SUPPORTING FAMILIES DURING TIMES OF CRISIS
Key Terminology
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.
Defining “Family”
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.
Key Terminology
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: A 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 the 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 FAC 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 Center: In the immediate hours after a mass-casualty or mass-fatality incident, a Family Reception Center should be established as the centralized location for families and friends to go, before the FAC 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 relative, 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, etc.
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 who are 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, an individual is deceased.
Postmortem Data: Information about the deceased that is used to compare to antemortem data on the missing person, for the purposes of identification.
Psychological First Aid (PFA): An evidence-informed modular approach for assisting people in the immediate aftermath of a disaster or terrorism. It is 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 (VIP): A database developed and managed by DMORT to manage antemortem and postmortem information for the purposes of helping to facilitate victim identification.
