Family Assistance Center

Facility should be large enough to handle the families depending on the size of the multiple death event (i.e. anticipating four to six family members per deceased).  If possible utilize churches, public auditoriums if local event...If family members coming from out of town, consider hotel/motel so that families can be housed and taken care of in the same facility.

Center should be set up as soon as possible after the event.  The Medical Examiner/Coroner can begin to gather antemortem information on the deceased individuals in order to begin identification process.  

An incident command structure should be established at the Family Center.  The IC or Center Manager could be a representative of the ME/Coroner.  Organizations involved in the staffing would be the ME/Coroners office, the Funeral Directors Association, American Red Cross, Salvation Army, mental health professionals, religious professionals (all faiths), security, food service, supplies, communicatons, medical services and volunteer organizations.

Examples of Center and Center Needs:

Room of large area referred to as the "family room".  With kitchen/food serving capabilities, area for day care, smaller offices, a room for a small chapel, separate exits by stair or elevators that can be secured.  Press area separate from "family room". Center hours at a minimum 7:00 am to 10:00 pm.  Famililes should always have mental health professionals available to them for counseling as well as clergy.  

Security should be very tight.  Provided by uniformed law enforcement officers.  Secruity should also extend to parking areas.  All entrances should be very controlled and entry only by people that needed to be in the center.  Even consider photo I.D.  Escorts for families going from inside to out should be considered (Military Chaplin's Service used in Oklahoma) as well as from Center to housing. In Oklahoma, there was an elaborate id process.  Use of color-coded name tags.  Each service or organization had a separate color (clergy, mental health, medical, media, etc).  Similarly family members were designaed with a blue dot immediate family, yellow dot for extended family, 

Press should be restricted to press area only.  They should have controlled entrance points with specific instructions on what they can and cannot photographer, or come in contact with family members.

Accurate records of the families should be maintained and tight control over where the families are and where they can be contacted in or outside of the Center.

Communications should be set up including phones in private areas, and televsion areas so families can watch any news broadcasts that they desire to watch.

Medial Unit established within the Center staffed by paramedics, RN's and physicians.

Workers should work two four hour shifts with two hour breaks between shifts as mandatory.  All workers are briefed prior to shifts as to current developments, problems, etc.

Notifications:

Once identifications are made, family should be called to separate office area within the center staffed by ME/Coroner's Office personnel.  Using a notification team to deal with the family (2 ME personnel, 1 mental health professional, and 1 member of clergy, 1 medical person).  This notification team meets the family, escorts them into a room where the family is notified that there has been an identification, answer any questions and take care of needs of the family they may have at this time. Mental health services can be organized into 4 primary functions: support services, family services, death notification and stress management.  There will be a highly stressfull and emotionally-charged times within the Center.  Critical stress debriefings for workers should not be overlooked. Even if need to have a 20-25 minute CISD after each shift.

Two times a day a representative of the lead agency should talk to the families in the Center, giving them information that was available concerning the number of bodies that had been recovered, the number of identifications, what the process was, how the work at the scene was going and try to answer any questions that the family members may have.  This information should be given to the families in a straightforward and truthful way while at the same time be sensitive of the nature of this incident.  

Also, at a minimum two times a day there should be press releases.  Public Information Officers should coordinate the press conference, but the ME/Coroner's representative should be answering the questions.  Also, family member should not be in contact with the press unless they wish to.  If a family member indicates they wish to speak with the press, they should be escorted to the press area by an Information Officer.

Other Issues/Concerns:

Any cards or posters or flowers sent from community, post around the Center.  Try to set up families together and allow them to return to the same spot each day. Cellular phones are very useful for communication for workers within the Center or for use to contact famililes if they leave the Center.

Day care area accessible for parents and for children to know their parents are only a step away....This should also be staffed with at least 1 mental health professional.

Sound Bites:

1. It is important to provide a sense of structure through leadership and communication at a time of overwhelming chaos and helplesness.

2.  Every effort is made to empower families by providing information in a truthful, respectful and non-intrusive manner.

3.  Family members are treated as normal people experiencing an abnormal event.

4. Provide a safe and protective environment for families to share their pain with people who care.

5.  Try to understand the emotional climate and how it differes from an outsider watching as families continue to hold vigil under what appears to be a blanket of deniel against realization of their worst fear.

6.  It is often critical for families to remain hopeful, to be vigilant, to not abandon or betray their loved one until the death notification is made.

WHAT MUST BE DONE

Locate and Resuce Surviors

Secure Scene-Protect the dignity of the victims.  Interference for responders from press.  Protect press and public from themselves (debris, boby fluids, etc.)

Remove Bodies

Identify Bodies-Three part tagging system, one for site, one for body, one for bag)

Temporary Morgues-Never let Press in (148 PC)

Return Bodies to Loved Ones

Recover Personal Property of Victims

Return Property to Loved Ones.

Secure Evidence for Investigation

Support Families-Set up Family Assistance Center.  This is not a shelter

Inform Press/Public-Two sites, at site/incident, at response site.

Clean up Site-Memorialize Site

Support Responders

Critical Stress Management- 

DMORTS-Diaster Mortuary Teams (Paid for by the Stafford Act).  22 people, free to incidents, includes 2 med.examiners and morticians.  (410)313-2473