Planning for a mass fatality incident can be almost as complex as responding to such an incident. Mass fatalities can arise from transportation incidents, pandemics, mud slides, mass shooting, or other sudden incidents. Thankfully mass fatality incidents do not occur often, but due to the impacts and complexity of managing such incidents every jurisdiction should have a plan in place to address them.
A mass fatality incident management plan should be an annex to a comprehensive emergency management plan. Just as with any deliberate emergency planning effort (ref CPG 101), we start by assembling a planning team. This planning team should represent all relevant stakeholders from across the community. Beyond your usual public safety agencies, the team should also include the coroner or medical examiner, public health, public works, hospitals, social services agencies, the American Red Cross, funeral directors, and cemetarians. It is also important to consider the cultural and/or spiritual requirements of how the deceased are handled so community leaders from these groups should also be included in your planning process.
Your plan should acknowledge the hazards in your community which can lead to a mass fatality incident. These should already have been identified through your hazard analysis/THIRA. If you have not conducted a THIRA, your planning team should discuss the impacts of such an event through a briefly outlined credible worst-case scenario then identify what capabilities are needed to address these impacts.
Assisting agencies may have some slightly different roles in the management of a mass fatality incident than they would in other incident responses. These differences should be identified in the mass fatality incident response plan. It should also be recognized that the causal nature of the incident is most likely to drive who will be in charge of such an incident. Typically there are other matters which must be mitigated to save lives, protect property, and stabilize the incident which will determine who is in charge. Because it is a mass fatality incident the coroner or medical examiner will be managing a significant portion of the incident and may also be driving policy based upon their legal responsibilities, but they may not be in command, although they may be likely to be part of a unified command.
While the coroner or medical examiner will be handling the deceased, it must absolutely be remembered that the living must also be cared for. First and foremost are the immediate survivors, if any, of the incident who will require emergency medical care. Depending on the nature of the incident, others may need to be treated for exposure. Mental health care is a much more prominent issue in a mass fatality than perhaps any other incident – and the need for mental health care applies to everyone working the incident, families and friends of victims and survivors, and the community at large.
A common venue in mass fatality incidents for providing mental health assistance to families and friends of victims and survivors is a Family Assistance Center (FAC). The Aviation Disaster Family Assistance Act of 1996 requires family assistance centers to be established for major transportation incidents (the joint responsibility of the NTSB and the American Red Cross) but these centers have been used for other mass fatality incidents as well. In additional to crisis mental health counseling, a variety of other services can also be provided at a FAC. A FAC should be established very quickly and it should be recognized that surviving victims may be stranded in the area and that family and friends will flock to the area – many of which may have little support structure or plans for essentials such as lodging. A FAC is also an ideal location for authorities to obtain information from survivors about the missing or deceased which will help with future identification. FACs are often located in hotels where large conference facilities, lodging, food, and other services can be obtained.
Another facility common to a mass fatality incident is a temporary morgue. Temporary morgues are established either as a matter of operational convenience (rather than having to transport remains to the jurisdiction’s usual morgue site) or because the usual morgue site is too small to accommodate a larger operation. Usually in conjunction with a temporary morgue is the need for cold storage for remains. This is most often accomplished via refrigerated trucks/containers. The incident morgue is obviously a secure location, with only authorized personnel being allowed access.
The amount of logistical planning required to establish and support facilities such as a family assistance center and temporary morgue lend themselves greatly to pre-planning efforts, including MOUs, site-specific standard operating procedures, mobile caches of disaster supplies, and exercises to test the standard operating procedures for setting up and running such facilities. There are a variety of resources available to assist you with assembling your mass fatality incident response plan from LLIS, the federal Disaster Mortuary Response Team (DMoRT), state health departments, state emergency management agencies, and funeral home director’s associations. The National Association of County and City Health Officials also has information which can assist you.
Take the time to create a mass fatality incident management plan, train personnel on the plan, and exercise it regularly. Mass fatalities represent some of the most complex incidents I’ve ever been involved in and are very multifaceted. As always, if your jurisdiction needs assistance in any preparedness efforts, Emergency Preparedness Solutions, LLC is here to help!
© 2014 Timothy Riecker