Family Assistance Center Planning for Mass Fatality Incidents Christine Mullarkey-Campbell October 31, 2016 Fall NCEMA Conference

What is a Mass Fatality?

Simultaneous Operations Survivor Gathering Area MPCC Hotline Service Provision Line Reunification Center Family Assistance Center Coordination Cell Friends & Relative Ctr. Family Assistance Center 1:00 4:00 18:00 24:00 48:00 96:00 144:00+ 0:00 Morgue Operations Initial Scene Reports Remains Collection & Transport Secure Site & Scene Investigation Unified Command—on scene EOC

Family Assistance Center & Hotline Incident Scene Hospital Morgue Family Assistance Center & Hotline EOC

Type of Incident Legislated Non-Legislated Aviation Disaster Family Assistance Act Foreign Air Carrier Family Support Act Rail Passenger Disaster Family Assistance Act Bus or other means of mass transit Structural Collapse Terrorism or acts of violence Natural Disasters

When would you open a Family Assistance Center?

Family Assistance Operations Immediate Response Friends & Relatives Center Survivor Gathering Area Reunification Rooms/Centers Intermediate Response Family Assistance Center (FAC) & FAC Coordination Cell Recovery Response Transition & Recovery, Ongoing Long Term Support & Resources, Agency Coordination

Fundamental Concerns of Family Members Notification of Involvement What is happening? Information & Resources How do I get information and access Resources? Victim Accounting Where is my loved one? Personal Effects Where are their/my belongings?

Who is Family? No established definition Best practices are to be inclusive Family groups tend to “self-regulate” Friend/Family member vs. legal next of kin (NOK) Legal next of kin is determined during the investigation process. Valuable antemortem data may come from someone who is not a spouse/partner or blood relative.

Media Management Brief FAMILIES First! Friends & Relatives are free to speak to media. Must not be inside FRC or FAC Pre-identify press conference locations Coordinate with local media to establish satellite truck staging. Brief FAMILIES First!

Family Assistance Operations Immediate Response Friends & Relatives Center Survivor Gathering Area Reunification Rooms/Centers

Crisis Situation: Incident location Hospital(s) A central location Families seeking information at last known location of loved one Incident location Hospital(s) A central location “What Happened?” Friends and Relatives Center “Where is my loved one?” Law Enforcement & Fire Other First Responders “How will I get information?” Location Organization Families

Friends and Relatives Center (FRC) Why have an FRC? Protection & privacy Buffer; not sequester Introduces order during a chaotic time Establishes a positive rapport early Information (in and out) * This location is temporary and provides basic needs.

Friends and Relatives Center (FRC) Staffing Staffing Duties Law Enforcement Medical Services Support Services Local Crisis Support Clergy *If applicable—facility or carrier representative. Check-in Table Briefing Support Logistics Family Escort

Family Briefings Suggested Agenda Who you are Why they are there What services are available Known facts at this time Information on next steps Managing access Scene situation update Collect information Repeat as necessary (more frequently early on, can be a repeat of the exact same information)

Reunification Center Small facility Used to reconnect survivors with family & friends. Should be separate (away) from FRC Staffed by: Law Enforcement Support Agency/Organization Facility or carrier representative (when applicable)

Family Assistance Operations Intermediate Response Family Assistance Center (FAC) & FAC Coordination Cell … Transition

Purpose of the FAC Provide factual information to family members about the incident Access to assistance and services Private, safe and secure location for family members to grieve Facilitate collection of ante-mortem data. Address basic physical and emotional/spiritual needs. Coordinate interagency response Avoid duplication of services and efforts

FAC Services Safety & security Crisis & grief counseling Spiritual Care Family Liaisons Childcare Interpretive services Legal Services Official briefings Meals & beverages Death notification Transportation (large and small scale) First Aid/Medical Other services as necessary

FAC Staffing Support/Services organization(s) Funeral Coordinator Health services workers or EMS Local Law Enforcement Medical Examiner (or Coroner) Personal effects management coordinator Other local support personnel (Health Dept., Emergency Management, etc.) Legislated Disasters will also include: Carrier management team Carrier support team NTSB TDA

FAC Considerations Accessibility Facility Security Security of victims & families Badging and identification Space available vs. space needed Family members that do not travel Media

Estimating space… Estimated Minimum: # of fatalities X ~3 family members Estimated Maximum: # of fatalities X ~8 family members Remember—Facilities can also be vertical!

Estimating space… Estimated Minimum: # of fatalities X ~3 family members =Amount of space Estimated Maximum: # of fatalities X ~8 family members

Estimating space… Estimated Minimum: # of fatalities X ~3 family members =Amount of space Estimated Maximum: # of fatalities X ~8 family members

Agencies in the FAC Coordination Cell FAC Command Structure Agencies in the FAC Coordination Cell Assess the situation Coordinate all aspects of the family assistance operation Define incident goals Define operational period objectives Develop exit strategy Troubleshoot issues and determine resolution Unified Command Structure Agencies’ core competencies remain intact Agencies’ missions remain intact Local jurisdiction’s roles & responsibilities

FAC Coordination Cell Primary service providers Authority according to Federal legislation and/or local or state jurisdiction. Multi-agency response Unified Command of the family assistance operation Each entity maintains its core competency and mission Representatives with decision-making authority

Family Briefings No—should NOT attend YES—should attend Media Local Attorneys Elected officials (TBD) Unassociated agency representatives What is the purpose? Local Emergency Management Law Enforcement/Fire Medical Examiner Support Services Key orgs. present in FAC Responsible Party (if applicable) Investigator Other, if needed

Family Briefings--Logistics Conference call line for families not present All families in one room (possible exceptions) Interpretive Services A/V Technology: Microphones, Photos/videos Formal presentation layout Ensure appropriate entrance/exit locations Schedule at appropriate times and post agenda

Family Briefing: Sample Agenda Investigator/Incident Commander Medical Examiner Responsible Party (if applicable) Service Provider (ARC, Salvation Army, etc.) Emergency Management Childcare Agency Next Briefing—announce time & date (First Briefing) Agencies Introduction Roles & Responsibilities FAC Support Services Preliminary Factual Information, if available Process expectation Next Scheduled Briefing

Last Briefing Considerations Dependent upon: On-scene activity Medicolegal Processes Victim Recovery, Antemortem interviews, Death notifications, Return FAC stats Pre-planned, announced in advance Last Briefing Agenda Current Status Overview of process moving forward—what to expect Contact information for continued communication & resources

Site Visit-Logistics Scheduled at request of families (~3 days) All families at the same time (some exceptions) Identifying objects and remains removed Schedule at end of work day, consider weather Transportation to & from site Site safety Non-permanent Memorial

Family Assistance Operations Immediate Response Friends & Relatives Center Survivor Gathering Area Reunification Rooms/Centers Intermediate Response Family Assistance Center (FAC) & FAC Coordination Cell Recovery Response Transition & Recovery, Ongoing Long Term Support & Resources, Agency Coordination

Utilizing Industry Professionals Assisting with remains collection and documentation. Record keeping at remains storage site. Collection of Antemortem Data @ Family Assistance Center Supporting hotline call center Documentation support at morgue

Good to know: Resource Mental Health—Critical Care Team can arrive on-site within approx. 6 hours of request receipt.

Spiritual Care vs Evangelism

This response is NOT an “All-Call”…it is essential to send the correct people to do the job!

Top 5 FAC Pre-Planning Steps Determine which entity/organization in your county/region will coordinate the FAC. Identify which organizations/agencies will respond to the FAC and what their likely role(s) will be. Pre-select possible locations that may serve as a FAC in your community. Request law enforcement to make necessary site security plans. Prepare for logistical needs to support this facility.

First 5 FAC Activation Steps Activate best available facility according to incident variables: size, location, accessibility. Contact FAC coordinator and activate responding partners. Ensure law enforcement is able to provide security for FAC. Notify fellow response partners that “need to know” about FAC location and operating hours. Activate any wrap around services needed for FAC. *If Legislated, ensure carrier rep is in agreement.

Upcoming Opportunities: FAC TTX workshops will be held in February & March 2017 across the 4 Public Health Preparedness Regions. Continued outreach to industry professionals through provision of approved continuing education credits.

Christine Mullarkey-Campbell Thank You! Christine Mullarkey-Campbell Christine.Mullarkey@dhhs.nc.gov 919-614-3761