Annex 23 - Fatality Management

Objective

The objective of this annex is to define the actions and roles necessary to provide a coordinated emergency response by students, administration, faculty, support personnel, visitors and departments for during an emergency situation or disaster. This plan provides personnel and departments with a general concept of potential emergency assignments following a fatality.

Situational Overview

The unexpected death of a student, employee or visitor is an event that may occur at any time and without warning. A death may occur on or off property, during a -sponsored event or travel, or may occur to a member of the campus community while at home or away from the University.  Regardless of the where or how the death occurred, will take a role in the management of the events that follow an unexpected death.

Concept of the Operations

Internal Notifications

One of the important touchstones for creating community involves establishing guidelines for use on the occasion of the death of a student or a member of the faculty or staff. needs to provide caring leadership when a member of the community dies.

When a member of staff learns of the death of a member of the community, the chief of police shall be immediately notified. The chief of police shall immediately notify the dean of students and the vice president for operations. The dean of students shall notify the vice president for student affairs. The vice president for student affairs shall direct all further notifications as necessary and warranted by the nature of the incident.

Community Notification

If appropriate, the vice president for student affairs or the dean of students will notify the immediate family of the death and circumstances, and will provide appropriate assistance (see “Death Notification Procedure” below).

In the event of an employee death, the chief of police will convey news of the death to the vice president for operations and the director of human resources.

If the deceased is an international student, the director of International Students and Scholar Services will be consulted about providing assistance to the deceased student’s family and the international student campus community.

Following notification of the next of kin, the vice president for student affairs or the dean of students may inform the campus community of the death through the following contacts:

    • Communications and Marketing
    • The point of contact designated in the event that family and friends of the deceased wish to make gifts/donations to an organization in the person’s memory.

Counseling Service

Psychological support

All appropriate University departments, staff and faculty will work with the Counseling Center and the Employee Assistance Program (EAP) to insure that all affected parties and groups know about the availability of counseling services provided by University. The counseling staff suggests placing the following notice in memorial service programs:

offers counseling and support to individuals experiencing bereavement and grief. If a student wishes to talk to a counselor, call 607-777-2772 to arrange an appointment with the University Counseling Center. In addition, University provides assessment and referral services to all employees through the Employee Assistance Program. EAP services may be obtained by contacting 607-777-6655.

Death of a Executive

In the event of the death of a executive, the University will need to inform internal and external audiences of this matter ensuring them that other executive officers and capable, experienced staff will provide stable interim management. This will be accomplished in the following manner:

    • As soon as possible, informing staff/students and external stakeholders about the death and circumstances.
    • Presenting information to staff/students and external stakeholders about who will assume duties on an interim basis.
    • Informing staff/students and external stakeholders about funeral/memorial services.
    • Informing the media about the death and University plans to move forward.
    • Providing opportunities for students, staff and external stakeholders to grieve and share.

Death Notification Procedures – Family Members

Members of law enforcement will typically make initial death notifications. Members of the administration may assist with the initial notification if appropriate and if requested by law enforcement. In cases where it is either inappropriate or not possible for University officials to participate in the death notification, may provide the following information to law enforcement so it can be shared with the family:

    • Condolences on behalf of
    • Name and contact information of the point-of-contact(s) for the family members
    • Brief summary of what may be able to offer to support the family (i.e. travel assistance, lodging, transportation, meals, etc.)

The purpose of these procedures is to help those who must assist with the notification of survivors of the death of a family member due to an unexpected event. Death notification is acknowledged to be one of the most difficult tasks faced by administrators, because learning of the death of a loved one often is the most traumatic event in a person’s life.

The principles described here are simple: notification should be done in person, in time, in pairs whenever possible, in plain language and with compassion. These recommended procedures were developed by people with much experience in death notification, and with help from survivors who have been through it. As one of the survivors put it, “Please remember you are assisting innocent victims of circumstance.”

If assisting law enforcement with the initial death notification, the information should be conveyed “in person,” “in time,” “in pairs” and “with compassion.”

“In Person”

Always make death notification in person — not by telephone.

    • It is very important to provide the survivor with a human presence or “presence of compassion” during an extremely stressful time. Notifiers who are present can help if the survivor has a dangerous shock reaction — which is not at all uncommon — and they can help the survivor move through this most difficult moment.

Arrange notification in person even if the survivor lives far away.

    • Work with local law enforcement to contact a medical examiner or law enforcement department in the survivor’s home area to deliver the notification in person.

Never communicate death information over the portable radio system.

    • Get the information over the telephone, or it might leak out to family through the media or private parties listening to radio frequencies. If radio dispatchers start to give information over the radio, stop them and call in.

“In Time” — and with certainty

Provide notification as soon as possible — but be absolutely sure, first, that there is positive identification of the victim. Notify next of kin and others who live in the same household, including roommates and unmarried partners.

    • Too many survivors are devastated by learning of the death of a loved one from the media. Mistaken death notifications also have caused enormous trauma.

Before the notification, move quickly to gather information.

    • Be sure of the victim’s identity. Determine the deceased person’s next of kin and gather critical information — obtain as much detail as possible about the circumstances of the death, about health considerations concerning the survivors to be notified and whether other people are likely to be present at the notification.

“In Pairs”

Always try to have two people present to make the notification.

    • Ideally, the persons would be a law enforcement officer, in uniform, and the medical examiner or other personnel such as a chaplain, University representative, victim service counselor, family doctor, clergy person or close friend. A female/male team often is advantageous.
    • It is important to have two notifiers. Survivors may experience severe emotional or physical reactions. (Some even strike out at notifiers.) There may be several survivors present. Notifiers can also support one another before and after the notification.

Take separate vehicles if possible.

    • The team never knows what it will encounter at the location. One notifier might need to take a survivor in shock to a hospital while the other remains with others. (Shock is a medical emergency.) One notifier may be able to stay longer to help contact other family or friends for support. Having two vehicles gives notifiers maximum flexibility.

Plan the notification procedure.

    • Before arrival, the notifier team should decide who will speak, what will be said, how much can be said.

“In Plain Language”

Notifiers should clearly identify themselves, present their credentials and ask to come in.

    • Do not make the notification at the doorstep. Ask to move inside and get the survivor seated in the privacy of the home. Be sure you are speaking to the right person. You may offer to tell children separately if that is desired by adult survivors.

Relate the message directly and in plain language.

    • Survivors usually are served best by telling them directly what happened. The presence of the team already has alerted them of a problem.

Inform the survivor of the death, speaking slowly and carefully, giving any details that are available. Then calmly answer any questions the survivor may have.

    • Begin by saying, “I have some very bad news to tell you,” or a similar statement.  This gives the survivor an important moment to prepare for the shock.
    • Then, avoid vague expressions such as “Sally was lost” or “passed away.”  Examples of plain language include: “Your daughter was in a car crash and she was killed.” “Your husband was shot today and he died.” “Your father had a heart attack at his work place and he died.”
    • Call the victim by name — rather than "the body."
    • Patiently answer any questions about the cause of death, the location of the deceased’s body, how the deceased’s body will be released and transported to a funeral home and whether an autopsy will be performed. If you don’t know the answer to a question, don’t be afraid to say so. Offer to get back to the survivor when more information is available, and be sure to follow through.
    • There are few consoling words that survivors find helpful — but it is always appropriate to say, “I am sorry this happened.”
    • Remember: Your presence and compassion are the most important resources you bring to death notification.
    • Accept the survivor’s emotions and your own. It is better to let a tear fall than to appear cold and unfeeling. Never try to “talk survivors out of their grief” or offer false hope. Be careful not to impose your own religious beliefs.
    • Many survivors have reported later that statements like these were not helpful to them: “It was God’s will,” “She led a full life,” and “I understand what you are going through” (unless the notifier indeed had a similar experience.)

“With Compassion”

Plan to take time to provide information, support and direction. Never simply notify and leave.

Do not take a victim’s personal items with you at the time of notification.

    • Survivors often need time, even days, before accepting the victim’s belongings.  Eventually, however, survivors will want all items. (A victim’s belongings should never be delivered in a trash bag.) Tell survivors how to recover items if they are in the custody of law enforcement officials.

Give survivors helpful guidance and direction

    • Survivors bear the burden of inevitable responsibilities. You can help them begin to move through the mourning and grieving process by providing immediate direction in dealing with the death.
      • Offer to call a friend or family member who will come to support the survivor  and stay until the support person arrives.
      • Offer to help contact others who must be notified (until a support person arrives to help with this duty).
      • Survivors may have a hard time remembering what is done and said, so write down for them the names of all who are contacted.

Follow up

Always leave a name and phone number with survivors.

Plan to make a follow-up contact with the survivor the next day.

    • If the death occurred in another county, state or country, leave the name and phone number of a contact person at that location.
    • Most survivors are confused and some might feel abandoned after the initial notification. Many will want clarifications or may need more direction on arrangements that are necessary.
    • Following up can be the last step in completing a “person-centered” and sensitive death notification that is truly helpful to survivors.

The notification team should be sure it is clear on any follow-up assignments that need to be carried out.

Death Notification in the Workplace

Survivors often must be notified at their workplace. Here are several tips to help apply the basic principles described above to a workplace notification.

    • Ask to speak to the manager or supervisor, and ask if the person to be notified is available. It is not necessary to divulge any details regarding the purpose of your visit.
    • Ask the manager or supervisor to arrange for a private room in which to make the notification.
    • Follow the basic notification procedures described above: in person, in time, in pairs, in plain language, with compassion.
    • Allow the survivor time to react and offer your support.
    • Let the survivor determine what he or she wishes to tell the manager or supervisor regarding the death. Offer to notify the supervisor, if that is what the survivor prefers.

Family Assistance

Non-Mass Casualty Incident

Family Support Services

Family members of the deceased will require support following the initial notification.  shall consider assisting the families with the following services, when necessary, based upon the needs of the family as well as the incident/event.

Family briefings

Families will have a strong need to receive a continuous flow of information and to understand what happened to their loved ones. Family briefings are convened to meet this need.

Always provide information to the family before releasing it to the general media.

Maintain contact the family once it is established regardless of whether additional information is available.

Family Liaison

should provide a single point of contact to act as a liaison between the family and the University. This person will be the family’s primary point of contact and plays a critical role is setting the tone of the experience.

The purpose of the family liaison is to assess immediate needs of family members and assist the family in accessing services.

The family liaison plays an important role in taking care of families by monitoring their visits, assessing their needs and by reporting to leadership on how families are responding to services provided by . This feedback allows to be proactive and flexible.

Spiritual care

  • Provide interdenominational pastoral counseling and spiritual care for people of all faiths who request it.
  • Be accessible to the families, friends and co-workers of victims and to University staff.
  • Provide emotional support/crisis intervention and assist mental health staff as needed.

Mental health services

  • Assist family members and staff in understanding and managing the full range of grief reactions.
  • Be accessible to the family and staff.
  • Provide Psychological First Aid, crisis intervention, mediation,and management of ‘at risk’ family members, including child and adolescent counseling.
  • Provide referrals, as requested, to mental health professionals and support groups that are in the family member’s local area.

Translation/interpreter services

The purpose of translation and interpretation services is to provide translation and interpretation services in individual and family meetings and family briefings and to translate important materials and antemortem records as needed.

Childcare

The purpose of childcare is to provide a safe and secure environment for the family’s children. The primary goal is to establish a friendly and healthy setting for short-term care while providing some respite for parents as they deal with a very difficult, challenging situation.

Services include:

    • Providing activities and caring support for children.
    • Providing structure, comfort and acknowledgement to minimize the impact of traumatic stress and to meet children’s unique needs.
    • Providing information and referral for families who need more extensive child care after Family Assistance Center (FAC) hours.

It is recommended that only licensed childcare providers be used to provide these services.

Food services

Food for families and for staff is required. The purpose of food services is to provide three high-quality meals daily and to make snacks and drinks available during all hours of operation.

Family logistical support

    • Lodging
    • Clothing
    • Transportation
    • Financial assistance
    • All other needs as they are identified

Mass Fatality/Mass Casualty Incident (MCI)

In the immediate aftermath of a mass fatality, families and friends will frantically seek assistance. They will gravitate to where they believe they will find their loved one or where they believe they will find information about them. That translates to the incident site and to local hospitals (thinking their loved ones are injured and have been transported to the nearest hospital). This is why a center or centers to provide family assistance immediately is so important.

administrators and local officials need to be prepared to mobilize appropriate resources to open a family assistance center in addition to managing the incident. Opening a Family Assistance Center (FAC) immediately and starting with basic services is critical to meeting families’ needs and to demonstrating to the public that there is some semblance of order, despite the disaster circumstances.

Providing family assistance that meets family needs in a mass fatality is a challenging job. Following a large-scale event, family assistance typically involves a range of services provided by local, state and federal agencies as well as nonprofits and private organizations. All services need to be victim-sensitive and easily accessible. An effective family assistance center is a multi-agency effort that requires leadership, collaboration, commitment, flexibility and organization. The challenges increase as family assistance staff work with families from many countries and cultures because family assistance must be provided in a way that is sensitive to cultural and language differences.

Family assistance is one of the most sensitive operations in mass fatality response. It is important for to work with local officials and organizations in the involvement of community planning and to understand its role in providing mass fatality family assistance.

Planning considerations

    • Anticipate eight to 10 family members per potential victim requesting assistance. For purposes of family assistance, family should be defined broadly and include the many individuals that consider themselves to be the victim’s ‘family,’ even when the law does not formally recognize the relationship. Any time family is used in this document, it includes all friends and loved ones that have identified themselves as ‘family’ to the victim.
    • Recognize the importance of understanding the full range of people who have been impacted by the incident who will need assistance: families of survivors, families and individuals living in the area impacted by the incident, coworkers of victims and families of missing persons.
    • Be prepared to adjust planning based on the nature of the incident itself, in particular, the length of time recovery and identification will take.
    • Plan from the perspective of the bereaved. It is important to realize that the families seeking assistance may remember how they were dealt with after the disaster for years to come.

Key Assumptions

The following are the key assumptions underlying family assistance:

    • Expect eight to 10 family members/loved ones for each potential victim.
    • Family members have high expectations regarding:
      • The identification of the deceased,
      • The return of loved ones to them, and
      • Ongoing information and updates.
    • Family members will begin to come to the incident site almost immediately. The family assistance cente r —with at least basic services — needs to be open and operating within 24 hours at most.
    • FAC operations may be long-term.
    • Responding to a mass fatality incident can be overwhelming, leading to traumatic stress. Support for responders is essential to monitoring and minimizing the impact.

Family Assistance Center (FAC)

The purpose of family assistance is to provide victims’ families with a secure and controlled area:

    • To provide a private place for families to grieve.
    • To protect families from the media and curiosity seekers.
    • To facilitate information exchange between , local officials and families so that families are kept informed and the medical examiner’s office can obtain information needed to assist in identifying the victims.
    • To address family needs (responding quickly and accurately to questions, concerns and needs — psychological, spiritual, medical and logistical).
    • To provide death notifications and facilitate the processing of death certificates and the release of human remains for final disposition.

Effective family assistance emphasizes compassion while imposing structure on a chaotic situation.

Family Assistance Guiding Principles:

    • Maintain a single focus: supporting the families.
    • Convey this single focus in all communications and actions, both internally and externally.
    • Deliver only unequivocal, accurate information to families with honesty and empathy. Although painful, the truth is always most supportive to the families.
    • Guide family member expectations from the beginning of the operation.
    • Accommodate families’ requests, group or individual situations to the maximum extent possible and recognize that some requests cannot be met.
    • Remain flexible, allowing room to adapt and evolve to meet new requirements and family needs.
    • Provide every opportunity for family members to make decisions to regain control of their lives.

Family Support Services

Within the FAC, the following services should be implemented, when necessary based upon the incident/event:

Family briefings

Families will have a strong need to receive a continuous flow of information and to understand what happened to their loved ones. Family briefings are convened to meet this need. Their purpose is:

    • To provide information to all families (at the FAC and not at the FAC) on the progress of recovery efforts, identification of victims, the investigation and other areas of concern.

Always provide information to families before releasing it to the general media.

Maintain contact with families once it is established regardless of whether additional information is available.

Bring in subject-matter experts as needed and plan to have rescue workers (selected via the Joint Information Center) and officials visit the families so that they can thank the workers for their efforts and support. When this occurs will depend on the nature of the incident.

Call center

The call center is an important communications link to victims’ families. It manages all calls coming into the family assistance center via a dedicated toll-free telephone number. It is set up as soon as possible after notification of a mass fatality incident. The purpose of the call center is:

    • To provide a critical communications link to victims’ families and to families requesting information on missing persons.
    • To act as a primary contact point for all incoming calls to the FAC.

Reception and information desk

The reception and information desk should be in a central, highly visible area. It is the families first point of contact and plays a critical role is setting the tone of the FAC experience.

The purpose of the reception and information desk is to welcome and check in families and visitors to the FAC to ensure FAC security, assess immediate needs of family members and assist families in accessing services.

The reception and information desk plays an important role in taking care of families by monitoring their visits, assessing their needs and reporting to leadership on how families are responding to services at the FAC.  This feedback allows the FAC to be proactive and flexible.

Be prepared to:

    • Meet families as they arrive.
    • Assist when necessary in coordinating activities to meet families’ needs.
    • Provide liaison between the family and the agencies involved as needed.
    • Control who gains access to the FAC. Each family member should receive a photo identification badge to allow access to secured areas and maintain the privacy of all families.

Spiritual care

  • Provide interdenominational pastoral counseling and spiritual care for people of all faiths who request it.
  • Be accessible to the families, friends and co-workers of victims and to the FAC staff and volunteers during all FAC hours, particularly during large group meetings and events.
  • Conduct religious services and provide worship opportunities.
  • Provide emotional support/crisis intervention and assist mental health staff as needed.
  • Serve as a member of the Death Notification Teams.

Mental health services

  • Assist family members and FAC staff and volunteers in understanding and managing the full range of grief reactions.
  • Be accessible to families and staff and volunteers during all FAC hours, particularly during large group meetings and events.
  • Provide Psychological First Aid, crisis intervention, mediation and management of ‘at risk’ family members, including child and adolescent counseling.
  • Provide referrals, as requested, to mental health professionals and support groups that are in the family member’s local area.
  • Provide Psychological First Aid and grief process educational materials for the FAC.

First aid/medication

  • Provide immediate emergency medical evaluation and stabilizing care to family members and FAC staff and volunteers.
  • Serve as a liaison with medical service providers in the event of a medical emergency.
  • Assist family members by providing general support and comfort.

Translation/interpreter services

The purpose of translation and interpretation services is to provide translation and interpretation services in individual and family meetings and family briefings and to translate FAC materials and antemortem records as needed.

Childcare

The purpose of childcare is to provide a safe and secure environment for FAC families’ children during main FAC operating hours. The primary goal is to establish a friendly and healthy setting for short-term care while providing some respite for parents as they deal with a very difficult, challenging situation.

Services include:

    • Providing activities and caring support for children.
    • Providing structure, comfort and acknowledgement to minimize the impact of traumatic stress and to meet children’s unique needs.
    • Providing information and referral for families who need more extensive child care after FAC hours.

It is recommended that only licensed childcare providers be used to provide these services.

Food services

Food for families and for staff is required. The purpose of food services is to provide three high-quality meals daily and make snacks and drinks available during all hours of operation. 

Guidelines for Food Services for Families and Staff

    • Arrange for two dining areas — one for families and staff and one for staff only (for when staff want private time/time to regroup).
    • Provide food (catered, made on premises, food vouchers for the hotel restaurant if the FAC is in a hotel).
    • Three high-quality meals daily.
    • Beverages and snacks during all FAC hours of operation.
    • Spiritual care counselors and mental health counselors should be available throughout the hours of operation in both dining rooms and in snack/beverage areas.

Family logistical support

    • Lodging
    • Clothing
    • Transportation
    • Financial assistance
    • All other needs as they are identified

Expectations for Hours of Operations

For most mass fatalities, expect the FAC to operate 24 hours/seven days a week in the beginning. While some services will be needed during all open hours, many of the direct services can be provided between 8 a.m. and 5 to 9 p.m.

Expectations Regarding Changing Needs

Experience providing family assistance after a mass fatality indicates that the needs of families will change over time. Anticipate this and plan accordingly. Flexibility is a key principle in providing family assistance.

Memorial Service

The decision to conduct a memorial service shall be made in consultation with the family of the deceased, administrators, the Counseling Center and the Employee Assistance Program (EAP).

If the University determines a memorial service should be arranged, the vice president for student affairs or the dean of students will consult with the family of the deceased to ascertain whether it is all right to proceed with a campus memorial service, and if so, what role the family may wish to have in planning and participating in the service. If the family has no objection to the campus service, but chooses not to participate or attend, the vice president for student affairs, the dean of students or his/her designee will organize a memorial service consistent with the needs of individuals and campus groups affected by the loss.

As soon as information has been gathered on a deceased student or staff member and plans for a memorial service are firm, the Vice President for Student Affairs or the Dean Students will draft a formal announcement to the community to be signed by the president (or other appropriate university official).