SUPPORTING FAMILIES DURING TIMES OF CRISIS
Defining Family Assistance Centers
At the start of your Family Assistance Center (FAC) planning process it is important that you and your team establish a common definition for “Family Assistance Center”, and its function in the context of a mass casualty or mass fatality incident in your community. The term “Family Assistance Center” may be confusing to some of your planning partners. “Family Assistance Center” often connotates a general location where individual assistance services are offered after a disaster. Examples of these services could include FEMA individual assistance for financial recovery, assistance with housing or assistance meeting other human service or financial recovery needs. There can be confusion about the difference between a Family Assistance Center, as it relates to a mass casualty or mass fatality incident response, and Disaster Assistance, Disaster Services or Disaster Recovery Centers, which are typical for most disasters regardless of the number of casualties. Depending on the nature of the incident, it is possible that families of the missing and deceased may also need access to these services. In these situations, it is important to ensure coordination with the other centers if they are available, or provide access to these services within the FAC. However, for your planning purposes it is strongly recommended the primary audience for your FAC be the loved ones of the missing and deceased, not all individuals impacted by the disaster.
Example definition: The Family Assistance Center is a secure facility established to serve as a centralized location to provide information and assistance about missing or unaccounted for persons and deceased, and support the reunification of the missing or deceased with their loved ones.
The term FAC often raises questions about how “family” is defined. For the purposes of your planning, “family” should be broadly defined to include individuals that may consider themselves to be part of the victim’s family, even if there is not a legal familial relationship. This could include friends, partners, caretakers and loved ones that have defined themselves or are indicated by other family members to be “family”. There will be circumstances in which authorities will need to identify the legal next of kin, however participation at a FAC should not be limited to these individuals alone.
Sample definition: Family is defined as any individual that considers themselves to be a part of the victim’s family, even if there is not a legal familial relationship. This includes individuals other family members characterize as family. This is distinguished from the legal next of kin, who may be the legally authorized individual(s) with whom the ME/C coordinates or who is authorized to make decisions regarding the decedent.
As your team begins the planning process it is helpful for everyone to become familiar with the concepts and terms used in mass-fatality response. Developing an understanding of the terminology, function, and purposes of these activities will help you better understand the needs and mission of the FAC and the relevant response agencies. The following terms are those that the planning team at Public Health – Seattle & King County found helpful to define.
Antemortem data: information about the missing or deceased person that can be used for identification. This includes demographic and physical descriptions, medical and dental records, and information regarding their last known whereabouts. Antemortem information is gathered and compared to post mortem information when confirming a victim’s identification
Autopsy: an examination of human remains that are recovered from the scene of the incident. Autopsies are generally conducted by a pathologist (commonly a forensic pathologist). The autopsy helps the pathologist to determine the cause and manner of death
Closed population: in the context of a mass fatality incident, a closed population refers to the number and names of the deceased being known, commonly via a confirmed manifest (e.g. list of passengers on a plane)
Death notification: the formal or official notification to the legal next of kin that their loved one is deceased and has been positively identified
Decedent: a deceased person
Death certificate: government issued certificate that serves as the official documentation of the date, location and the certification of the cause and manner of a person’s death. The death certificate is a critical piece of documentation usually needed to handle a person’s life insurance benefits and manage their estate after death
Death certification: the official determination of cause and manner of death. This is usually determined by the pathologist after autopsy, or by a physician responsible for the care of an individual prior to death
Disaster Behavioral Health: the provision of mental health, substance abuse and stress management to disaster survivors and responders
Disaster Mortuary Operational Response Team (DMORT): DMORTs are federal teams within the National Disaster Medical System (NDMS) that provide support for mortuary operations following a mass fatality disaster. In addition to the general DMORT teams, the DMORT capabilities include Disaster Portable Morgue Units (DPMU), a Weapons of Mass Destruction (WMD) Team and a Family Assistance Center (FAC) Team.
Family interview: a conversation conducted with family members and/or friends by representatives from the Medical Examiner/Coroner’s Office or Family Assistance Center staff to collect antemortem information about the missing or deceased person. For example, this may be an interview to complete the DMORT Victim Identification Profile form, which includes demographic and physical descriptions of the individual
Family Reception Services: In the immediate hours after a mass casualty or mass fatality incident, a Family Reception Services should be established as a centralized location for families and friends to go, before the Family Assistance Center is operational. Depending on the nature of the incident, this could be established at a community location, a hospital or a hotel
Human remains: a whole body or any part(s) thereof
Human remains recovery (Recovery): the retrieval of human remains from the scene of the incident
Legal next of kin: the closest blood relatives or spouse or domestic partner (depending on the state), who are legally authorized to make decisions regarding the deceased or the living during medical emergency if the individual is incapacitate. The order of next of kin may vary by state, but frequently includes spouse, then adult children, parents, siblings
Missing person: in the context of disasters, an individual whose whereabouts, status or well-being is unknown
Open population: in the context of a mass fatality incident, an open population refers to the number and names of the deceased being unknown. Incidents with open populations require more resources to determine who has been reported missing and potentially among the deceased. The World Trade Center bombings on September 11, 2001 are an example of an open population incident
Personal effects: the personal belongings associated with the missing person or decedent
Positive identification: confirming scientifically that an individual is deceased
Postmortem data: information about the deceased that is used to compare to antemortem data on the missing, for the purposes of identification
Psychological First Aid: an evidence-informed modular approach for assisting people in the immediate aftermath of a disaster and terrorism used to reduce initial distress and to foster short and long term adaptive functioning
Reunification: the process of reuniting family members with their missing or deceased loved one
Victim Identification Profile: a database developed and managed by DMORT to manage antemortem and postmortem information for the purposes of helping to facilitate victim identification