Examining Child Fatality Reviews and Cross-System Fatality Reviews

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Examining Child Fatality Reviews and Cross-System
Fatality Reviews

• David Kelly, J.D., M.A.
• Childrens Bureau
• Liz Oppenheim, J.D.
• Ying-Ying T. Yuan, Ph.D.
• Walter R. McDonald Associates, Inc.

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Examining Child Fatality Reviews and Cross-System
Fatality Reviews to Promote the Safety of
Children and Youth at Risk

• Funded by the Administration on Children, Youth
  and Families, Childrens Bureau
• 9/26/2011 through 9/25/2012

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Project Goals

• Gain an understanding of the types or
  recommendations made by fatality reviews
• Gain an understanding of the outcomes and impact
  of the recommendations
• Identify best practices for improving
• Collaboration and increased efficiency within
  and among fatality reviews
• Identification and implementation of
  cross- cutting prevention strategies

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Fatality Reviews

• Child Death Review (CDR)
• Children up to age 18
• Deaths due to accidents, homicides, suicides and
  fatalities resulting from abuse and/or neglect
• Review child deaths to better understand how
  children die and identify prevention strategies
• Citizen Review Panel-Fatality Review (CRP-FR)
• Birth to age 18
• Children involved with CPS or child welfare only
• Identify child welfare practices and policies
  that may have been a factor in the fatalities

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Fatality Reviews

• Fetal and Infant Mortality Review (FIMR)
• Children younger than one year old
• Public health strategy to identify ways to
  improve services and resources for women,
  infants, and families to prevent infant deaths
• Domestic Violence Fatality Review (DVFR)
• Review deaths of adults
• Goal is to identify issues in the service
  delivery systems that may prevent future deaths
  from domestic violence

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Project Components

• Literature Review
• Review of Recommendations and Outcomes
• Site Visits
• National Meeting

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Key Findings from Literature Review Fatality
Reviews

• All States but one have Child Death Review (CDR)
  teams
• 17 States use their CDR team as the citizen
  review panel for review of fatalities
• 200 Fetal and Infant Mortality Review (FIMR)
  programs in 40 States
• 144 Domestic Violence Fatality Review (DVFR)
  teams at the State and local level

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Key Findings from Literature Review
Inputs/Processes

• Coordination and collaboration
• Authorizing legislation
• Members
• Scope
• Information access and review
• Identification of risk factors
• Identification of prevention strategies

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Key Findings from Literature Review Outputs

• Development of recommendations
• Reporting findings
• Implementing recommendations

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Key Findings from Literature Review Impact

• Impact Reduce preventable child death rates
• Difficult to determine
• Some examples

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Key Findings from Literature Review Outcomes

• Impact
• Improved collaboration
• Increased funding
• Strengthened organizational capacity
• Improved policies/legislation
• Increased public awareness/education
• Improved service delivery

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Key Findings The National Child Death Review
Case Reporting System (NCDR-CRS)

• A majority (86.7) of the child deaths were not
  identified as CAN related deaths
• Largest categories of cause of death for CAN
  related
• 17.9 weapons related
• 12.3 asphyxia
• 11.2 drowning
• Recommendations

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Four Questions for Small Group Discussion

• Have reviews been useful for prevention? If yes,
  how have they been useful?
• Have reviews been useful in strengthening
  practice? If yes, how have they been useful?
• What types of collaboration are being utilized in
  reviewing and preventing child abuse fatalities?
• How could fatality reviews be more useful to
  child welfare, law enforcement, and the courts?

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Contact Information

• David Kelly david.kelly_at_acf.hhs.gov
• Liz Oppenheim loppenheim_at_wrma.com
• Ying-Ying T. Yuan yyyuan_at_wrma.com