears and concerns about hurricanes. The techniques used by 

Project H.O.P.E. crisis counselors, such as arts and crafts, skits, puppet shows, 

games, and singing, are standard tools used by therapists and recommended by 

professional associations to stimulate the interest and lower the defenses of at-risk 

individuals such as seniors and children. Crisis Counseling Program guidelines 

list such strategies as an appropriate use of the grant funds, and staff have 

described them as beneficial counseling tools used in previous disasters. Site 

visits by CMHS staff to observe the various techniques verified that they did 

conform to Crisis Counseling Program guidelines. 

Although Florida’s grant applications did not highlight the specific presentations 

to be used, one district noted in the Regular Services Program application that 

crisis counselors would focus on services to children in a manner allowing the 

children to express feelings and emotions through the arts, crafts, music, and 

puppets. Another district noted that children could greatly benefit from use of 

recovery-oriented activities such as games and other play activities to assist them 

in coping with stresses and in expressing their feelings. Introductory 

presentations were not used in all districts. For example, the skit called “Windy 

Biggie,” which used costumed characters to address children’s fear of hurricane 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 10 
winds, was used in only two districts and other skits were primarily held in the 

seven districts with the Hurricane Wilma program. 

The specific activities or strategies, which have been used since Crisis Counseling 

Program inception, were developed by each provider (Florida state district or 

contracted provider) to be appropriate to the indigenous population, both 

culturally and to the age or developmental stage. For example, young children 

may not have the verbal skills necessary to communicate their fears or concerns. 

Activities like puppet shows, drawing, and singing can help children articulate 

their feelings to adults who can help them. These activities can be used to teach 

children coping skills, as well as how and where to seek help. 

The shows and games lasted approximately 15 to 30 minutes and were at the 

beginning of the group presentation, after which an interactive discussion of 

hurricane-related issues (constituting the “counseling”) was held with the 

audience. For example, after the skits, the crisis counselors engaged the children 

in a 20 to 45 minute group discussion about the disaster that provided an 

opportunity to see how well children were coping and identify those who may 

have needed additional follow-up and services. Hurricane Bingo is a strategy 

designed to appeal to seniors who can be impacted by disasters but difficult to 

reach, and the game uses objects and symbols to help seniors identify reactions 

and discuss coping strategies. 

While Project H.O.P.E.’s reporting to CMHS and FEMA did not specifically 

include a requirement for identification of these preliminary activities, we 

determined from reviewing district weekly reports and input from the state office 

that about 1,400 introductory presentations were made at group activities. We 

estimated that about 2% to 3% of personnel and travel costs, or around $450,000 

in total, were attributable to these introductory presentations. 

The introductory presentations were used at day care centers, assisted living 

centers, nursing homes, and sometimes during and after school. They were 

initiated as a general practice by Project H.O.P.E. staff, but follow-on 

presentations at other locations were generally based on demand, and feedback 

from the districts resulted in strategy adjustments as needed. For example, most 

Hurricane Katrina teams discontinued senior Bingo when it was determined that 

they were not reaching the intended audience of older Hurricane Katrina survivors 

due to difficulties with locating these survivors. 

There were no eligibility or admission tests to identify who could attend the 

Project H.O.P.E. group sessions or presentations because they were held in 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 11 
hurricane-impacted areas and it was assumed most of the population was affected 

in some way by the disasters. Although some people not impacted by the 

hurricanes attended some presentations, conducting an eligibility test would be 

impractical because most attendees would have suffered some impact, whether 

personally or incidentally. Moreover, there were no additional costs incurred by 

the Project due to the participation of individuals not impacted by Hurricanes 

Katrina or Wilma. 

A multitude of opinions within the medical and social services professions exist 

about the best approaches for counseling people subjected to emotional distress, 

but most recognize there is no prescriptive one-step approach to address such 

conditions and that children and seniors often require special approaches. 

Conclusion: The strategies, techniques, and methods of delivery used by Project 

H.O.P.E. to reach special populations such as children and seniors were consistent 

with Crisis Counseling Program guidelines and those employed by industry 

professionals. 

Publicity 

To increase public awareness, Project H.O.P.E. staff distributed flyers and 

brochures throughout the various communities and to the media and hotlines for 

use by survivors. Mail outs to potential survivors were not used, primarily due to 

the costs involved and limited information about survivor locations. Also, each 

agency involved with disaster assistance generally issued its own publicity about 

available services and programs, and this action was cited as contributing to 

survivor confusion and anxiety, especially during the period immediately after the 

disaster. Coordinated and integrated public information and publicity campaigns 

significantly increase the public’s understanding of recovery and assistance 

programs available, and contribute to the ability to reach the target populations. 

Although CMHS made standard radio and television public service 

announcements available for use, we heard a number of comments that indicated 

that the state of Florida did not use the methods of “getting the word out” 

effectively enough to ensure that everyone recognized the name of Project 

H.O.P.E. and knew its role in disaster assistance. Instead, the district was 

responsible for ensuring its own service area was informed. Experience with 

other Crisis Counseling Program grant projects shows that when public 

information campaigns are managed by the state, name recognition and 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 12 
understanding of the grant project mission are significantly increased globally and 

contribute to the ability to reach the target populations. 

Integrated Efforts 

Project H.O.P.E. staff often duplicated outreach activities performed by FEMA’s 

Voluntary Agency Liaisons, Community Relations, and Public Affairs staffs. 

FEMA’s Voluntary Agency Liaisons’ primary function is to coordinate with the 

many voluntary and charitable agencies to identify needs of disaster survivors not 

addressed through FEMA or state and local programs that may be relieved 

through some other means. FEMA’s Community Relations and Public Affairs 

staffs work to ensure that neighborhoods and communities are kept informed of 

assistance available from FEMA, other federal agencies, state, and sometimes 

local and community resources. These functions frequently involve such 

activities as routinely gathering and disseminating information on FEMA’s 

disaster programs to individuals, canvassing neighborhoods to locate survivors, as 

well as the delivery of new or updated FEMA or other federal agency program 

information to community organizations or the media. 

Considerable resources were involved in canvassing neighborhoods or notifying 

survivors about FEMA disaster assistance programs on the part of both Project 

H.O.P.E. and FEMA’s Community Relations and Public Affairs staffs. Work 

carried out by Project H.O.P.E. crisis counselors in gathering detail on available 

community resources and services for survivors could have been greatly reduced 

through sharing of information with the state program offices. This type of 

information had already been, or was in the process of being, gathered by the 

various FEMA components as part of their own standard procedures. 

The complementary missions and overlapping activities of the Voluntary Agency 

Liaisons, Community Relations, and Public Affairs components could be more 

fully integrated to ensure that disaster survivors are getting consistent messages 

about the services available and the roles played by each. Development of 

procedures would help ensure improved coordination of the grant project 

publicity, such as announcing the existence and services of the Crisis Counseling 

Program immediately after grant award and working with other responding 

entities to integrate publicity about the various services available to disaster 

survivors. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 13 
Recommendation 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #1: Implement standard practices to ensure the 

exchange of outreach information and coordination of efforts in 

publicizing services available to disaster survivors, including available 

community and governmental services, among the state and local Crisis 

Counseling Program project offices, FEMA’s Voluntary Agency Liaisons, 

Community Relations, and Public Affairs. 

Information Sharing to Locate Disaster Survivors 

Staff from Project H.O.P.E., as well as local government and voluntary 

organization officials, told us they experienced difficulty obtaining information 

from FEMA about disaster survivors who applied for FEMA assistance, 

specifically names, addresses, or lodging accommodations where Hurricane 

Katrina evacuees were being housed. Project H.O.P.E. staff told us that FEMA 

cited privacy restrictions as the reason they could not share the information. As a 

result, Project H.O.P.E. staff used considerable resources and time canvassing 

impacted areas to identify people who might need services, as well as posting 

notices in communal locations and holding community events, to ensure the 

information got to the survivors who did not know how to access the various 

services available. 

Much of the work performed by Project H.O.P.E. staff to identify survivors 

needing counseling was also performed by FEMA’s Voluntary Agency Liaisons, 

as well as staff from both Community Relations and Public Affairs. Both Project 

H.O.P.E. and FEMA, and potentially other state and local organizations, 

expended considerable resources to canvass neighborhoods or notify survivors 

about disaster assistance programs. Sharing information among those involved in 

the process of identifying survivors in need of assistance could have been 

considerably more efficient and effective, and could have provided disaster 

survivors with less confusing, consistent, and comprehensive information on 

services available to them. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 14 
Recommendation 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #2: Collaborate with other government agencies 

providing disaster relief to help identify and establish contact with those 

needing crisis counseling. 

Managerial Oversight and Project Monitoring 

Although substantial oversight and reporting was conducted, our review of reports 

noted limited on-site monitoring, except by district officials directly responsible 

for Crisis Counseling Program implementation. It is important that FEMA and 

CMHS officials observe the field performance of crisis counselors and assess the 

value of counseling activities conducted, including those using introductory 

strategies such as skits or games. While time constraints during oversight visits 

often limit on-site monitoring at field sites by FEMA and CMHS, more 

independent and on-site monitoring is needed beyond interviewing counselors and 

viewing presentations at state or local offices. 

Oversight and monitoring was performed by Project H.O.P.E. district officials, 

including district program supervisors and Project H.O.P.E. project managers, in 

addition to the state, FEMA, and CMHS officials, through such vehicles as daily 

briefings, weekly and quarterly reports, weekly conference calls, and site visits. 

All monitoring is done in coordination with FEMA’s Regional Office and 

Headquarters Crisis Counseling Program staff. 

Within Florida’s Department of Children and Families, the district supervisors are 

responsible for various mental health programs in their districts and operate with 

considerable autonomy. The Florida’s Department of Children and Families’ 

Director of Federal Disaster Grants, which included Project H.O.P.E., has 

responsibility for monitoring, recommending, and coordinating the execution of 

the grant as awarded, but has limited authority over grant project implementation 

and the customization of techniques and methodologies for the delivery of 

services by the districts. 

It is expected that individuals identified as having needs that fall outside the scope 

and duration of the Crisis Counseling Program will be referred to other agencies 

that provide mental health treatment on a permanent, long-term and regular basis. 

The criteria and methodology for referral is constantly reinforced by grant project 

officials throughout the grant project period, and monitored to ensure consistent 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 15 
application by the crisis counselors. Supervisors provide ongoing review of staff 

activities to ensure that they are consistent with the scope and intent of the Crisis 

Counseling Program, and the state’s grant application. CMHS and FEMA also 

monitor activities throughout the grant project, including review of regular 

reports, site visits, and regular discussions with the state’s grant project staff. 

District Project H.O.P.E. managers held weekly meetings with crisis counseling 

teams to assess activities and resolve identified problems and, as time permitted, 

conducted on-site visits to observe team and counselor performance and audience 

reactions to presentations. District weekly reports forwarded to the state office 

were detailed, with program activities, accomplishments, problems, and 

challenges. Issues raised in the reports were addressed at weekly meetings, 

including any needs for additional training. Typical challenges reported included 

such things as: 

•	 dealing with the lack of information from FEMA about locations and 

names of survivors; 

•	 alternatives when resources were lacking at other agencies to allow them 

to adequately address the referrals made by counselors; 

•	 concerns about data collection forms that did not properly identify services 

provided, such as a multi-lingual component; and 

•	 handling the change of data analysis elements during the grant project 

period that reduced the usefulness and availability of data to evaluate 

program results. 

Florida state officials reviewed district weekly reports and conducted site visits 

that included interviews with Project H.O.P.E. staff and observing the skits and 

games prepared by the district offices. FEMA and CMHS officials reviewed 

progress reports submitted by the state office and accompanied state officials to 

multiple district offices for staff interviews and observing presentations. Detailed 

trip reports, including recommendations, were prepared after each site visit by 

CMHS. 

Recommendation 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #3: Enhance oversight and monitoring by requiring 

observation by FEMA and CMHS of on-site crisis counseling services to 

better assess the activities and field performance of crisis counselors. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 16 
Methodologies to Assess Effectiveness 

Measuring the benefits or success of grant projects like Project H.O.P.E. is 

difficult, and officials at all government agencies involved with these programs 

are working toward identifying and implementing more effective results-oriented 

measurements. Currently, the statistics captured to measure the grant project’s 

impact only quantify the number of service recipients or number of interactions 

completed by crisis counselors. Both supporters and critics of Project H.O.P.E. 

generally agree that methods need to be developed and used that measure results 

in terms of outcomes (identifiable improvements in mental behavior and 

emotional improvements) rather than outputs (the number of people assisted). 

A multitude of varying opinions within the medical and social services 

professions exist about the best approaches for counseling people experiencing 

emotional distress or more serious problems, but almost all professionals in these 

fields recognize there is no prescriptive one-step approach for such conditions. 

Concerns about the validity or value of such activities in crisis counseling, or the 

worthiness of them to be federally funded, need to be addressed by subject matter 

experts, within HHS and CMHS. 

Officials at schools, day care centers, senior citizen facilities, and other 

governmental or voluntary organizations assisting with disaster relief, were 

generally not queried to obtain feedback about Project H.O.P.E. Anecdotal 

information and correspondence from appreciative survivors was collected, but 

not formally queried about the counseling services provided and the impacts of 

the disasters. Historically, anecdotal and testimonial information received was 

used to determine the value of certain techniques, the strategic impacts for 

judging future grant applications, and the type of guidance that may be needed for 

consistency. While such stories and letters are rewarding for the grant project 

staff and encouraging for the oversight staff, they are not measures that can prove 

effectiveness or efficiency to external observers. 

Local and governmental officials told us that Project H.O.P.E. was a valuable 

resource for non-threatening interactions that provided emotional support, hope, 

and guidance to individuals and communities affected by disasters. Overall, these 

officials believed Project H.O.P.E. was a critical element in the recovery process, 

that staff did an outstanding job under very difficult conditions, were disappointed 

that the program was being terminated in December 2006, and felt that media 

perceptions did not provide a balanced or accurate portrayal of the grant project. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 17 
Program Evaluation and Measurement 

Florida initiated two surveys to obtain feedback from survivors about Project 

H.O.P.E. The survey was developed by CMHS and provided to survivors at the 

conclusion of individual crisis counseling sessions. Project H.O.P.E. reported that 

in August 2006, 210 questionnaires were provided to Hurricane Katrina survivors 

and 940 were provided to Hurricane Wilma survivors. The response rate for these 

questionnaires was 14% for Hurricane Katrina and 32% for Hurricane Wilma. 

District officials told us they had not received any feedback on the results of the 

survey from state officials, and thus were unable to address any issues or 

problems that may have surfaced. State officials told us that the response rates 

were too low to be meaningful and thus no feedback was provided to the districts. 

A state official believed the primary reason for low response was that the 

questionnaire was not user-friendly and needed to be revised to be a more 

effective tool for assessing ongoing performance and results. The Hurricane 

Wilma survey results noted that 55% of respondents rated the Crisis Counseling 

Program or counselor as “A”, 22% as “B”, and 13% as “C” out of a grading range 

of “A” (very good) to “E” (very poor). The results of the second survey were not 

available during our review. 

CMHS currently has a contract in place with the National Center for PostTraumatic Stress Disorder that will recommend methods of evaluating such 

counseling programs that will be available some time in the future. Project 

H.O.P.E. staff told us that they believe considerable work still needs to be done to 

adjust the National Center for Post-Traumatic Stress Disorder’s data collection 

efforts to be more incident- and circumstance-related and less post-traumatic 

stress-related, which tends to skew the responses given on questionnaires and 

surveys. 

It is difficult to evaluate and measure improvements in mental behavior or 

emotional improvements, but results-oriented measurements are crucial to 

determining the benefits obtained from grant project activities and adjusting 

future activities accordingly. For example, standardized, user-friendly customer 

satisfaction surveys and consistent data collection methods could be used to 

evaluate value of the service delivery method used and to obtain feedback and an 

independent assessment of observed services and activities from those directly 

involved with Project H.O.P.E. services, such as school teachers and community 

leaders. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 18 
Recommendation 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #4: Develop and implement consistent resultsoriented measurements to determine the effectiveness of grant projects 

funded. 

Recommendation #5: Require the grantee, as part of the grant 

application, provide a strategy for measuring behavioral and emotional 

improvements based upon the various counseling methods used. 

Consistency in Grant Project Framework 

Crisis Counseling Program guidelines do not prescribe standardized activities, 

promotional materials, a service delivery methodology, staffing levels, hiring 

parameters, or grant project design. Because of the variety of approaches to each 

circumstance, population, or organization, the Crisis Counseling Program was 

designed to be unstructured and flexible. This is because the Crisis Counseling 

Program is to be implemented by the grantee in response to the needs of specific 

circumstances, population, or organizations rather than fitting their grant project 

into a standard mold. The boundaries and parameters (or the structure) for 

servicing their own populace are left up to the grantee for definition in their grant 

project design, with the expectation that a thorough assessment of their 

constituents’ needs and the available resources will help them properly determine 

that design. CMHS staff told us that this flexibility allows personalized and 

tailored approaches and ensures effective service delivery to the appropriate target 

population. However, a standardized structure and basic format for a state’s grant 

project application helps to ensure that the grant application review panel can 

verify that all characteristics necessary for sufficient assessment of needs and 

resources are covered, and uses language and statistics comparable across grant 

applications to permit programmatic strategic analysis. CMHS frequently works 

with the state in developing their grant applications to ensure that all 

characteristics necessary for sufficient assessment have been addressed. 

Generally, “best practices,” as identified through informal means, are shared 

within and among grant project staff throughout the state during the grant period. 

However, because the Crisis Counseling Program is only available after a 

Presidentially declared incident and is temporary, the knowledge and experience 

about counseling and outreach gained by the disaster-specific temporary 

employees is lost when the grant period and the associated employment ends. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 19 
There are few situations when staff that have a foundational understanding of the 

differences between mental health and crisis counseling are involved in 

subsequent Crisis Counseling Program grant projects. As a result, with each new 

disaster declaration, each district’s implementation of the state’s grant project 

involves the process of learning about program requirements and designing 

approaches and materials from scratch. This frequently results in a wide variety 

of initial methodologies and interpretations that may differ dramatically from 

district to district. 

Even for Florida, which is regularly struck by hurricanes of varying magnitude 

each year and is familiar with the Crisis Counseling Program, considerable effort 

and resources went into developing Project H.O.P.E. In addition, the 

independence and relative self-governing relationship of the districts with the 

state of Florida’s Mental Health Services made the differences in implementation 

and methodologies even more pronounced. Crisis Counseling Program grant 

projects are often designed and managed at the state level, whereas Florida’s state 

officials were mostly coordinators and grant contact points, and not the primary 

designer or manager. This made standardization of methodologies and 

development of a consistent message difficult at the outset. 

The Florida districts supplemented the state’s issuances of grant project guidance 

by developing creative customized Project H.O.P.E. promotional material, 

including brochures, flyers, and informational bulletins and used state and federal 

Crisis Counseling Program guidance. While the tailoring of materials and 

techniques to suit a particular audience or locale should continue to be 

encouraged, beginning from an agreed-upon standard and customizing within 

defined parameters would ensure primary consistency that would tie the grant 

project together across the state. However, the opportunity exists for a state “how 

to” handbook that highlights the basic Crisis Counseling Program elements, 

including best and approved practices, such as successful types of introductory 

strategies and recommended training episodes. Project H.O.P.E. staff said that 

such a tool would improve the consistency of grant project implementation, 

reduce start-up time and individual district preparation of materials, and assist 

with educating the public about the grant project’s objectives and services. 

Districts could supplement this tool with information targeted to the population 

and service needs in their district. 

A significant challenge in operating the Crisis Counseling Program is to ensure 

that services are tailored to the unique issues in each disaster, while at the same 

time ensuring that basic program philosophy, concepts, and requirements are 

understood and implemented consistently across the country. While there has 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 20 
been increased consistency in types and quality of services provided in recent 

years, there is still variation in the use of staff and service delivery models, 

particularly in communities that have little experience with the Crisis Counseling 

Program. A CMHS report noted that there remains some variation in the use of 

staff and service delivery models in Project H.O.P.E. type programs, and this was 

observed to a degree with respect to district determinations on use of skits and 

games as introductory strategies for group presentations. 

Many project counselors told us that they could have been more effective in 

designing their approaches and setting up their services if they had been started 

off with more guidance and reference materials. Many wanted to know how other 

states had done certain things, if just to provide ideas. In reviewing the many 

materials and reports, we noted differences in the messages or designs across the 

districts that could be confusing to disaster survivors who could be led to believe 

that the services being offered were somehow different depending on the district 

office involved. District staff told us that they were working to document and 

preserve programmatic materials and procedures for future use as part of their 

grant closeout activities. State staff said that after Project H.O.P.E. terminated, 

they hoped to have the resources and time to prepare such a manual or template. 

Final district reports due after program termination are intended to include crisis 

counseling staff input on lessons learned and recommendations for program 

improvement. These reports could be a valuable tool for identifying needed 

actions for the future. 

Recommendation 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #6: Require the project grantee create a consistent 

grant project design framework statewide that identifies and addresses 

potential challenges or obstacles, whether in the state oversight structure 

or in the diversity of target populations. 

Staffing 

Qualifications of Counselors and Project Managers 

Approximately 450 staff were involved with Project H.O.P.E. at the height of the 

program, which was implemented to varying degrees throughout the state. 

Thirteen districts implemented Project H.O.P.E. for Hurricane Katrina evacuees 

and five districts for Hurricane Wilma survivors. The grant projects were 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 21 
implemented by the state in some districts and by contractors with mental health 

and counseling experience in other districts. Teams varied in composition 

depending on the type of event, the size of the geographical area involved, and 

unique cultural or language needs. 

Teams were encouraged to have professional staff assume supervisory roles in 

order to provide clinical support to paraprofessional team members. State 

officials instructed each service provider to seek out both professional and 

paraprofessional workers for the grant project. Our review of information 

collected on team leaders revealed that efforts were made to employ staff, 

including Project H.O.P.E. managers, team leaders, and crisis counselors, with 

degrees in a field dealing with human reactions to disaster-related conditions. 

Some districts were more successful than others, although Project H.O.P.E. 

managers, state and district supervisors, and contractor officials with whom we 

discussed staffing, were all supportive of the staff mix used and noted that 

professionals in the fields of psychology, social work, counseling, nursing, or 

related professions were available to assist counselors as necessary. They said 

that many team leaders and counselors had degrees, others had partially 

completed degree work, and others were from the community. Those counselors 

from the community were considered essential to the success of Project H.O.P.E. 

because of their knowledge of local cultures and languages. 

Several local newspaper articles raised concern about the qualifications of the 

staff used to implement the Crisis Counseling Program, with a primary concern 

being the limited number of professionals in the mental health field administering 

or supervising crisis-counseling services. FEMA’s guidelines for the Crisis 

Counseling Program do not establish mandatory qualifications or degrees for 

specific positions. Rather, the guidelines suggest a typical team be composed of a 

mix of professionals and paraprofessional staff, including people who are not 

human service professionals, but who have strong intuitive skills about people or 

relate well to others, possess good judgment, common sense, and are good 

listeners and live in the community. A typical outreach team was composed of 

mental health professionals and paraprofessionals from the community, all trained 

in the basics of disaster mental health and the Crisis Counseling Program. Crisis 

counselors from the community are generally known by local community 

members, or are part of the cultural or ethnic group receiving the services. 

Prospects are usually very slim that licensed professionals are available on quick 

notice for a tenuous short-term employment at low pay and no benefits. 

Professional staff members are defined as individuals with a master’s degree level 

or higher in psychology, social work, counseling, psychiatric nursing, or related 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 22 
professions. State officials told us that they had very few such applicants for the 

positions advertised in spite of fairly extensive recruitment efforts. 

Paraprofessional staff members are defined as those with a bachelor’s degree or 

less, or those who are not human service professionals. Specific language skills 

are also crucial in many cases. The crisis counselors were typically supervised 

and trained by professionals that had advanced training and experience. Project 

H.O.P.E. provided professional oversight by a mental health professional 

throughout the grant project, along with close supervision from the state Program 

Supervisor. 

Information provided by Florida’s program office about the 40 Project H.O.P.E. 

team leaders employed by the districts documented the following primary 

educational attributes: 

•	 2 with PhDs in psychology; 

•	 15 with masters’ degrees, including 6 in social service, 2 in 

psychology, and 2 in counseling; 

•	 18 with bachelors’ degrees, including 6 in psychology, 3 in social 

service, 2 in management, and 1 in life sciences; 

•	 1 project manager with a master’s degree in education; 

•	 2 with some college; and 

•	 2 with high school diplomas. 

For Miami and surrounding areas where a contractor was the major provider of 

counseling services, both Hurricanes Katrina and Wilma staff possessed 

considerable educational attributes. Project H.O.P.E. supervisors told us that 

teams had been organized to best serve the needs of Hurricane Katrina survivors. 

Teams more clinically oriented were used for Hurricane Katrina survivors 

because evacuees had suffered severe losses and were relocated far from family 

and friends. Although Hurricane Wilma hit Florida directly and caused 

considerable damage, the counseling services identified as needed for this 

population emphasized more outreach activity than clinically oriented services. 

Other Project H.O.P.E. managers also noted that qualifications of staff reflected, 

and were tailored to, the needs of different populations. 

It was generally acknowledged by everyone we spoke with that when employing 

about 450 temporary hires in a short timeframe, there will be instances where 

selections may be questioned, performance may not meet expectations, or some 

employees may become dissatisfied with the grant project or their position, 

regardless of whether the employee has a higher education or employment was 

based on other factors. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 23 
Project H.O.P.E. did not fully meet the criteria laid out in the state’s grant 

application, which had planned for crisis counseling team leaders to be mental 

health professionals. However, local government and voluntary organization 

officials generally expressed satisfaction with the qualifications and performance 

of Project H.O.P.E. staff and noted the need for a disparate mix of staff who could 

deal with a wide range of problems, most of which were attributable to short-term 

distress rather than long-term or serious mental health issues. In several districts, 

Project H.O.P.E. staff efforts were recognized by grant project partners or the 

media through proclamations and award ceremonies. 

Conclusion: The overall qualifications of Project H.O.P.E.’s staff were generally 

sufficient to effectively implement the grant project, as defined in the grant 

application and according to FEMA guidelines. 

Training 

Crisis Counseling Program guidelines stress that all staff, professional or 

paraprofessional, need to be provided with training in the scope and services of 

the Crisis Counseling Program, emotional responses to disaster, and techniques 

for integrating disaster experiences. Project H.O.P.E. staff received training to 

prepare them for working and coping with the wide range of behavioral and 

emotional problems commonly seen after disasters, and methods of approaching 

or engaging individuals who may be experiencing such disorders as anxiety, 

adjustment, situational depression, and substance abuse, for example. This also 

included learning to identify signs in a disaster survivor when it is encouraged to 

refer individuals for mental health treatment by a licensed or certified 

professional, and on counselors coping with the stresses related to disaster work. 

A professional with advanced training and experience designed, supervised, or 

conducted this crisis counseling training. 

The primer curriculum includes training modules developed at the national level 

and presented by a cadre of researchers and practitioners in disaster recovery. 

This mandatory training, generally one to two days in length, includes modules 

on: 

•	 Crisis Counseling Program Intermediate Services Program Training; 

•	 Immediate Services Program to Regular Services Program Transition 

Training; 

•	 Regular Services Program Mid-Program Training; and, 

•	 Anniversary and Phase-down Training. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 24 
Project H.O.P.E. staff provided additional new or reinforcement training at both 

state and district levels for disaster relief workers, as well as on a variety of 

special interest topics requested by crisis counselors to assist with particular needs 

and problems encountered. Much of this training occurred in conjunction with 

the weekly staff meetings in the districts, and included subjects such as emotional 

responses to disaster, compassion fatigue, team building, stress management, 

communication skills, self care, and interactive exercises dealing with survivor 

and staff needs. The State Program Development Trainer estimated that about 35 

hours of formal training was provided to crisis counselors. Those conducting the 

training sessions included practitioners in disaster recovery (federal and state) and 

Project H.O.P.E. managers, most of whom had prior experience in Crisis 

Counseling Program type projects. 

CMHS contracted with the National Center for Post-Traumatic Stress Disorder, a 

component within the Veterans Health Administration of the U.S. Department of 

Veterans Affairs, and Dartmouth Medical School, in May 2006, to conduct a 

survey of Hurricane Wilma crisis counselors in Florida. The survey was intended 

to obtain feedback about the grant project quality and stress levels of counselors 

working in Florida six months after Hurricane Wilma. Anonymous responses 

were received from 158 of the 240 counselors queried. The key findings were: 

•	 the counselors believed that the project was doing a good job of 

meeting the needs of the communities it served; and 

•	 the counselors expressed concern that the quality of training they had 

received needed improvement, but their ratings of working conditions 

and resources were in the higher range. 

A survey of Hurricane Katrina crisis counselors in Florida produced similar 

responses. A comparison of results from the two surveys noted that Hurricane 

Wilma counselors were more stressed than Hurricane Katrina counselors, which 

was attributed to the extra challenges of working in an area directly affected by 

the disaster. In both cases, the counselors identified the need for improved 

orientation training, additional counseling skills subjects, targeted instruction for 

different populations, and better technical resources (supplies, laptops, etc.). 

Conclusion: The training of Project H.O.P.E.’s staff was generally sufficient to 

effectively implement the grant project and was consistent with FEMA 

guidelines. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 25 
Management Response and OIG Analysis 

The State of Florida’s Department of Children and Families fully endorsed and FEMA’s Disaster 

Assistance Directorate generally concurred with all the recommendations we offered to 

strengthen the Crisis Counseling Assistance and Training Program. Recommendations 1, 4, 5 

and 6 have been resolved and closed because they have been implemented. We consider 

recommendations 2 and 3 resolved because steps are being taken to implement them; however, 

they will remain open until they have been fully implemented. FEMA projects that these 

recommendations will be fully implemented following discussions with Crisis Counseling 

Program stakeholders in September and December 2008. We will close each recommendation as 

FEMA provides evidence that they have been implemented. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 26 
Appendix A 

Purpose, Scope and Methodology 

This review was prompted by congressional requests asking us to examine 

the Federal Emergency Management Agency’s (FEMA) Crisis Counseling 

Assistance and Training Program (Crisis Counseling Program), 

specifically Florida’s Project H.O.P.E., as a result of media allegations of 

malfeasance, waste, and abuse. Our objectives were to determine whether 

Project H.O.P.E. was: (1) expending funds according to the scope of the 

grant award; (2) being properly monitored to ensure that all participants 

were operating within approved guidelines, as defined by CMHS and 

FEMA; and (3) carrying out approved activities to meet the intent of the 

Crisis Counseling Program. During the course of our review, we 

expanded our scope to encompass a general assessment of the Crisis 

Counseling Program. 

To assess the Crisis Counseling Program, we: 

•	 Interviewed staff from the Florida Department of Children and 

Families’ Substance Abuse and Mental Health Program, district 

managers, Project H.O.P.E. managers, and local government and 

voluntary organization officials; 

•	 Reviewed weekly and quarterly reports, financial budgets and 

expenditure reports, statistical service delivery data, grant project 

procedural guidelines, descriptions of methodologies and techniques, 

training materials and plans, provider contracts, and promotional 

materials; 

•	 Interviewed staff from CMHS and examined site visit reports, grant 

applications, monitoring and oversight files and records, and prior 

grant project evaluations; and 

•	 Examined the Crisis Counseling Program guidance, Crisis Counseling 

Program regulations, topical studies and publications, and prior audit 

reports. 

Our review focused on the Crisis Counseling Program grants that were 

awarded and executed subsequent to Hurricanes Katrina and Wilma, 

including the Immediate Services Program, which operated during the 

period September 7, 2005, through March 14, 2006, and the Regular 

Services Program, which operated during the period March 15 through 

December 14, 2006. We emphasized our review work on the Regular 

Services Program due to the expanded services provided under this 

program phase. Though we concentrated our interviews in the three 

counties of Broward, Palm Beach, and Miami-Dade, we examined data 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 27 
Appendix A 

Purpose, Scope and Methodology 

from locations throughout the state, and discussed the program for all 

locations with the state officials. 

We reviewed the implementation of Project H.O.P.E. according to 

established regulations and guidelines provided and approved by the 

grantor (FEMA) and administrative agency (CMHS), but did not address 

the adequacy or intent of these guidelines. 

We conducted our review between November 2006 and January 2007 

under the authority of the Inspector General Act of 1978, as amended, and 

according to the Quality Standards for Inspections issued by the 

President’s Council on Integrity and Efficiency 

We appreciate the extensive assistance and full cooperation we received 

from the staffs at the Center for Mental Health Services, Florida’s 

Department of Children and Families, as well as the input from the Project 

H.O.P.E. managers and team leaders. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 28 
Appendix B 

Recommendations 

We recommend that FEMA’s Assistant Administrator for Disaster Assistance: 

Recommendation #1: Implement standard practices to ensure the exchange of outreach 

information and coordination of efforts in publicizing services available to disaster survivors, 

including available community and governmental services, among the state and local Crisis 

Counseling Program project offices, FEMA’s Voluntary Agency Liaisons, Community 

Relations, and Public Affairs. 

Recommendation #2: Collaborate with other government agencies providing disaster relief to 

help identify and establish contact with those needing crisis counseling. 

Recommendation #3: Enhance oversight and monitoring by requiring observation by FEMA 

and CMHS of on-site crisis counseling services to better assess the activities and field 

performance of crisis counselors. 

Recommendation #4: Develop and implement consistent results-oriented measurements to 

determine the effectiveness of grant projects funded. 

Recommendation #5: Require the grantee, as part of the grant application, provide a strategy 

for measuring behavioral and emotional improvements based upon the various counseling 

methods used. 

Recommendation #6: Require the project grantee create a consistent grant project design 

framework statewide that identifies and addresses potential challenges or obstacles, whether in 

the state oversight structure or in the diversity of target populations. 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 29 
Appendix C 

Congressional Inquiry 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 30 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 31 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 32 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 33 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 34 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 35 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 36 
Appendix D 

Management Comments to the Draft Report 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 37 
Appendix E 

Major Contributors to this Report 

Norman Brown, Director, Preparedness and Mitigation Division, Office of 

Emergency Management Oversight 

Katherine Roberts, Auditor, Preparedness and Mitigation Division, Office 

of Emergency Management Oversight 

Hubert Sparks, Senior Program Analyst, Preparedness and Mitigation 

Division, Office of Emergency Management Oversight 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E.
 

Page 38 
Appendix F 

Report Distribution 

Department of Homeland Security 

Secretary 

Deputy Secretary 

Chief of Staff 

Deputy Chief of Staff 

General Counsel 

Executive Secretary 

Director, GAO/OIG Liaison Office 

Assistant Secretary for Office of Policy 

Assistant Secretary for Office of Public Affairs 

Assistant Secretary for Office of Legislative Affairs 

Under Secretary for Management 

DHS Public Affairs 

Federal Emergency Management Agency 

Administrator 

Deputy Administrator 

Assistant Administrator for Disaster Assistance 

Director, Office of Policy 

Director, GAO/OIG Liaison Office 

Center for Mental Health Services 

Director 

Branch Chief, Emergency Services and Disaster Relief Branch 

Project Officer 

Inspector General, U.S. Department of Health & Human Services 

Florida Department of Children and Families 

Director, Mental Health Program Office 

Director, Federal Disaster Behavioral Health Projects 

Inspector General 

Office of Management and Budget 

Chief, Homeland Security Branch 

DHS OIG Program Examiner 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 39 
Appendix F 

Report Distribution 

Congress 

Congressional Oversight and Appropriations Committees 

The Honorable Susan Collins 

The Honorable Tom Feeney 

The Honorable Robert Wexler 

The Honorable Bill Nelson 

FEMA’s Crisis Counseling Assistance and Training Program; State of Florida’s Project H.O.P.E. 

Page 40 
Report Distribution 

Additional Information and Copies 

To obtain additional copies of this report, call the Office of Inspector General 

(OIG) at (202) 254-4199, fax your request to (202) 254-4305, or visit the OIG 

web site at www.dhs.gov/oig. 

OIG Hotline 

To report alleged fraud, waste, abuse or mismanagement, or any other kind of 

criminal or noncriminal misconduct relative to department programs or 

operations: 

• Call our Hotline at 1-800-323-8603; 

• Fax the complaint directly to us at (202) 254-4292; 

• Email us at DHSOIGHOTLINE@dhs.gov; or 

•	 Write to us at: 

DHS Office of Inspector General/MAIL STOP 2600 

Attention: Office of Investigations – Hotline 

245 Murray Drive, SW, Building 410 

Washington, DC 20528. 

The OIG seeks to protect the identity of each writer and caller.