Batesville Herald Tribune, Batesville, Indiana

November 26, 2013

Officials learn how to handle mass fatalities

Debbie Blank The Herald-Tribune
The Batesville Herald-Tribune

---- — BROOKVILLE – What happens when Franklin County is the site of a school bus accident, commercial plane crash, tornado or other disaster that kills a handful or hundreds of persons?

Andrew Naumann, the new Franklin County Health Department public health coordinator, called a necessary, but grim meeting Nov. 14 at the government center so that public safety officials and volunteers could discuss his first draft of the FCHD Mass Fatality Management Plan, part of its All-Hazards Plan.

Looking around the table at the sheriff, deputy coroner, assistant fire chief, FCHD preparedness administrator, three emergency medical technicians, two newspaper reporters and an Indiana State Department of Health Region 9 employee, he noted, “Everybody here is responsible for responding to incidents.” The plan can be revised, but “everything I have in here does meet the state and federal planning requirements.”

There are more than 15 scenarios for which county leaders must prepare. They range from an earthquake, flood or dire flu outbreak to building collapse, multiple homicide or large fire. Naumann said most of these emergencies are rare. Larry Race, Brookville assistant fire chief, noted, “We have responded to plane crashes in Franklin County.”

On arriving at a tragic scene, ISDH employee Susan Gross said, “You’re going to know instantly, ‘Boy, we need some help.’”

Franklin County Emergency Management Agency officials and firefighters will determine the disaster’s level. Naumann categorized them as Level 1, 3-5 fatalities with intact remains; Level 2, 6-20 deaths with intact remains or fewer bodies that are “highly fragmented and/or highly dispersed”; Level 3, more than 20 fatalities or less bodies that are in pieces and/or scattered. The first level does not require an Emergency Operations Center, but the second and third do.

Naumann reported, “In talking to Wanda (Lee, the county coroner), she mentioned about five (dead) folks is the top number of people we could handle here” without more help.

Gary Solar, an FCEMA member, EMT and Drewersburg firefighter, asked, “How did you come up with 20” for Level 3? The coordinator answered, “Twenty is the fewest number DMORT (Disaster Mortuary Operations Response Team) will respond to.”

Deputy coroner Brian Baxter said, “I think three is a low number” of deaths for Level 1. Later in the meeting, he proposed higher numbers and other attendees seemed to agree: Level 1, 6-12; Level 2, 12-20; Level 3, 21+.

The plan noted, “In all incidents regardless of size, the coroner will assess resource needs via on-scene representatives.” More death investigation staff may be requested through FCEMA. Staff who would assist with the investigation, search and recovery and transportation of remains could include health department personnel, Medical Reserve Corps volunteers or employees of other county agencies.

Naumann pointed out specialized agencies will help depending on the type of catastrophe: terrorism, FBI; explosion, Bureau of Alcohol, Tobacco, Firearms and Explosives; water accident, Coast Guard; train and plane crashes, National Transportation Safety Board.

FCEMA will serve as the first point of contact for requests for assistance from state and federal governments. Two resources overseen by the Indiana Department of Homeland Security, the Indiana Mortuary Emergency Response Team and Disaster Portable Mortuary Unit, are located at Camp Atterbury and could arrive in 24 hours at the earliest, according to the coordinator. The Region 5 DMORT can be here no later than 48 hours after the incident.

Baxter said the county coroner’s office has mutual aid agreements with its counterparts in surrounding counties. Another resource for equipment could be the Indiana Coroners Association.

According to Solar, “If the state doesn’t have the resource, the governor has to request it from the president.”

Naumann admitted, “We have a lack of some of the response resources” recommended by the FBI, such as equipment to set up a grid system at a scene. He wants to develop a list of items the coroner’s office needs and apply for a grant.

For Level 2 and 3 disasters, an Emergency Operations Center will be activated. Everybody there, including FCEMA and FCHD representatives, the county coroner and commissioners, would provide input for public information. Commissioners also can issue a county emergency declaration.

“We don’t have a full-time county public information officer,” he pointed out. County council member Joe Sizemore said Commissioner Tom Linkel is the county spokesman.

According to Naumann, “As an incident would unfold … we would work together” to develop the right messages that are factual, but not panic inducing.

The plan stated, “Identifying human remains and returning the deceased to the next of kin is the top priority of the Franklin County Coroner’s Office, and it strives to do this with the utmost respect and speed. Health department personnel will communicate this to family members via the Family Assistance Center, while also reiterating why the identification process may take more time than expected.”

Appropriate personnel must notify families of the dead in an appropriate manner, Naumann emphasized. Race was concerned about notification because of bystanders with cellphones. “It is pertinent that we get our act together and notify people as soon as we can before the crowd does it for us.” Sheriff Ken Murphy confirmed that many times the family already knows about a death before the officer arrives with the news. He added, “We have a chaplain program ... that has been very helpful.” The volunteer clergy are “there to listen.”

As the Family Assistance Center plan is developed, the coordinator will get attendees’ input. Relatives of those involved in the disaster should be close to the scene, “but not close enough to see.” The location will be a gathering spot for family members, a clergy member and/or Community Mental Health Center grief counselor.

There are many details to consider. The plan noted, “During a mass fatality incident, responders may also find themselves working in physically precarious circumstances, including adverse weather, biohazards, confined spaces and building debris. These concerns should be addressed ahead of time through training and discussion of expectations and of safety precautions responders should take …”

According to the document, “Failure to conduct an effective mass fatality investigation or to adequately provide for the family and friends of the deceased will erode the public’s faith and trust in the response and recovery efforts.”

The plan will continue to evolve. The document stated, “It is crucial to the success of this plan that staff members be regularly trained in its implementation ...” Naumann is tasked with maintaining the plan and its attachments. “Edits to operational documents are ongoing; the plan in its entirety will be reviewed and revised every three years,” although the coordinator added it probably will happen once a year.

Debbie Blank can be contacted at debbie.blank@batesvilleheraldtribune.com or 812-934-4343, Ext. 113.