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Family Reunification and Support
Topic Collection
July 29, 2019

Topic Collection: Family Reunification and Support

Disasters can strike at any time, forcing many families and friends to be separated from their loved ones or displaced for long periods of time. Tracking and reunification is a key aspect of disaster management and recovery, but also one of the most challenging. The guidance documents, case studies, templates, and systems outlined in this Collection will help health and medical providers better understand their role in family reunification and support. Healthcare preparedness planners can utilize existing systems and concepts traditionally used by other response agencies and reunification agencies.

Please note: Pediatric and family resources are considered integrated, therefore, there is no separate sub-category in this Topic Collection specific to children/ pediatrics.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

Must Reads


This ASPR TRACIE tip sheet highlights best practices and issues related to planning for, activating, and operating hospital or healthcare facility Family Information Centers (FIC)/ Family Support Centers (FSC), in collaboration with Family Reception Centers (FRC) and Family Assistance Centers (FAC).
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This webinar transcript (webinar video is no longer available online) describes the presentation made by representatives from FEMA, the U.S. Department of Health and Human Services, the U.S. Department of Justice, the National Center for Missing and Exploited Children, the District of Columbia and a state and local emergency manager from the state of Connecticut. The presentation focused on different types of reunification systems available and strategies for integrating these procedures and protocols into your jurisdiction’s emergency plans.
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Federal Emergency Management Agency (FEMA), U.S. Department of Health and Human Services (HHS), American Red Cross (ARC), and National Center for Missing and Exploited Children (NCMEC). (2013). Post-Disaster Reunification of Children: A Nationwide Approach.
This guidance document provides a comprehensive overview of the coordination processes necessary to reunify children separated from their parents/legal guardians in the event of a large-scale disaster and reflects how the whole community - to include educational, child care, medical, and juvenile justice facilities, nongovernmental organizations, state, local and federal partners, voluntary and faith based organizations, disability and pediatric experts, and private sector partners can work together to achieve one wide ranging mission. This document can assist in developing new, or apply to existing, emergency preparedness plans and/or reunification procedures.
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Kimmer, S., Altman, B., Strauss-Riggs, K. (2013). Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals. Uniformed Services University of the Health Sciences, National Center for Disaster Medicine and Public Health (NCDMPH).
This free, online, self-paced training course uses three case studies (tornado, earthquake, and wildfires) to discuss the key tasks for tracking and reunification of children in disaster, identify designated individuals or agencies to assist in tracking and reunification, and access information on key tasks and contacts. The course length is approximately one-hour and is accredited for Continuing Education credit. There is also guidance available for those that want to use the lesson for in-person training.
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Shields, S., Wilson, M., Amara, R., et al. (2013). Family Information Center Planning Guide for Healthcare Entities. Los Angeles County Emergency Medical Services Agency (EMS).
This guide for healthcare providers describes the elements to develop a Family Information Center (FIC) plan, which includes providing information, support services, and reunification assistance to families of disaster patients. This guide includes activation, management, and demobilization of a FIC, in addition to example forms, diagrams, and needed resources.
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Family Assistance Centers (FAC)


This ASPR TRACIE tip sheet highlights best practices and issues related to planning for, activating, and operating hospital or healthcare facility Family Information Centers (FIC)/ Family Support Centers (FSC), in collaboration with Family Reception Centers (FRC) and Family Assistance Centers (FAC).
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This plan includes the Family Assistance Center Concept of Operations and protocols for Chatham Emergency Management Agency (Georgia). It addresses roles and responsibilities of the multiple response agencies.
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Government of the District of Columbia. (n.d.). District of Columbia Family Assistance Center (FAC) Plan. (Accessed 9/27/2017.)
This plan--though specific to the District of Columbia--can serve as a mode for others interested in planning to establish a Family Assistance Center after a mass fatality event to provide services to those seeking assistance regarding the status of their loved ones.
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* Los Angeles County Office of Emergency Management and Los Angeles County Department of Mental Health. (2014). Los Angeles County Operational Area Family Assistance Center Plan (Contact ASPR TRACIE to access this file.).
This plan provides a framework for the activation, operation, management, and demobilization of a County Operational Area (government led) Family Assistance Center (FAC) during large scale mass casualty incidents (e.g., earthquakes) and local incidents such as shootings and explosions. The establishment of a FAC can: ensure a place for loved ones to gather information; serve as a coordination spot for first responders; and be a location where emotional support and other types of health support can be provided. (The Los Angeles County Operational Area covers all 88 cities and the unincorporated areas in the county).
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* Louisiana Department of Health and Hospitals (2006). Reuniting the Families of Rita and Katrina: Louisiana Family Assistance Center.
This report documents key missions of the Louisiana Family Assistance Center after Hurricanes Rita and Katrina. They provide background on their tasks, challenges, statistics of families supported, and lessons learned. The center was open for 11 months and had 13,197 missing reports filed, 99% of the missing list cleared, and 98% of the human remains have been identified.
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Maine Disaster Behavioral Health. (2014). Family Assistance Center SOP.
This plan includes the Family Assistance Center protocols for Maine Disaster Behavioral Health. It addresses roles and responsibilities of the multiple response agencies, and core and support services.
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U.S. Department of Justice, Federal Bureau of Investigation; and National Transportation Safety Board. (n.d.). Mass Fatality Incident: Family Assistance Operations. Recommended Strategies for Local and State Agencies. (Accessed 9/27/2017.)
This guide was developed for local and state agencies involved in the response to mass fatality events. It provides an overview of the family assistance process and the FAC operations as they relate to transportation and criminal incidents.
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Virginia Department of Emergency Management. (2012). Commonwealth of Virginia Family Assistance Center Plan.
This plan provides state agencies (within Virginia) with the management framework under which they will cooperate to establish, operate, and close a FAC. The FAC core and support services are addressed.
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This plan provides a framework to facilitate multi-county, regional coordination of situational awareness and response related information for the purpose of determining when a Family Assistance Center (FAC) is needed after a catastrophic incident. It includes several tools (e.g., checklists, templates, and job action sheets) that may be used for planning or response to implement a FAC.
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General Resources


Missing Persons Community of Interest (n.d.). Missing Persons Community of Interest (MPCI) Documents. (Accessed 6/1/15.)
An online forum for professionals and interested persons dealing with missing persons related issues to dialogue; share education and training opportunities; post resources; foster policy and community standards development to accelerate the incorporation of lessons learned; share emerging technologies; and improve how missing persons information is collected, managed, and acted upon. The Documents page lists various MCPI developed documents as well as resources from member organizations.
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National Center for Missing and Exploited Children (NCMEC) (2016). Team Adam.
A program of specially-trained retired law enforcement professionals from the federal, state and local levels. In addition providing technical assistance to law enforcement agencies and families in serious cases of missing children, they also provide support to emergency management agencies, hospitals, and public health agencies in the event that children become separated from their families due to disaster.
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Guidance Documents


* Coyote Crisis Collaborative. (2019). Documents (Reunification and Hospital Reception Site).
This webpage includes links to the following documents designed to help staff draft plans related to emergency call management and reunification after a disaster/ mass casualty incident: Emergency Call Center Planning (2016); Family Reunification Center Planning Guide (2017); and Hospital Reception Site Planning Guide (2019).
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Division for At-Risk Individuals, Behavioral Health, and Community Resilience (ABC). (2017). The Role of Healthcare Providers in Combating Human Trafficking during Disasters. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response.
The materials on this webpage can be used by disaster responders and health professionals: understand the relationship between human trafficking and disasters; recognize signs of human trafficking; identify the resources that exist for further training on this topic; and determine next steps if human trafficking is suspected.
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* Federal Emergency Management Agency (FEMA), U.S. Department of Health and Human Services (HHS), American Red Cross (ARC), and National Center for Missing and Exploited Children (NCMEC). (2013). Post-Disaster Reunification of Children: A Nationwide Approach.
This guidance document provides a comprehensive overview of the coordination processes necessary to reunify children separated from their parents/legal guardians in the event of a large-scale disaster and reflects how the whole community - to include educational, child care, medical, and juvenile justice facilities, nongovernmental organizations, state, local and federal partners, voluntary and faith based organizations, disability and pediatric experts, and private sector partners can work together to achieve one wide ranging mission. This document can assist in developing new, or apply to existing, emergency preparedness plans and/or reunification procedures.
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Gubbins, N. and Kaziny, B. (2018). The Importance of Family Reunification in Pediatric Disaster Planning. Clinical Pediatric Emergency Medicine. 19 (3): 252-259.
This article briefly reviews the status of pediatric disaster planning; resources to support pediatric disaster planning; and essential components of a family reunification plan, with a focus on children’s needs.
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Nager, Alan. (2009). Family Reunification- Concepts and Challenges. Clinical Pediatric Emergency Medicine, 10(3): 195-207.
Author outlines key family reunification considerations during disaster planning and response. He discusses the challenges and solutions in the following areas: practice and planning, clinical services, ancillary support, transportation and accommodations, communication and identification, and psychological support.
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Reidenberg, J., Gellman, R., Debelak, J., et al. (2013). Privacy and Missing Persons after Natural Disasters. Center on Law and Information Policy, Fordham University School of Law and the Woodrow Wilson International Center for Scholars.
The authors identifies key legal and policy issues surrounding privacy and missing persons following a disaster, and highlights current missing persons information sharing activities during disasters. The authors recommend a set of options and strategies that organizations and policy makers can pursue to address some of the privacy concerns.
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* Shields, S., Wilson, M., Amara, R., et al. (2013). Family Information Center Planning Guide for Healthcare Entities. Los Angeles County Emergency Medical Services Agency (EMS).
This guide for healthcare providers describes the elements to develop a Family Information Center (FIC) plan, which includes providing information, support services, and reunification assistance to families of disaster patients. This guide includes activation, management, and demobilization of a FIC, in addition to example forms, diagrams, and needed resources.
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Lessons Learned /Case Studies


This ASPR TRACIE tip sheet highlights best practices and issues related to planning for, activating, and operating hospital or healthcare facility Family Information Centers (FIC)/ Family Support Centers (FSC), in collaboration with Family Reception Centers (FRC) and Family Assistance Centers (FAC).
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Barthel, ER., Pierce, JR., Speer, AL., et al. (2013). Delayed Family Reunification of Pediatric Disaster Survivors Increases Mortality and Inpatient Hospital Costs: A Simulation Study. (Abstract Only.) Journal of Surgical Research, 184(1), 430-437.
The authors used a mathematical simulation to examine how a delay in admitting and discharging pediatric cohort affects mortality and the cost of inpatient care. The authors note that children are often transported to specialty centers after disasters which leads to separation from the families. The results of the simulation argue for improvement in identification technology and logistics for rapid reunification of pediatric survivors with their families.
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Blake, N., Stevenson, K. (2009). Reunification: Keeping Families Together in Crisis. (Abstract Only.) Journal of Trauma-Injury Infection & Critical Care, 67(2): 147-151.
This article addresses the lack of a plan or system for reunifying families after a disaster. Particular attention was paid to children's psychosocial well-being, the lack of interoperable tracking systems and transporting patients and children, especially across state lines.
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This article highlights the efforts made by NCMEC post-Katrina to reunify children and their families. Both Project ALERT and Team Adam were utilized along with the help of private organizations.
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This article includes excerpts to the President from internally displaced children regarding what they expect to be done within the government that will allow them to be reunified with their families. It also lists ways to prepare for future disasters that will prevent families being split up due to a disaster.
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* Louisiana Department of Health and Hospitals (2006). Reuniting the Families of Rita and Katrina: Louisiana Family Assistance Center.
This report documents key missions of the Louisiana Family Assistance Center after Hurricanes Rita and Katrina. They provide background on their tasks, challenges, statistics of families supported, and lessons learned. The center was open for 11 months and had 13,197 missing reports filed, 99% of the missing list cleared, and 98% of the human remains have been identified.
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Plans, Tools, and Templates


American Academy of Pediatrics, in collaboration with Massachusetts General Hospital, Center for Disaster Medicine. (2018). Family Reunification Following Disasters: A Planning Tool for Health Care Facilities.
This planning tool was created to assist hospitals with their plans to provide information, support services, and safe reunification assistance to family members of patients who have experienced disasters. It provides potential solutions to reunification-related challenges, including: planning for the secure reception, tracking, and care of large numbers of children who may present to a hospital following a mass-casualty event; identifying injured and unaccompanied children in a disaster; tracking unaccompanied children during their hospital stay; and what legal authority a hospital has to administer care to minors when the parent/guardian is unavailable to participate in the informed consent process.
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This ASPR TRACIE tip sheet highlights best practices and issues related to planning for, activating, and operating hospital or healthcare facility Family Information Centers (FIC)/ Family Support Centers (FSC), in collaboration with Family Reception Centers (FRC) and Family Assistance Centers (FAC).
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Chung, S., Christoudias, C.M., Darrell, T., et al. (2012). A Novel Image-based Tool to Reunite Children With Their Families After Disasters. Academic Emergency Medicine, 19(11): 1227-1234.
This article reports the findings of tests completed to determine the accuracy of various child identification tools. One tool, “Feature-Attribute-Matching,” extracts facial features from photographs to be matched with a parent's description of their child. The other tool, "User-Feedback," allows parents to choose photographs resembling their child which then reprioritizes the images in the database.
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* Coyote Crisis Collaborative. (2019). Documents (Reunification and Hospital Reception Site).
This webpage includes links to the following documents designed to help staff draft plans related to emergency call management and reunification after a disaster/ mass casualty incident: Emergency Call Center Planning (2016); Family Reunification Center Planning Guide (2017); and Hospital Reception Site Planning Guide (2019).
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* Federal Emergency Management Agency (FEMA), U.S. Department of Health and Human Services (HHS), American Red Cross (ARC), and National Center for Missing and Exploited Children (NCMEC). (2013). Post-Disaster Reunification of Children: A Nationwide Approach.
This guidance document provides a comprehensive overview of the coordination processes necessary to reunify children separated from their parents/legal guardians in the event of a large-scale disaster and reflects how the whole community - to include educational, child care, medical, and juvenile justice facilities, nongovernmental organizations, state, local and federal partners, voluntary and faith based organizations, disability and pediatric experts, and private sector partners can work together to achieve one wide ranging mission. This document can assist in developing new, or apply to existing, emergency preparedness plans and/or reunification procedures.
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* Los Angeles County Office of Emergency Management and Los Angeles County Department of Mental Health. (2014). Los Angeles County Operational Area Family Assistance Center Plan (Contact ASPR TRACIE to access this file.).
This plan provides a framework for the activation, operation, management, and demobilization of a County Operational Area (government led) Family Assistance Center (FAC) during large scale mass casualty incidents (e.g., earthquakes) and local incidents such as shootings and explosions. The establishment of a FAC can: ensure a place for loved ones to gather information; serve as a coordination spot for first responders; and be a location where emotional support and other types of health support can be provided. (The Los Angeles County Operational Area covers all 88 cities and the unincorporated areas in the county).
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This white paper can help healthcare facility emergency planners plan for and better support non-resident/foreign patients in general and after a mass casualty/mass fatality incident.
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* Pate, B. (2008). Identifying and Tracking Disaster Victims: State-of-the-Art Technology Review. (Abstract Only.) Journal of Family & Community Health, 31(1): 23-34.
An analysis of various tracking systems to use in times of disaster and their limitations in terms of scalability.
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* Shields, S., Wilson, M., Amara, R., et al. (2013). Family Information Center Planning Guide for Healthcare Entities. Los Angeles County Emergency Medical Services Agency (EMS).
This guide for healthcare providers describes the elements to develop a Family Information Center (FIC) plan, which includes providing information, support services, and reunification assistance to families of disaster patients. This guide includes activation, management, and demobilization of a FIC, in addition to example forms, diagrams, and needed resources.
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Tamer, Hadi. NYC Department of Health and Mental Hygiene, Office of Emergency Preparedness and Response. (2015). Using Health Information Exchange for Family Reunification. 2015 Annual Public Health Preparedness Summit.
This presentation given at the 2015 Annual Public Health Preparedness Summit, gives an overview of existing family reunification systems, why the New York City Emergency Patient Search (NYCEPS) workgroup recommended to leverage Health Information Exchanges (HIE), and how NYCEPS was developed. Also includes legal and privacy considerations for hospitals and healthcare facilities.
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Western Region Homeland Security Advisory Council. (2017). Children in Disasters Emergency Preparedness: Family Reunification Plan Template.
This template can be used by any organization (e.g., hospitals, educational institutions, and day care centers) to develop a family reunification plan. It addresses information on topics including reunification protocols, legal authorities, terminology, methods of reunification, and coordination of efforts with key stakeholders.
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Reunification Systems


American Red Cross (n.d.). Safe and Well. (Accessed 3/23/2017.)
This web-based system maintained by the American Red Cross allows users to list themselves as safe and well, and to search for family and friends that have registered as safe and well.
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Federal Emergency Management Agency (FEMA) (n.d.). National Emergency Registry and Locator System (NEFRLS). (Accessed 6/1/15.)
This secure, online systems provides a platform for survivors and loved ones to communicate their location and leave messages. It provides the following options for users: I am Displaced, Search for a Displaced Person, Report/ Search for a Missing Child, and I want to Register/ Search by Telephone.
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National Center for Missing and Exploited Children (NCMEC) (n.d.). National Emergency Child Locator Center. (Accessed 3/23/2017.)
This dedicated call center operated by the National Center for Missing and Exploited Children (NCMEC) can be activated at the request of a disaster-impacted state to intake child-related reunification calls, to alleviate some of the call load from the impacted state’s emergency communications systems, and to coordinate tips and leads with on-the-ground reunification efforts. The NECLC has the capacity to expand or relocate to back-up sites.
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National Center for Missing and Exploited Children (NCMEC) (n.d.). Unaccompanied Minors Registry. (Accessed 4/19/2018.)
This data collection tool is focused on collecting basic information of children who have been separated from their families as a result of a disaster. Individuals can provide basic information and photos concerning a located child whose parents are missing. Once registration information is submitted, NCMEC will cross-reference it against any potential phone calls from a child’s parents who may be searching for their child.
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* Pate, B. (2008). Identifying and Tracking Disaster Victims: State-of-the-Art Technology Review. (Abstract Only.) Journal of Family & Community Health, 31(1): 23-34.
An analysis of various tracking systems to use in times of disaster and their limitations in terms of scalability.
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Thoma, G., Antani, S., Gill, M., et al. (2012). People Locator: A System for Family Reunification. (Abstract Only.) IT Professional. 14(3): 13-21.
An overview of a reunification system called People Locator created by the National Library of Medicine. This database has various connection options such as submitting person information via email, using a web page, or using the mobile application ReUnite. At this time the database uses photos and metadata (age, gender and name) to support reunification.
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Trainings/Webinars


This webinar transcript (webinar video is no longer available online) describes the presentation made by representatives from FEMA, the U.S. Department of Health and Human Services, the U.S. Department of Justice, the National Center for Missing and Exploited Children, the District of Columbia and a state and local emergency manager from the state of Connecticut. The presentation focused on different types of reunification systems available and strategies for integrating these procedures and protocols into your jurisdiction’s emergency plans.
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Kimmer, S., Altman, B., Strauss-Riggs, K. (2013). Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals. Uniformed Services University of the Health Sciences, National Center for Disaster Medicine and Public Health (NCDMPH).
This free, online, self-paced training course uses three case studies (tornado, earthquake, and wildfires) to discuss the key tasks for tracking and reunification of children in disaster, identify designated individuals or agencies to assist in tracking and reunification, and access information on key tasks and contacts. The course length is approximately one-hour and is accredited for Continuing Education credit. There is also guidance available for those that want to use the lesson for in-person training.
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Agencies and Organizations


National Mass Care Strategy Reunification.
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