Child Death Review

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Child Death Review The State of the Nation
and The CDR Case Reporting System
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• Improving our understanding
• of why children die
• And taking action to
• prevent child deaths

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Child Death Review has Evolved in past 10 years
from An Investigative Focus better identifying
child abuse fatalities
To a Prevention Focus understanding the risk
factors in all child deaths
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Purpose of CDR by State
Prevention At minimum, external causes Criminal
justice Child abuse and neglect In Transition
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The Scope of the Review

• Half review deaths to all causes.
• Five review only maltreatment deaths.
• 48 states review deaths through at least age 17,
  one state to age 15 and one state even reviews up
  to age 24 (New Mexico).
• States vary greatly on time frames for the
  review.

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Supporting Legislation

• CDR is mandated or enabled by law in 45 states.
• Eleven states in past 3 years.
• Laws usually address
• State and local team roles
• Type of deaths reviewed
• Membership on teams
• Confidentiality
• Access to Records
• Reporting
• Agency authority

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Wheres the Money in the States

• CDR has never been heavily funded, and relies on
  volunteer efforts.
• Funding ranges from a high of 850,00 to nothing.
  MCH Title V directly funds 8 programs, state
  general funds pay for 7 programs, and others find
  funds from multiple sources. Only 4 states report
  that they fund local teams.

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Models Vary

• State and Local Teams Local teams conduct
  intensive case reviews and state boards review
  findings of local teams and/or review cases. (37)
• State-only teams conduct case reviews of selected
  cases. (12)
• Local teams review cases independently without
  any state-supported program or board. (2) Three
  years ago 7 states had no state-level support.

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The Objectives of Child Death Review

• Accurate identification and uniform reporting on
  every child death.
• Improved investigative systems.
• Improved services for families and community.
• Improved communication and linkages among
  agencies.
• Understanding of risk and protective factors in
  child deaths.
• Changes in legislation, policy and practice, to
  prevent deaths and improve child health and
  safety.

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Uncovering the Layers
The Death Event
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Team Members

• Coroner
• Law Enforcement
• Social Services
• EMS
• Public Health
• DA/PA
• Education
• Health care

• Fire
• Juvenile Court
• Mental Health
• Advocates
• Ad hoc
• Child Advocates
• Clergy
• Funeral Home

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State Actions

• Sate suicide Prevention Plan
• Strengthened graduated licensing
• 1 million trigger locks purchased and distributed
  by state police.
• Truck bed legislation.
• Safe Sleep funding and campaign.
• Major policy and practice changes at CPS.
• New birth match project.
• Abandoned new born program

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Reports of Findings

• Forty one states have a case report tool, 17
  states have legislation that requires a report.
• 33 states publish an annual report with findings
  and recommendations.

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How do States Use their CDR Data?

• Local teams present findings to community groups
  and to push for local interventions.
• State teams review local findings to identify
  trends, major risk factors and to develop
  recommendations.
• Teams use data as a quality assurance tool for
  their reviews.
• State teams use findings to develop action plans
  based on their recommendations.
• National groups use state and local CDR findings
  to advocate for national policy and practice
  changes.
• Local teams and states use their reports to keep
  or increase CDR funding!!!

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Child Death Review Case Reporting System
30 person work group of 18 states over two years,
chaired by Neil Maniar of Massachusetts Analyzed
32 state case report forms. Developed standard
data elements, data dictionary and 32
standardized reports. Software developed by
Michigan Public Health Institute Project funded
by Maternal and Child Health Bureau, HRSA, HHS
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Standardized Reports National Center Level
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States Under Consideration for the Pilot
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The Center for Child Death Review is a program
of the Michigan Public Health Institute For more
information, call 1-800-656-2434.
www.childdeathreview.org
The Center for Child Death Review is supported in
part by Grant No. 1 U93 MC 00225-01 from the
Maternal and Child Health Bureau (Title V, Social
Security Act), Health Resources and Services
Administration, Department of Health and Human
Services.