Housing Standards That Promote Health

Physical changes to the nation's housing supply are an ongoing process. Two important recent developments are relevant to disaster-related housing recovery operations: (1) the issuance in 2014 of the National Healthy Housing Standard (APHA and NCHH, 2014), which is an update of the 1986 Housing and Health: Recommended Minimum Housing Standards from the American Public Health Association; and (2) the issuance of “green” housing standards. The National Healthy Housing Standard covers duties of owners and occupants, structural concerns, noise, crowding, injury prevention, chemical safety, smoke and carbon monoxide alarms, lighting and electrical issues, safety, ventilation and moisture, and contaminants. “The Standard constitutes minimum performance standards for a safe and healthy home” (APHA and NCHH, 2014).

Green building is “the practice of creating structures and using processes that are environmentally responsible and resource-efficient throughout a building's life-cycle from siting to design, construction, operation, maintenance, renovation and deconstruction. . . . Green buildings are designed to reduce the overall impact of the built environment on human health and the natural environment” (EPA, 2014). In recent years, a plethora of green standards for construction practices have appeared. These include Enterprise Green Communities, the ICC-700 National Green Building Standard, the U.S. Environmental Protection Agency's (EPA's) Indoor AirPlus, and Leadership for Energy & Environmental Design (LEED). Each program has different criteria, a different method for calculating whether a project meets the criteria, and different criteria for different types of housing project (e.g., multifamily or single-family). For example, LEED has four levels of certification: Certified, Silver, Gold, or Platinum, and certification can be for family homes, neighborhoods, existing building operations, interior design, or new building construction (USGBC, 2009). The Enterprise Green Communities standard has mandatory health requirements. Table 10-1 shows some examples of criteria used by Enterprise Green Community and LEED.

TABLE 10-1

Examples of Green Building Criteria.

Another housing program employing standards relevant to post-disaster reconstruction is the Resilience STAR™ program. This pilot project by the U.S. Department of Homeland Security is modeled after the EPA's ENERGY STAR certification program. The designation will be given to structures that are built to withstand damage from disasters, using criteria from the Insurance Institute for Business & Home Safety's FORTIFIED program. The FORTIFIED criteria cover building or retrofitting roofs, soffit vents, entry and garage doors, chimneys, and foundations (Insurance Institute for Business & Home Safety, 2012). The committee found no studies showing improved health outcomes associated with the FORTIFIED criteria, indicating a need for further evaluation.

Green Housing Standards and Health

Energy conservation often is the driving force behind the adoption of “green” building standards in residential structures, but it also has been bolstered by the promise of ancillary environmental health benefits for the building occupants. According to the World Health Organization (WHO), for example, the annual burden of mortality due to cold homes can be estimated conservatively at 30 percent of excess winter deaths in Europe (Rudge, 2011). Beyond the straightforward impact of thermal improvements, energy conservation can plausibly be related to health because it often includes the following: repair or replacement of heating and cooling equipment to increase efficiency and reduce the generation of pollutants such as carbon monoxide; improvement of ventilation to remove contaminants; air sealing and improvement of building envelopes, which often can reduce moisture leaks from the exterior; and reduced moisture incursion (WHO, 2011). Further, increased energy efficiency and resultant reductions in household energy costs leave individuals with more income to spend on other essentials, such as food and medicine. The “Heat or Eat” study found that families whose energy costs were lowered as a result of receiving fuel assistance had a reduced odds ratio both of being at aggregate nutritional risk for growth problems and of hospitalization (Frank et al., 2006). Results of one recent study suggest that more than 30 housing elements typically included in green standards could plausibly be associated with health outcomes (Jacobs et al., 2014a). These elements include high-efficiency furnaces, programmable thermostats, absence of carpeting in kitchens and bathrooms, foundation waterproofing, radon and lead testing and mitigation, and doors and windows that reduce air infiltration and water penetration.

Evidence of positive health outcomes associated with rebuilding housing in compliance with green standards is robust. Improvements in general self-reported health, respiratory health (notably asthma), mental health, and other health outcomes following both new construction and housing rehabilitation that comply with green building standards have been found in numerous studies (see Table 10-2). Most of these studies relied primarily on self-reported health, using structured interview data collection instruments. Substantial evidence, however, indicates that self-reported health is correlated with other, more objective measures, such as clinical outcomes (Burstrom and Fredlund, 2001; Halford et al., 2012; Idler et al., 2000; Krokstad et al., 2002; Li et al., 2011; Mansson and Rastam, 2001; Marmot et al., 1995; Miilunpalo et al., 1997; Pietilainen et al., 2011; Singh-Manoux et al., 2007).

TABLE 10-2

Summary of Literature Showing Improvements in Health Due to Green Housing Interventions.

There appear to be no studies to date showing that use of green building standards in the context of post-disaster rebuilding also promotes better health, but there is little reason to expect different results. Further research is needed to assess the link between health outcomes and housing reconstruction that complies with green building standards in the post-disaster context.

Disaster-Related Health Hazards

Disasters can cause significant damage to homes, resulting in increased exposure to new threats and exacerbation of existing threats. Common examples include safety hazards from debris and health hazards such as high levels of mold and microbial products associated with allergies, asthma, and other respiratory conditions (IOM, 2004; Krieger, 2010; Wilson et al., 2010). High concentrations of microbial toxins and allergens result from microbial growth under conditions of dampness and inadequate ventilation, both of which can be prevalent in the indoor environment after a disaster. There have been reports of very high levels of exposure to mold and bacterial toxins among both occupants and recovery workers who repair moisture and mold problems in housing (Chew et al., 2006). Additionally, post-disaster use of temporary housing that has chemical contaminants such as high levels of formaldehyde has been associated with respiratory problems, sensitization, and other adverse health outcomes (Murphy et al., 2013). Moisture control, ventilation, and chemical source control are therefore essential elements for healthy housing in the context of disaster recovery (HHS, 2009).

Strain on Capacity

The sudden destruction of large proportions of a community's housing stock as the result of a disaster places a considerable burden on the housing sector during recovery. Repair, rehabilitation, and new construction of housing stock that would otherwise take years must be accomplished at a greatly accelerated pace to meet needs for both human and economic recovery. Governmental housing agencies can be overwhelmed by such tasks as inspection, permitting, and oversight; there may also be insufficient labor and materials within a community to meet reconstruction needs. Construction contractors and subcontractors from outside the community may come in to assist, but this creates an additional need to check that they hold the proper licenses and certifications to ensure that they can perform the work properly and safely, as well as to help prevent fraudulent, incorrect, and unhealthy building practices and noncompliance with codes.

Displacement and the Need for Healthy Temporary Housing

After a disaster, individuals frequently require short- and sometimes long-term temporary housing. Following Hurricane Katrina, for example, more than 400,000 individuals were displaced from their homes (Geaghan, 2011), while more than 12,000 were displaced following the Loma Prieta earthquake in 1989 (CA Department of Conservation, 2013; Lew, 1990). Although many displaced survivors seek short-term shelter with relatives and friends, others may go to emergency congregate shelters established in the immediate aftermath of an event by local governments, the American Red Cross, or others. Such emergency shelters often close within a few weeks following a disaster, but repair and replacement of lost housing stock can take several years (Marin County Sheriff, 2003). Evidence shows that longer-term temporary housing needs to be established as soon as possible to enable rapid community recovery, mitigate the potential spread of disease, prevent avoidable injuries, and avoid potential adverse behavioral health outcomes that occur when large numbers of individuals are housed in shelters for extended periods of time. Displaced children who lived in a shelter after Hurricane Katrina, for example, experienced increased trauma symptoms and were more likely to be referred for mental health services as compared with displaced children who lived elsewhere (Osofsky et al., 2009). These findings are consistent with previous research on the mental health effects of living in shelters after Hurricane Andrew (Sattler et al., 1995).

Following a disaster, survivors in most cases prefer to stay in their original communities—next to their schools, jobs, and neighbors. If adequate housing is not made available, however, residents will leave the community, temporarily or permanently, further disrupting social networks and degrading the community and its economy. Communities with limited housing stock are at particular risk (Association of Bay Area Governments, 2014). Moreover, secondary impacts of long-term displacement include increases in psychological distress (Freedy and Simpson, 2007), posttraumatic stress symptoms in children (Lonigan et al., 1994), and violence (Marin County Sheriff, 2003; Rezaeian, 2013). Therefore, communities need to establish plans ahead of disasters to guide how temporary housing will be provided for survivors for the months to years following a disaster and how needs for permanent housing will be met. Even if temporary housing is provided for a timely manner, it is important to recognize that (1) displacement disrupts people's social networks, (2) survivors are likely to be more vulnerable than they were prior to the disaster, and (3) the availability of community resources will be limited.

Loss of Affordable Housing

Low-cost housing, including rental properties, tends to be concentrated in older buildings and more vulnerable locations. For these reasons, it is often affected disproportionately by disasters (Florida Department of Community Affairs, 2010). Not only are these homes more likely to be destroyed, they are also less likely to be rebuilt. After Hurricane Katrina, housing recovery varied significantly by housing type—single-family dwellings were rebuilt or repaired more quickly than multifamily units, and many rental housing investors chose simply not to rebuild and to “take their investment money elsewhere” (McIntosh, 2013). This loss of affordable housing—coupled with an increase in demand for such housing—created a dearth of housing options for lower-income residents, and many simply did not return to New Orleans (AlJazeera America, 2013). Consequently, failure to plan adequately for replacement of low-income housing will further widen the affordability gap and may result in the permanent loss of residents, with attendant workforce and tax base losses.

Federal Level¹

At the federal level, multiple agencies—including HUD, the U.S. Department of the Treasury, and the U.S. Department of Agriculture (Rural Housing Service)—provide funding for housing (primarily for low-income housing) and perform oversight functions. Many of the federal programs may, with the infusion of additional resources, help meet post-disaster housing needs. For example, the U.S. Department of the Treasury administers low-income housing tax credit programs and related mortgage bond programs with the states. These funds are important sources of capital for reconstructing low-income housing after a disaster, and they also often specify housing standards and codes that must be complied with, including fair housing regulations. HUD's HOME Investment Partnerships Program (HOME) also is designed to create affordable housing for low-income people. HOME offers grants to states and localities with which to construct, buy, or rebuild affordable housing or to provide direct rental assistance. In the event of a disaster, a grantee may request that HOME funds be expedited or that program requirements be modified to facilitate recovery (HUD, 2014e). HUD's Office of Public and Indian Housing provides financial assistance for low-income housing across the country, which encompasses both conventional public housing and vouchers for privately owned low-income housing, and these programs can sometimes be used to provide temporary housing assistance in the disaster recovery context.

The Federal Emergency Management Agency (FEMA) and HUD are the primary players in disaster-specific preparedness and recovery, as relates to shelters and housing. Immediately after a disaster, FEMA and its partners (including the American Red Cross) coordinate sheltering assistance through Emergency Support Function (ESF) #6—Mass Care, Emergency Assistance, Housing, and Human Services—under the National Response Framework. FEMA and HUD partner to provide interim housing assistance, which generally falls in the period of transition from ESF #6 to the Housing Recovery Support Function (RSF) under the National Disaster Recovery Framework (NDRF, described in more detail in Chapter 3). For issues related to permanent housing, HUD has lead responsibility as the coordinating agency for the Housing RSF.

Disaster-specific funding provided by FEMA and HUD is an important resource for post-disaster recovery. FEMA's Hazard Mitigation Grant Program provides funding to state governments for the implementation of long-term hazard mitigation measures, including property acquisition, structure elevation, floodproofing, and retrofitting of existing structures (FEMA, 2013a). FEMA's Individual Assistance program provides financial assistance for temporary housing, as well as for repairs or replacements not covered by insurance (FEMA, 2015). FEMA's Public Assistance program provides money to states and communities for rebuilding infrastructure, such as roads, utilities, and public transportation facilities. Although the Public Assistance funds cannot be used specifically for housing, the repair and reconstruction of infrastructure are vital to the success of housing efforts. In the event of a supplemental congressional appropriation, HUD's Community Development Block Grant for Disaster Recovery (CDBG-DR) (discussed in more detail in Chapter 4) is a significant source of funds for assisting homeowners with repairs and new construction after a disaster. At least half of CDBG-DR funds, which are distributed through the state or local government, must be used to benefit low- or moderate-income people (unless a waiver is granted), and may be used for a range of efforts, including

• purchasing damaged properties within a flood plain and relocating those residents;
• rehabilitating homes and buildings damaged by a disaster; and
• assisting homeowners with down payments, interest rate subsidies, and loan guarantees (FEMA, 2013a).

In past disasters such as Hurricane Sandy, FEMA and HUD have jointly implemented the Disaster Housing Assistance Program (DHAP). This program provides such assistance as rent subsidies, security deposit assistance, and utility deposit assistance for displaced residents (HUD, 2014c).

In 2009, FEMA released the National Disaster Housing Strategy, which outlines the nation's current approach to post-disaster housing and describes a new direction for meeting disaster housing needs (FEMA, 2009a). It lays out roles and responsibilities at all levels and includes a detailed description of disaster housing programs. The strategy emphasizes the importance of collaboration among government, nongovernmental organizations, and the private sector. At the federal level, interagency collaboration on the strategy's implementation is facilitated by the FEMA-led National Disaster Housing Task Force, and an implementation plan for the strategy was released in 2010. The strategy identifies the challenges to the current system and establishes six goals for a new framework for disaster housing:

1.

Help affected residents and communities meet their own housing needs and return to self-sufficiency as quickly as possible.

2.

Organizations must understand and fulfill their fundamental responsibilities and roles, and coordinate their efforts across sectors.

3.

Housing assistance must be responsive to the complex needs of disaster victims, including those with special needs (e.g., those with disabilities, children, pets), and be culturally and linguistically appropriate and accessible.

4.

Organizations must build their own capabilities, and know how to request assistance if it is needed, in order to provide a broad range of housing options.

5.

Disaster housing assistance must be integrated with related community support services (e.g., case management or support for the elderly) and long-term recovery efforts.

6.

Organizations must jointly plan for housing needs following the full range of potential disasters that may occur, from small-scale to catastrophic events (FEMA, 2009a).

One of the areas for improvement addressed by the National Disaster Housing Strategy is interim disaster housing. The strategy notes the importance of identifying alternatives to traditional interim housing, such as travel trailers, manufactured homes, or existing vacant units. FEMA launched the Joint Housing Solutions Group in 2006 to research, evaluate, and identify these potential alternatives. The Joint Housing Solutions Group developed a Housing Assessment Tool that analyzes alternative housing according to four criteria: range of use, livability, timeliness, and cost. The Joint Housing Solutions Group, which includes experts from HUD, the National Institute of Building Sciences, and multiple FEMA divisions, provides expertise and ground support to FEMA's disaster housing operations (FEMA, 2009a).

State and Local Levels

Several types of state and local housing agencies are involved in providing housing services and regulating housing construction. They include the following:

• Housing authority—The local housing authority typically is an independent local organization, with commissioners appointed by the local elected public official or tribal leader. The housing authority often owns housing, such as public housing, and also provides vouchers and other subsidies to low-income tenants and homeowners and low-income housing providers. There are wide differences in how housing authorities are organized across the country, but all receive funding through HUD's Public and Indian Housing program.
• Homeless services—These are local housing agencies that provide services for those who are unable to acquire housing, with support from HUD's Emergency Solutions Grant program and others.
• Zoning/permitting—These local departments regulate the types and locations of housing, as well as how modifications to that housing are made, through permitting, inspections, codes, and other means.
• State housing department and state housing finance agencies—Most housing is regulated by local jurisdictions, not at the state level, with important exceptions, such as the provision of low-income housing tax credits. The state housing department typically is the entity that oversees housing in rural areas, while city housing agencies oversee housing in urban and suburban areas, although there are exceptions.

Nongovernmental and Philanthropic Organizations

Nongovernmental and philanthropic organizations have a critical role to play by representing community voices, particularly those of vulnerable residents, and by filling gaps not addressed by government programs or private investments. National-level philanthropies such as the Annie E. Casey Foundation have been important funders of post-disaster revitalization efforts, particularly for underserved areas. Further, community-based organizations such as tenants' associations and tenants' unions ensure that community members have a voice in how housing is rehabilitated and built, and they can help facilitate interactions with private and public housing providers. The multifamily building community has many organizations that advocate on behalf of its members and can be a powerful force throughout the recovery process. Examples of such organizations include the National Multifamily Housing Council, National Leased Housing Association, Council of Large Public Housing Authorities, National Association of Housing and Redevelopment Officials, and National Apartment Association, all of which could play a significant role in rebuilding and promoting successful recovery. Community development corporations are local nonprofit organizations or quasi-governmental entities that provide and develop low-income housing, often with the support of subsidies such as low-income housing tax credits. Organizations such as Habitat for Humanity and Rebuilding Together use volunteers to build or rehabilitate low-income housing, while Architecture for Humanity provides pro bono design services after disasters. These nongovernmental organizations need to be actively engaged in post-disaster recovery efforts to ensure optimal functioning as part of a coordinated effort instead of a series of disconnected projects.

Private Businesses

Private businesses play a key role in recovery and can sometimes be more nimble than government agencies, but, as described below, neighborhood redevelopment will require close coordination between private and public sector stakeholders. Insurance companies have a large role in providing financing for recovery when homes have been damaged or destroyed by a disaster. However, certain kinds of damage (e.g., damage due to flooding) may not be covered, leaving homeowners to fend for themselves. Coordination between insurance companies and local and state government insurance commissions is essential because insurance companies may provide settlements or funds for reconstruction of housing before determinations have been made about whether (and where) rebuilding should occur and which standards and codes should apply. Once these determinations have been made, replacement costs may be impacted, and insurance settlements may no longer be adequate. Likewise, private developers may undertake acquisition and other preconstruction activities before the parameters of reconstruction have been set, making early coordination with local government essential. Builders and contractors bring essential skills to the rebuilding context, and special efforts may be needed to ensure that a reliable, trained workforce is available to carry out rebuilding efforts. Finally, lending and finance organizations, such as banks, mortgage institutions, underwriters, and others, play an essential role in providing needed capital as well as in specifying how private funds can be used for which activities. Public–private partnerships ensure that key decisions in the recovery process are made out by all responsible parties in a coordinated manner.

Partnering Organizations and Cross-Sector Collaboration

As stated in the National Disaster Housing Strategy, success in disaster housing requires “genuine collaboration and cooperation among the various local, State, tribal, and Federal partners, nongovernmental organizations, and the private sector to meet the needs of all disaster victims” (FEMA, 2009a). One potential mechanism for this type of collaboration between housing and non-housing sectors is a disaster housing task force (discussed in more detail below) that brings together the various players with key roles in disaster housing response and recovery.

Engaging the Community in Housing Recovery

The community is an integral partner in housing recovery. In addition to housing agencies and housing providers, community-based organizations need to be involved in housing decisions. This can be achieved by involving such organizations as tenant unions, building associations, neighborhood associations, and advocates for low-income housing in the recovery planning process. Working through these community-based groups can help reach vulnerable populations by leveraging the existing connections between community groups and these populations. Low-income populations in particular are at risk of exclusion from decisions that impact them. In Galvestson, Texas, for example, residents who were displaced by Hurricane Ike's destruction of the community's public housing units were excluded from the recovery process because input was sought only from those still living in Galveston (Nolen, 2014). As a result, the public housing on the island was very nearly not rebuilt. Involving community-based organizations and seeking input from all sectors of the population can make housing recovery plans more fair, equitable, and sustainable.

Establishing a Disaster Housing Task Force

Because timelines are compressed and resources are often scarce following a disaster, a community needs to establish a disaster housing task force² before a disaster strikes to begin establishing plans and identifying potential resources to guide recovery. Prior to a disaster, this task force is responsible for

• performing vulnerability assessments;
• developing an understanding of existing resources of the salient organizations; and
• developing plans, programs, and procedures to enable rapid rebuilding of healthy housing.

Representation on this task force should include a broad range of agencies and community organizations. In Marin County, California, for example, the task force included representatives from 16 different local government agencies, each with a specific set of responsibilities (see Box 10-1). However, the committee believes that the local health department should not only serve on the task force and assist in the delivery of medical and behavioral health care but also should ensure that all actions taken by the task force are based on information about what will best serve the community's immediate- and long-term health needs. Further, displaced individuals often require an array of human services with which health department personnel may not be familiar, so it is important that both health and human services expertise be represented on the task force. In addition to local government agencies, the task force should coordinate with relevant federal agencies, such as HUD, FEMA, and the U.S. Department of Health and Human Services (HHS) to ensure optimal vertical integration.

BOX 10-1

Example of Agency-Specific Responsibilities in a Post-  Disaster Housing Task Force: Marin County, California. Marin County Community Development Agency: Lead the Post-Disaster Housing Task Force (Task Force). Coordinate local, state, and federal (more...)

Conducting Vulnerability and Capacity Assessments

A primary pre-disaster function of a disaster housing task force is to acquire knowledge about the community's current housing stock. This knowledge greatly improves the ability of a community to plan for and recover from a disaster (HUD, 2007). Knowing current housing conditions enables a community to plan for temporary housing needs, prepare to assist residents with post-disaster repairs and rebuilding, and make policy decisions that will result in the redevelopment of a more resilient and sustainable community. Before a disaster, data should be gathered on the housing stock in the community, the vulnerabilities of the housing, vacancy rates, the proportions of rental and owner-occupied residences, and the suitability of various properties for temporary or long-term housing after a disaster. Many different strategies can be used to perform housing vulnerability assessments, depending on the risks the community faces. Hillsborough County, Florida, for example, which is most likely to experience hurricanes, uses a methodology that categorizes residential parcels by wind and flood vulnerability (Hillsborough County Government, 2010). This analysis provided Hillsborough County planners with data showing that about 22 percent of the county's housing stock was located in the 100-year flood plain. Knowing where clusters of vulnerable houses are located helps county planners determine where temporary shelters are more likely to be required, for example. This information also may assist a community in identifying priority redevelopment areas. For example, areas with houses that have lead-based paint or asbestos might be slated for major renovation after a disaster to mitigate those hazards.

Not only is it important to conduct an assessment of housing vulnerabilities; communities such as Hillsborough County also perform institutional capacity assessments to determine what capabilities exist within the community to promote rebuilding and guide the development of policies that may promote the effectiveness of these capabilities during recovery (Hillsborough County Government, 2010). This assessment includes an inventory of different organizations and the roles and expertise of each. This assessment needs to include a determination of which manufactured housing vendors would be capable of providing the type of temporary units that would be needed for on-site and group temporary housing sites in the event of a disaster. Based on this determination, formal relationships may be established with different vendors, but as highlighted by the case of Hillsborough County, these relationships should be flexible so that if a particular vendor does not have the necessary stock in a timely manner, the community can move on to another vendor.

Identifying Pre-Disaster Plans, Programs, and Procedures

Prior to a disaster, the disaster housing task force should establish an inventory of existing local plans, ordinances, programs, and procedures relevant to housing during long-term recovery (Hillsborough County Government, 2010). After a disaster, the task force will be able to use this inventory to locate resources and identify opportunities for rebuilding. An example of an inventory, developed by Hillsborough County, is shown in Table 10-3. Opportunities to leverage existing programs to rebuild housing should be examined.

TABLE 10-3

Hillsborough County, Florida, Pre-Disaster Housing Recovery: Primary Plans, Programs, and Procedures.

Planning for Siting of Temporary Housing

Emigration of residents from communities that have been struck by a disaster (and have experienced the resultant social and economic impacts, such as revenue loss, blight, and disruption of social networks) may be reduced by facilitating the timely and efficient transition of displaced individuals from shelters to temporary housing. Communities vulnerable to disasters should work with state and federal partners and use existing guidance (APA, 1998; ARC, 1998) in developing plans to guide where and how temporary housing is to be established. Potential sites can be designated in advance, or communities can develop criteria for temporary housing sites and apply those criteria to the post-disaster selection of sites after considering the extent and location of damage. To protect health and promote well-being, sites should

• be free of health hazards (e.g., contamination) and not subject to further safety and health risks (e.g., flooding); and
• adequately support those without access to private vehicles (near public transportation and/or in walkable distance from essential community amenities and employment centers).

In selecting group sites for long-term temporary housing, possibilities for conversion to permanent affordable housing units should be considered. Long-term temporary housing requires a significant investment in infrastructure (e.g., roads, utilities) that can be capitalized on during the construction of permanent housing (Florida Department of Community Affairs, 2010). Collaboration with urban and regional planning agencies and the community is essential to identifying appropriate locations for siting of temporary housing.

Assessing Housing Needs

Assessment (including quantification) of housing needs is an important first step in promoting housing recovery after a disaster. It includes data collection and analysis from sources that include the Census Bureau, preliminary damage assessments, shelters, and the community directly (e.g., evaluation of the extent of damage to housing stock) (FEMA, 2009b). Online databases, such as the National Shelter System (NSS) and FEMA's Housing Portal, can be used to help identify available housing.

An early decision that must be made in the immediate aftermath of a disaster is whether the existing housing or building stock will be adequate to house the displaced, new temporary units will be needed, or displaced populations should be transferred to nearby cities with adequate housing. This determination depends in part on pre-disaster vacancy rates and the suitability of vacant properties. To increase efficiency, these data should be gathered during pre-disaster assessments. Immediately after a disaster, HUD or a local entity should survey the entire HUD-assisted and HUD-owned housing inventory in and near the jurisdiction to determine the vacant units and vouchers available for providing temporary housing for displaced families (FEMA, 2009b).

If housing resources within an affected region cannot meet all of the community's housing needs, alternatives may include relocation outside of the community, although this solution may impede the community's recovery since it will further disrupt social support systems and may have long-term consequences for the community's viability. Furthermore, tensions can arise in host communities where large numbers of survivors relocate. Other solutions include the use of rental housing beyond the affected area, which can be facilitated through HUD's Housing Choice Voucher program (Section 8); immediate repair assistance so that damaged homes and rental housing can be made habitable; and the use of transitional shelters and temporary housing units (FEMA, 2009b).

Preventing Unnecessary Displacement

Displacement of people from their homes after a disaster—whether they go to a shelter, a relative's house, or temporary housing—has effects on health, and it also disrupts social connections that are integral to community functioning (Spokane et al., 2012). Evidence on the health effects of displacement is scarce because of a lack of pre-disaster data, an emphasis on short-term recovery, and the ambiguity of an appropriate follow-up period (Uscher-Pines, 2009). It is clear, however, that displacement is associated with psychological morbidity (including anxiety and depression), and there are indications that displaced individuals may experience a decrease in general health status and an increase in health care utilization (Uscher-Pines, 2009). Therefore, preventing unnecessary displacement after a disaster may prevent some negative health outcomes.

Protecting Homeowners and Recovery Workers Against Health Risks

In any effort to conduct repairs, the health and safety of recovery workers must be protected. A training system will be needed to ensure that workers, including volunteers wishing to aid in recovery operations, have the knowledge, skills, and equipment to do their work safely. All workers involved in housing and other building recovery and immediate repair/stabilization should be trained in how to identify potential mold, asbestos, lead-based paint, and injury hazards in homes they are seeking to repair and in how to control those hazards for both themselves and future occupants (e.g., mitigation practices). Measures to protect recovery workers also include provision of personal protective equipment, such as protective clothing, goggles, and fit-tested respirators, as well as plans for handling any work-related injuries expeditiously, including on-site first aid capacity. A wealth of information resources on worker protection during disasters is available through the National Clearinghouse for Worker Safety and Health Training, which is maintained by the National Institute of Environmental Health Sciences (NIEHS).⁴ NIEHS also offers training for response and recovery workers through its worker education and training program. After Hurricane Sandy, for example, NIEHS mobilized its worker education and training resources to support cleanup efforts (NIEHS, 2013). Guidance on mold mitigation in the context of disasters is available from many sources, including the National Center for Healthy Housing (2008) and the EPA (2010).

While multifamily housing often has property management personnel responsible for repairs and maintenance, owners of single-family housing are more likely to adopt a “do it yourself” attitude. Such homeowners, especially those whose houses have sustained minimal damage, may attempt to repair and remediate damages themselves. Therefore, homeowners need ready access to information on how to protect themselves from injury or illness as they repair their homes. For example, homeowners need information about identifying and mitigating lead-based paint, mold, and asbestos hazards, as well as injury prevention practices such as turning off the electricity when there is standing water or avoiding carbon monoxide poisoning from the indoor use of gas-powered tools or generators. This type of information can be provided to homeowners in pamphlets available at disaster recovery centers, home repair stores, and other places where homeowners may seek information. Homeowners also can utilize the resources of HUD's Office of Healthy Homes and Lead Hazard Control, which has developed a disaster recovery portal providing information about how housing-related hazards can be exacerbated by a disaster and how to identify and address them⁵ (HUD, 2014d).

Providing Short- and Long-Term Temporary Housing That Meets Health and Human Service Needs

When displacement cannot be avoided, temporary housing must be found for residents affected by a disaster. This short- and long-term temporary housing must be adequate to support the health of its occupants. Tent cities, vacation trailers, special event and conference centers, hotels and motels, railroad cars, shipping containers, covered stadiums, and cruise ships are all examples of temporary short-term solutions that should not be used to meet intermediate- and long-term housing needs during recovery because of potential health impacts associated with both physical and social environments (FEMA, 2009b).

Following the sheltering operations of the initial response phase, decisions must be made about options for interim housing for displaced individuals. Generally, there are three options:

• leveraging the appropriate existing buildings in either impacted or host communities;
• setting up temporary housing units (not vacation trailers) that FEMA may purchase and deploy (these may be placed on a homeowner's property if feasible); and
• using community sites to provide temporary housing—usually a last resort because it is dependent on the location, design, and infrastructure of the site selected and on whether the community finds it acceptable to use the site for more permanent housing (FEMA, 2009b).

The first option can involve FEMA's Multi-Family Lease and Repair Program (MLRP), which works to make better use of existing vacant multifamily property units in impacted or host communities. The MLRP provides funding to property owners for repairs to existing properties in exchange for the owners' making units available to individuals and households eligible for FEMA assistance (FEMA, 2013b). This program provides an “opportunity to minimize cost and reduce recovery time when the temporary housing needs are expected to be extensive and where local, affordable and accessible rental resources are insufficient to meet the permanent housing need” (FEMA, 2009b, p. 68). Many jurisdictions already have inadequate affordable healthy housing options, and repairing existing residential or commercial buildings can increase housing availability and affordability in many urban areas. The repairs should ensure that the units comply with the National Healthy Housing Standard developed by the American Public Health Association and the National Center for Healthy Housing. Applicable housing and energy codes also should be observed.

The second option entails the use of housing units that can lend themselves to becoming permanent residences, either in whole or in part. This option can involve the use of private sites where nearby housing will be restored.

The third option involves the use of community sites for temporary housing. As noted, this is usually a last resort because it is dependent on the location, design, and infrastructure of the site selected.

The degree to which any of these three options proves feasible will depend largely on the extent to which the affected or host communities are willing to allow “temporary housing” to become “permanent housing” (FEMA, 2009b). If commercial and private facilities fail to meet the community's housing needs, factory-built housing may be an alternative. Such housing should be placed in community site configurations, and the layout should include communal common areas to promote social interaction and to provide play areas for children. Factory-built housing typically is used to meet temporary housing needs. These manufactured homes, therefore, generally are located on commercial pads or sites developed specifically for such a purpose, although they also can be placed in existing commercial temporary sites. Alternatively, factory-built units may be placed on private sites so that homeowners can remain on their personal property as they repair or rebuild their permanent home (FEMA, 2009b).

HUD (through local housing authorities and others) can sell or lease housing it owns to displaced individuals at a discounted price. To minimize rebuilding time and reduce costs, federal-, state-, and local government-owned housing should be considered a primary option following a disaster. Additionally, the U.S. General Services Administration (GSA) can be used to acquire leases from private landowners. At the state and local levels, governments are responsible for identifying vacant land they own (FEMA, 2009b). These strategies help ensure that the short- and long-term housing needs of affected communities can be met adequately and quickly following a disaster.

Ensuring Safety and Health in Temporary Housing

Although emergency situations in which large numbers of individuals and families are displaced may require creative solutions to ensure that basic sheltering needs are met in the immediate aftermath, requirements for temporary housing that will be used to meet longer-term needs (months to years) should be significantly more stringent. If mobile vacation trailers are used for temporary housing (although this is not recommended), residents should be transferred from them as quickly as possible because they are not manufactured for long-term occupancy, and there is evidence that their use compromises occupants' health as a result of inadequate indoor air quality (e.g., formaldehyde) and inadequate space (CDC, 2010). Manufactured housing should comply with the National Healthy Housing Standard and should not include components that off-gas hazardous substances. Such housing also may require special siting and construction considerations, such as tie-downs in tornado areas and seismic designs in earthquake zones. The adequacy of housing with regard to health can be assessed using various tools, including the Housing Habitability checklist in Box 10-2 and the CDC/HUD Healthy Housing Inspection Manual, which also is available in a computerized ACCESS database suitable for laptops and tablets.

BOX 10-2

Health and Safety Checklist for Temporary Housing. All short- and long-term temporary housing should comply with the following checklist: Structure and materials: The structures must be structurally sound so as to pose no threat to the health and safety (more...)

Key principles of healthy housing that should be applied to temporary post-disaster housing include proper ventilation (both adequate fresh air and its distribution), moisture and mold control, maintenance, integrated pest management, avoidance of toxic chemicals and agents, safety (free of injury hazards), accessibility, cleanliness, and adequate lighting (HHS and HUD, 2006).

Supporting Social Connectedness

As discussed earlier in this chapter, the selection of sites for long-term temporary housing will have a significant impact on the experiences of those who are living there, and thus on its success. For example, temporary housing should be located near places of employment or transportation routes that can provide access to places of employment. Location, access, and mitigation of vulnerabilities are critical, but communities also need to consider other variables that can improve health outcomes, including how best to maintain social networks and ensure access to health care and social services.

One option for minimizing the negative impacts of relocation is to locate temporary housing on a person's original property—for example, to place a trailer next to a house that is being repaired. If residents remain on their own property, their lives are minimally disrupted, and existing social networks and neighborhood cohesiveness are maintained. When it is necessary to establish temporary housing such as a trailer park, a common choice for transitional housing, the park can be designed in a way that supports social connectedness. In Figure 10-1, for example, the park on the left shows a typical arrangement: trailers are aligned in rows, with the door of one facing the side of another, and there are no communal spaces or walking paths. The park on the right shows an alternative design: trailers are arranged in groups of four around common courtyards, and paths are placed around the park to encourage social interaction and casual contact (Spokane et al., 2012).

FIGURE 10-1

Alternative arrangements of post-disaster temporary housing. NOTE: The figure on the left shows the typical arrangement of Federal Emergency Management Agency (FEMA) trailers after Hurricane Katrina, which provided little space and opportunity for social (more...)

Survivors with Disabilities and Special Medical Needs

People with disabilities and medical issues have unique needs in sheltering operations. Special-needs and medical shelters may be established to provide care that is normally provided in nursing homes or hospitals, but advance planning is essential to ensure that medical personnel and volunteers can adequately meet the medical needs of the shelter residents (ADA, 2007). Medicare- and Medicaid-certified nursing homes are required to have emergency plans and to train staff in providing emergency services; however, a recent study found that these plans have major gaps, and nursing home administrators (more than 70 percent of those surveyed) report significant challenges in preparing for a disaster (HHS, 2012). Under the Americans with Disabilities Act, emergency shelter programs must not exclude or deny benefits to those with disabilities—shelter must be available that is physically accessible to people with disabilities, including those in wheelchairs (ADA, 2007). Such needs will also need to be accommodated in temporary housing arrangements.

The Homeless

The homeless are especially vulnerable to the impacts of disasters. They are among the most difficult to reach with any pre-disaster information-gathering systems, and the lack of baseline information is cited as one of the primary problems encountered in disasters (Runkle et al., 2012). In addition, homeless persons are four times more likely than the general population to suffer from severe mental illness—20-25 percent of the U.S. homeless population suffers from severe mental illness, whereas only 6 percent of Americans are severely mentally ill (National Coalition for the Homeless, 2009). Compounding these problems are higher addiction rates, social isolation, lack of income, lack of transportation, and limited means of communication for people who lack a permanent residence.

The same issues that create difficulties in helping the homeless prepare for disasters persist during recovery. Without addresses, homeless people cannot be contacted by relief organizations or file for benefits. If homeless populations are disconnected before disasters, the impact of the disaster often puts them farther out of reach of disaster recovery safety nets. Disasters also create newly homeless populations as a result of a multitude of factors, including lost employment, destruction of affordable housing, and associated rent increases. The city of New Orleans serves as an example of such issues and the challenges they pose to successful disaster recovery. According to a 2010 report on homelessness in New Orleans after Hurricane Katrina, the rate of homelessness in the city had nearly doubled 5 years after the flood, with thousands of homeless people living in the city's abandoned buildings. Fully 75 percent of these individuals were Katrina survivors, and alarmingly, most had been stably housed prior to the storm (UNITY, 2010).

Special efforts are needed to address the particular challenges facing homeless populations during disasters and to combat systemic issues that cause the most vulnerable victims of a disaster to fall into homelessness. Strategies proposed on the basis of experience with past disasters include

• a communication plan to relay timely and accurate information to health and human service agencies, and a platform for reporting operational status and needs;
• a homeless-specific sheltering and evacuation plan (National Coalition for the Homeless, 2014);
• the conversion of abandoned buildings into permanent supportive housing, where on-site case management services are available to help homeless individuals with disabilities remain stably housed after a disaster;
• the formation of outreach and housing search teams to identify homeless individuals and families and connect them with temporary and permanent housing; and
• continued investment in addressing affordable housing shortages to help low-income homeowners and renters finds new homes (UNITY, 2010).

These strategies require concerted collaboration among governmental and nongovernmental stakeholders from the social services and housing sectors.

Incentivizing the Use of Green and Healthy Housing Standards

HUD recently required compliance with an industry-recognized “green” standard for construction and rehabilitation of housing damaged by Hurricane Sandy that is supported by CDBG-DR funds⁷ (see Box 10-4). This important development shows that using green healthy housing standards in the context of disaster recovery is feasible and can be accomplished at the programmatic level. Although there may be some increased upfront costs associated with building in accordance with these standards, testimony provided to the committee suggested there was little resistance to complying with such standards (Smith Parker, 2014). Based on the demonstrated positive impacts of green building standards to health (discussed earlier in this chapter), the committee believes that HUD's requirement should be extended to all recovery efforts.

BOX 10-4

Post-Hurricane Sandy Requirements for “Green” Rebuilding. In specifying how Community Development Block Grant for Disaster Recovery (CDBG-DR) funds can be used in Hurricane Sandy rebuilding efforts, the U.S. Department of Housing and Urban (more...)

Housing regulations and standards typically are triggered during the course of specific building stages (e.g., obtaining permits for new construction projects) and housing transactions (e.g., sales, rentals, subsidies, financing), as well as in response to public health concerns (e.g., noise complaints, vermin, surveillance of lead poisoning in children due to lead-based paint). Little clarity exists, however, as to how housing—either temporary or rebuilt after a disaster—should comply with such standards. HUD's requirement to rebuild housing in the wake of Hurricane Sandy in compliance with green healthy housing standards is commendable (HUD, 2013). Given the proliferation of such green standards, however, additional guidance is needed to help communities understand the specific standards that should be applied.

Strengthening the Resiliency of Housing

Rebuilding in a way that mitigates against future disasters helps “break the cycle of disaster damage, reconstruction, and repeated damage” (FEMA, 2014). Mitigation protects against damage and loss of life, enables a community to recover more quickly, and reduces the financial impact of a disaster. Mitigation can be performed on individual homes, neighborhoods, or entire communities. Mitigation methods include floodproofing; elevating structures; reinforcing roofs, windows, walls, and doors; using fire-resistant materials (excluding those containing asbestos); planting vegetation to control stormwater; building levees and dams; and moving homes away from disaster-prone areas.

Funds are available to both individuals and communities for mitigation activities. Individuals may apply for home disaster loans through the SBA, and additional funding is available specifically for mitigation activities—up to 20 percent of the total amount of disaster damage. The SBA's low-interest disaster loans are available to businesses, nonprofits, homeowners, and those with rental properties for purposes of repairing or replacing real estate, personal property, and business assets (SBA, 2014). In addition, CDBG-DR and FEMA's Hazard Mitigation Grant Program funds can be used by states and communities for such purposes as purchase of hazard-prone homes and conversion of the land to green spaces, recreational areas, or wetlands; stormwater management; structure elevation; floodproofing; and retrofitting of existing buildings. Special considerations related to buyouts are discussed in Chapter 9.

Ensuring Adequate Affordable Healthy Housing

Affordability is a key component of healthy housing and healthy neighborhoods. If housing improvements following a disaster are not affordable, families may be forced to leave the area or to choose between paying rent and taking care of their health (as described in the “Heat or Eat” study reviewed above). According to the Homeless Coalition of Hillsborough County, “the biggest contributing factor to the rising number of homeless people is the shortage of affordable housing for people with limited incomes,” a shortage that is only likely to increase following a disaster (Hillsborough County, 2010).

Beyond the disaster recovery context, housing affordability is related to health outcomes generally. For example, renters who receive financial assistance for housing under HUD's Housing Choice Vouchers (Section 8) are less likely to suffer housing-related health issues than non-voucher holders (Lindberg et al., 2010). Voucher holders are less likely to experience

• overcrowding,
• malnutrition due to food insecurity,
• concentrated neighborhood poverty (Lindberg et al., 2010),
• higher rent burdens (Van Ryzin and Kamber, 2002), and
• low age-standardized weight for children (Meyers et al., 2005).

At the neighborhood level, those with high poverty rates also have many poor health outcomes, including mortality, poor child and adult physical and mental health, and negative health behaviors (Diez-Roux et al., 1997; Ellen and Turner, 2003; Ellen et al., 2001; Kawachi and Berkman, 2003; Macintyre and Ellaway, 2000, 2003; Macintyre et al., 2002; Pickett and Pearl, 2001; Waitzman and Smith, 1998). Living in such neighborhoods can limit residents' access to education and employment, which in turn can contribute to housing instability or homelessness (Lindberg et al., 2010), both of which are exacerbated by disasters.

Many communities already lack adequate affordable housing before a disaster, so a disaster can present an opportunity to increase the supply of such housing. Funding for disaster recovery far outpaces funding for community development generally—the funding request for traditional CDBGs in 2013 was about $3 billion, while $16 billion was allocated in CDBG-DR funds for post–Hurricane Sandy recovery (Gilmore and Standaert, 2013). In addition to the use of federal funding, a community can increase affordable housing by requiring or incentivizing developers to build certain types of housing. A program in Cedar Rapids, Iowa, for example, allows developers to build homes on city-owned lots provided that the homes' final sale price does not exceed $150,000 (Cedar Rapids, 2014a).

Some communities have sought to develop mixed-income housing, which includes housing for low-, middle-, and high-income individuals within a defined area, usually a building or neighborhood (Levy et al., 2010). Yet while the evidence that segregated neighborhoods and housing are associated with poor health outcomes is clear (Jacobs, 2011), the evidence that mixed-income neighborhoods are associated with positive health outcomes is mixed. Because no studies qualified for review, the Community Preventive Services Task Force was unable to find sufficient evidence to determine the effectiveness of creating mixed-income housing developments as an approach to reversing neighborhood deterioration, improving physical or mental health status, or increasing community cohesion and civic engagement (TFCPS, 2003). There is some evidence that moving into mixed-income communities leads to improvements in obesity in adults and mental health improvements in girls aged 12-19 (Orr et al., 2003), but the evidence for potential mental health improvements is mixed. One recent study, for example, found an increased prevalence of mental health disorders in boys aged 10-15 who had moved into a mixed-income community compared with those who had not moved into such a community (Kessler et al., 2014). While a disaster may present the opportunity to develop mixed-income housing, further research is needed on the associated health outcomes. In addition, turning formerly low-income areas into mixed-income housing may decrease the concentration of poverty, but it also may decrease the supply of affordable housing and leave some residents without realistic housing options (Ross, 2013).

Providing Financial Incentives

Financial incentives can be used to encourage rebuilding in a healthier and more resilient and sustainable way, including the use of green or healthy standards, the building of affordable housing, or rebuilding on land that is not disaster-prone. In Cedar Rapids, Iowa, for example, the city used a combination of incentives and disincentives for rebuilding after a flood. The city purchased approximately 1,400 properties that were in flood-prone areas or had been severely damaged, which helped homeowners move on financially. CDBG-DR funds were used to create mixed-income housing, and state and local tax credits were offered to developers for building in a downtown core area, which improved the availability of dense, multifamily, affordable housing in mixed-use neighborhoods. The city council distributed public funding for rebuilding only in areas that were not in the 100-year flood plain or in the path of the city's new flood control system. Moreover, a city program designed to “fill in” vacant properties provides free lots to builders when they agree to use build affordable homes using green standards, among other requirements (Cedar Rapids, 2014a,b). Other methods can include

• expedited building permits or reduced fees for homeowners that include mitigation and sustainability measures in their repairs;
• expedited permitting for rebuilding in an area that has been designated as a priority for redevelopment (Hillsborough County Government, 2010); and
• using green or healthy building standards as additional “points” in a competitive bidding program for developers seeking to build.

One consideration, however, is that there must be a need for the type of housing that is incentivized; otherwise, there will be an imbalance in housing stock supply and demand. In Hancock County, Mississippi, for example, the supply of multifamily rental units was increased because of post-hurricane incentives; however, there is little demand for this type of housing in the community (Hillsborough County Government, 2010).

Federal requirements tied to grants are also important drivers of forward-looking approaches to redevelopment and consideration of vulnerable populations. Communities using CDBG-DR funds after a disaster, for example, are required by HUD to use at least 50 percent of the funds to benefit low- or moderate-income people (HUD, 2014b), and post-Sandy rebuilding using CDBG was required to conform to green building standards (see Box 10-4).

Priority: Establish a Disaster Housing Task Force and Integrate It into Community Recovery Organizational Structures under the National Disaster Recovery Framework (NDRF)

Primary Actors¹: Housing Agencies

Key Partners: State/Local Health Departments,² Social Services Agencies, Emergency Management Agencies, Environmental Health Agencies, Health and Medical System Partners (including Nursing Homes and Other Long-Term Care Institutions), Community Development Organizations, Public Works and Utilities, Disaster Relief Organizations (including the American Red Cross and Long-Term Recovery Committees), Federal Agencies (including the U.S. Department of Housing and Urban Development [HUD] and Federal Emergency Management Agency [FEMA]), Private Sector (including Housing Finance Entities and Developers)

Key Recovery Strategy:

• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Bring together a wide variety of governmental and nongovernmental organizations under the umbrella of a disaster housing task force to establish plans and identify resources for recovery.

□

Ensure that key health and social services organizations are represented on the disaster housing task force.

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Priority: Conduct Vulnerability and Capacity Assessments, Including an Inventory of Existing Plans and Housing Stock

Primary Actor: Disaster Housing Task Force

Key Partners: Housing Agencies, Urban and Regional Planning Agencies, Community Development Organizations, Emergency Management Agencies, State/Local Health Departments, Social Services Agencies, Private Sector (including Housing Manufacturers, Providers, and Developers)

Key Recovery Strategy:

• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Assess the current housing stock, including vacancy rates and the suitability of vacant properties for post-disaster housing.

□

Assess the vulnerabilities of the local housing stock according to the risks that the community faces.

□

Consider current community health and social welfare problems during the identification of priority redevelopment areas (e.g., locations already suffering from blight and associated with significant health disparities).

□

Assess institutional capacity for housing recovery: What organizations exist, what are their roles and expertise, and how can they collaborate during recovery?

□

Identify manufactured housing vendors and determine which are capable of providing temporary housing units. Establish preliminary but flexible relationships with vendors.

□

Inventory the local plans, programs, or procedures that are relevant to housing during long-term recovery to identify opportunities to leverage existing programs, including those already serving vulnerable populations.

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Priority: Plan for Siting of Temporary Housing

Primary Actor: Disaster Housing Task Force

Key Partners: Urban and Regional Planning Agencies, Community Development Organizations, State/Local Health Departments, Transportation Agencies, Social Services Agencies, Public Works and Utilities, Private Sector, Federal Agencies (including FEMA), Community Members

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Preserve and promote social connectedness in plans for immediate response, short-term housing, and long-term rebuilding.
• Consider needs for access to health and social services during all phases of housing recovery.
• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Identify potential sites for temporary housing and develop criteria for housing sites to be applied after a disaster.

□

Ensure that sites are free of health hazards and not subject to further damage or disaster-related risks.

□

If possible, locate temporary housing sites near essential community services and public transportation to facilitate access to goods, services, and employment.

□

For long-term temporary housing, consider a site that could be converted to permanent housing units, thus capitalizing on necessary investments in infrastructure.

□

Collaborate with the community and urban and regional planning agencies to identify appropriate locations.

Priority: Assess Housing Needs

Primary Actor: Disaster Housing Task Force

Key Partners: Federal Agencies (including HUD and FEMA)

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Consider needs for access to health and social services during all phases of housing recovery.
• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Quantify available housing stock in and near the community, including HUD-assisted and HUD-owned housing.

□

Assess the extent of damage to the housing stock and its suitability (health/safety) for temporary housing.

□

Determine the need for temporary housing and whether the existing housing stock can fulfill that need.

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Priority: Prevent Unnecessary Displacement

Primary Actor: Disaster Housing Task Force

Key Partners: Private Sector (including Mortgage Servicers), Federal Agencies (including HUD's Federal Housing Administration [FHA], and FEMA)

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Preserve and promote social connectedness in plans for immediate response, short-term housing, and long-term rebuilding.
• Consider needs for access to health and social services during all phases of housing recovery.
• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Consider implementing a “rapid repair” program for housing requiring relatively simple repairs so people can remain in their homes.

□

Coordinate with financial partners to provide foreclosure relief to homeowners suffering short-term financial difficulties due to the disaster.

□

Provide assistance to homeowners, particularly the most vulnerable, who lack adequate insurance or means of repairing their own homes.

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Priority: Protect Homeowners and Recovery Workers Against Health Risks

Primary Actors: State/Local Health Departments

Key Partners: Housing Agencies, Environmental Health Agencies, Health and Medical System Partners, Federal Agencies (including the National Institute of Environmental Health Sciences [NIEHS])

Key Recovery Strategy:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.

Activities include but are not limited to:

□

Train recovery and repair workers and volunteers in identifying hazards (e.g., mold, asbestos), protecting themselves, and mitigating the hazards.

□

Provide information to homeowners, occupants, volunteers, and contractors regarding hazard identification, protective measures, and mitigation (e.g., by disseminating pamphlets at disaster recovery centers and home repair retail stores).

□

Provide personal protective equipment (e.g., respirators, goggles, clothing) as needed.

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Priority: Provide Short- and Long-Term Temporary Housing That Meets Health and Human Service Needs

Primary Actors: Housing Agencies, Federal Agencies (including FEMA and HUD)

Key Partners: Private Sector (including Land and Housing Owners), State/Local Health Departments, Social Services Agencies, Transportation Agencies

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Preserve and promote social connectedness in plans for immediate response, short-term housing, and long-term rebuilding.
• Consider needs for access to health and social services during all phases of housing recovery.
• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Provide housing by leveraging existing buildings and/or purchasing temporary housing units.

□

Utilize FEMA's Rental Repair Program to repair rental housing and make it available to disaster victims.

□

Make sure new or repaired units comply with the National Healthy Housing Standard and applicable housing codes.

□

Conduct advance planning to ensure adequate personnel and training for special-needs and medical shelters and appropriate temporary housing for special-needs populations.

□

Ensure that shelters and temporary housing are compliant with the Americans with Disabilities Act.

□

Consider placing housing units on homeowners' property to minimize disruption and maintain neighborhood cohesion, social connectedness, and access to services.

□

If housing units are placed on group sites,

–

arrange the site in a configuration that encourages social connectedness; and

–

if possible, locate the site near or with “wraparound” services such as health care, schools, daycare, social services, public transportation, and employment counseling.

Priority: Incentivize the Use of Green and Healthy Housing Standards

Primary Actors: Elected Officials and Community Leaders, Federal Agencies (including HUD)

Key Partners: Housing Agencies, Urban and Regional Planning Agencies, Community Development Organizations, State/Local Health Departments, Environmental Health Agencies, Private Sector (including Developers)

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Consider needs for access to health and social services during all phases of housing recovery.
• Incentivize the use of healthy and/or green criteria for the rebuilding of homes, buildings, and neighborhoods.

Activities include but are not limited to:

□

Ensure that long-term housing is built in compliance with current housing codes (even if compliance was waived during short-term recovery).

□

Use permitting processes strategically to ensure that houses are rebuilt in concert with the availability of necessary services and infrastructure.

□

Give expedited permitting or financial incentives (e.g., tax credits) to builders using healthy and green housing standards.

□

If the local government is allocating funding for the building or repair of properties, require the use of healthy housing and green standards.

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Priority: Strengthen the Resiliency of Housing

Primary Actors: Elected Officials and Community Leaders, Housing Agencies

Key Partners: Federal Agencies (including HUD), Environmental Health Agencies, Emergency Management Agencies, Urban and Regional Planning Agencies, Community Development Organizations

Key Recovery Strategies:

• Protect survivors and recovery workers from health hazards associated with unhealthy or unsafe housing.
• Preserve and promote social connectedness in plans for immediate response, short-term housing, and long-term rebuilding.
• Consider needs for access to health and social services during all phases of housing recovery.
• Incentivize the use of healthy and/or green criteria for the rebuilding of homes, buildings, and neighborhoods.
• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Rebuild homes, neighborhoods, and communities using principles of resiliency:

–

Neighborhoods are compact, walkable, and mixed-use.

–

All members of the community participate in planning and decisions with an eye toward making the community more equitable.

–

Connections and partnerships in the community are preserved and strengthened.

–

Housing is efficient and durable.

–

Preparedness and recovery plans are continually reassessed.

Consider disaster-resistant building strategies, such as installing elevated mechanical systems and locating living space above the ground floor.

Consider opportunities to mitigate against future disaster damage by buying out disaster-prone properties and converting them to green or community space.

Give financial incentives to builders or homeowners that incorporate mitigation in their repairs or rebuilding.

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Priority: Ensure Adequate Affordable Healthy Housing

Primary Actors: Elected Officials and Community Leaders, Housing Agencies

Key Partners: Community- and Faith-Based Organizations, Federal Agencies (including HUD), Community Development Organizations, Private Sector (including Developers)

Key Recovery Strategy:

• Engage community members, including representatives of and advocates for vulnerable populations, in the development of post-disaster housing plans to ensure that the needs of all community members are met.

Activities include but are not limited to:

□

Use federally assisted housing programs, such as Housing Choice Vouchers and others, to help low-income residents afford housing that is regulated for health and safety.

□

Use financial incentives or expedited permitting to encourage the building of affordable housing or mixed-income neighborhoods.