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S. Hrg. 111–547 

CHILDREN AND DISASTERS: A PROGRESS REPORT 

ON ADDRESSING NEEDS 

HEARING 

BEFORE THE

AD HOC SUBCOMMITTEE ON DISASTER RECOVERY 

OF THE

COMMITTEE ON 

HOMELAND SECURITY AND 

GOVERNMENTAL AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED ELEVENTH CONGRESS 

FIRST SESSION 

DEEMBER 10, 2009 

Available via http://www.gpoaccess.gov/congress/index.html 

Printed for the use of the Committee on Homeland Security 

and Governmental Affairs 

( 
(II) 

COMMITTEE ON HOMELAND SECURITY AND GOVERNMENTAL AFFAIRS 

JOSEPH I. LIEBERMAN, Connecticut, Chairman 

CARL LEVIN, Michigan 

DANIEL K. AKAKA, Hawaii 

THOMAS R. CARPER, Delaware 

MARK L. PRYOR, Arkansas 

MARY L. LANDRIEU, Louisiana 

CLAIRE MCCASKILL, Missouri 

JON TESTER, Montana 

ROLAND W. BURRIS, Illinois 

PAUL G. KIRK, JR., Massachusetts 

SUSAN M. COLLINS, Maine 

TOM COBURN, Oklahoma 

JOHN MCCAIN, Arizona 

GEORGE V. VOINOVICH, Ohio 

JOHN ENSIGN, Nevada 

LINDSEY GRAHAM, South Carolina 

ROBERT F. BENNETT, Utah 

MICHAEL L. ALEXANDER, Staff Director 

BRANDON L. MILHORN, Minority Staff Director and Chief Counsel 

TRINA DRIESSNACK TYRER, Chief Clerk 

AD HOC SUBCOMMITTEE ON DISASTER RECOVERY 

MARY L. LANDRIEU, Louisiana, Chairman 

CLAIRE MCCASKILL, Missouri 

ROLAND W. BURRIS, Illinois 

LINDSEY GRAHAM, South Carolina 

ROBERT F. BENNETT, Utah 

BEN BILLINGS, Staff Director 

ANDY OLSON, Minority Staff Director 

KELSEY STROUD, Chief Clerk 
(III) 

C O N T E N T S 

Opening statement: Page 

Senator Landrieu .............................................................................................. 1 

Prepared statements: 

Senator Landrieu .............................................................................................. 33 

WITNESSES 

TUESDAY, DECEMBER 10, 2009 

Mark K. Shriver, Chairperson, National Commission on Children and Disasters ........................................................................................................................ 5 

Hon. W. Craig Fugate, Administrator, Federal Emergency Management Agency, U.S. Department of Homeland Security ....................................................... 7 

Rear Admiral Nicole Lurie, M.D., MSPH, Assistant Secretary for Preparedness, U.S. Public Health Service, U.S. Department of Health and Human 

Services ................................................................................................................. 9 

William Modzeleski, Associate Assistant Deputy Secretary, Office of Safe 

and Drug-Free Schools, U.S. Department of Education ................................... 10 

Paul G. Pastorek, Louisiana State Superintendent of Education, Louisiana 

Department of Education .................................................................................... 19 

Matt Salo, Legislative Director of the Health and Human Services Committee, 

National Governors Association .......................................................................... 21 

Melissa Reeves, Ph.D., Chairperson, Prevent, Reaffirm, Evaluate, Provide 

and Respond, Examine (PREPaRE) Committee, National Association of 

School Psychologists ............................................................................................. 23 

Douglas W. Walker, Ph.D., Project Director, Fleur-de-lis Project ....................... 25 

ALPHABETICAL LIST OF WITNESSES

Fugate, Hon. W. Craig: 

Testimony .......................................................................................................... 7 

Prepared statement .......................................................................................... 52 

Lurie, Rear Admiral Nicole, M.D., MSPH: 

Testimony .......................................................................................................... 9 

Prepared statement .......................................................................................... 56 

Modzeleski, William: 

Testimony .......................................................................................................... 10 

Prepared statement .......................................................................................... 72 

Pastorek, Paul G.: 

Testimony .......................................................................................................... 19 

Prepared statement .......................................................................................... 79 

Reeves, Melissa, Ph.D.: 

Testimony .......................................................................................................... 23 

Prepared statement with an attachment ....................................................... 88 

Salo, Matt: 

Testimony .......................................................................................................... 21 

Prepared statement .......................................................................................... 82 

Shriver, Mark K.: 

Testimony .......................................................................................................... 5 

Prepared statement with attachments ........................................................... 39 

Walker, Douglas W., Ph.D.: 

Testimony .......................................................................................................... 25 

Prepared statement with attachments ........................................................... 94 
Page

IV 

APPENDIX 

Charts submitted for the record by Senator Landrieu ......................................... 36 

Department of Homeland Security Report entitled ‘‘Homeland Security Grant 

Program, Supplemental Resource: Children in Disasters Guidance,’’ Fiscal 

Year 2010, submitted by Mr. Fugate .................................................................. 107 

Project Fleur-de-lis: ‘‘An Intermediate and Long-term School-based Mental 

Health Service Model for Youth Exposed to Disasters,’’ submitted by Mr. 

Walker ................................................................................................................... 125 

National Association of School Psychologists Report entitled ‘‘What is a School 

Psychologist?’’ submitted by Dr. Reeves ............................................................. 174 

Questions and responses submitted for the record from: 

Mr. Fugate ........................................................................................................ 203 

Dr. Lurie ............................................................................................................ 206 

Mr. Modzeleski ................................................................................................. 210 

Mr. Pastorek ..................................................................................................... 213 

Mr. Salo ............................................................................................................. 216 
(1) 

CHILDREN AND DISASTERS: A PROGRESS 

REPORT ON ADDRESSING NEEDS 

THURSDAY, DECEMBER 10, 2009 

U.S. SENATE, AD HOC SUBCOMMITTEE ON DISASTER RECOVERY, OF THE COMMITTEE ON HOMELAND SECURITY

AND GOVERNMENTAL AFFAIRS, Washington, DC. 

The Subcommittee met, pursuant to notice, at 2:30 p.m., in room 

SD–342, Dirksen Senate Office Building, Hon. Mary L. Landrieu, 

Chairman of the Subcommittee, presiding. 

Present: Senator Landrieu. 

OPENING STATEMENT OF SENATOR LANDRIEU 

Senator LANDRIEU. Good afternoon, everyone. Thank you so 

much for being here today for this hearing of the Subcommittee on 

Disaster Recovery. We have had a series of hearings on the subject 

of how the National Government, with our partners at the State 

and local levels, as well as our nonprofit and private sector partners, can do a better job of preparing for, responding to, and recovering from catastrophic disasters, and I really appreciate all the 

support from those testifying and those listening in to this hearing 

today. 

Today’s hearing is entitled, ‘‘Children and Disasters: A Progress 

Report on Addressing Needs.’’ The Subcommittee’s overall objective 

today is to evaluate the special needs of children during the preparedness, response, and recovery phase of disasters and the extent 

to which current planning and programs address those needs. 

This Subcommittee held a previous hearing on this subject on 

August 4, 2009. We have convened once again to evaluate the 

progress that has occurred in the 4 months since. 

The National Commission on Children and Disasters was created 

as a result of the Kids in Disasters Well-Being, Safety, and Health 

Act, which was introduced in 2007 by Congresswoman Corrine 

Brown from Florida and Senators Chris Dodd from Connecticut 

and several of us in the Senate. I was proud to be a cosponsor, 

along with former Senator Kennedy and 31 other Members of Congress. I want to particularly thank Congresswoman Corrine Brown 

for her leadership in this area, having passed the bill in the House 

which established the Commission. We will be hearing from that 

Commission today. 

We will begin by reviewing the recommendations of the Commission’s interim report, which was issued on October 14. Next, we 

will hear from our Federal partners to learn what they have done 
2 

1The chart referenced by Senator Landrieu appears in the Appendix on page 36. 

2The chart referenced by Senator Landrieu appears in the Appendix on page 37. 

since that time to address some of the recommendations. And last, 

we will discuss the challenges that displaced families and host communities encountered following the Gulf Coast hurricanes in 2005, 

as they sought health care, day care, child care, and educational 

opportunities for children that had been displaced. 

Let me just briefly start with a 5-minute opening statement and 

then I will go into introducing our first panel. 

We are focused, in particular, on the needs of children because 

children are the focal point of a family, and parents who cannot 

find an open school or day care center after a disaster may be 

forced to relocate to a different community when we are calling on 

them to rebuild the one that was destroyed. Or parents, if they 

can’t find adequate care for children, have to stay home or stay in 

a relative’s home when we actually need them back at work, because these parents are nurses, doctors, teachers, first responders, 

construction workers that we depend on for the recovery. 

There are 32.5 million families with children in the United 

States. Ninety percent of them include a parent who works. In 62 

percent of the households that contain married couples and children, both parents are members of the workforce. If parents can’t 

work after a disaster, the community, as I said, will have no 

nurses, teachers, first responders, grocery store owners, gas station 

operators, carpenters, bus drivers, just to name a few, and it will 

make the recovery even that much more difficult. So this is an essential component, in this Chairman’s view, of recovery and I am 

pleased to know that I have many people here that share that view 

with me. 

The provision of child care and reopening schools are essential 

elements to the recovery. We understand that child care facilities 

are both public and private. Some of them are not-for-profit and 

therefore eligible for FEMA assistance now. But many are privately 

owned and operated, mostly operating on very slim profit margins, 

doing good work in the community. Most of the times, at least in 

my neighborhood where I grew up, day care centers were run out 

of people’s homes. If those homes have been destroyed by a flood, 

how do we establish new opportunities to get those day care centers restarted? 

I want to show a chart on this issue because this has been a 

major focus of mine. The chart shows totals after Hurricanes 

Katrina, Rita, Ike, and Gustav. The chart shows the applications 

for small business loans for child care centers, so I think you can 

see there were 327 total applications. There were less than probably a third, 131, that were approved, 124 were declined, and 72 

were withdrawn.1

When we show the other chart broken down by parish, if you 

want to show that, it is even more stark.2 This is just a snapshot 

of what happened in Louisiana in the same metropolitan area, but 

different parishes, Orleans Parish, Jefferson Parish, and Saint Bernard. There were 275 day care centers in Orleans Parish in August 

2005, and in June 2009, we had climbed, a very difficult climb back 

up to only 141. 
3 

1The charts referenced by Senator Landrieu appears in the Appendix on page 38. 

But if you look at Saint Bernard Parish that had 26, a smaller 

parish, they are just barely back up to 13. It will be 5 years this 

August—5 years. And again, if we can’t find places for children, it 

is hard to find workers, since most parents are workers, and that 

is one of the main subjects of this hearing. We can’t continue to neglect these facilities and families who rely on them nor can we continue to underestimate their importance to a full and robust recovery. 

The other charts indicate the number of schools.1 Do we have 

those charts up? If you see here, you can see the school situation 

is still—we are really struggling, and we have our superintendent 

here to talk about this. And although we have made good progress, 

you can see the difficulty of this recovery—222 schools postKatrina. Orleans Parish now has 154. Jefferson Parish has slightly 

less. And then look at St. Bernard Parish, 22 schools, only 11 open 

today. And, of course, St. Tammany Parish, which was a hard-hit 

parish but also one that has recovered more quickly and was a host 

parish to Orleans Parish. We have three more schools there than 

we did before. But this is just to show you what the struggle still 

is. 

Reopening schools and day care centers inside the disaster area 

is critical, but we must also look outside the disaster area and address the needs of displaced families in host communities. Hurricanes Katrina and Rita displaced over 370,000 children along the 

Gulf Coast, many of whom lost their homes and were unable to return for months. Families had to enroll their children in new 

schools, new child care centers, new State-run health care programs, and in many instances that was extremely challenging. 

The Federal Government and several States established ad hoc 

programs to assist them. We are going to spend some time in this 

hearing talking about what worked and whether some of these programs should be made permanent. 

Children have unique needs that require specialized planning. As 

our FEMA Administrator, who is here with us today, Craig Fugate, 

said, we must ensure that emergency planning accounts for citizens 

in the community, all citizens, not just able-bodied adults with 

ample resources. And children are just not small adults. They have 

special needs, and I agree with him. 

Finally, let me mention mental health. As the Commission pointed out, children are disproportionately affected by disasters in comparison to adults when it comes to mental health. Children suffer 

higher rates of depression, post-traumatic stress disorder, and behavioral problems following a disaster. LSU’s Department of Psychiatry screened 12,000 children in schools during the 2005 and 

2006 school year. Eighteen percent of them had a family member 

who was killed in the storm—18 percent. Forty-nine percent, almost 50 percent of the children screened, met the threshold for 

mental health referral. And 1 year later, that referral rate was 

lower, but not that low. It was 30 percent. 

So according to some good research from GAO that we have reviewed, we know that that is still a great challenge. The greatest 
4 

barriers to accessing mental health services are transportation, 

stigmatization, and financial problems. 

School-based counseling—and then I will conclude—that same report emphasized an approach to service delivery that I would like 

to focus on today, which is a model of school-based counseling. Save 

the Children and RAND have also commended this approach. 

Schools that require psychological assessments after a disaster can 

help remove the stigma when all children are being addressed and 

spoken to. Placing providers in schools helps parents save money 

on treatment costs and avoid having to leave work and drive their 

children to the point of service, particularly when the point of service that they used to drive to no longer exists. 

This is very important for people to understand. The hospital 

that was right around the corner is closed. The doctor’s office that 

you used to visit is gone. The doctor has moved to Houston or to 

Atlanta. It is not the same after a disaster as before, getting your 

children to these points of service, which literally no longer exist, 

particularly after a catastrophic disaster. 

School counselors also represent an existing workforce that can 

be trained in advance of a disaster, rather than relying exclusively 

on counselors only that deploy to the disaster area for a limited 

time. So hopefully we will hear some good suggestions about 

school-based counseling today. 

And finally, millions of parents, educators, counselors, social 

workers, nonprofit innovators, and community leaders work hard 

every day to improve the lives of children in this Nation. Through 

the continued efforts of the Commission and State and Federal 

partners that are here today, we must provide strategic leadership 

and resources to move our children out of harm’s way before disaster strikes, get them quickly back into school and to a day care 

support system that helps their parents get back to work, work 

that we depend on to rebuild our communities. We must invest in 

a smart, strategic, community-based support network. That is what 

this hearing is about today. 

So I am pleased to begin this hearing and to introduce our first 

panel. We will be very happy to hear their remarks on this subject. 

Our first witness is Mark Shriver, who Chairs the National Commission. As I said, this Commission was authorized by Congress 

and recently released its initial report. I really look forward to Mr. 

Shriver’s testimony today as he discusses the interim report and 

ongoing efforts to address these and other needs. 

Next we have Craig Fugate, Administrator of FEMA. This is his 

third time before this Subcommittee. We are honored to have him 

speak here again. He previously served as Director of the Florida 

Division of Emergency Management, so he brings a lot of State experience and, of course, some very well respected national leadership. 

Rear Admiral Nicole Lurie is the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health 

and Human Services. The ASPR coordinates interagency activities 

between Homeland Security and other Federal agencies, State, and 

local officials to protect civilians from acts of bioterrorism and other 

public health emergencies. She also testified before this Subcommittee in August. We are pleased to have her here again. 
5 

1The prepared statement of Mr. Shriver with attachments appears in the Appendix on page 

39. 

And finally, Bill Modzeleski. He is the Associate Assistant Deputy, U.S. Department of Education, Office of Safe and Drug-Free 

Schools, where he is involved in the design and development of 

drug, alcohol, and violence programs. He has 25 years of experience 

at the local and Federal levels in the area of criminal and juvenile 

justice. Today, he will discuss Emergency Impact Aid programs created to address the needs of students displaced by Hurricanes Rita 

and Katrina. 

So let us begin with our first panel. You have each been given 

5 minutes to summarize your testimony. We are pleased to begin 

with you, Mr. Shriver and thank you for your leadership. 

TESTIMONY OF MARK K. SHRIVER,1 CHAIRPERSON, NATIONAL 

COMMISSION ON CHILDREN AND DISASTERS 

Mr. SHRIVER. Thank you, Madam Chairman. I am very honored 

to be here once again with the opportunity to testify. The Commission is especially grateful to the Subcommittee and your leadership 

for your continued and diligent focus on the recovery needs of children affected by disasters. 

The Commission’s interim report, which you referenced earlier, 

Madam Chairman, has 21 primary recommendations and 25 supporting statements to help guide the implementation. For today’s 

hearing, I will focus on just a few key areas. 

When it comes to long-term recovery, the Commission strongly 

urged FEMA and the Obama Administration to aggressively intensify efforts to develop a National Disaster Recovery Framework. We 

are pleased that the President established a Long-Term Disaster 

Recovery Working Group, and the Commission intends to make 

meaningful contributions to the report that is due to the President 

in just a few months and the design framework, which is due in 

June 2010. 

The overarching principle for recovery from disasters, as you 

have mentioned, Madam Chairman, must be to create self-sufficient families and a new and improved normalcy for all children, 

especially children who are socially and economically disadvantaged. The National Disaster Recovery Framework currently in development should specify services that must be provided to children 

affected by disasters, such as safe, stable housing; access to physical, mental health, and oral health services; child care; adequate 

nutrition; disaster case management; and other services. 

A specific Federal entity should be designated with oversight, coordination, and guidance responsibilities, as the Commission’s report indicates, to create awareness of all forms of Federal assistance to state and localities that address the needs of children and 

families affected by disasters. 

Second, on the disaster case management services front, the 

Commission is very pleased that FEMA and the Administration for 

Children and Families have recently come to terms on an interagency agreement that was announced here in front of your Subcommittee a few weeks ago. The ACF model is comprehensive in 

scope and focused on achieving measurable, positive outcomes for 
6 

children and families. ACF’s program was originally intended to 

transfer responsibilities to local agencies as quickly as possible. 

However, FEMA prefers that the disaster case management responsibilities transfer to the affected State. 

Recognizing the difficulties encountered in State-led programs 

envisioned for Texas and Louisiana, as you know, following Hurricanes Gustav and Ike, which resulted in extensive delays in services being delivered to kids, the Commission has posed a number 

of questions to FEMA which are in the written testimony, so I 

won’t go through them all, but I think there are a couple of key 

issues that we have actually spoken to the Administrator about 

and I think he will probably allude to them, and I think they have 

some good answers, but I think that bears making sure that we 

watch that going forward. 

As far as child care, Madam Chairman, the charts that you 

showed behind you are incredibly revealing. Nearly 12 million children under the age of five are in child care each week. Child care 

providers must be prepared for disasters, not only to ensure children’s safety and mental well-being in the face of danger, but also 

to facilitate recovery by providing support services to parents, 

guardians, employees, and employers in the aftermath of a disaster. 

The Commission sees the reauthorization of the Child Care Development Block Grant program as a prime opportunity to address 

the lack of basic disaster preparedness among child care providers 

across the country. There is a report, from Save the Children, 

which shows that only seven States have child care facilities in 

schools that meet the basic minimum requirements for child care 

for disaster planning and response. 

The Commission has been collaborating with FEMA to identify 

areas of potential disaster assistance for child care services. We are 

very pleased that FEMA, under Administrator Fugate’s leadership, 

has committed to provide temporary facilities for child care providers that sustained damage beyond repair and to support States’ 

efforts to stand up emergency child care facilities and provide 

emergency child care services for a very brief term in the immediate aftermath of a disaster. 

However, the Commission recommends a change to the Stafford 

Act that would allow FEMA to continue supporting the provision 

of child care services for a longer duration in the recovery phase 

and to provide assistance to affected families for placement of children in child care. The major shortcoming of the Stafford Act is the 

inability to support the repair, restoration, or rebuilding of private, 

for-profit entities, such as child care facilities, that provide essential community services. 

Madam Chairman, I know there is a lot of discussion in the Congress about the fact that there shouldn’t be dollars out of the Stafford Act to support for-profit entities, but I think your charts really 

reveal in very vivid numbers that there has got to be something 

done. If folks are not in favor of using Federal dollars to assist forprofit entities that are providing essential services, then surely 

under your leadership we can come up with a creative solution. 

When you have that many entities not providing services to work-
7 

1The prepared statement of Mr. Fugate appears in the Appendix on page 52. 

ing families, it is really a disaster waiting to happen, and it is happening. 

Madam Chairman, I know my time is up. There are other statements in the report. The only other thing I did want to say which 

is not in my testimony is the issue of medical countermeasures. I 

know Dr. Lurie has been appointed by Secretary Sebelius to look 

into this issue as a result of the H1N1 virus, and I think it is imperative for this Subcommittee and this Congress to make sure 

that children’s needs are identified throughout that process and 

throughout the funding mechanisms that are put out to study this 

issue. The Institute of Medicine is revealing how to deal with 

issues to provide medical countermeasures in this country, as well. 

But once again, children’s needs are overlooked on so many of 

these efforts. So I hope that the Subcommittee and your leadership 

will continue to look at the issue of medical countermeasures in 

children, which make up over 25 percent of the population not 

being addressed in those issues. 

Thank you very much again for your leadership. 

Senator LANDRIEU. Thank you very much. Administrator Fugate. 

TESTIMONY OF HON. W. CRAIG FUGATE,1 ADMINISTRATOR, 

FEDERAL EMERGENCY MANAGEMENT AGENCY, U.S. DEPARTMENT OF HOMELAND SECURITY 

Mr. FUGATE. Good afternoon, Madam Chairman. In August, you 

asked us to address these issues and we are here today to give you 

a progress update of what we have been able to accomplish in the 

last 4 months. 

At that time, we announced that we were going to create a Children’s Working Group within FEMA to begin addressing the Commission’s recommendations and looking at things in a more holistic 

approach versus developing one box, but really looking across our 

programs so that as we plan, prepare, respond, and recover from 

disasters, we incorporate the entire community and recognize that 

children are 25 percent or more of that community that we plan 

for. 

The Commission’s interim report and its steps have really tailored and driven what we have looked at, and working closely with 

Mark and others from the Commission, we have been trying to address these issues within the scope of authorities we currently 

have, but also identify issues that may require additional assistance. So I would like to share that progress with you today. 

As was reported out by Mark Shriver, we have the interagency 

agreement with the Administration for Children and Families, and 

I think this is one of the things that is really important to us in 

FEMA. We try to explain to people, we are not the team, we are 

part of a team, and we need to really reach out in the Federal family where that expertise is and bring that in, and this contract and 

the ability to bring these services forward in this agreement will 

provide that initial response. 

But as Mark pointed out, as well, at the point where this should 

now be devolved to a State program, where previously FEMA 

would look at grant requests and the grant for these services on 
8 

the technical means of the grant, we are partnering back with Administration for Children and Families to help us assess the quality of that grant to ensure that the services that are being proposed 

are going to be effective in delivery and use the expertise that HHS 

brings to this process to help us assess that grant versus merely 

looking at it from the standpoint of was the grant properly filled 

out. 

And I think this gets back to some of the concerns about how effective we were able to bring these programs when they moved to 

the State and continue them. We are willing to work with States 

to encourage them to utilize this inter-local agreement and contract 

back to the service providers if their program is not ready to go. 

Some of the other issues that were brought up by the Commission were looking at how we integrate children in all of our areas. 

So here are some of the steps we took. Yesterday, Secretary 

Napolitano announced over $2.7 billion in Homeland Security 

grants now available for the application. We were able to, through 

the Children’s Working Group, develop specific language to go into 

the grant guidance to address children’s issues. This is the first 

time, if you looked at these grants, that it really says that these 

activities are eligible. It was never denied they could do it, but we 

felt it was important to take the recommendations of the Commission and provide specific language in the grant guidance saying 

that, yes, these types of activities are not only allowable, they are 

desired in your grant applications. 

We also had been working with the Commission over shelter supplies that children need, and Red Cross had taken a leadership role 

in this. We went back and met with our working group in Red 

Cross and the Commission to further refine the shelter list of supplies for disasters to incorporate the needs of children. We have 

taken and have consolidated that list now that the Red Cross is 

using with the Commission’s input are in the process, through our 

Logistics Directorate, of actually going out and bidding out and 

building these packages. 

Obviously, if a disaster strikes now, we are able to take those 

lists and go, but we want to incorporate, again, and stay away from 

sole sourcing or non-competitive bid products, so we are building 

that into our acquisition schedule. Logistics implies that we should 

be ready to go sometime in February, but we have the list now if 

something happens and we need to go. 

The last part of it was in child care facilities and services. Again, 

the Commission made several recommendations, particularly in 

day care services. We were able to go back, and again, I give a lot 

of credit to Tracy Wareing and the folks that were leading the 

charge on the Children’s Working Group, to really get with our 

public assistance folks and clearly get guidance on the fact that we 

consider providing day care services in the response phase an eligible activity, that we clearly consider, as Mark pointed out, facilities 

and other temporary facilities to provide those services should be 

eligible, and clearly indicate that not-for-profit day care centers will 

also be looked at as eligible if they did not qualify for SBA, for 

FEMA assistance to an eligible nonprofit for a critical function in 

the community. 
9 

1The prepared statement of Admiral Lurie appears in the Appendix on page 56. 

So these are some of the things that we have gone back and 

made sure that, within our public assistance program under the 

Stafford Act, we are going to be able to deliver those services. 

And so with that, Madam Chairman, we will conclude and appreciate further guidance and any questions you may have. 

Senator LANDRIEU. Thank you. Admiral Lurie. 

TESTIMONY OF REAR ADMIRAL NICOLE LURIE, M.D., MSPH,1

ASSISTANT SECRETARY FOR PREPAREDNESS, U.S. PUBLIC 

HEALTH SERVICE, U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Admiral LURIE. Thank you, Madam Chairman. It is a privilege 

to testify again before you this afternoon. I want, first, also to commend this Subcommittee for its leadership on this critical issue and 

its focus on children as well as the critical work of the National 

Commission, and I am thrilled to be joined by my colleagues from 

FEMA and Education to create really a seamless system to support 

children in disasters. 

I, too, would like to just provide a brief overview of the progress 

that HHS has made since we last met, and I am also prepared to 

discuss the action that we have taken to address the Commission’s 

interim recommendations. 

Beginning with my office, as you know, ASPR plays a pivotal role 

in coordinating emergency response efforts across the Department 

and among our Federal, State, and local partners. As we have done 

for our H1N1 and recent response to the tsunami in American 

Samoa, in those efforts, children’s focused activities ranged from 

ensuring the availability of pediatric suspension of antivirals when 

it was in short supply to deploying emergency physicians trained 

in pediatric care as well as mental health teams. 

We have been using tools such as HavBed and a recent ventilator 

survey to identify and monitor the surge capacity for children during H1N1. And we have been building on our web capability using 

mapping methods to be sure that we actually have enhanced 

awareness to identify where there are pockets of children, particularly disadvantaged children, before we send teams in to assist, including locations of schools and day care facilities, pediatric hospitals, and intensive care services. And we will be adding additional information over the next year on other special needs of children, in addition, language and other needs. 

We have also been enhancing the National Disaster Medical System to focus on pediatric issues, and as you may know, we now 

have appointed a pediatrician as our Deputy Chief Medical Officer. 

We now have about two-thirds of NDMS clinicians trained in pediatric care and have been evaluating our equipment caches to be 

sure that they can be modified to meet the needs of children. 

You have just heard from Administrator Fugate about the collaboration with the Agency for Children and Families, and we are 

really thrilled about the progress in that area, as well. As you 

know, ACF monitors the status of Head Start and child care facilities. During H1, ACF did the same, monitoring closures of all Head 

Start centers and child care centers. But importantly, also, it facili-
10 

1The prepared statement of Mr. Modzeleski appears in the Appendix on page 72. 

tated access to information about how parents and children could 

protect themselves during the pandemic and help people seek out 

vaccine and encourage vaccination among particularly vulnerable 

groups. 

And you have just heard about the interagency agreement recently signed between FEMA and ACF, and so I don’t feel like I 

need to go into that further, but we are really very pleased, also, 

about the ability to preposition contracts so they can be executed, 

as needed. 

CMS has also been active, and as you know, in the aftermath of 

the hurricanes, CMS developed a model template that States could 

use to ensure the portability of benefits and really taking a hard 

look at issues related to enrollment, retention, portability, and coverage. CMS is currently consulting with State Medicaid and CHIP 

directors and many other stakeholders to make recommendations 

about how to enhance those efforts, and that work is, I believe, well 

underway, and we anticipate these efforts will continue to enhance 

knowledge and ultimately lead to some really solid recommendations about how to improve the coordination of care for displaced 

children. 

With regard to mental health, we all know that effective disaster 

preparedness is an essential part of SAMHSA’s mission. The number of programs they have, including the counseling, training, and 

assistance program, continue to be active. Since we last testified, 

our team has met with Commission staff to plan a coordinated response to the interim recommendations, as well as receive the recommendations of our Advisory Committee’s Disaster Mental Health 

Subcommittee, with which there is a great deal of synergy with the 

Commission recommendations, and we are actively working those 

issues now. 

With regard to the countermeasure issue just identified, we recently convened a pediatric preparedness and response workshop 

focused on many of these issues, and our recent PHEMCE stakeholders workshop really paid special attention to the development 

of countermeasures for children. And as we have just seen through 

the issues about H1N1 and even something as simple as pediatric 

antivirals, this is just a very critical issue for us moving forward. 

Finally, we all know that what happens in early childhood often 

determines health over the life course, and particularly for those 

reasons, we remain fully committed to continually improving our 

efforts to address the recovery of children and look forward to continuing to work with the Subcommittee, colleagues across government, the Commission, and other partners. 

I would be happy to answer further questions. 

Senator LANDRIEU. Thank you very much. Mr. Modzeleski. 

TESTIMONY OF WILLIAM MODZELESKI,1 ASSOCIATE ASSISTANT DEPUTY SECRETARY, OFFICE OF SAFE AND DRUG-FREE 

SCHOOLS, U.S. DEPARTMENT OF EDUCATION 

Mr. MODZELESKI. Thank you, Madam Chairman. Thank you for 

the opportunity to be here today to discuss how the Department of 

Education has responded to the needs of children affected by disas-
11 

ters, including the role that we at the Department of Education 

played after Hurricanes Rita and Katrina, and to address the recommendations made by the National Commission on Children and 

Disasters in their October interim report. 

I want to begin by providing a brief overview of the status of 

emergency management planning in elementary and secondary 

schools. In that regard, I am pleased to report that almost every 

school in the country has developed an emergency management 

plan. However, while most schools have these plans, we know from 

a variety of sources that a number of these plans have weaknesses. 

To help schools address these weaknesses and to help ensure 

that they have the necessary resources to plan for, respond to, and 

recover from emergencies, we are implementing a variety of activities, including Project SERV, the Readiness Emergency Management for Schools, or REMS Program, the Readiness Emergency 

Management for Higher Education Program, and the School Counseling Program. Let me provide you a brief overview of each of 

these. 

Project SERV was created by Congress and implemented by the 

Department of Education in 2001 to help schools restore the learning environment as quickly as possible after experiencing an event 

that disrupts teaching and learning. Events such as school shootings or natural disasters, including hurricanes, can have a traumatic effect on students, parents, and faculty, and Project SERV 

funds can be used for additional services that are often needed, 

such as mental health counseling, security assistance, or substitute 

teachers. 

For example, shortly after Hurricane Katrina struck the Gulf 

Coast, we made grants totaling $7 million to each of the states that 

were directly impacted by the hurricane. SERV funds were used for 

a variety of efforts, including hiring additional counselors and social workers, providing supplemental educational services for students who had missed school, and offering teacher professional development on recovery-related topics. 

In February 2008, after the shootings at Virginia Tech and 

Northern Illinois University, Project SERV was expanded so funds 

could be awarded to institutions of higher education. Since the inception of the program, we have made 74 awards, all except one 

to K-through-12 schools, totaling $26 million. The grants were 

made in response to a variety of traumatic incidents. 

The Readiness Emergency Management for Schools initiative 

was created by Congress and implemented by the Department of 

Education in 2003. The program is designed to provide funds to 

districts to create, strengthen, or improve emergency management 

plans at the district and school building levels. Funds from this initiative can be used by LEAs to train school personnel in emergency 

management procedures, including training and recovery-related 

areas, to coordinate with local community partners, and to improve 

local capacity to sustain emergency management efforts. Since the 

inception of this program, we made 717 awards to school districts, 

including awards to Saint Bernard, Saint Tammany, and Jefferson 

Parishes. 

Education also administers the program, Elementary and Secondary School Counseling Program. While not primarily a disaster 
12 

recovery program, the program supports enhanced access to mental 

health services for students and helps schools provide a comprehensive counseling program to meet students’ needs, including recovery from a crisis. 

Aside from these various programs, Education provides training 

and technical assistance focused on emergency management to assist schools in their efforts to plan for and recover from disasters. 

The framework for our emergency management guidance was published in 2003 and provides school officials with information on 

critical concepts and components of good crisis planning. 

In addition to our broad and ongoing efforts to address emergency management in all schools, Education engaged in numerous 

activities designed specifically to support the recovery effort following Hurricanes Rita and Katrina. In the days, weeks, and 

months following the hurricanes, Education staff conducted numerous calls, meetings, and training sessions with State and local officials, and provided written guidances needed to respond to concerns. Education also granted waivers to various provisions of fiscal 

and Administration requirements of the Education Department requirements. Additional information about these programs can be 

found in my written testimony. 

In its interim report, the National Commission on Children and 

Disasters made two recommendations related to elementary and 

secondary schools. In Recommendation 7.1, the Commission suggested the establishment of a School Disaster Preparedness Program, including the appropriation of funds to Education for a dedicated and sustained funding stream for all SEAs. 

In Recommendation 7.2, the Commission suggested enhancing 

the ability of school personnel to support children who are traumatized, grieving, or otherwise recovering from a disaster. 

We appreciate the Commission’s work and believe that the many 

activities I have discussed here today have helped schools be better 

prepared to plan for, respond to, and recover from disasters. We 

are currently reviewing the recommendations to determine what 

additional actions we may take to provide schools with the most effective emergency management support possible. 

Thank you very much. 

Senator LANDRIEU. Thank you very much. 

I just got a notice that they have just called a vote, but I am 

going to continue on and then take a brief recess and come back. 

Mr. Shriver, let me begin with you. You have done, I guess, the 

most extensive general work on this subject. What would be the 

short version of your assessment of how well the Federal agencies 

are working together to keep children at the focus? Do you think 

that the agencies are appropriately focused on process or outcomes 

or a combination? And if you had to tell this Subcommittee about 

one or two areas of progress or lack thereof, what would those be 

at this point? 

Mr. SHRIVER. It is a long question and I will give you a very 

short answer. I think that there are a lot of folks that care about 

this issue. I think the interim report has been received very well. 

But I think, really, the question is what actions are going to be 

taken that make a difference in kids’ lives. I think there are a lot 

of folks in the Federal Government that have a lot of responsibility 
13 

over a bunch of different areas and it is hard to coordinate that 

and coordinate it across agencies, departments much less. 

I think what has happened at FEMA under Administrator 

Fugate’s leadership is very strong steps to make concrete changes 

to have a working group and a high-level person on that. That 

working group cuts across the agency or across FEMA and meets 

with him and we have, through the Commission, a monthly meeting with the Administrator which forces the issues on a monthly 

basis, and I think that type of structured, results-driven approach 

is critical. 

I would say that if other agencies across the Federal Government 

were to do that, that would be fantastic. I think that is a concrete 

step that reports to a high-level person with strong staff support 

that makes a difference and is, again, on a monthly basis meeting 

with the Commission and Commission staff. So there is a lot of accountability on that. 

The Administrator and I talked a while ago about the issue of 

child care, and child care regulations fall under the Child Care Bureau at HHS. They don’t have the expertise to lay out plans for disaster preparedness response and recovery. FEMA has that. FEMA 

doesn’t have the expertise to deal with kids and child care facilities. Getting them together to really work on that, where they can 

form a very strong team and come up with strong results that will 

help kids in child care facilities be prepared for disasters, that is 

some work. So I think, frankly—— 

Senator LANDRIEU. And I might mention on that that SBA has 

a responsibility to finance them. So they need to be at the table, 

as well, and I guess my question would be, since FEMA is at these 

meetings, or you are at the monthly meetings with FEMA, is the 

Department of Health and Human Services there? Is the Department of Education there? And if so, I would like to hear from you 

all. And if not, why not? Do you need a special invitation, or do you 

feel like it is not something that is a priority, or—if you want to 

start, Admiral. 

Admiral LURIE. I will have to confess, I will need to consult with 

my colleagues at ACF about whether they are at these monthly 

meetings. I do know that ACF and FEMA have been working extremely actively together and I think this interagency agreement 

that was signed December 1 is really strong evidence of that and 

I think there is a full intent to continue to collaborate on the planning and taking advantage of the synergies for which there are. 

I know that I meet regularly, as well, with my staff about children’s issues now and to look at the kinds of things that we can 

do going forward, both through H1N1 and through this response, 

as well as the other opportunities that we have in the countermeasures area. 

I am just informed, in fact, that ACF is at this regular meeting, 

so that is ongoing—— 

Senator LANDRIEU. Let me just be clear, and it may just be that 

I am not clear. Administrator Fugate, is it your idea or under your 

general framework that FEMA is going to enter into an agreement 

with each Federal agency as it relates to something in their jurisdiction relative to children? For instance, do you perceive that you 

will have an agreement with the SBA along certain lines, or an 
14 

agreement with Health and Human Services, an agreement with 

Education, so it is a series of interagency agreements between you 

and these agencies? Or is it going to be one interagency framework 

or understanding? Could you describe how we are building this, because it is a different kind of approach. 

Mr. FUGATE. Yes, Madam Chairman. I think, to be fair to my fellow agencies here, the meetings that we have been having with 

Mark Shriver and the Commission have really been focused on 

their specific recommendations to FEMA’s delivery of services. As 

we go through that process, we have been really working on the 

FEMA side and internal to FEMA to make sure we have gotten 

that right. 

Again, what it does is it puts us in a position to then approach 

ACF on how do we provide counseling. You guys do this better 

than us. We need to leverage your expertise. Let us get this agreement in place. So we really, in this first 4 months, have been mainly focused on the Commission’s reports that directly stated about 

FEMA’s delivery programs to get that. 

I think our national long-term recovery strategy that the President has tasked us with and given Secretary Napolitano and the 

Secretary of HUD, the co-chairs of that, is really, I think, where 

we are going to start looking at some of these issues that go beyond 

the immediate response and get into recovery, and I would envision 

that to be the framework, that as we take the Commission’s recommendations and we have been making sure that we have done 

outreach to the Commission and their constituencies when we have 

gone out and had these meetings to have them there, that those 

things that would be Stafford Act-driven, we are going to work on. 

But those things that require agencies to support that or that expertise resides in other agencies, we want to build that linkage. 

But I think, ultimately, the National Response Framework will 

probably be the best vehicle to look at some of the more downrange 

issues, many of the issues you are pointing out here, schools and 

other things that are going to go beyond just Stafford Act, rebuilding the schools. We have got to make sure we have teachers. We 

have got to make sure we have all the support mechanisms. Those 

are the kinds of things that I think that long-term recovery framework is going to give us a better way to hook our agencies together. 

Senator LANDRIEU. Well, you know I have shared this with you 

privately and publicly many times. I don’t expect, as the Chairman 

of this Subcommittee, and I think no one in the Federal Government expects FEMA to do everything. We understand that you 

have statutory limits and budgetary limits. But what we are looking for FEMA to be is the expert on disaster, the coordinator, the 

nudger, the pusher, the prodder to other agencies to step up and 

do what they do so that we can have a successful response and not 

a patchwork response. We can have a successful recovery, not a 

patchwork recovery. 

And really, as I continue to study and observe this, it is almost 

breathtaking in the gaps that still exist, even after Hurricanes 

Katrina and Rita, and even after the good work that you and particularly this Administration has done. We still don’t seem to have 

a consensus almost 41⁄2 years later how to finance day care centers, 

how to basically accommodate tens to, in the case of Louisiana, re-
15 

member, we had 40,000-plus children displaced—not 400, not 

4,000, not 14,000, 40,000—47,000 children looking for a place to go 

to school on that Monday morning. And we still haven’t really resolved that issue at the Federal level as to whether they are going 

to go to a school that is public, private, Catholic, etc. I mean, this 

is 41⁄2 years later. 

I am looking at a report card from ‘‘Are States Prepared to Protect Children During Disasters,’’ from Save the Children, and was 

actually quite aghast when I saw that over half of the States do 

not require plans for have evacuation, reunification, or special 

needs of children in care, including the State of Louisiana, and the 

States of Kansas and Missouri, which have had tornadoes, including Kentucky, Georgia, and Florida, which have been hit hard recently, that there is no law on the books in those States—even in 

my own State, which I am floored to learn. They don’t have requirements for these evacuation and reunification plans. 

Now, I don’t know if this Subcommittee has the time to pass legislation requiring all these things. It would seem to me to be sort 

of a common sense administrative approach, either through holding 

back Federal funding or saying you can’t get Federal funding unless you do these certain things, to require this. So again, I mean, 

that is part of what this hearing is about, is how much new law 

do we need and why is this not so obvious to people, particularly 

given the tragedies that have happened recently just from hurricanes, let alone some of the other disasters that we have experienced. 

So if you all would just ponder that, I am going to recess for 10 

minutes, go vote and to come back. We will reconvene with maybe 

a question to each of you all and then go right into the second 

panel. Thank you very much. 

We stand in recess. 

[Recess.] 

Senator LANDRIEU. Thank you very much for your patience. The 

meeting will come back to order after our brief recess. 

I am going to finish up with a question for each of our first panel 

and then go right into our second panel. 

The Department of Education, as you know, under the really extraordinary leadership, as I vividly remember, of Senator Kennedy 

and Mike Enzi, Senator Enzi, Congress quickly established the 

Emergency Impact Aid Program in October 2005 to provide tuition 

reimbursement for K-through-12 students who were displaced. 

There were, as I said, over 300,000 students displaced. The Department of Education administered this program until it sunset at the 

end of the 2005–2006 school year. It served over 180,000 students 

in 49 States. 

According to your review, Mr. Modzeleski, how did that program 

work? How did it function? What are your views? And should we 

put something permanent into the law so we could quickly access 

it again if we needed it? 

Mr. MODZELESKI. Thank you, Senator. Please note that, in my 

written testimony, I provide a lengthy statement about that particular program, and one of the things that really worked very well 

with that program is the ability to move it out very quickly. Other 

aspects of that are being reviewed and we would be more than 
16 

happy to work with you to give you a complete review of how it 

worked. 

If you would allow me, I would like to take one minute on the 

question that you had about the evacuation plans from schools because I think it is very important. 

Senator LANDRIEU. Go ahead. 

Mr. MODZELESKI. We have, as I said, provided funds for 717 

school districts in the area of readiness emergency management for 

schools, trying to get schools prepared to deal with disasters. Our 

approach has been to provide them with a broad-based rubric to develop their crisis plans, make sure it is an all-hazards plan, make 

sure it deals with all four phases of crisis planning, and—— 

Senator LANDRIEU. And how many school districts did you say? 

Mr. MODZELESKI. Seven-hundred-and-seventeen. 

Senator LANDRIEU. Do you know how many there are in the 

country? 

Mr. MODZELESKI. There are 15,000. 

Senator LANDRIEU. OK. 

Mr. MODZELESKI. The ‘‘however’’ is that 23 of the 25 largest 

school districts have received funding, so when we look at the large 

school districts—when we look at the number of kids who have received funds or have benefitted from funds from the Department of 

Education for emergency management, it is approximately half. So 

we have about 50 million kids in schools in this country. We realize 

that there are a lot of small school systems that haven’t received 

those fundings, and we plan to continue to provide them with funds 

in FY2010, funds that you have been gracious enough to appropriate. 

But on evacuation, the point is that for schools, we must look not 

only at the district level, but at the school level because every 

school is different. 

We took a look at the Louisiana law, because when the GAO reported on emergency management planning for schools, they basically said that Louisiana did not have a requirement for developing 

emergency management plans. Well, they do, and their requirement for emergency management plans is similar to a lot of other 

States, and that is that it is a very broad-based plan. And the reason why many of these plans are broad-based at the State level is 

because there is a recognition that the districts within the State 

are very different. 

So rather than articulate specifically what needs to be done—because if they did that, it may be ten or 12 pages long of just all 

the things that need to be done—most States have adopted a procedure for schools which says, broadly speaking, here is what really 

we want you to do, and based upon your resources, based upon 

your needs, based upon your expertise to develop plans around 

that. We have tried to supplement that, and part of my written testimony goes into a rather lengthy discussion about the training and 

technical assistance that the Department of Education has provided and continues to provide to help schools improve their crisis 

planning. 

Senator LANDRIEU. OK. I would like to ask Administrator 

Fugate, is this at all either shocking or troubling to you, or do you 

think this is just the nature of the way this works. This is 41⁄2
17 

years after Hurricane Katrina, and yet more than half the States, 

even having witnessed what happened, don’t seem to have any 

laws in place requiring just this basic planning requirement. If you 

could respond. 

Mr. FUGATE. I think, in general, when you look at day care, 

whether States even license day care facilities and those types of 

activities they are involved in there, this has not been something 

that has been uniformly applied. As the report shows, some States 

have requirements for emergency plans and other States do not. 

Some States only require it around certain hazards, like nuclear 

power plants. 

And again, on the Federal side, our general ability to direct this 

is looking at what funding is available for day care centers. So, 

again, it may not be in the Federal Emergency Management Agency, within HHS, the funding that they provide to provide affordable 

day care. But again, partnering and looking at how we can 

incentivize that and provide not only a requirement with the Federal dollars to do training, but then provide the materials appropriate. 

Because again, as we know, many of these are not very large facilities with a lot of resources, and a lot of times they are, as you 

point out, very small operations. So we don’t want to come in with 

planning requirements so egregious that we put people out of business. But really, how do we provide them the tools to protect their 

children while they are there—— 

Senator LANDRIEU. Well, and I am more concerned—I mean, I 

am concerned about protecting children in day care centers, but I 

am also very much focused on how to reestablish them after they 

are either destroyed or impacted, because I realize that some people may think this is a side item, but again, when you think about 

rebuilding a community after a disaster, most of the people that 

can do that are parents. 

The electricians have to repair the lines. The contractors have to 

lay new pavement on the streets. The debris removal teams have 

to remove trees. Most of those people have children. They are not 

retirees. Their children are of school age, just by the nature of who 

is in the workforce. 

So this issue of who is taking care of children while you are trying to recover is central to the successful recovery effort. There is 

just no way around it. And so the sooner that I can grasp that the 

Federal agencies understand that, the better off we will all be, because it is not just a separate program. It is the basic foundation 

of recovery. 

What is it that we have to do to either provide funding, support, 

etc, so that the parents that we are depending on to lead the recovery can actually do so, because if we don’t, they are going to be taking care of their children while the streets don’t get paved, the electric lines don’t get up, and hospital operating rooms don’t get 

turned back on because there is no one to run them. I mean, this 

is a problem in normal, regular life and daily life in America, but 

it becomes so obvious after a disaster if you have lived through it 

like I have. 

Let me just go on to one or two more questions. For planning requirements for the HHS grants, let me ask Health and Human 
18 

Services about something that has come to our attention. You realize that there are thousands and thousands of children in the custody of parents when disasters happen, and grandparents and 

guardians. But there are also thousands of children actually in the 

custody of the government. Those would be foster care children. 

In Louisiana when Hurricane Katrina hit, we had 5,000 children 

in foster care. Mississippi had approximately 2,700. Texas had 

31,000. Florida had 30,000. And Alabama had 6,000. So just the 

Gulf Coast, that is almost 75,000 children. 

What is our plan for foster children, because some of them may 

be in group homes with ten or 15 other children. Some of them are 

in family-like settings. Do we have any special plans in place that 

if a major hurricane hits the Gulf Coast again, these 75,000 foster 

care kids who are displaced can do what, go where? 

Admiral LURIE. Well, it is certainly fair to say that there was not 

a plan in place before Hurricanes Katrina and Rita and I think everybody has really recognized the needs and the special needs of 

these children. As things stand right now, ACF’s Children’s Bureau 

very actively works with children in the foster care system, and 

post-disaster, the SAMHSA crisis counseling people also very frequently encounter children in foster care and families with children 

in foster care and start to serve as one-stop, at least triage to help 

children and foster children access the appropriate services. 

Similarly, in the middle of response, through our ESF–8 mechanisms, our operations center is able to get everybody across the 

whole spectrum that touches the health of children involved to try 

to coordinate acutely. 

Going forward, this is clearly one of the things that has to be a 

piece of a coordinated approach to children and all of the kinds of 

special issues they have. Going forward, our new Policy Office will 

have a focus on children, and these are the kinds of issues that absolutely need to be taken up. 

Senator LANDRIEU. OK. And again, I just really, really encourage 

you to really understand just the dynamics of what happens in a 

major catastrophe and the special needs of this particular population and the limitations of the foster parents who under even normal circumstances struggle, and then when they have lost their 

home and they have lost any transportation, it makes their ability 

to meet the contract of fostering extremely difficult. 

And finally, let me ask Health and Human Services, a major 

issue that came up was the portability and reciprocity between 

States relative to SCHIP. So as children left Louisiana and went 

to Mississippi, we had difficulty getting not just their medical 

records, but care for them in the 6 months they were in Mississippi, or if they went to Arkansas or they went to Texas. Has 

that been addressed, and if so, to what degree and what more do 

we need to do? 

Admiral LURIE. Well, that, too, is just a really important issue 

to take on. I think it is fair to say that the statutory and regulatory 

policies within State Medicaid programs have mechanisms in place 

to ensure the portability issues. That doesn’t mean that the parents 

on the ground understand how to navigate the Medicaid program 

to do it or that the providers understand on the ground how to do 

that, and I think that is a place where the connect between the 
19 

1The prepared statement of Mr. Pastorek appears in the Appendix on page 79. 

sort of administrative and bureaucratic procedures and the real life 

procedures and policies really have fallen apart and not done very 

well. 

As you know, the CHIPRA legislation really requires a very hard 

look at all of this going forward. CMS has been actively engaged 

and involved in that. I believe that in the next week or two, in fact, 

the sort of external stakeholder engagement process will begin. I 

know there are already a lot of ideas that people have generated 

internally about how to do this and we are looking forward to much 

more of this. This has just got to be nailed down. 

Senator LANDRIEU. OK. Well, thank you all very much. I am 

sorry I am going to have to dismiss our first panel. I appreciate 

your testimony. The record will remain open if there is anything 

else you would like to submit. And let me thank you all. 

To save time, I am going to go through the introductions as the 

next panel comes forward. 

Our first witness will be Paul Pastorek, Superintendent of Education in the State of Louisiana. For the last 20 years, he has been 

a leader in education reform, not only in our State but throughout 

the Nation. He formed Next Horizons, a nonprofit organization that 

serves as a state-wide think tank to connect Louisiana’s leadership, 

spanning education and government. And most importantly, or 

equally importantly, he served in our State’s Elementary Board of 

Secondary Education on the ground, so he gives a perspective that 

is real and relevant to the discussion today. 

Matt Salo is Legislative Director of Health and Human Services, 

National Governors Association (NGA). Prior to joining the NGA, 

he was a health policy analyst at the National Association of State 

Medicaid Directors. We are appreciative to have him today. 

Dr. Melissa Reeves, our third witness, is a certified school psychologist with an extraordinary background in this area. 

And finally, Douglas Walker is Clinical Director at Mercy Family 

Center and Project Fleur-de-lis in Louisiana. We are very proud of 

that project. In response to the devastation caused by Hurricane 

Katrina, he created this project as an intermediate and long-term 

school-based mental health service model. It now operates in over 

64 New Orleans schools. We are really proud of the work that he 

has done and look forward to potentially suggesting this as a national model. We are very anxious to hear his testimony today. 

But, Mr. Pastorek, why don’t we get started with you, and thank 

you for taking time out of your busy schedule to be with us. 

TESTIMONY OF PAUL G. PASTOREK,1 SUPERINTENDENT, 

LOUISIANA DEPARTMENT OF EDUCATION 

Mr. PASTOREK. Thank you, Madam Chairman. I am very pleased 

to be here today, and I want to thank you, first of all, for your leadership, particularly for our State but also for our Nation. This is 

a particularly important hearing and we have had quite a few experiences in recent years and I appreciate you allowing me to share 

those experiences, not only for Hurricanes Katrina and Rita, but 

also for Hurricanes Gustav and Ike, which was a slight reliving of 

that, although not quite to scale. 
20 

I also want to thank our citizens in this country, our Federal 

agencies, and our Congress for the help that we did get after Hurricane Katrina. It was as speedy as it could be, I suppose, and it was 

as important and as substantial as it could be under the circumstances. Notwithstanding that, though, many challenges were 

experienced and continue to be experienced in Louisiana, all along 

the Gulf Coast, from both Hurricanes Katrina and Rita. 

At that time, we had about 370,000 students in two States, Louisiana and Mississippi, that were displaced immediately after August 29, 2005. My children were part of that displacement, being 

a resident of New Orleans. Today, we still have many thousands 

of children who have not returned. In New Orleans itself, we had 

a population of about 65,000 students. Today, we have a population 

of about 38,000 students. In Saint Bernard Parish, probably the 

hardest hit parish from Hurricane Katrina, about 10,000 pre-storm 

and about 5,200 today. So the ability to recover is a significant 

challenge when you are dealing with storms of this magnitude. 

Now, I would like to submit my testimony, but I am going to just 

mention a couple of key points that I think are important to keep 

in mind. 

Immediately after the—well, on the onset of the storm, on August 28, when hundreds of thousands of people evacuated—millions 

of people, really, evacuated from Southeast Louisiana and Southern 

Mississippi, children moved to other locations. Children moved to 

Houston, to Baton Rouge, to Shreveport, to Atlanta, and, indeed, 

to 50 States around the country. 

School districts were immediately impacted. When thousands of 

kids showed up in Baton Rouge the following Monday and Tuesday 

and Wednesday as they trickled in, and they showed up in Houston, districts had to immediately place teachers in the classroom, 

immediately had to find textbooks, computers, space, and immediately had to find transportation. Those costs were immediately 

incurred. 

Now, even with the quick action of Congress after this event, and 

with your leadership, that of former Senator Kennedy, and others, 

Impact Aid Grants which were provided by Congress did not finally 

show up until January 2006, which means that districts all over 

this country had to provide resources to students which they did 

not plan for and did not really, frankly, have the resources to do. 

Now, much was done within the State to reallocate resources, but 

communities in our State have local taxes and they did not share 

the local taxes that were formerly received in Orleans Parish associated with children, or formerly received in Saint Charles Parish. 

So when kids went to Baton Rouge, Baton Rouge’s local taxes had 

to carry that weight of those children, and the same is true for out 

of State. When kids went to Houston and to Atlanta, they were 

having to carry that weight, as well, and immediately having to do 

so. So districts had to dig down deep inside to cash flow the operations until such time as emergency funds were received. 

So I want to urge this Subcommittee and I want to urge Congress to consider a permanent fund to be available for these kinds 

of displacements so that school districts, not only in Louisiana, but 

all over the country, wherever a disaster may occur, would be immediately available to districts so that we would not have to cash 
21 

1The prepared statement of Mr. Salo appears in the Appendix on page 82. 

flow this kind of emergency response on the backs of those receiving school districts. 

And the second major point I would like to bring to your attention is the issue of records and recordkeeping for students. When 

they do move, there are great difficulties in being able to translate 

the records of these students. Some districts and States are more 

prepared than others, but having some uniformity in this process 

would be a great assist for the receiving districts. 

Just one example. As we know, special education students have 

Individualized Education Plans. When they leave Saint Bernard 

Parish in a hurricane or some other affected area, whether it be 

in Louisiana or otherwise, they show up at a school in Houston, let 

us say, and they don’t have their IEP. They don’t have their record 

of what grade they are in. And some kids don’t actually tell us exactly what their needs are. [Laughter.] 

Senator LANDRIEU. No. 

Mr. PASTOREK. Some of them want to be in a higher grade than 

they actually are. [Laughter.] 

So it really is a bit of a confusion. So at the end of the day, I 

would urge you to consider that as you go forward, as well. 

And I have other points that I have raised in my testimony and 

I will reserve those for later comment. 

Senator LANDRIEU. I really appreciate that. Thank you so much. 

Mr. Salo. 

TESTIMONY OF MATT SALO,1 LEGISLATIVE DIRECTOR FOR 

HEALTH AND HUMAN SERVICES, NATIONAL GOVERNORS ASSOCIATION 

Mr. SALO. OK. Thank you, Madam Chairman. On behalf of the 

Nation’s Governors, I really appreciate the opportunity to come before you and talk about the State role in making sure that the 

health care needs of kids were met post-Hurricanes Katrina and 

Rita. 

Clearly, there is nothing we can do to prevent major catastrophes, but as you know, one of the key functions of State and 

local governments is to prepare for, react appropriately to, and recover from these incidents. 

Hurricanes Katrina and Rita, unfortunately, were a disaster of 

a scope that we couldn’t really have prepared for. No one was really prepared for that, and the devastation that the hurricanes and 

the flooding left in their wake totally ruined the infrastructure of 

government. It ruined the infrastructure of the health and social 

services networks all along the Gulf Coast and it was quite the 

challenge, clearly. 

I do think that there are positives to take out of this. I think that 

we have learned a lot from that experience in knowing where the 

holes are, where the flaws in our preparedness planning are, where 

we do need to find improvements in the safety net. And I do think 

that given all of the challenges, there was an enormous effort on 

behalf of State officials to try to do as best as they could in that 

situation. 
22 

Within 24 hours of what was, in effect, the largest and fastest 

mass migration in this country’s history, we had Governors and 

State Medicaid directors on the phone with each other, with HHS, 

working and talking constantly to try to figure out how to best 

track, take care of, and protect the kids and the families, the seniors and people with disabilities who were in nursing homes who 

were displaced or otherwise affected. 

Clearly, we do think we need to do more. Clearly, I think we 

have learned a lot of lessons. I would say, clearly, we need to spend 

more time and more focus on thinking about the unique needs of 

children. I think the point is very well taken that they are not just 

little adults. But I think it is also important to note that children 

are, at the end of the day, members of a family unit and it is important to keep that in mind, as well, as we try to really take care 

of them as best we can. 

So with respect to actual recommendations that we would make 

in terms of what lessons we have learned since the hurricanes, I 

think four basic thoughts, the first of which is we need to strengthen and build upon the current framework of disaster planning and 

response. The lessons that we have is that all disaster planning 

really is local, and truly all disasters are different. Hurricanes 

Katrina and Rita were very different than sort of the wildfires and 

the interstate floods you saw in Iowa, and all of those are different 

than the terrorist attacks of September 11, 2001. 

The fact that all of these things are different and the fact that 

the immediate response is always local means that we need to 

build upon and strengthen sort of the State and local structure that 

is there, and I think there are a number of ways that the Federal 

Government can help us in doing that. I think, clearly, in our work 

with the Department of Homeland Security, with the sort of tabletop exercises over the past number of years that have operated regionally, trying to respond to various things like hurricanes or 

avian flu or other terrorist attacks, we have learned a lot. I think 

we can build those up, we can refocus those on the needs of children. 

Specifically what we learned in Louisiana and Mississippi and 

some of the other States is it is hard to get the infrastructure of 

the Medicaid system up and running when the State Medicaid employees had to worry about their child care needs. So it is not just 

the child care needs of the nurses who are taking care of people, 

but of folks who are actually in the infrastructure itself. 

A second piece is funding. I think the funding is critical. We 

worked very well with HHS on all sorts of different waivers and 

waiver templates to help kids as they move from Louisiana to Arkansas and in every other State. But at the end of the day, there 

wasn’t anything that HHS could do about the fact that, at the end 

of the day, those waivers just said the host State had to bill all the 

services back to the home State, and clearly, Louisiana and Mississippi and the other impacted States could not afford to pay the 

bills in those times. 

Congress did come along and provided 100 percent Medicaid 

funding, provided uncompensated care package. That was extraordinarily useful. I would argue that I think we need to replicate 
23 

1The prepared statement of Ms. Reeves with an attachment appears in the Appendix on page 

88. 

that, make it permanent somehow so that enacting that doesn’t 

take quite so long the next time we have a situation like this—— 

Senator LANDRIEU. You have 30 seconds. 

Mr. SALO. And then I think the other—I guess the final piece 

that I would mention is around health information exchange. It 

doesn’t matter how much money there was or how much planning 

there was if the only records of someone’s medications or of their 

medical history, kind of like their school records, if they were submerged six feet under dirty water in a metal filing cabinet, they 

weren’t going to help anybody. And I think we have gone a long 

way towards making sure this country is prepared for an interoperable health information exchange, but we are not there yet and I 

think we need to continue to move forward. A lot of that will prevent some of the problems that we saw in Hurricanes Katrina and 

Rita. So thank you. 

Senator LANDRIEU. Thank you, Mr. Salo. Dr. Reeves. 

TESTIMONY OF MELISSA REEVES, PH.D.,1 CHAIRPERSON, PREVENT, REAFFIRM, EVALUATE, PROVIDE AND RESPOND, EXAMINE (PREPaRE) COMMITTEE, NATIONAL ASSOCIATION OF 

SCHOOL PSYCHOLOGISTS 

Ms. REEVES. Good afternoon and thank you, Madam Chairman. 

It is a privilege to be here today on behalf of the National Association of School Psychologists and to share my view on the critical 

roles that schools must play in crisis response and recovery. In addition to being a graduate educator at Winthrop University and 

also a school psychologist, I am also lead developer of the NASP 

PREPaRE School Crisis Prevention and Intervention Training Curriculum and have more than 15 years of direct experience in helping schools respond to crises. 

My remarks today are going to focus on the significant role of 

schools in keeping our children safe and healthy in the event of a 

crisis. After both September 11, 2001 and the Gulf Coast hurricanes, we saw America’s schools thrust into the center of the Nation’s crisis response, and I think it is safe to say that this country 

would have been unable to meet the needs of children and youth, 

even to the extent that we have, without our schools. As you have 

heard today, this support is vital because trauma can have significant psychological consequences that can interfere with learning 

and development. 

First and foremost, schools are where children reside for a significant amount of time each day. The learning environment provides structure, support, and opportunities to build coping skills. 

Second, school personnel know the students. They can monitor 

the residual and emerging effects of the crisis and provide continuity of support over time. 

And third, schools are familiar and accessible to families. This increases the likelihood that they will seek and accept support for 

their children and be more engaged in their children’s learning and 

recovery. 
24 

Community-based services are also critical to meeting the full 

continuum of children’s needs. However, in schools, community 

services need to be closely coordinated with those provided by 

school-employed mental health professionals, such as school psychologists, counselors, social workers, and nurses. Ensuring the ongoing presence of school-employed mental health professionals is 

important because of our specialized training with children, knowledge of schools, and our familiarity with students. 

I saw firsthand as a crisis responder following the Columbine 

High School shooting, there were many mental health professionals 

offering assistance, but some lacked the special knowledge and 

training needed to work in schools with traumatized youth. Those 

lacking this knowledge were not particularly helpful, and in some 

cases, they actually did more harm than good. 

This brings me to a key point. School crisis response is not a 

matter of choice for schools. When a crisis occurs, the school can 

be immediately transformed from an environment focused on learning to a triage center, emergency shelter, evacuation site, counseling center, communication depot, and/or a liaison between families and community services. I can tell you that the entire school 

staff, including the front office staff, become crisis caregivers who 

provide a critical sense of normalcy for children. 

The problem is that very few schools today are adequately prepared to perform this role. We need legislation that links schools 

into policies and funding to ensure that all phases of emergency response are efficient and effective. 

So what does this look like? Effective school crisis response requires planning and strategies appropriate to the learning environment. These encompass physical and psychological safety, school 

community collaboration, a designated school crisis response team, 

and staff training. In training professionals across the country, I 

have often seen some of these components addressed, but rarely all. 

For example, a crisis plan may address physical safety with 

minimal focus on psychological safety, or staff training may focus 

on plan development, but not on plan execution. 

As a leader with NASP, I have had the privilege to help develop 

the PREPaRE School Crisis Curriculum designed to help schools 

build this capacity at the local level. NASP has long been a leader 

in school crisis response, providing direct support in schools, training, research, and free public resources. The PREPaRE Curriculum 

was developed by school-based professionals and integrates the 

U.S. Department of Education’s Readiness and Emergency Management Guidelines and the National Incident Management System. PREPaRE combines the important aspects of crisis team and 

crisis plan development with extensive training on how to minimize 

children’s traumatic impact within the school setting. 

To date, PREPaRE has trained close to 5,000 school and community professionals from more than 38 States, we offered it in New 

Orleans after the hurricane, also in several foreign countries, and 

in addition, we have trained over 200 local trainers. As one administrator put it. PREPaRE has provided the continuity amongst providers that we have striven to reach for years. 

How can Congress help schools build this capacity? We need 

clear policies that recognize the importance of schools in disaster 
25 

1The prepared statement of Mr. Walker with attachments appears in the Appendix on page 

94. 

and crisis response. These policies must give schools the mandate 

and funding to develop crisis plans and teams, train school staff, 

strengthen the schools’ capacity to deliver short- and long-term 

mental health services, and sustain these supports over time. 

We need national school crisis response standards and a national 

repository for best practice resources and technical assistance. We 

also need research to evaluate the efficacy of school crisis training 

and strategies. Streamlined access to emergency funds in the event 

of a crisis with the goal of restoring learning environments as 

quickly as possible is critical. And we need a clearly-defined mechanism for school-community collaboration that lays out roles, responsibilities, and the use of resources. 

Last, schools need an adequate number of school-employed mental health professionals such as school psychologists who can provide the ongoing expertise and support before, during, and following a crisis. These are the professionals trained to link services 

and interventions to learning, not just in the event of a major disaster, but through daily challenges that affect children’s academic 

achievement and well-being. 

Again, I would like to thank you for your leadership on these 

issues and the opportunity to be here today. 

Senator LANDRIEU. Thank you very much for that excellent testimony. Mr. Walker. 

TESTIMONY OF DOUGLAS W. WALKER, PH.D.,1 PROJECT 

DIRECTOR, FLEUR-DE-LIS PROJECT 

Mr. WALKER. Thank you, Madam Chairman, for allowing me to 

represent our State of Louisiana as a child psychologist and a father of two young children. 

Friday after the storm, we found ourselves evacuated to East 

Baton Rouge Parish, and I was lucky enough to be at the right 

place at the right time to be invited to the Louisiana Department 

of Education Office of Community Services. When I arrived there 

to discuss a possible plan, I was shocked to find out, as I was handed the evacuation sheet, that there was no plan. And at the end 

of that day, they sent me out that weekend to develop a plan for 

the State. 

As politics would have it and the Stafford Act, the calls stopped 

coming for meetings at the Department of Education, so I turned 

to the schools that were opening in our area. Along with Father 

William Maestri, the Catholic Schools, was linked with Catholic 

Charities and found funding to start what is now called Project 

Fleur-de-lis. Project Fleur-de-lis is now the largest school-based 

mental health response to Hurricane Katrina. We currently have 

64 schools in our program. 

We started in that fall, and gathering a consensus of what the 

area schools needed. We gathered along the way evidence-based 

practice and we layered it in such a way that made sense to the 

needs of our schools. 

The first school we entered was Cathedral School in the French 

Quarter. We chose that school because the first responders children 
26 

were going there. We were fully operational in our three-tiered 

model of care in the fall of 2006. One side of the care involves 

triaging. Every single week for nearly the past 4 years, counselors 

come to Mercy Family Center and triage kids who are in need of 

care. Now, early on, they asked me, Dr. Walker, so you are just 

going to serve the kids who are traumatized, correct? I said, well, 

tell me who those are going to be. Tell me who. It is everybody. It 

is my kids. It is your kids, its everyone. 

So through funding by Catholic Charities, American Red Cross, 

Booth-Bricker, Freeport-McMoran, we entered out of the Catholic 

schools (we still have about 32 Catholic schools) and entered into 

the charter schools, the public schools, and we also have a couple 

of private schools. So we have helped as many as 1,000 students 

with free care, kids every single week provided free care. 

Our triage model of care, as far as school-based interventions, involve now psychological first aid. We use PREPaRE, actually, for 

untimely deaths and CBITS, Cognitive Behavioral Intervention for 

Trauma in Schools. And at the top of the triangle is Trauma-Focused Cognitive Behavioral Therapy. I am now a certified trainer 

in CBITS. I have trained over 200 counselors in Southeast Louisiana. Over the past 4 years of service, we have provided services 

for as many as 200 kids in CBITS, over 100 kids for Trauma-Focused Cognitive Behavioral Therapy, and, of course, are available 

to provide psychological first aid if, God forbid, we have to roll out 

that first level of care. 

I am proud to say that it is a grassroots organization. Project 

Fleur-de-lis is part of the Sisters of Mercy Health Care System, 

and I am a father of two young boys, and I can say that every single night that Project Fleur-de-lis keeps me up at night, but it is 

why I get up in the morning. 

Recommendations—I think that we need to fund intermediate 

and long-term care, and with particular focus on the schools and 

providing care in the schools. The Success of Project Fleur-de-lis 

comes about by two areas of expertise. First and the foremost is the 

expertise that lies in the school counselors in the schools. They 

know their community best, and that is why Project Fleur-de-lis 

has been successful, combining that expertise with evidence-based 

practice available through the National Child Traumatic Stress 

Network and other fine organizations such as NASP. 

Second recommendation, that we look at a coordinated effort in 

training school psychologists, mental health professionals, counselors in the community and school-based throughout the United 

States so when something like this again happens, we have a 

standard registry to pull from for expertise to help. 

Finally, I would like Fleur-de-lis to be considered as best practice, a tiered model of care, finding kids where they live in schools 

and providing the services they need post-disaster. 

Again, Madam Chairman, thank you for your invite today and I 

look forward to working with you all in the future. 

Senator LANDRIEU. Thank you very much, and thank you for creating this new model, and also your passion. 

Let me ask you, as a professional, the work that you were doing 

before Hurricane Katrina and then the work that you started to do 

after Hurricanes Katrina and Rita with the Fleur-de-lis Project, 
27 

what training did you lack that you just had to learn as you went 

that maybe we should be aware of in just the basic training for 

your profession? Could you try to describe—— 

Mr. WALKER. Yes. 

Senator LANDRIEU [continuing]. A little bit of your learning 

curve—— 

Mr. WALKER. I was minding my own business before the storm. 

[Laughter.] 

I had a fellowship in pediatric psychology and infant mental 

health, so I knew trauma pretty well by way of hospitals and certainly abuse and neglect of young children by way of those fellowships. What I lacked was evidence-based treatment, treatment that 

provided not only the best research, but also combined the value 

and cultures of the community and the expertise of the clinicians 

themselves. 

We were trained first with CBI which was sponsored by Save the 

Children at the time. That was our large group intervention. Next 

came that summer was Cognitive Behavioral Intervention for Trauma in Schools. And finally, Trauma-Focused Trauma Behavioral 

Therapy. And it is a tiered level of care where the large CBI and 

now psychological first aid blankets an entire school, and that is 

where you start. That is where you begin. And those kids are then 

in turn triaged up to CBITS, to small group intervention, usually 

about ten kids, primarily ages four to nine. And then if those kids, 

in turn, need additional therapy, then we do more intense work, 

one-on-one work through Trauma-Focused Cognitive Behavioral 

Therapy. So those are the things—that have been really our keystones or our building blocks for the past 4 years. 

Senator LANDRIEU. Were you limited in any way either by your 

own vision of the program or the funding you received for actually 

treating the child in the context of their family? For instance, if 

brothers and sisters were going to other schools or cousins were in 

the same school, or a single mom, is the work that would be done 

at the school level only for the children, or were there times when 

family members came in, as well? 

Mr. WALKER. Well, I would say the time after Hurricane Katrina 

for all of us was frenetic, and we have a lot of evidence to suggest 

that traditional mental health therapy in clinics like my own (I still 

do patient care 2 days a week) is difficult to achieve. We can’t expect parents to go to a clinic, like you said before, Madam Chairman, that doesn’t exist anymore. It is the schools and it is the kind 

of a center where we meet up with parents for school meetings, as 

well. 

When children are spread out and treated as a family, that is 

more of a challenge, when you have a teenager, you have a fourth 

grader. But we do the best we can and the school environment really needs to be opened up to provide this type of treatment postKatrina—I mean, after storms, especially when we consider that is 

where we live and we know the impact of trauma on learning. So 

it is a slam dunk and a win-win, in my opinion. 

Senator LANDRIEU. Mr. Pastorek, two questions. You weren’t the 

Superintendent when Hurricanes Katrina and Rita hit, but you 

have been for the past few years. Is this issue coming up to you 

still from your principals and your teachers at schools that are in 
28 

the disaster-affected area, how has it come up, and what are you 

doing about it, or what are some of the things that they share with 

you about their ongoing needs in this area? 

Mr. PASTOREK. Well, I was just in New Orleans a few weeks ago 

visiting four schools. The challenges are still quite significant. I 

think the emergency response most readily gravitates to buildings 

and infrastructure and least easily gravitates to the soft side of 

supporting kids in this situation. 

So you can see relatively quick response on the facility side, even 

though that was a long response, but relatively quick. But on the 

psychology, psychological services, the other kinds of services, it 

has been very difficult, very slow, and very inadequate. 

So what I hear from principals is that the numbers of kids who 

are homeless in New Orleans are much larger than they have ever 

been before the storm. These are functionally homeless and real 

homeless, kids who literally are living in other people’s homes, kids 

who are living with non-relatives. And I was at a high school in 

New Orleans, and you know Ms. Laurie at O. Perry Walker High 

School. She was telling me that she estimates the numbers of 

homeless now in her high school at about 20 percent, which is a 

pretty phenomenal number. 

The impact is significant, and when you consider the psychological and psychosocial impact of these kinds of kids who are still 

suffering from the storm nearly 5 years later, it is significant. And 

it isn’t because people aren’t trying, and it isn’t because we don’t 

want that to happen. But the infrastructural support and the focus 

of emergency response and recovery is not really as heavy on that 

as it could be. So that is part of it. 

And then I think the other part of it is that kids who are coming 

back are coming back today—literally since the start of school in 

September, we have had 1,700 new students come into the City of 

New Orleans to return to school, and they come back without really 

having been in school in a number of cases, living in a homelesstype or functional homeless-type situation. So these kids are coming back with tremendous needs even now, almost 5 years later. 

So the challenges are great. The challenges are significant. I 

think, I don’t think people still understand the magnitude of what 

has happened and how much and how difficult it is. 

And then I will add one other piece in here. The impact on the 

adults who are trying to educate the kids and trying to provide 

other services to kids are also still being felt. Those people are still 

trying to recover homes, even today, and trying to rebuild homes. 

So they are trying to do two things at one time, do their work and 

rebuild their homes and also manage and take care of their kids. 

So while there are certainly parts of the city and parts of the school 

system that have recovered, it continues to be a long slog. 

I will give you one final point. We had our first new school that 

was built from the ground up post-Katrina and it was opened only 

3 months ago. We have many schools slated for reopening and we 

have many facilities slated for reopening. And we have probably 

moved at lightning speed, frankly, in the education arena at rebuilding schools. But it is still a long haul to go. 

Senator LANDRIEU. Ms. Reeves, did you want to add anything to 

that? I see your head nodding as he is speaking. 
29 

Ms. REEVES. Yes. All of their points are really valid and we tend 

to focus more on what we refer to as physical safety. The psychological safety piece is either completely overlooked or it is really 

minimized. I know from the schools’ perspective, there are a lot of 

different contributing factors, but one of the biggest pieces is there 

is a shortage of school-employed mental health professionals. Those 

that are there are just spread so thin. There are huge ratios of the 

school-employed mental health professionals to students and they 

just can’t meet all of the needs. 

In addition to that, we also have key decision makers within the 

educational system that draw these arbitrary boundaries between 

academic achievement and mental health. I even had one decisionmaker in a larger school district say to me, ‘‘well, mental health 

is not the responsibility of schools.’’ And I think that person meant 

that from the aspect of we have so many other priorities coming 

at us as educational administrators that somewhere we have to 

say, here is the line. But you can’t arbitrarily separate those. They 

do go hand in hand, and I think all of us today have spoken to the 

importance of that. 

In addition, school-employed mental health professionals, and I 

will speak from the angle of a school psychologist, still have many 

ikey decisionmakers and administrators that see us in the role that 

we were in 20 years ago; which is assessing students for special 

education qualification. Our roles have expanded tremendously to 

include direct mental health services. But again, those key decision 

makers that determine how many school psychologists are going to 

be employed and determine what our job roles look like, they keep 

wanting to put us back in that old testing role. And a lot of times, 

we have barriers put up that don’t allow us to utilize our training 

in providing direct services to children. 

The Project Fleur-de-lis is a great example of school-community 

collaboration and the importance of providing those direct mental 

health services to kids, and school-employed mental health professionals can help with that if we are allowed to and if we have the 

resources to be able to do so. 

Senator LANDRIEU. Our time is coming to an end, but Mr. Walker, just again for the record, your organization, Fleur-de-lis, received how much money from government sources and how much 

from charitable contributions? 

Mr. WALKER. Yes. We are a proud member now of the National 

Child Traumatic Stress Network and we are funded for $1.4 million until 2012. We are also currently funded by a—— 

Senator LANDRIEU. Through a Federal grant? 

Mr. WALKER. Federal grant, through SAMHSA, yes, the NCTSI 

grant. We also currently are funded from Baptist Community Ministries locally. And prior to that, throughout the years, our other 

major contributors included American Red Cross, Booth-Bricker, 

Freeport-McMoran local—— 

Senator LANDRIEU. So it was truly a private—— 

Mr. WALKER. Yes. 

Senator LANDRIEU [continuing]. Not-for-profit—— 

Mr. WALKER. Correct. Yes. 

Senator LANDRIEU [continuing]. And now a government-supported collaboration. 
30 

Mr. WALKER. Exactly. We entered the NCTSN last fall, but until 

2007, it was a private enterprise. 

Senator LANDRIEU. OK. Mr. Salo, do you have anything to add, 

because I have got one more question for Mr. Pastorek and I didn’t 

want to pass you up. Anything that is on your mind that you want 

to add or answer? 

Mr. SALO. Yes. No. I just think that all of my fellow panelists 

have raised really legitimate issues. One of the things that I worry 

about moving forward with is how do we build the capacity to do 

all these things given the current economy and the state of the 

State budgets. 

Senator LANDRIEU. Well, let me ask you this. Has the National 

Governors Association either post-Hurricanes Katrina, Rita, Gustav, or Ike, or post any major disaster established a permanent 

subcommittee among the National Governors to work on these 

issues. Coordinated evacuation plans? Reciprocity? Have you ever 

established that through National Governors—— 

Mr. SALO. Yes. 

Senator LANDRIEU [continuing]. And if so, is there one that exists 

today, such a committee? 

Mr. SALO. Yes. We do have our State-Federal affairs side of our 

organization, sort of a homeland security committee, broadly written, whose function is a lot of these issues. We also have our Center for Best Practices, where we have a number of staff who are 

devoted precisely to preparedness planning, public health, and a 

number of the issues that go hand-in-hand with a lot of the Memorandums of Understanding that go on between the States. So we 

do have that in place. We are there to work with States. I know 

also the State Medicaid Directors Association was working very 

well with the States in terms of the Medicaid and sees the SCHIP 

Directors post-Katrina—— 

Senator LANDRIEU. Well, I raise that because as this Subcommittee continues this work—this is a special focus, it is not our 

only focus, but a special focus on pushing through a major piece of 

legislation relative to reforms regarding how governments and our 

partners respond and treat and help children recover in the context 

of children as members of the family. I would really appreciate 

input from the National Governors Association and potentially 

maybe establishing some sort of committee for the next 6 months 

to work with us would be welcomed on our part. 

Final question to you, Mr. Pastorek. We are debating right now, 

how do we establish this reimbursement for students moving from 

one school to another school and whether that reimbursement 

should follow the student, whether there should be any restrictions 

or guidance relative to students going from public school to private 

school or parochial school to public or public to parochial. Do you 

have any views on that? Is it wise for us to consider some of those 

restrictions, or is it better just to let parents get their kids in whatever school they can and figure out the details later? 

Mr. PASTOREK. I have given actually great thought to that issue, 

and frankly, I think you need to have the money following the 

child, regardless of the sources of either public-private on the starting end or on the receiving end. I think it is extremely important 

to understand that in this emergency circumstance, people are 
31 

struggling to figure out what to do, where to go, and sometimes 

their choices are quite limited. Sometimes their choices are quite 

problematic. 

So I do think it is important to recognize that everyone is entitled to an education and everyone is entitled to get a quick recovery for themselves to get back in the cycle. And it is important for 

the children especially not to get into the haggling over where do 

you come from and where are you going to, but what is the community’s obligation to get children back online as promptly as possible. 

It is not only from an academic education perspective, but I 

would argue it is from a psycho-social perspective, as well. Children 

need to be back in the classroom. That actually was a quite 

calming influence for children who had to be uprooted and moved 

from one location—from their home, from their community, from 

their school—and placed elsewhere. To come back to a school setting is extremely important. 

So I think it is very important to be focused on the child and not 

only the restrictions and so on and so forth, because even applying 

those restrictions are going to give rise to all kinds of uncertainty 

on the part of the parent as to what to do, what they can do, what 

they can’t do, and then it causes restraint on them to be able to 

make decisions that are in the best interest of their children. 

Senator LANDRIEU. Thank you very much. 

This tuition reimbursement provision will be in the children’s 

bill, which is what we are putting together now. So that is a major 

portion of this bill. 

But I thank you all. Unfortunately, our time to close the hearing 

has arrived. We have received tremendous testimony. A variety of 

different issues have come forward, and I thank you all for participating. 

Again, the record will stay open for 15 days. Please feel free to 

add any supplemental material or additional comments from colleagues or others that you would like to submit to the record. We 

will be using this record to build the provisions of this part of the 

bill. 

So I thank you all very much, and the hearing is adjourned. 

[Whereupon, at 4:30 p.m., the Subcommittee was adjourned.] 

(33) 

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Æ