FLORIDA EMERGENCY MORTUARY. Hurricane Season 2004 Summary OPERATIONS RESPONSE SYSTEM

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1 FLORIDA EMERGENCY MORTUARY Hurricane Season 2004 Summary OPERATIONS RESPONSE SYSTEM

2 What is FEMORS? Florida Department of Health - Office of Emergency Operations Lead state agency for Emergency Support Function 8 University of Florida William R. Maples Center for Forensic Medicine Contract provider for forensic services FEMORS Program (Inaugurated 2002) Professional Mass Fatality Forensic Response Teams

3 What is FEMORS? Forensic Specialists 300+ (Human Remains & Evidence) Disaster Response Managers Pathologists, Odontologists Anthropologists, DNA Analysts Medical Investigators, Autopsy Technicians Crime Lab Analysts, Fingerprint Analysts CSI Technicians, Administrative Specialists

4 FEMORS - Services FEMORS Can Provide Aid For*: Search and recovery Scene documentation Family Assistance center Antemortem data collection Mobile Morgue Operations Forensic examinations Postmortem data collection DNA Acquisition Personal effects processing Remains identification Coordination of release of remains Records management Database administration Medical/psychology support Safety Officers and Specialists DPMU Set-Up Example Courtesy: DMORT * Equipment funding is needed to complete the service options

5 DOH & Maples Center Fall 2001 Spring 2002 DoH-OEO contacted the William R. Maples Center for Forensic Medicine at the University of Florida to explore mass fatality response issues and strategy. To create a State asset to assist local needs July 1, 2002 FEMORS inaugurated under the 1999 CDC Bioterrorism Grant with $150,000 to develop website, recruit professional volunteers, and provide initial training Working Group of forensic subject matter experts was established to guide development

6 FEMORS-Resources Personnel Assets (Current Program) 300+ Members Registered (all disciplines) Annual Response Training Seminars Specialty Training Seminars (Odontology and Family Assistance Teams) Activated members become temporary state employees OPS positions with Department of Health Equipment Assets (Future) Funding still needed for response equipment, warehouse, maintenance, and joint RDSTF training exercises

7 FEMORS - Funding $250,000 $10,000 * $50,000 $200,000 $40,000 $150,000 $250,000 $100,000 $150,000 $150,000 $50,000 $0 FY FY 03-04* FY CDC CDC (Redirect Training) HRSA (Brochure) CDC (Redirect Equipment) * CDC approved $418,000 redirected (i.e., unused 03-04) 04) funds for equipment on August 23 rd with a spending deadline of August 30 th! <$10,000 was spent.

8 FEMORS - Funding FY Funding ($250,000) provides: Continuing operations through University of Florida, Maples Center for Forensic Medicine Management support: Director of Operations (1.0 FTE) and Director of Finance (.75 FTE) Continuing Training Programs Annual for all Members Family Assistance Team Odontology Team Go Team Work/Planning Sessions Activation compensation is provided separately by DOH as OPS positions

9 FEMORS-Why? Preparedness Rule #1: You can t give your disaster away others may help but YOU still own it!

10 Local Ownership Local ME can t pass the responsibility! Deaths resulting from acts of homicide, suicide, or accident, and those constituting a threat to public health, fall under the jurisdiction of the medical examiner (Ch , Florida Statutes). For this reason, the medical examiner takes custody of any such death to verify identity, determine the cause of death, and initiate the death certificate.

11 Typical Incident Activation Disaster Incident with Mass Fatalities ME Requests Aid Local EOC ESF-8 Activation State Warning Point Notification Dept of Health EOC ESF-8 Activated

12 Resource Determination FEMORS Go Team Activated Provides a Needs Assessment Liaison for Resource & Site Assessment Medical Examiner Primary Needs Decision Maker Family Assistance Center Location & Staffing Needs Temporary Morgue Location & Equipment Needs Support Staff and Section Leader Identification

13 FEMORS - Mission In the event of a mass fatality incident, FEMORS will Assist and Support. Medical Examiner retains control and determines level of help required to identify victims, preserve evidence, and reunite remains with families. Request for activation is made through local EOC to State EOC, Emergency Support Function (ESF) 8 Desk (Health and Medical Services).

14 Hurricane Season Charley - Alerted and Activated 2. Frances - Alerted and Not Activated 3. Ivan - Alerted and Activated 4. Jeanne - Alerted and Partially Activated

15 Hurricane Charley FEMORS Timeline: Friday, August 13 th 11:00 am Track to Tampa 1:30 pm Shift to East 1:55 pm SEOC, ESF-8 placed FEMORS on alert FEMORS requested two refrigerated trailers be placed on stand-by. 3:00 pm Team queried by e- mail for readiness status 37 Members on Ready List 3:45 pm Charley landfall at Charlotte County

16 Hurricane Charley Timeline Activation Message: Saturday, Aug. 14 th 12:38 am ESF-8 Activated FEMORS 37 FEMORS team members deployed due to initial report (39 more became available in 24 hours) Initial reports included 20+ confirmed dead, trailer parks devastated and bodies everywhere including a 5-story Condo that had collapsed with those inside calling out to rescuers by cell phone.

17 Hurricane Charley Timeline Saturday, Aug. 14 th Staging set for 12 noon, Saturday at the Charlotte County EOC (damaged). FEMORS Command arrived at the Charlotte County EOC at 6:00 a.m. Attended 7:00 am EOC briefing. All 3 hospitals damaged All 31 Trailer Parks to be checked by Search and Rescue Teams Cell phone service out ME could not be located.

18 Hurricane Charley Timeline Saturday, Aug. 14 th Site visit to ME office Intact but no power Staff not present Contact with ME office established 11:30 am at EOC ME in Pakistan Investigator in Charge FEMORS Split staging areas to ME office (briefly) and Best Western Motel with two reefers

19 Hurricane Charley Timeline Saturday, Aug. 14 th Throughout the day, reports of fatalities varied wildly, but only a minimal number arrived. 31 Trailer Parks had to be checked by Search and Rescue Teams

20 Hurricane Charley Timeline Saturday, Aug. 14 th One search and rescue leader at EOC told FEMORS Command: They stopped counting when they hit triple digits. Rumors Continued

21 Hurricane Charley Timeline Saturday, Aug. 14 th Temporary Storage logged in found remains at reefers and took identification photographs. Four Storm Related Victims Recovered Others held for funeral homes without power

22 Hurricane Charley Timeline Saturday, Aug. 14 th Phone contact established with Acting ME 3:45 pm Meeting set for 9:00 am Sunday morning Chief Investigator was authorized by ME to identify needs Team briefings held to update responders

23 Hurricane Charley Timeline Saturday, Aug. 14 th By late afternoon, rumors evaporated Only 4 cases were to be processed 31 Members deactivated to return home 7 returned Sunday to process victims at the Medical Examiner s Office

24 Hurricane Charley Timeline Temporary Storage Operation (4 Days) Maintained to Tuesday evening, Aug 17 th when trailer was moved to ME s office. Power restored to ME late Wednesday.

25 Hurricane Charley Timeline Lessons Learned Pre Event contact between ME and EOC is critical. ME should be the one to initiate call for assistance. FEMORS should establish contact with ME prior to arrival. Go Team (10-12) response is preferred, not 37 all at once.

26 Hurricane Frances Timeline Wednesday, Sept. 1st 2:37 pm SEOC, ESF-8 placed FEMORS on alert FEMORS requested that two reefers and one RV rental (for command center) be placed on stand-by 90 Members on Ready List

27 Hurricane Frances Timeline Friday Sept. 3rd FEMORS sent messages to medical examiner districts in Frances path about EOC requests for aid Sunday, Sept. 5th Landfall St. Lucie/ Martin Counties

28 Hurricane Frances Timeline Sunday, Sept. 5 th Not Activated Minimal fatalities, No rumors Wednesday, Sept 8 th Funeral homes in St. Lucie, Indian River, Martin, and Okeechobee Counties reported natural death remains backlogged due to Lack of power (refrigeration) Lack of physician contact (death certificates unsigned) Flooded cemeteries (delayed burials) Contingency plan for FEMORS to provide temporary refrigerated storage operation developed. Local funeral homes solved the problem by sharing refrigeration resources

29 Hurricane Ivan

30 Hurricane Ivan Timeline Tuesday, Sept. 7 th Stand Down from Frances with advisory that Ivan was approaching. Wednesday Sept. 8 th Team queried by for readiness status 101 Members on Ready List

31 Hurricane Ivan Timeline Sunday, Sept. 12 th FEMORS sent messages to six medical examiner districts in Ivan s path about EOC requests for aid Tuesday, Sept. 14 th Ivan s path better defined-panhandle

32 Hurricane Ivan Timeline Wednesday, Sept. 15 th 4:30 pm SEOC, ESF-8 placed FEMORS on official alert FEMORS requested two reefers and one RV for command center be placed on stand-by Thursday, Sept. 16 th 2:00 am Ivan landfall Mobile, AL

33 Hurricane Ivan Timeline Thursday, Sept.16 th 12:01 pm ESF-8 8 Activated FEMORS FEMORS Go-Team 12 members mobilized for staging at 5:00 am Friday at Crestview rest stop on I-10 I Additional members set for later stagings Activation Message: Initial reports, from a helicopter deputy, indicated 30+ bodies floating in the water. Other rumors quickly surfaced which made the estimated death toll climb to 60.

34 Hurricane Ivan Timeline Thursday, Sept.16 th RV picked up at SEOC for 5:00 am staging on I-10 Friday, Sept.17 th DOT escorted Team into Medical Examiner s Office for 7:00 am meeting with Dr. Minyard

35 Hurricane Ivan Timeline Friday, Sept.17 th AM Dr. Minyard s game plan Estimates of 60+ fatalities persist One Shift 7 am to 7 pm 6-10 autopsies/day (9 cases present plus 6 coming from Ft. Walton satellite office) Staffing needs set for Morgue Investigations FAC (Family Assistance Center) Reefers

36 Hurricane Ivan Timeline Friday, Sept.17 th AM FEMORS Activities Staff Assigned FAC Operations established at hospital entrance Team 12 present 8 enroute 9 more activated DEXIS Dental Unit ordered Reefer ramps made Afternoon meeting Request made to activate DMORT s FAC

37 Hurricane Ivan Timeline Saturday, Sept.18 th AM meeting Rumors evaporating DMORT put its FAC Team request on hold Additional FEMORS responders cancelled while enroute Funeral home remains storage started FAC continued recording missing persons

38 Hurricane Ivan Timeline Saturday, Sept.18 th Noon Rumor 12 bodies in collapsed building (proven falsereporter counted 12 X markers left by Search and Rescue!) Pace under control, power restored Deactivated 2 team members Group Photo

39 Hurricane Ivan Timeline

40 Hurricane Ivan Timeline Sunday, Sept.19 th ME staff got chance to return home for damage assessments Missing person reports slowing 11 storm related, 1 unidentified Deactivated more team members CISD Dinner to help responders unwind and relax

41 Hurricane Ivan Timeline Monday, Sept. 20 th 13 storm related, 0 unidentified FAC shut down Deactivated 6 more team members Many funeral homes still without power Tuesday, Sept. 21 st FEMORS operations ended 15 storm related total (at that point) Dr. Minyard decides to join FEMORS (prefers Indian to Chief!)

42 Hurricane Ivan Timeline Lessons Learned Pre Event contact between ME and EOC was beneficial. ME should be the one to initiate call for assistance (not law enforcement). FEMORS established contact with ME prior to arrival to verify need. Go Team (10-12) was effective. FEMORS/DMORT coordinated SUPPORT to the Medical Examiner.

43 Hurricane Jeanne Timeline Thursday, Sept. 23 rd Advisory from NOAA. Jeanne s path could lead up the east coast of Florida Friday, Sept. 24 th Team queried by for readiness status 63 Members on Ready List FEMORS sent messages to medical examiner districts in Jeanne s path about EOC requests for aid and contact info

44 Hurricane Jeanne Timeline Saturday, Sept. 25 th 10:00 am SEOC, ESF-8 placed FEMORS on alert RV Command Post was retrieved from Tallahassee and taken to Pinellas ahead of storm wind impact For potential rapid post-storm southern route response to East coast if needed

45 Hurricane Jeanne Timeline Sunday, Sept. 26 th Landfall Martin/St. Lucie Counties Not Activated Minimal fatalities, No rumors Tuesday, Sept. 28 th SEOC, ESF-8 placed FEMORS on Stand Down RV returned to SEOC

46 Hurricane Season Charley - Alerted and Activated 76 Members on Ready List 37 Members Activated 2. Frances - Alerted and Not Activated 90 Members on Ready List 3. Ivan - Alerted and Activated 101 Members on Ready List 30 Members Activated 4. Jeanne - Alerted and Not Activated 63 Members on Ready List 2 Activated for Command Post Staging

47 Preparedness Rule #2 FEMORS prepares now because HOPE is neither an option nor a plan of action!