Powerful Harris County Institute of Forensic Sciences Connections - PDF document

75TH ANNUAL JPs/Clerks Class: Mass Justices of the Peace Fatality Response in and Constables Texas Association Education Conference Isla Grand Beach Resort South Padre Island June 24-28, 2019 Wednesday, June 26, 2019 3:15–4 p.m Ms. Allison C. Reese, Manager of Emergency Management Powerful Harris County Institute of Forensic Sciences Connections This session will address mass fatality response operational objectives and the support available through the Texas Mass Fatality Operations Response Team.

Allison C. Reese, Manager of Emergency Management, Harris County Institute of Forensic Scientists, Houston Allison C. Reese serves as manager of Emergency Management at the Harris County Institute of Forensic Sciences. She manages the Institute’s emergency preparedness and response program for internal operations as well as coordination with external partner agencies, which includes fatality management, continuity of operations, severe weather response and other plans. Reese is also responsible for regional mass fatality management education and collaboration, including coordinating the nationwide Mass Fatality Management Symposium in Houston and numerous other workshops and conferences. Reese is a founding member of the Texas Mass Fatality Operations Team (TMORT) Steering Committee, a member of the Texas Medical Incident Support Team and executive secretary for the Organization of Scientific Area Committee Disaster Victim Identification Subcommittee. In 2014, Reese earned her certification as a Master Exercise Practitioner (MEP) from FEMA’s Emergency Management Institute.

Texas Emergency Medical Task Force Component Overview The TX EMTF Program is a series of components that activate resources on behalf of Texas on a State Mission Assignment [SMA] that provides a custom, scalable approach to medical disaster response. The key to the program is the ability to activate our members from EMS & fire departments, public and private healthcare organizations, regional coalitions, & state and local government who provide personnel & assets that activate during disasters. •Medical Incident Mgmt. •Public Safety Logistics •Custom Multi-Patient Personnel Augmenting Subject Matter Experts in Vehicles with a Transport Operations Centers &/ Staging Large Numbers of Capability of 20+ Patients Command Posts Assets •Care & Mass Trasport / •Subject Matter Experts & •Manges the Staging Site, Evacuation of Injured / Ill Leaders in the ESF-8, Mobilization, & Tracking of •REHAB / Force Protection Health & Medical Arena Activated ESF-8 for Responders Resources Medical Ambulance Incident Support Staging Mgmt. AMBUS Team Team •Teams of 5 Ambulances •Teams of 5 Nurses with a •Temporary Healthcare with a Strike Team Leader Strike Team Leader Infrastructure that Rapidly Deploys & Provides High •Supplemental Medical •Augment Nursing Staff Quality Patient Care in Transport of Large-Scale Shortages in Disasters that the Field Patient Movement are Specialty Specific Missions (ED, ICU, Burn, etc.) •Deployable Emergency Room with Scalable Teams & Assets Registered Ambulance Mobile Medical Nurse Strike Unit Strike Team Team •Provide Assistance with •Deployable Pre-Hospital •Teams of 5 Air Site, Morgue, Victim & Hospital Teams Ambulances with a Strike iIdentification & Capable of Caring for &/ Team Leader Information Center Transporting a HCID •Supplemental Medical Operations to Patient Transport for Critical and Medicolegal Authorities in •PPE Caches Pre- Large-Scale Patient a Mass Fatality Incident Positioned Across the Movement Missions State Mass Fatality Infectious Air Medical Operations Disease Strike Team Response Team Response Unit For more information, visit www.TXEMTF.org •Tactical Medic Support or contact your Regional Coordinator: for Large-Scale / Complex-Coordinated EMTF 1: www.PanhandleRAC.com Terror Incidents EMTF 2: www.NCTTRAC.org •Specialized Teams of 2 Paramedics / APPs / EMTF 4: www.RAC-G.org Physicians & an ALS / MICU Ambulance EMTF 6: www.SETRAC.org EMTF 7: www.CATRAC.org Tactical Medic EMTF 8: www.STRAC.org Support Unit EMTF 9: www.BorderRAC.org EMTF 11: www.CBRAC.org State Coordinating Office: www.TXEMTF.org

Texas Emergency Medical Task Force Component Overview MISSION Provide operational assistance to medicolegal authorities § with incident site, deployable morgue, victim identification center, & victim information center operations following a mass fatality incident that overwhelms a local jurisdiction. CAPABILITIES Available statewide as an activated, 24/7 response asset § TMORT is composed of [4] teams that can deploy independently § or all at once on behalf of the State: § Incident Site Team (IST) : Conduct scene investigations to locate, document, & recover human remains & personal effects. Staffing: Human Remains Recovery, Mapping, & Evidence Tracking Specialists Personnel / Asset Counts Morgue Operations Team (MOT) : Conduct disaster morgue operations § Staffing & asset profiles are to examine human remains. Staffing: Admitting, Triage, Storage, typing dependent. Each team Personal Effects, Photographers, Radiographers, Pathologists, Autopsy has [4] scaled teams typed. Assistants, Dentists, Anthropologists, DNA & Fingerprint Specialists, & Exit Type I Teams: Review. [Disaster Portable Morgue Unit is maintained by SETRAC in Houston] IST: [25] Personnel / [8-14] Assets Identification Review Team (IRT): Compares antemortem & postmortem § MOT: [41] Personnel / [8-13] Assets data to identify human remains. Staffing: Dependent on the ID methods IRT: [7] Personnel / [2-3] Assets used, & could include Anthropologists, DNA Scientists, Fingerprint Analysts, Pathologists, Odontologists, &/or Death Investigators. VICT: [29] Personnel / [6-7] Assets Victim Information Center Team (VICT): Conducts family interviews, § Type II Teams: gathers antemortem data, & collects DNA samples. Staffing: Family IST: [17] Personnel / [7-13] Assets Interviewers, Records Collection & Management, Personal Effects, & MOT: [28] Personnel / [7-11] Assets DNA Reference Collectors. IRT: [5] Personnel / [2-3] Assets TMORT will collaborate with jurisdictions in the set-up of Family § Assistance Centers [FAC] however, FAC staffing & operations are the VICT: [16] Personnel / [4-5] Assets jurisdiction’s responsibility. Type III Teams: Medical examiners’ offices, academic institutions, & private § IST: [15] Personnel / [4-9] Assets entities provide the deployable team members for the TMORT. MOT: [21] Personnel / [5-9] Assets TYPING IRT: [5] Personnel / [2-3] Assets VICT: [10] Personnel / [2-4] Assets Matrix for determining TMORT team requests: § [scaled & typed by fatality count & incident variables] Type IV Teams: all teams [1-2] Personnel / [1] Asset Multiple Type I Type I Type II Type II Locations Type I Type I Type II Type III Contaminated Type I Type I Type II Type III Charred Fragmented, Type I Type I Type II Type IV Commingled Intact, Visually Type I Type II Type III Type IV Recognizable Est. 100 Est. 50 Est. 25 Est. 10 fatalities fatalities fatalities fatalities §

TEXAS DEATH INVESTIGATION SYSTEM • No state medical examiner • 254 counties • 13 Medical Examiner Offices serve 16 counties • 4 private forensic pathology service companies • 600+ Justices of the Peace • Variation in resources, capabilities, training, funding, etc 1

MASS FATALITY INCIDENTS: 2000-2018 1-300 301-700 701-1000 Total Incidents: 3,707 1001-2000 Total Fatalities: 23,964 >2000 Avg. Deaths/MFI: 6.5 MASS SHOOTINGS: 2000-2019 2

TEXAS MASS FATALITY INCIDENTS: 2000-2018 Total Incidents: 106 Total Fatalities: 600 Avg. Deaths/MFI: 5.7 WHY TMORT? 3

TMORT Limited local capabilities Best Practices EMERGENCY MEDICAL TASK FORCE • Statewide system supported by the TX Department of State Health Services • Comprised of local agencies with Memorandums of Agreement to provide staff when requested (can decline) • State missions begin with the authority having jurisdiction requesting TX EMTF assets through the standard Emergency Management resource requesting process • Sponsoring entities are reimbursed for vehicles, equipment, and personnel when deployed as a state mission assignment 4

EMERGENCY MEDICAL TASK FORCE Ambulance Medical Incident Mobile Medical Staging Mgmt AMBUS Support Team Unit Team Registered Mass Fatality Infectious Ambulance Nurse Strike Operations Disease Strike Team Team Response Team Response Unit Air Medical Tactical Medic Strike Team Support Unit TMORT MEMBERS ( A S O F J U N E 2 0 1 9 ) 5

TMORT COMPONENTS Morgue Incident Site Operations Team Team Victim Identification Information Review Team Center Team INCIDENT SITE TEAM OPERATIONS TEAM ROLES • Scene documentation (including mapping • Site Supervisor and photography) • Evidence Tracking Specialists • Decedent numbering system • Mapping Specialists • Search and recovery of human remains • Human Remains Recovery Specialists • Collection of associated personal effects • Evidence inventory maintenance • On scene coordination with investigating agencies 6