Many Thanks to the Following Individuals, Who Served on the Family Reunification Center

Many thanks to the following individuals, who served on the Family Reunification Center Subcommittee and made this Planning Guide possible:

Joel Bunis

Allen Clark

Jennifer Cunico

Austin Creswell

Gil Damiani

Tony DiRienzi

Gary Ells

Dan Stanley

Darrell Duty

David Leinenveber

Chris Lyons

David McCarthy

John Moede

Kore Redden

Deb Roepke

Melanie Rouse

Kris Scharlau (Chair)

Joyce Stout

Jannine Wilmoth

Much of this Guide was derived directly from the following the Los Angeles County Operational Area Family Reunification Center (FRC) Plan, Version 1, March 31, 2010; Http://www.apctoolkits.com/family-assistance-center; or Seattle and King County Healthcare Coalition’s Family Reception Services Guidelines for Hospitals. Attachment O Version April 2012.

Family Reunification Center Planning Guide (DRAFT)

Mission: To provide a planning guide to assist local jurisdictions in Arizona in setting up a Family Reunification Center (FRC) for families in case of a mass casualty incident.

Scope:

1.  Provide accurate and timely information to the family and friends of victims (clients) regarding the incident in a private and secure environment.

2.  Provide a mechanism to coordinate efforts between law enforcement, EMS, hospital, call center, and medical examiner personnel to facilitate identification of victim status and client notification.

3.  Provide emotional support and spiritual care services to clients.

4.  Protect families from the media and curiosity seekers.

5.  Provide a child care safe zone for unaccompanied minors.

6.  Support family reunification.

7.  Provide death notifications to next of kin for victims that have died when identity is known.

Planning Assumptions:

1.  Expect a minimum of eight to ten family members or loved ones to arrive or need assistance for each victim.

2.  After an incident, family members will immediately call or self- report to the hospital they believe their loved one may have been taken.

3.  Coordination among responding agencies about family members, missing persons, and patient tracking will be necessary.

4.  An FRC will be necessary to provide a safe place for families to convene until a Family Assistance Center or shelter is activated.

5.  Families will have high expectations regarding:

a.  Identification of the deceased,

b.  The return of loved ones and their belongings,

c.  Accurate and timely information and updates.

6.  Victim identification may take multiple days, weeks, months or even years.

7.  Not all families will grieve or process information in the same way.

8.  Ethnic and cultural traditions will be important factors in the way families grieve or process information.

9.  Both Behavioral Health and Spiritual Care resources should be available.

10.  Responding to a mass casualty or mass fatality incident can be overwhelming and lead to traumatic stress. Support for staff will be essential.

11.  A specific safe zone must be established for unaccompanied minors to ensure appropriate release to a custodial adult.

Definitions:

Family / Any individuals that consider themselves to be a 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”.
Immediate Family / A defined group of relations, used in rules or laws to determine which members of a person'sfamilyare affected by those rules. It normally includes a person's parents, spouses, siblings and children.
Custodial Parent / The parent, also considered the primary care parent, a child resides with full time. Most custodial parents have been awarded physical custody of a child by a court of law.
Legal Guardian / A person or entity who has been granted the legal authority (and the corresponding duty) to care for the personal and property interests of another person, called a ward.
Legal Next of Kin / The nearest blood relatives of a person who has died, including the surviving spouse.
Separated Children / Children who have been separated from both parents or from their previous legal or customary primary caregiver, but not necessarily from other relatives. These may, therefore, include children accompanied by other adult family members.
Unaccompanied Minors / Children who have been separated from both parents, legal guardians, and other relatives and are not being cared for by an adult who, by law or custom, is responsible for doing so (18 or under).
Reunification / The process of reuniting family members with their missing or deceased loved one.
Call Center / Following a mass casualty or mass fatality incident, this designated space is activated as a communications hub to collect information from families and friends of possible victims (integrates Medical Examiner/Coroner interviews); to direct families and friends to appropriate Hospital Reception Sites, Family Reunification Centers, or Family Assistance Centers for reunification and assistance; and to direct other callers to appropriate recipients, such as Public Information Officers.
Family Assistance Center
(Long-Term) / Following a large mass casualty or mass fatality incident, this designated county or state space is established as a centralized location for families (and friends) to gather, receive information about the victims and grieve, protect families from the media and curiosity seekers, facilitate information sharing to support family reunification (e.g., direct families to Hospital Reception Sites if victims are known to have been transported to the location), and provide death notification when patients die and identity is known. This Center is long-term and may target delivery of a range of services and/or may focus on families and friends of missing or deceased victims.
Family Reunification Center
(Short-Term) / In the immediate hours after a mass casualty or mass fatality incident, this designated community space is established as a centralized location for families (and friends) to gather, receive information about the victims and grieve, protect families from the media and curiosity seekers, facilitate information sharing to support family reunification (e.g., direct families to Hospital Reception Sites if victims are known to have been transported to the location), and provide death notification when patients die and identity is known. This Center is short-term and may be replaced by a Family Assistance Center or shelter in the event the County or State or other jurisdiction deems this to be necessary.
Hospital Reception Site / A hospital space designated to provide a private and secure place for families to gather, receive information about the patients and grieve, protect families from the media and curiosity seekers, facilitate information sharing with other hospitals and partners to support family reunification (e.g., direct families to Family Reunification Centers if victims are missing), and provide death notification when patients die and identity is known.

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Activation: The FRC may be activated as part of disaster response operations. The decision to activate an FRC is made at the discretion of the local Incident Commander (or Emergency Operations Center Director or Unified Command), according to the Disaster Plan for the local jurisdiction. The activation process is displayed on the next page.

If the event exceeds the definition of a small event (50 or less victims) or the jurisdiction’s capacity, consideration should be given to opening additional sites or contacting the next largest government agency for assistance or activation of a Family Assistance Center (FAC). In addition, consideration should be given in planning as to how transition from an FRC to an FAC will occur, if the event is extended over days or grows beyond the capacity of the community to handle. Hence, dialogue should occur with Red Cross, the Salvation Army, faith-based organizations, and/or other organizations that normally supply assistance to a county or region under such circumstances so that forms and processes are familiar.

Site Selection: The following should be considered as the preferable general guidelines to pre-qualify facility for use as a FRC:

1.  Site Accessibility:

a.  Approval from facility owner, jurisdiction, or relevant agency;

b.  Easy access from major roads, freeways, or public transit;

c.  Close proximity to individuals and clients affected by the incident;

d.  Proximity to mass transportation resources;

e.  Adequate number of parking spaces;

f.  Parking lot layout that is amenable to law enforcement access restriction; and

g.  Availability on short notice.

2.  Usable Space and Resources:

a.  Large indoor space to accommodate needs listed;

b.  Multiple exterior ingress/egress points (preferably two egress points);

c.  Proximity to restrooms, tap water source, telephone and security station;

d.  Controlled heating/air conditioning;

e.  Flow consideration for FRC required areas to include:

§  Client reception and badging area;

§  Client briefing area;

§  Client waiting area (for completing forms);

§  Client services areas (individual rooms for behavioral health, spiritual care, and social services);

§  Client television, computer, and telephone banks;

§  Client feeding area;

§  Staff reception, badging, and credential area;

§  Staff restricted area (victim tracking, missing persons, and multiple rooms for notification);

§  Command staff briefing area;

§  Staff work area;

§  Staff break room; and

§  Logistics/IT area.

f.  Appropriate space for a child care area, including the following:

§  Enclosed space with narrow entrance,

§  Real walls (or solid partitions), and

§  Unencumbered access to two means of ingress/egress.

g.  Food preparation and/or consumption, including any applicable cultural or religious considerations regarding the types of food permitted on the premises;

h.  Ability to support communications and technological infrastructure, including expected power load and data transmission capability;

i.  Telephones available in facility;

j.  Tables and chairs available on-site; and

k.  Facility conforms with jurisdiction and Federal regulations:

§  Certificate of Occupancy,

§  OSHA facility requirements,

§  ADA compliant or modifiable to be compliant (including all access/egress), and

§  Affirmative Action Compliance criteria Security.

3.  Safety

l.  Easily secured perimeter and

m.  Endorsement of local law enforcement.

Attachments:

A – Job Descriptions (Examples):

1.  Hospital Reception Site Division Supervisor.

2.  Hospital Reception Site Child Care Area Unit Leader.

3.  Refer to Resources below for additional guidance.

B – Activation Checklist.

C – Child Care Area (CCA) Checklist.

D – Access and Functional Needs Accommodations Checklist.

E – Equipment and Supply Checklist.

F – Psychological First Aid Tools.

G – Family Reunification Center Sign-In Sheet

H – Intake Form for Callers.

I – Child Identification Form.

J – Contact Information.

K – Demobilization Checklist.

Resources: Los Angeles County Operational Area Family Reunification Center (FRC) Plan, Version 1, March 31, 2010; Http://www.apctoolkits.com/family-assistance-center; or Seattle and King County Healthcare Coalition’s Family Reception Services Guidelines for Hospitals. Attachment O Version April 2012.

Attachment A - Job Action Sheets (Examples)

Customize these and other Job Action Sheets to integrate within your Incident Command Plan. Your ICS structure may already have Job Action Sheets covering other positions, such as security. For additional Job Action Sheets, go to http://www.apctoolkits.com/family-assistance-center.

FAMILY REUNIFICATION CENTER (FRC)

DIVISION SUPERVISOR

JOB ACTION SHEET

YOU REPORT TO: ______

FAMILY REUNIFICATION CENTER LOCATION:______

PHONE: ______

MISSION: Organize and manage the operations of the Hospital Reception Site.

Immediate (Operational Period 0-2 Hours) / Time / Initial
Receive appointment and briefing from the Reunification Branch Director.
Notify your usual supervisor of your FRC assignment.
Determine need for and appropriately appoint FRC division members, distribute corresponding Job Action Sheets. Complete unit assignments.
Complete Activation Checklist.
Document all key activities, actions, and decisions in an Operational Log (refer to ICS).
Brief the FRC unit members on current situation; outline unit action plan and designate time for next briefing.
Confirm the designated FRC area is available, and begin distribution of personnel and equipment resources.
Communicate and coordinate with Behavioral Health/Spiritual Services Unit Leader to determine:
§  Available staff (mental health, nursing, chaplains, experienced volunteers, etc.) that can be deployed to the FRC to provide psychological support, and intervention.
§  Location and type of resources that can be used to assist with a mental health response, such as toys and coloring supplies for children, mental health disaster recovery brochures, fact sheets on specific hazards (e.g., information on chemical agents that include symptoms of exposure), private area in the facility where family members can wait for news regarding their family member, etc.
Assess problems and needs; coordinate resource management.
Instruct all FRC unit members to periodically evaluate equipment, supply, and staff needs and report status to you; address those needs with appropriate FRC unit staff; and report status.
Coordinate with Liaisons.
Coordinate information with patient tracking staff for the FRC.
Immediate (Operational Period 0-2 Hours) / Time / Initial
Document all communications (internal and external).
Intermediate (Operational Period 2-12 Hours) / Time / Initial
Talk regularly with the Reunification Branch Director to report status and to gather information to relay important information to FRC unit staff.
Continue coordinating activities in the FRC.
Ensure prioritization of problems when multiple issues are presented.
Coordinate use of external resources; coordinate with Liaison Officer if appropriate.
Develop and submit a FRC action plan to the Reunification Branch Director when requested.
Ensure documentation is completed correctly and collected.
Advise the Reunification Branch Director immediately of any operational issue unable to be corrected or resolved.
Ensure staff health and safety issues being addressed; resolve with Employee Health and the Safety Officer.
Extended (Operational Period Beyond 12 Hours) / Time / Initial
Continue to monitor the FRC unit’s ability to meet workload demands, staff health and safety, resource needs, and documentation practices.
With the assistance of Liaisons, verify/credential external personnel sent to assist.
Work with the Reunification Branch Director on the assignment of external resources. Coordinate assignment and orientation of external personnel sent to assist.
Rotate staff on a regular basis. Provide for staff rest periods and relief.
Document actions and decisions on a continual basis.
Continue to provide the Reunification Branch Director with periodic situation updates.
Ensure your physical readiness through proper nutrition, water intake, rest, and stress management techniques.
Observe all staff and volunteers for signs of stress and inappropriate behavior.
Upon shift change, brief your replacement on the status of all ongoing operations, issues, and other relevant incident information.
Decentralize/Demobilize / Time / Initial
As needs for the FRC decrease, notify Reunification Branch Director. When instructed to demobilize, return staff to their normal jobs and combine or deactivate positions in a phased manner.
Ensure the return/retrieval of equipment/supplies/personnel.
Debrief staff on lessons learned and procedural/equipment changes needed.
Upon deactivation of your position, brief the Reunification Branch Director on current problems, outstanding issues, and follow-up requirements.
Upon deactivation of your position, ensure all documentation and FRC Operational Logs are submitted to the Reunification Branch Director.
Submit comments to the Reunification Branch Director for discussion and possible inclusion in the after-action report; topics include:
§  Review of pertinent position descriptions and operational checklists.
§  Recommendations for procedure changes.
§  Section accomplishments and issues.
Participate in stress management and after-action debriefings. Participate in other briefings and meetings as required.

FAMILY REUNIFICATION CENTER (FRC)