Fatality Management Planning Williamson County, Texas Texas Emergency Management Conference San Antonio, Texas Wednesday May 17, 2017 Jarred Thomas, CHS-V, CEM, TEM, Williamson County EMC and Director Ryan Moeller, Director, PHEP, Williamson County and Cities Health District John Litaker, PhD, Managing Director, The Litaker Group TDEM 2017 Conference May 17, 2017 Page 1
Background on our Presenters Jarred Thomas Ryan Moeller John Litaker Jarred Thomas, Director of Emergency Management for Williamson County, is a 24-year veteran in public safety. Thomas was employed as a Shift Commander for Wilco EMS prior to obtaining his current position in 2008. He earned Bachelor of Science degrees from Texas A&M University in 1994 and the University of Texas in 1996. Ryan Moeller has worked for the last 8 years at the Williamson County and Cities Health District. He is currently the Director of Emergency Preparedness and Response. Prior to this position he served 8 years in the U.S. Army Special Operations Command, including 2 combat tours in Iraq and Afghanistan, as a Civil Affairs Specialist. John Litaker has worked for 15 years as a health scientist and consultant focusing on applied research. He has worked, lived, and studied in London England, Hong Kong, and the USA. He holds a PhD in health outcomes research, a master of medical science degree, and a master of public health degree. He is based in Austin, Texas. TDEM 2017 Conference May 17, 2017 Page 2 2
Outline for Today s Presentation There are four areas we want to focus on today 1. Real life incident in Williamson County, Texas in which we put our draft fatality management plan to work 2. What we learned from that incident to make our fatality management plan stronger 3. The four key components of the Williamson County fatality management plan and examples of how it can be used 4. Process we used to develop a functional plan that could be supported by first responders, the judicial system, county officials, and others in Williamson County TDEM 2017 Conference May 17, 2017 Page 3 3
Introduction First off, a little regional history in our planning efforts 1. As a region (by that we mean the CAPCOG area) we have been working on fatality management planning for a while 2. In 2014 CAPCOG completed a regional mass fatality framework 3. In 2015 Williamson County undertook the process to operationalize fatality management activities using a multidisciplinary approach 4. What we have is an integrated plan to support fatality management from accident scene to morgue operations TDEM 2017 Conference May 17, 2017 Page 4 4
Disclaimer We are about to show images from a real life incident that includes human remains. If this could be upsetting to you or if you do not wish to view this portion of the presentation we will understand if you would like to step out. TDEM 2017 Conference May 17, 2017 Page 5 5
Background Saturday April 9, 2016 Crash occurred ten miles NE of Taylor AC 90 Twin-Turboprop aircraft with eight passenger seats The plane with two pilots had departed the Georgetown airport earlier in the morning for a training exercise TDEM 2017 Conference May 17, 2017 Page 6 6
The scene Hazardous materials from the crash and a fire Debris field of about 200 square feet A wheat crop about 3 feet high Fractured and comingled remains (approximately 200 individual fragments from two persons) throughout the debris field Human remains impaled in the ground due to the crash TDEM 2017 Conference May 17, 2017 Page 7 7
Injury Recovery Fatality Management Williamson County Fatality Management Plan Scene Response and Human Remains Recovery Process ASSUMPTION: Triage, Treat, Transport Occurs Continue Normal Scene Response Activities NO Scene Response Conduct Scene Assessment by Emergency Services Review Checklist to Determine if FM Plan Should be Activated One or More Trigger Met? YES Maybe Notify Emergency Communications NO Contact JP and Wilco EMC to Inform Them of Incident JP, EMC, and IC Discuss FM Plan YES Needs To Be Activated and Extent? YES Secure Scene Continue Triage, Treat, and Transport as necessary Fatality Management / Human Remains Scene Assessment Locate Human Remains (SARR Team) Conduct Death Investigation (Death Investigation Team) Chemical Decontamination Needed? YES Conduct Decontamination Activities NO Obtain JP Approval to Move to Staging Site or Temp Storage Engage Human Remains Removal Team Human remains transported to storage or ME Acronyms EMC: Emergency Management Coordinator; HRR: Human Remains Recovery; JP: Justice of the Peace TDEM 2017 Conference May 17, 2017 Page 8 8
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Debris Field TDEM 2017 Conference May 17, 2017 Page 10 10
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Personal Effects TDEM 2017 Conference May 17, 2017 Page 16 16
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Lessons Learned Having a plan even if just a flow chart helped us guide what needs to be done and in what order This was not a mass fatality incident as there were only two fatalities But this was a fatality management incident because we had over 200 fractured and comingled remains That this plan is best served to support complex fatality management incidents TDEM 2017 Conference May 17, 2017 Page 24 24
Injury Recovery Fatality Management Williamson County Fatality Management Plan Scene Response and Human Remains Recovery Process ASSUMPTION: Triage, Treat, Transport Occurs Continue Normal Scene Response Activities NO Scene Response Conduct Scene Assessment by Emergency Services Review Checklist to Determine if FM Plan Should be Activated One or More Trigger Met? YES Maybe Notify Emergency Communications NO Contact JP and Wilco EMC to Inform Them of Incident JP, EMC, and IC Discuss FM Plan YES Needs To Be Activated and Extent? YES Secure Scene Continue Triage, Treat, and Transport as necessary Fatality Management / Human Remains Scene Assessment Locate Human Remains (SARR Team) Conduct Death Investigation (Death Investigation Team) Chemical Decontamination Needed? YES Conduct Decontamination Activities NO Obtain JP Approval to Move to Staging Site or Temp Storage Engage Human Remains Removal Team Human remains transported to storage or ME Acronyms EMC: Emergency Management Coordinator; HRR: Human Remains Recovery; JP: Justice of the Peace TDEM 2017 Conference May 17, 2017 Page 25 25
Williamson County Fatality Management Plan Concept of Operations (Plan Components) A Scene Response and Human Remains Recovery Trigger(s) 1. Incident exceeds local jurisdictional capacity due to 5 or more deaths, comingled remains, fractured remains, a widespread debris field, or additional support is required Response Objective(s) 1. To locate and recover human remains in a safe, timely, and dignified manner while respecting religious and cultural traditions 2. To support the death investigation process B Morgue Operations Trigger(s) 1. Cold storage capacity in Williamson County is exceeded 2. Unidentified human remains, comingled / fracture remains require identification Response Objective(s) 1. To provide additional cold storage 2. To identify human remains and personal effects for return to next of kin C Family Assistance Center Trigger(s) 1. A fatality management incident occurs that requires a secure, non-public space to provide family assistance and to support ante-mortem data collection and information dissemination to affected families Response Objective(s) 1. To provide assistance and information to family members in a secure, non-public location 2. To support the ante-mortem data and interview collection process D Interment Trigger(s) 1. An incident involving a large sustained number of deaths, fractured remains, or comingled remains that cannot be accommodated by normal burial processes 2. A decedent with a high consequence infectious disease 3. Disinterred remains secondary to flooding TDEM 2017 Conference May 17, 2017 Page 26 Response Objective(s) 1. To provide temporary or permanent burial in order to protect the health and safety of the community 26
Williamson County Fatality Management Plan Concept of Operations (Plan Components) A B C Scene Response and Human Remains Recovery Morgue Operations Family Assistance Center Trigger(s) 1. Incident exceeds local jurisdictional capacity due to 5 or more deaths, comingled remains, fractured remains, a widespread debris field, or additional support is required Response Objective(s) 1. To locate and recover human remains in a safe, timely, and dignified manner while respecting religious and cultural traditions 2. To support the death investigation process D Interment TDEM 2017 Conference May 17, 2017 Page 27 27
Williamson County Fatality Management Plan Concept of Operations (Plan Components) A B Scene Response and Human Remains Recovery Morgue Operations Trigger(s) 1. Cold storage capacity in Williamson County is exceeded 2. Unidentified human remains, comingled / fracture remains require identification Response Objective(s) 1. To provide additional cold storage 2. To identify human remains and personal effects for return to next of kin C Family Assistance Center D Interment TDEM 2017 Conference May 17, 2017 Page 28 28
Williamson County Fatality Management Plan Concept of Operations (Plan Components) A B C Scene Response and Human Remains Recovery Morgue Operations Family Assistance Center Trigger(s) 1. A fatality management incident occurs that requires a secure, nonpublic space to provide family assistance and to support ante-mortem data collection and information dissemination to affected families Response Objective(s) 1. To provide assistance and information to family members in a secure, non-public location 2. To support the antemortem data and interview collection process D Interment TDEM 2017 Conference May 17, 2017 Page 29 29
Williamson County Fatality Management Plan Concept of Operations (Plan Components) A B C Scene Response and Human Remains Recovery Morgue Operations Family Assistance Center Trigger(s) 1. An incident involving a large sustained number of deaths, fractured remains, or co-mingled remains that cannot be accommodated by normal burial processes 2. A decedent with a high consequence infectious disease 3. Disinterred remains secondary to flooding Response Objective(s) 1. To provide temporary or permanent burial in order to protect the health and safety of the community D Interment TDEM 2017 Conference May 17, 2017 Page 30 30
Fatality Management Components Examples Aircraft incident Scene response and human remains recovery Morgue operations Family assistance center Undocumented immigrants Morgue operations Explosion Scene response and human remains recovery Morgue operations Family assistance center TDEM 2017 Conference May 17, 2017 Page 31 31
Plan Development How we developed our plan Look at best practices and examples Lower Rio Grande Valley Development Council Plan Houston Regional Catastrophic Preparedness Initiative Plan Focus on our community We are a Justice of the Peace community; not ME Input and knowledge from the JP Judge Judy Hobbs Input and knowledge from County Attorney Mr. Dee Hobbs Input and knowledge from EMS, Fire, Emergency Management, Communications, CATRAC, CAPCOG, public health Training and exercising TDEM 2017 Conference May 17, 2017 Page 32 32
Plan Development Next Steps This is a living document; we will use lessons learned from real life events to revise and update the plan We want to share with you what we have done The plan (SOG) Scene assessment checklist Fatality kit inventory sheet Training videos Checklist for developing your plan Download from: URL HERE TDEM 2017 Conference May 17, 2017 Page 33 33
Finally A project of this magnitude depends on a lot of help Manual Cruz, Lower Rio Grande Valley Development Council Eddie Olivarez, Hidalgo County HHS Allison Woody, Houston Regional Catastrophic Preparedness Initiative Bruce Clements, Texas Department of State Health Services Dee Hobbs, Williamson County Attorney Dan Cohen, Williamson County EMS Williamson County law enforcement agencies, fire departments, EMS, hospitals, and emergency management CATRAC and CAPCOG Special thanks to Judge Judy Hobbs Williamson County JP, Precinct 4 TDEM 2017 Conference May 17, 2017 Page 34 34
Contact Information Jarred Thomas, CEM, TEM Emergency Management Coordinator Williamson County Office of Emergency Management Office:+1 (512) 864-8269 Mobile +1 (512) 748-8634 jthomas@wilco.org Ryan Moeller Director, Emergency Preparedness and Response Section Williamson County and Cities Health District Office:+1 (512) 943-3671 Mobile +1 (512) 965-6681 ryan.moeller@wilco.org John R. Litaker, PhD Managing Director The Litaker Group Office +1 (512) 804-5545 Mobile +1 (512) 633-5948 jlitaker@litakergroup.com TDEM 2017 Conference May 17, 2017 Page 35