Louisiana Mass Fatality Planning Framework 2014

Lessons Learned ESF 8 assumed mass fatality response duties in the aftermath of Katrina Lessons learned: The state must establish a clear Incident Command System and structure prior to any incident. Role of parish Coroners Role of federal resources such as DMORT A regional planning approach must be a key component of any state framework Information management must be a primary component of any response LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS2

Key Components State ICS structure Capacity planning and mortality estimates Tools for regional planning Information Management Public and secure portals and tools Family Assistance Center planning Regional CONOPS approach MOUs with other resources Dept. of Corrections for temporary interment sites State Police for DNA testing and missing persons functions LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS3

State Plan Framework Current focus Completing an all-hazards plan that: Can accommodate a large scale incident Integrate with local and regional plans Builds on relationships with Coroners, Funeral Directors, FACES Lab, and other stakeholders and partners Continuing development of the Mass Fatality DRC network Preparation for the 2016 hurricane season Protocols and situational awareness Use of the ESF 8 Portal and other tools LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS4

State Plan Framework Focus Continued Incorporation of mass fatality groups into the Regional Healthcare Coalitions While a State plan is necessary, there will continue to be an effort to develop regional plans incorporating the HCCs Region 2 is an emerging model of the various local stakeholders working together Parish Coroners HCC core group Designated Regional Coordinators LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS5

Immediate Goals Incorporate the local coroners and other mass fatality stakeholders in the communications systems used by the HCCs (i.e. the ESF 8 Portal) Work with this Coroner Plannign Cell and the HCCs to: Socialize the State plan and modify as needed Develop regional field operating guides that can be replicated if needed Focus on the planning for a local/regional response Clarification of ESF 8 support available to local coroners if requested Planning for the unthinkable LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS6

2014 State Plan Outline LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS7 Section 1: Introduction and Background Section 2: Recovery Operations Section 3: Morgue Operations Section 4: Family Assistance Center Section 5: Identification Section 6: Hospital and Healthcare Roles and Responsibilities Section 7: Supplemental Information

Section 1 Introduction and Background 8

Planning Assumptions The purpose of mass fatality response is to recover and identify the dead and to ensure a timely, safe, and respectful disposition of the human remains A catastrophic mass fatality incident will cause critical human remains care management issues and activities, thus overburdening the capability and capacity of local government. All disasters are local events. The State Of Louisiana ESF 8 DHH may be tasked with managing a mass fatality response that occur within the State of Louisiana if the local Coroners is unwilling or unable to perform their duties. When necessary, the State of Louisiana ESF 8 DHH may request assistance from state and federal agencies in accordance with any relevant emergency management system. LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS9

Planning Assumptions Continued Through the EMAC process, GOHSEP will coordinate out-of-state resources. Federal agencies and resources responding under the auspices of the National Response Framework (NRF), Catastrophic Incident Annex, will integrate into the state and local State Emergency Management System (SEMS) organizational structure. A mass fatality incident may severely affect infrastructure. Major utilities, essential services, and supplies, including fuel, could be non- existent. A mass fatality plan does not address the needs of injured survivors. Partnerships with other agencies, departments, and organizations involved in emergency response are essential. An effective plan involves key local stakeholders and will improve local capability, thus facilitating a rapid response with better integration of resources from all levels of government. LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS10

Operational Components LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS11

Org Chart for a Response LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS12

Section 2 Recovery Operations 13

Recovery Operations Site Evaluation Grid/Sector Determination Contaminated Incident Sites Incident Command Structure Documentation Staging Area Transport Vehicles Transportation of Human Remains Vehicle Specifications for Transporting Human Remains Transportation of Recovery Personnel Convoys Safety Personal Protective Equipment (PPE) Lifting Techniques Surroundings/Potential Hazards LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS14

Recovery Operations Continued Numbering Recovery Number Field Number The Triple Check Method Recovery Missions Recovery Teams Recovery Procedures Transfer Site Location: Condition of the Site Safety Personnel Security Transfer Site Procedures Transfer Site Equipment/Supplies Transfer Site Trailers LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS15 Evolving Technologies

Section 3 Morgue Operations 16

Morgue Operations Plan of Operations Morgue Command Structure Morgue Site and Facility Location Size Ventilation, Waste Disposal, Heating and Cooling, Electricity, Water Supply, Lighting, Communications, Rest Areas for Personnel, Restroom Facilities, Grounds Security and Traffic Perimeter Security Credentialing and Controlled Access Interior Security Traffic Control LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS17

Morgue Operations Morgue Safety Universal Precautions, Climate, Trip/Fall Hazards Pictures and Media Relations Overview of Operations Maintaining Quality and Chain of Custody Numbering and Tracking, Documentation, and Escorting the Human Remains Victim Identification Program (VIP) General Supplies and Equipment Operational Tasks and Personnel Decontamination Trailer Management Receiving Remains Holding LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS18

Morgue Operational Flow LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS19

Section 4 Family Assistance Center Operations 20

FAC Operations Evaluating the Situation, Sizing the Operations, and Establishing the Family Assistance Center Major Operational Sections Legal Budget and Finance Quality Program Public Relations Logistics Security LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS21

FAC Operations Continued Support Services Nutritional Services First Aid Services Psychosocial/Spiritual Support Services Housing Services Children’s Play Area Transportation Services Call Center Intake Information Technology DNA, Dental, and Pathology Family Notification and Body Release Transition Plan LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS22

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS23

Section 5 Identification Center 24

Identification Center Operations Identification of Human Remains Identification Standards and Guidelines Categories of Identifications Incident Command Structure Operational Tasks and Personnel Data Management Verification Notification of Death Death Certificates LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS25

Section 6 Hospital and Healthcare Roles & Responsibilties 26

Hospital & Healthcare Roles & Responsibilities Fatality Coordination with the State of Louisiana ESF 8 Mass Fatality Plan Activation and Coordination Communication with the State of Louisiana ESF 8 Handling and Storage of Human Remains Identification of a Body Holding Area Preparing the Human Remains Transportation of the Human remains to the Body Holding Area Identification of Human Remains Daily Reporting Interaction with Family Members Tracking of Human Remains Personal Property Human Remains Release Procedures LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS27

Hospital & Healthcare Roles & Responsibilities Mental Health/Psychosocial Support for Staff Release of Public Information Equipment and Supplies Universal Precautions Education and Training LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS28