NEW ORLEANS — An American Red Cross program that offers subsidies for mental health care to people affected by hurricanes on the Gulf Coast has been so undersubscribed that the organization is extending the deadline to apply and the period in which benefits will be offered by 6 months.
The Red Cross also has doubled the amount of money available to each applicant—from $1,000 to $2,000.
Anyone—even if he or she did not live in one of the affected Zip codes—who lost a family member may be eligible to receive benefits.
The organization is reluctant to give out figures on how many people have used benefits under the Access to Care program and how many it hopes to accommodate. Jeanne Ellinport, director of communications for hurricane recovery at the Red Cross, said in an interview that there is a cap on the amount of money that will be distributed, but that the program has not come close to reaching that limit.
One psychiatrist who's been trying to get the word out about the program—Dr. Grayson S. Norquist, professor and chairman of the department of psychiatry and human behavior at the University of Mississippi Medical Center in Jackson—said he had been told that as many as 40,000 people could receive benefits and that only about half that many have done so.
Access to Care was launched in late September 2006, about a year after hurricanes Katrina, Rita, and Wilma ravaged the Gulf Coast of Louisiana and Mississippi, as well as New Orleans and parts of Alabama, Florida, and Texas. It was modeled after a program instituted in New York after the attacks of Sept. 11, 2001, according to Jacqueline Yannacci, program manager, emotional support for recovery, at the Red Cross.
Both the Sept. 11 program and the hurricane-related program are administered by the Mental Health Association of New York City.
Past experience has shown that depression, anxiety, and posttraumatic stress disorder tend to hit the hardest about a year after a disaster, hence the September 2006 launch, Ms. Yannacci said.
Those eligible for Access to Care are people who lived, before the hurricanes hit, in a Zip code affected by one of the three storms—about 133 counties in Texas, Louisiana, Mississippi, Alabama, and south Florida, Ms. Yannacci said. The residents have to provide proof of residence in those areas before the storm. While that might be close to impossible for storm victims whose homes were flooded or wiped out by winds or a storm surge, Ms. Yannacci said the Red Cross does everything possible to help people get proof. Those who received assistance from the Red Cross are in an organization database; in some instances, case managers call utilities or do other detective work to get residency proof, she said.
Applicants have to show that the storms had a significant impact on their lives—for instance, that they had been displaced from their homes for longer than 2 weeks, had lost their home or job, or their children had been uprooted and placed in a new school. If the “significant impact” criteria are met, even people who no longer live in those areas are eligible.
Initially, applications had to be received by Oct. 1, 2007; that has now been extended to March 30, 2008. Services will be covered from Aug. 30, 2005, to Sept. 30, 2008—instead of April 1, 2008. Claims can be filed as late as Dec. 30, 2008.
The Red Cross also removed a big potential hurdle for applicants. Initially, they had to use insurance benefits—if they had them—before they could receive Access to Care funds. Now, if they are accepted into the program, applicants can make use of up to $2,000 without using their insurance first. The payments can be made directly to providers—psychiatrists, social workers, psychologists, even acupuncturists. The money can be used for counseling, acupuncture, testing and evaluation of children up to age 21, and psychotropic medications.
Dr. Norquist said few of those who might use Access to Care—and few of his psychiatric colleagues on the Gulf Coast—know about the program, he said in an interview.
A major issue for Gulf Coast residents who might want to seek psychiatric care is the continuing shortage of health providers. Mississippi Gulf Coast clinics have about 75% of the staff they had before the hurricane, and they are seeing as many or more patients, Dr. Norquist said.
Meanwhile, the Metropolitan Human Services District (MHSD), a semiregional agency in charge of providing and managing publicly provided mental health and substance abuse services, is collaborating with the Red Cross to increase awareness of Access to Care. But a change in strategy might be needed, said Dr. Jerome Gibbs, executive director of the MHSD. “We need to think about how we market and label the services we provide,” he said, noting that for many people, there is still a stigma attached to seeking care for a mental health issue.