Family Assistance Center Planning for a Non-Federally Regulated Mass Fatality Incident

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TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation. Family Assistance Center Planning for a Non-Federally Regulated Mass Fatality Incident PRESENTER: Mark Fulmer, Emergency Preparedness Planner, Tarrant County Public Health CO-PRESENTER: Matt Honza, Assistant Emergency Management Coordinator, Tarrant County Office of Emergency Management May 18, 2017 Texas Emergency Management Conference A healthier community through leadership in health strategy.

Federally Regulated (Legislated) MFI s as they Pertain to FAC Operations Defined by specific federal legislation: Aviation Disaster Family Assistance Act (1996) Rail Passenger Disaster Family Assistance Act (2008) Also: Pipeline Disasters and some instances where there are NTSB investigations for charter & school bus accidents.

For Most Aviation, Rail, & Pipeline Disasters The National Transportation Safety Board (NTSB) is usually one of the leading agencies. The NTSB developed its basic model for FAC operations in 1996 and has utilized it for more than 30 aviation & rail disasters since then. Commercial Air & Rail carriers may appropriate significant resources for FAC operations. The NTSB may either play an active role in FAC operations depending upon the MFI or leave this to the local jurisdiction depending upon the incident

Most other MFI s (non-federal/non-legislated) will be LOCAL in terms of FAC OPS Industrial Site Disasters Building/Structure Collapses & Fires Active Threat Incidents; Mass Shootings Catastrophic Natural Disasters: Tornados, Floods, Wild-Fires *Small aircraft or transportation accidents (NTSB may lead investigations but local jurisdictions will manage FAC) Most MFI S will require your LOCAL PLANNING & RESOURCES FOR FAC OPERATIONS

*Case in Point Examples Williamson County recovery operations involving a small aircraft with two fatalities Jarred Thomas, EMC Caldwell County Hot Air Balloon Disaster Martin Ritchey, EMC For both of these events, while the NTSB facilitated the investigation, the local jurisdictions handled the family support services directly

Getting Ready to Plan Your FAC Engage your local Medical Examiner or JP in your FAC planning process from the very beginning! Your FAC Plan should closely follow & be complementary to your MFI Plan (i.e., activation thresholds, etc.) Gather information: best practice models, MFI/FAC exercises & seminars, AAR s on real MFI s (The BEST), etc. Utilize existing resources that are available (plans, toolkits, guides, etc.)

Make Your FAC Planning Flexible, Adaptive & Inclusive Who will facilitate FAC OPS? (NTSB, Trauma/Medical, FBO s, EMC) Medxcel/Dell Children s If rural what resources are available? (DSHS, Volunteer Responders, Justice of the Peace) For larger jurisdictions will you select FAC sites and develop MOU s? Consider resources from local ISD s What about large corporate resources for industrial site accidents? (HR, corporate liaisons) DON T PLAN IN A SILO!

Two FAC Planning Resources to Consider Request a copy at preparednessplanning@dshs.texas.gov. Download PDF from NTSB.gov

Another Resource U.S. Department of Justice: Mass Violence & Terrorism Tool Kit https://www.ovc.gov/pubs/mvt-toolkit/index.html

Don t Forget to Check Out Best Practices Seattle/King County

Build Your FAC Planning Team Some key members to recruit: Medical Examiner representative or JP Official Emergency Management Disaster Behavioral Health Partners Reps from Hospitals, RAC s, MOC s Law Enforcement VOADS (Red Cross, Salvation Army, MRC, etc.) Public Information (PIO) Public Health (Directors, PHEP, Policy & Planning, etc.) Information Technology Finance & Administration (Purchasing)

FAC Planning Project Management Develop goals & objectives for each FAC component: Call Center, Staff & Organization, M.E. Team, DBH Teams, Security, etc. Delegate tasks based upon SMART objectives Allow each planning team member to be actively engaged in their particular SMA EXERCISE THE PLAN!

For Consideration: Will Your FAC Include a FRC? The Family Reception Center (FRC) is a temporary option that should be considered for your FAC planning. The NTSB utilizes the FRC for interim operations during the first 4 6 hours until a full FAC can be activated. It has a modest complement of staff & resources until there can be a transition to full FAC operations. The FRC is especially helpful for larger response operations and can open simultaneously with the Call Center. Once the FAC is running, the FRC is demobilized. NOTE: In the Orlando Shooting, their trauma center provided for the initial FRC operations especially since this was where most of the families were showing up!

Plan Your FAC Operations Call Center (On site or virtual? Inbound/Outbound call volume; Integrate missing persons, information & crisis intervention; more on upcoming slides) Medical Examiner Team (victim ID, ante-mortem interviews, personal effects admin, disposition of remains, death notifications, etc.) Disaster Behavioral Health Team (crisis intervention, CISM, spiritual support chaplains, clergy) Administration (registration, ID badging, case management, family room attendants, etc.) Security (restricted site access; no media/safe environment for families) Public Information (release of information should be in synch with family briefings; NOTE: M.E. PIO) Information Technology (support for call center & case management systems, communications (radio & LAN), work stations, laptops, network, Wi-Fi, printers, etc.) Logistics Support (facility management, transportation, staffing, etc.) Hospitality Services (child care, food & beverages, ground transportation, local amenities, mobile device charging stations, etc.)

Anticipate Your Activation Matrix What is the MFI activation threshold set by your Medical Examiner? How will M.E. request FAC activation? *If possible, activate Call Center within 4 6 hours of the MFI The FAC Site should be activated within 12-24 hours of the MFI *Will your Call Center be located in your FAC?

Call Center Operations; TASK #1 provide essential information to families (i.e., FAC hours, location, etc.) TASK #2 collect critical information from families (i.e., known missing, possible missing, unknown) for M.E., First Responders & Law Enforcement TASK #3 provide any crisis intervention as needed (i.e., PFA triage) 3 Primary Tasks

Visitor Registration & Check-In Visitors checked in and badged for security Each family is registered and an electronic intake file record is initiated Visitors receive information packets and are escorted to a waiting/briefing room area and have access to an information kiosk/booth

Waiting Room/Briefing Area Regularly scheduled briefings provide families with important information & updates Families are scheduled for interviews with M.E. staff and law enforcement as needed Attendants & greeters provide personal escort for families to their appointed areas Mental health, chaplains & clergy are also available for the families and can take them to private areas as needed

Behavioral Health Assistance Team Trained mental health staff provide services Grief support, crisis intervention, religious/spiritual support (chaplains/clergy) CISM critical incident stress management

M.E. Team Victim ID Services Victim ID; ante-mortem interviews Critical communications with MFI site exchange of information Personal effects administration Death notification, disposition of remains

Plan Staff Positions & Develop Job Action Sheets FAC Director Call Center Director Call Center Staff (inbound/outbound) Medical Examiner FAC Team Behavioral Health Assistance Team Chaplains/Clergy Law Enforcement/Security Logistics Specialist Logistics Support Team Information Technology Registration & Badging Attendant Waiting Room Attendant Facilities Coordinator Greeters & Escorts Hospitality Services Team A minimum of 25 30 staff will be needed to support FAC Operations

Tarrant County FAC

Select Your FAC Sites Survey potential sites (i.e., hotels, convention centers, schools, etc.) Survey Team should include: Law Enforcement, IT, Emergency Management Do assessments for traffic, parking, security, child care, interview rooms, etc. Develop MOU s; include your Legal, business office & purchasing department

NTSB FAC LAYOUT

Tarrant County FAC Floor Plan

After the FAC Demobilization: Community Recovery Although the typical FAC will usually conclude its initial operations within a few weeks, once the last victim is identified & released the recovery & support process are ongoing. The recovery process following the MFI is most critical for the healing of the community. This process will take months and years for a community to heal the work is just beginning for most mental health professionals and faith based organizations

TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation. Mark Fulmer smfulmer@tarrantcounty.com Tarrant County Public Health Matt Honza - mrhonza@tarrantcounty.com Tarrant County Office of Emergency Management Fort Worth, Texas A healthier community through leadership in health strategy.