2. Capability Cliff Notes Series PHEP Capability 5—Fatality Management What Is It And How Will We Measure It? For sound, click on the megaphone and then move arrow away from icon

3. Sound File Glitches These presentations have sound files that can be heard by clicking on the megaphone in the lower right corner, when the presentations are in Slide Show mode only. However, the slide will automatically forward to the next slide, or the sound will halt, if the arrow is left on the megaphone icon, due to an unavoidable glitch. To hear sound files, please move arrow away from megaphone icon as soon as it is clicked.

4. Learning Objectives Become familiar with Capability Functions Become familiar with Tasks that complete the Functions Understand how these Functions and Tasks are measured or may be measured in the future (Performance Measures)

5. Fatality Management Fatality management is the ability to coordinate with other organizations (e.g., law enforcement, healthcare, emergency management, and medical examiner/coroner) to ensure the proper recovery, handling, identification, transportation, tracking, storage, and disposal of human remains and personal effects; to certify cause of death; and to provide access to mental/ behavioral health services to the family members, responders, and survivors of an incident. How can health departments ensure fatalities are addressed, and the families of those affected are given support?

6. Fatality Management Functions What Can Health Departments Do to Address Fatalities and Support Families? 1.Determine role for public health in fatality management 2.Activate public health fatality management operations 3.Assist in the collection and dissemination of ante-mortem data 4.Participate in survivor mental/behavioral health services 5.Participate in fatality processing and storage operations

7. Capabilities and Measures Resources The presentation will be an overview of what the functions and tasks mean, linked to the performance measures. Please note that since the capabilities PDF document has come out, more performance measures have been developed. If performance measures have come out since the creation of the capabilities document below, they have been included in these tutorials following their function slide, even if the PDF lists that there are no measures for that function. For functions that still have no measures, questions for health departments to begin thinking about measures have been included instead. For exact lists of the capabilities and performance measures, and data collected for the measures, documents can be found at these links: For Capabilities, Functions, and Tasks: http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf For Performance Measures: http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938

8. Function 1: Determine role for public health in fatality management How can health departments identify ways to assist in managing fatalities? 1.Before an incident, identify the possibilities for fatalities and the impact of those fatalities, based on risk assessment. 2.Before an incident, coordinate with subject matter experts to determine public health’s role in addressing fatalities. 3.Before an incident, coordinate with jurisdictional, private and federal organizations that cover Emergency Support Function 6 (Mass Care) and other Emergency Support Function 8 functions, such as behavioral health, to determine their roles and requirements for the response.

9. Function 1 Measurement How does CDC measure if health departments or other responsible organizations have identified their roles? Identify the following processes to define roles: What are the planning and response duties of public health and key partners? What is the legal/regulatory authority governing fatality management in the jurisdiction? What are the critical pathways/trigger points/circumstances leading to public health response actions? Sign an MOA/MOU/Mutual Aid Agreement (MAA)/contracts/letters of agreement to support fatality management activities, if requested by the fatality management lead. What legal waivers would need to be in place in order to carry out public health’s fatality management activities? Only if requested by jurisdiction’s fatality management lead : A formal written agreement for public health to support fatality management activities in the jurisdiction. A full list of data elements for this measure can be found on pgs 35-36 of PHEP Performance Measures: http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938

10. Function 2: Activate public health fatality management operations Tasks: What do health departments need to do to start fatality management operations? 1.Assess information from the incident to determine what resources are needed from public health. 2.Identify and coordinate ESF 8 resources and expertise to make recommendations regarding all phases of human remains disposition: recovery, processing (e.g., decontamination, infection control, and other mitigation measures), storing, and disposing. 3.Coordinate with appropriate partners to begin processes for human remains disposition. (Public health may have supporting role.) 4.Share information about incident details between partners and programs, based on the scope of the incident.

11. Function 2 Measurement How does the CDC measure if health departments or other responsible organizations are preparing to handle or assist in managing fatalities? There are no performance measures for this task. However to measure fatality management planning, consider the following questions: What agencies are taking the lead? What tasks do public health agencies need to complete? When do public health tasks need to be completed? What information should public health communicate with other agencies regarding the incident?

12. Function 3: Assist in the collection and dissemination of ante-mortem data Tasks: How should health departments assist in gathering and sharing ante-mortem information? 1.Coordinate with partners to establish a mechanism (e.g., Family Assistance Center) to collect ante-mortem information. 2.Coordinate with partners to identify and assemble the resources required to collect and communicate ante-mortem data. 3.Coordinate with partners to assist, if needed, in sharing ante-mortem information with families of the deceased and law enforcement officials. 4.Coordinate with partners to support electronic recording and reporting of ante- mortem data through electronic systems or other information sharing platforms.

13. Function 3 Measurement How does the CDC measure if health departments or other responsible organizations have been successful in sharing ante-mortem information? There are no performance measures for this task. However to measure completeness of information sharing, consider the following questions: Have families received needed information regarding their deceased loved ones? What partners did public health coordinate with to get that information to families? Who else received information on the deceased that needed it? Did anyone received information on the deceased who did not need it? How was the information shared?

14. Function 4: Participate in survivor mental/behavioral health services Tasks: How can health departments assist survivors in getting mental/behavioral health services? This can be a lead role, or a supporting role in finding and referring to services. 1.Coordinate with partners to assemble staff and resources for non- intrusive mental/behavioral health services to responders. 2.Coordinate with partners to provide culturally appropriate assistance (e.g., addressing language barriers and religious or cultural practices). 3.Coordinate with partners to provide mental/behavioral health services to family members of the deceased and incident survivors.

15. Function 4 Measurement How does the CDC measure if health departments or other responsible organizations have assisted in providing successful behavioral/mental health services to survivors? There is no performance measure associated with this function. However to measure the ability to provide or find services for survivors or responders, consider the following questions: What organizations does public health work with to provide mental public health assistance to responders or survivors? How many responders and survivors have received mental/behavioral health assistance who needed it? What are the characteristics of the population of survivors in terms of culture, or language needs? How many of the survivors received assistance that matched their cultural/language needs?

16. Function 5: Participate in fatality processing and storage operations Tasks: How can health departments participate or assist in processing and storage of fatalities? 1.Make recommendations to lead agency on procedures for the safe recovery, receipt, identification, decontamination, transportation, storage, and disposal of human remains. 2.Assist, if needed or requested, in multi-specialty forensic analysis to identify human remains and determine the cause and manner of death. 3.Coordinate with partners to support electronic reporting of deaths. 4.Coordinate with partners to facilitate the collection and reporting of mortality information (e.g., vital records).

17. Function 5 Measurement How does the CDC measure if health departments or other responsible organizations have assisted adequately in fatality processing and storage? There are no performance measures associated with this function from the CDC, but consider the following questions: What recommendations were made by public health for the processing and storage of remains? What was the outcome of that processing and storage? Were any forensic analyses conducted? How was information on the fatalities collected and reported? What proportion of the fatalities was reported according to national standards? How long did it take to complete reporting into vital records or other sources?

18. Questions? Please contact: Rachel Coles Program Evaluator--CDPHE 303-692-2764 rachel.coles@state.co.us