Meeting of the North Carolina Child Fatality Task Force ...

Meeting of theNorth Carolina Child Fatality Task Force

September 20, 2021

Roll Call Attendance & Approval of Minutes

Minutes from last meeting on 1-11-21 have been posted on the CFTF website, the link has been sent out and is also linked to on your agenda.

NC DHHS COVID – 19 Response

COVID-19 and Children

Elizabeth Cuervo Tilson, MD, MPHState Health DirectorChief Medical Officer

Child Fatality Task ForceSeptember 20, 2021

4North Carolina Department of Health and Human Services

Four Key Metrics – All Quickly Rising

Source: https://covid19.ncdhhs.gov/dashboard

What Percentage of ED Visits this Season are for COVID-like Illness Compared to Previous Seasons?

Daily Cases by Date Reported

Daily Number of People Currently Hospitalized

Positive Tests as a Percent of Total Tests

https://covid19.ncdhhs.gov/dashboard

Case Rates Increasing Statewide

https://covid.cdc.gov/covid-data-tracker/#county-view


Delta variant is the most common variant in NC

Spreads easily because it's highly contagious

Children age 0-17 years have highest case rates for first time in pandemic

Case Rates Declining, but

COVID Cases per 100K Population by Age Group and Report Date

High school and middle school highest among school aged children

Case Rates Highest for School Aged Children

PCR Test Positivity Highest in ChildrenTest positivity rates have plateaued in recent weeks

across most age groups; remain highest for children.

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Perc

ent o

f ED

Visit

s for

CLI

Week Ending Date

Percent of NC ED Visits for COVID-Like-Illness (Not Flu) Within Each Age Group by Week

0-18 19-24 25-44 45-64 65+Source: NC DETECTGenerated: 09/13/21

Pediatric Hospitalizations in Southeastern United States

https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions


Multi-System Inflammatory Syndrome in Children (MIS0C)

https://covid19.ncdhhs.gov/dashboard/cli-surveillance

Children can transmit to others – including adults at higher risk – Teachers, staff, family members

Record Number of Cases in K12 Clusters

0100200300400500600700800

Cas

es

Week of Illness Identification

Cases Linked with Any Educational ClusterChild Care Camp K12 School College/University

Since June 2020, there have been 462 K-12 clusters

– 362 at public schools – 100 at private schools

There are currently 192 active clusters – 178 at public schools – 14 at private schools

In total, there are 4,277 cases associated with all K-12 clusters

– 3,387 cases among students – 890 cases among staff– 3,194 cases at public schools – 1,083 cases at private schools

K-12 Cluster Metrics

14

MULTI-LAYERED PROTECTION CAN GREATLY REDUCE RISK OF SPREAD

Vaccines are Working

People who are fully vaccinated are 3.96 times less likely to be get COVID-19 and more than 13 times less likely to die from COVID-19.

Age-Adjusted Case and Mortality Rates in Vaccinated vs. Unvaccinated PopulationsCases Deaths

Attack Rate Ratio (week ending 8/28): 3.96 Death Rate Ratio (week ending 8/28): 13.47

0

200

400

600

Atta

ck R

ate

per 1

00,0

00

Week End Date

Age Adjusted Attack Rate in Unvaccinated Age Adjusted Attack Rate in Vaccinated

Data in shaded area may be

incomplete

Data in shaded area may be

incomplete

0

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Deat

h Ra

te p

er 1

00,0

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Week End Date

Age Adjusted Death Rate in Vaccinated Age Adjusted Death Rate in Unvaccinated

16

VACCINATION STATUS BY AGE

https://covid19.ncdhhs.gov/dashboard/vaccinations

0-12 years – 0%

Not currently eligible for vaccination

Q & A

NC DHHS COVID – 19 Response 27

Science Brief: Transmission of SARS-CoV-2 in K-12 Schools and Early Care and Education Programs – Updated

https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/transmission_k_12_schools.html

NCDHHS Division of Public Health| Safe States Annual Conf| September 10, 2020 19

NC Department of Health and Human Services

Injury Surveillance Update

Child Fatality Task Force

Shana Geary, MPHNC Division of Public HealthSeptember 20, 2021

NCDHHS, Division of Public Health | CFTF Injury Surveillance Update | September 20, 2021 20

Outline

• Overall Child (ages 0-17) Injury Trends• Child Injury Deaths and ED visits by injury type

• Motor vehicle traffic (MVT) injuries• Firearm • Self-inflicted/Suicide• Unintentional medication/drug overdose• Child maltreatment


Overall Injury Trends


There were 319 child injury deaths in 2020*, a 15% increase from 2019 (n=277).

*2020 Provisional Data as of 9/1/2021; Data limited to North Carolina residents ages 0-17 Source: NC State Center for Health Statistics Death Certificate Data, 2019-2020

05

1015202530354045

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Number of Child Deaths 2019 2020*

Note: 2020 data are provisional

Total Child Injury Deaths: 2019 n=277; 2020 n=319


63

64

34

31

18

21

15

8

65

Child firearm deaths almost doubled in 2020*. Motor vehicle traffic (MVT) deaths decreased.

83

36

35

15

25

18

8

10

47

MVT - Unintentional

Firearm - Assault

Suffocation - Unintentional

Firearm - Self-Inflicted

Drowning - Unintentional

Suffocation - Self-Inflicted

Poisoning - Unintentional

Unspecified - Assault

Other

2019 2020*


Total Child Injury Deaths: 2019 n=277; 2020 n=319


NC experienced a 18% decrease in overall ED visits between 2019 and 2020

Note: Provisional 2020 and 2021 data as of 9/13/2021, limited to NC residentsWeeks begin at 01/01 and end at 12/30 for 2019 and 12/29 for 2020

Source: NC DETECT ED Visits, 2019-2021

There are known data quality gaps for May-June 2021 that are impacting the shown trends. Interpret the data for these months with caution


There was a 31% decrease in injury ED visits among children (0-17) between 2019-2020.

Note: Provisional 2020 and 2021 data as of 9/13/2021, limited to NC residents ages 0-17Weeks begin at 01/01 and end at 12/30 for 2019 and 12/29 for 2020

Source: NC DETECT ED Visits, 2019-2021

Total Child Injury ED Visits: 2019 n=191,531; 2020 n=132,937

There are known data quality gaps for May-June 2021 that are impacting the shown trends. Interpret the data for these months with caution


40,292

17,518

18,902

16,530

11,428

5,998

6,084

3,149

26,219

Fall - Unintentional

MVT - Unintentional

Struck By/Against - Unintentional

Unspecified - Unintentional

Natural/Environmental - Unintentional

Cut/Pierce - Unintentional

Overexertion - Unintentional

Poisoning - Unintentional

Other

The number of child injury ED visits decreased across all injury categories in 2020.

2019 Child Injury ED Visits 2020* Child Injury ED Visits

*2020 Provisional Data as of 9/1/2021; Data limited to North Carolina residents ages 0-17 Source: NC DETECT ED Visit Data, 2019-2020

26,427

12,457

10,062

9,621

7,613

4,891

3,370

2,667

21,679

Total Child Injury ED Visits: 2019 n=191,531; 2020 n=132,937


MVT Injuries


Child MVT Deaths decreased by 32% in 2020.


Total Child MVT Deaths: 2019 n=83; 2020 n=63

14 1417

3841 42

1013

7

32

23

40

0-4 5-9 10-14 15-17 Female Male

2019 2020

Number of child MVT deaths by age and sex

Most deaths were among children ages 15-17 and males.


Most MVT deaths were among white children. The Hispanic MVT death rate increased in 2020.


Total Child MVT Deaths: 2019 n=83; 2020 n=63; NH – non-Hispanic

0.0

1.0

2.0

3.0

4.0

5.0

2019 2020*

Rate per 100,000

HispanicNH BlackNH White

42

26

10

2

1

2

29

17

13

4

NH White

NH Black

Hispanic

NH Asian

NH AI/AN

Unknown

2019 2020*Number of Child MVT Deaths


The proportion of child MVT ED visits has increased in 2021.

Note: 2020 Provisional Data as of 8/10/2020; Data limited to North Carolina residents ages 0-17 Source: NC DETECT ED Visits, 2019-2021

0.0%2.0%4.0%6.0%8.0%

10.0%12.0%14.0%16.0%18.0%


% of Child InjuryED Visits 2019 2020* 2021*

Total Child MVT Injury ED Visits: 2019 n=17,537; 2020 n=12,468


Firearm Injuries


36

15

4

1

Assault

Self-Inflicted

Unintentional

Undetermined

Child firearm deaths increased by 88% in 2020

2019 Child Firearm Deaths 2020* Child Firearm Deaths


Total Child Firearm Deaths: 2019 n=56; 2020 n=105

Most deaths were homicides followed by suicides.

64

31

9

1


The number of child firearm deaths among ages 15-17 almost doubled in 2020.


Total Child Firearm Deaths: 2019 n=56; 2020 n=105

4 414

34

9

47

8 6

25

66

19

86

0-4 5-9 10-14 15-17 Female Male

2019 2020

Number of child firearm deaths by age and sex

Most deaths were among males.


The number of firearm deaths tripled among NH white children in 2020*. Rates increased the most among NH Black children.


Total Child Firearm Deaths: 2019 n=56; 2020 n=105; NH – non-Hispanic

0.0

2.0

4.0

6.0

8.0

10.0

2019 2020*

Hispanic

NH Black

NH White

7

14

33

2

0

0

10

42

49

3

Hispanic

White NH

Black NH

AI/AN NH

Asian NH

Other NH

2019 2020*Number of child firearm deaths Rate of child firearm deaths per 100,000


The proportion of child firearm injury ED visits increased by 89% between 2019 and 2020.

0.0%

0.1%

0.2%

0.3%

0.4%

0.5%

0.6%


% of Child Injury ED Visits 2019 2020* 2021*


Total Child Firearm Injury ED Visits: 2019 n=334; 2020 n=438


Most child ED visits for firearm injuries were unintentional.

77%

21%

1%

2%

82%

14%

1%

2%

Unintentional

Assault

Self-Inflicted

Undetermined

2019 2020*

Percentage of child firearm injury ED visits


Total Child Firearm Injury ED Visits: 2019 n=334; 2020 n=438

7%

6%

19%

68%

16%

83%

0-4

5-9

10-14

15-17

Female

Male

Percentage of 2020* child firearm injury ED visits by age and sex

NCDHHS, Division | Suicide and Self-Inflicted Injury Update | 3/5/2021 37

NC Firearm Injury Surveillance Through Emergency Rooms (FASTER)

• NC one of 10 states funded for enhanced surveillance of non-fatal firearm injuries.

• Goals of NC-FASTER:1. Increase the timeliness of aggregate reporting of

ED visits for nonfatal firearm injuries.

2. Disseminate surveillance findings to key partners working to prevent or respond to firearm injuries.


Suicide and Self-Inflicted Injuries


15

18

1

2

Firearm

Suffocation

Poisoning

Other

Child Suicide deaths increased by 53% in 2020.

2019 Child Suicide Deaths 2020* Child Suicide Deaths


Total Child Suicide Deaths: 2019 n=36; 2020 n=55

Most deaths involved firearms followed by suffocation.

31

20

3

1


Most suicide deaths were among children ages 15-17 and males.


15

21

9

27

20

35

17

38

10-14 15-17 Female Male

2019 2020*

Number of child firearm deaths by age and sex

Total Child Suicide Deaths: 2019 n=36; 2020 n=55


The number of suicide deaths almost doubled for NH white children in 2020*.


Total Child Suicide Deaths: 2019 n=36; 2020 n=55; NH – non-Hispanic

6

20

8

2

3

37

9

1

4

1

Hispanic

White NH

Black NH

AI/AN NH

Asian NH

Other NH

2019 Child Suicide Deaths 2020* Child Suicide Deaths


The proportion of child self-inflicted injury ED visits increased by 44% between 2019 and 2020.

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%




Total Child Self-Inflicted Injury ED Visits: 2019 n=2,742; 2020 n=2,745


Medication/Drug Overdose


The proportion of unintentional med/drug overdose ED visits among children 15-17 increased by 43% between 2019 and 2020.


Total Unintentional Med/Drug Overdose ED Visits: 2019 n=366; 2020 n=352

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%




Child Maltreatment


The proportion of child abuse/neglect* ED visits increased by 24% between 2019 and 2020.


*Total Child Abuse/Neglect ED Visits: 2019 n=1,968; 2020 n=1,698; includes suspected or confirmed abuse/neglect

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total



Questions?Shana Geary

[email protected]

Scott [email protected]

www.injuryfreenc.ncdhhs.gov

http://www.injuryfreenc.ncdhhs.gov/

Review of 2021 CFTF Legislative Action Agenda Items and Legislative UpdateKaren McLeod, MSWChair, Child Fatality Task Force

Child Fatality Prevention System Strengthening

• SB 703 addresses CFTF recommendations

• Sponsors are Sen. Edwards, Sen. Bergin

• SB 703 is in the Senate Rules Committee and has not received a hearing

• Funding is not in House or Senate budget

The recommendations addressed in the bill involve agency action, changes in law, new state funding to do the following:

• Create a State Office of Child Fatality Prevention to put state support for system all in one place to coordinate and support local teams, data, and whole CFP System.

• Implement a centralized electronic data and information system that includes NC joining 45 other states in a national electronic data system.

• Reduce the volume of team reviews to focus on certain categories most likely to yield prevention opportunities.

• Reduce the number and types of teams performing fatality reviews by combining the functions of the four current types of teams into one local team.

• Formalize Task Force functioning and expand reporting by the Task Force.

• Appropriate funding to support this restructuring and system work.

Statewide Firearm Safe Storage Awareness Initiative

• Addressed in HB 427; sponsors are Rep. Hanig, Carter, C. Smith

• Passed House on a vote of 116 to 1

• HB 427 is included in the House version of the budget; not included in Senate version

A FEW DATA POINTS:• From 2010 to 2019 (ten years),

460 child deaths in NC due to firearm injury (age 17 and younger)

• From 2016 to 2019 (five years), 437 hospitalizations & 1,246 ED visits

• In NC, firearms are used in almost half of youth suicides

• More than 75% of guns used in suicide attempts and unintentional injuries of kids were stored in the home of the victim, relative, or a friend (national study)

• Dramatic rise in gun purchases in 2020

• Appears to be significant rise in firearm-related deaths to children in 2020 (based on provisional data; final 2020 data not yet available)

Funding to Prevent Infant Deaths Associated with Unsafe Sleep Environments

• SB 537 addressed this CFTF recommendation for additional $85K (current funding is only $45K)

• Sponsors are Sen. Bergin, Sen Krawiec

• SB 537 did not get a hearing; funding is not included in House or Senate budget

Strengthen Infant Safe Surrender Law

• HB 473 addresses CFTF recommendations; sponsored by Rep. White, Rep. Bradford, Rep. Riddell

• HB 473 passed the House unanimously and is currently in Senate Rules (no funding in this bill)

• SB 535, nearly identical to HB 473, sponsored by Sen. Burgin, Sen. Krawiec; no hearing

CFTF recommendations were for changes in law to make it more likely the law will be used in circumstances for which it was intended to protect a newborn infant at risk of abandonment or harm by making legislative changes to accomplish the following:1) remove “any adult” from those designated to accept a surrendered infant;2) provide information to a surrendering parent;3) strengthen protection of a surrendering parent’s identity;4) incorporate steps to help ensure the law is only applied when criteria are met.

Funding to increase the number of school nurses, social workers, counselors, psychologists to move toward nationally recommended ratios

• Senate budget appropriates recurring funding for 115 additional school psychologists

• House budget includes $1.7 million to establish a school psychologist grant program

• No recurring funding in either House or Senate budget to increase number of school nurses, social workers, counselors

Legislation that would add child abuse and neglect reporting requirements to topic list for required mental health training for school personnel

• No bill introduced.• Bill that relates to child abuse and neglect

reporting (not CFTF-related) is SB 693 which became Session Law 2021-132 and requires:

• DHHS to develop a plan to create and implement a statewide child protective services hotline

• Public schools to provide students with information and resources on child abuse and neglect via a document provided to students yearly and displays posted throughout schools

Legislation that would require ignition interlocks for all DWI offenders

• HB 402 = SB 183 – bills do not expand the use of ignition interlocks to all DWI offenders as recommended by the CFTF but the bills would require studying the issue of expanded use.

• House sponsors: Faircloth, Stevens, Clampitt; Senate sponsors: Britt, Sawyer, Daniel

• S 183 passed the Senate and is now in House Rules Committee after a favorable report from Judiciary 1.

• H 402 has passed the House and is currently in the Senate Transportation Committee after a favorable report from Judiciary.

Tobacco prevention funding: $7 mil. for youth and $3 mil. for Quitline (endorse)

• House budget provides funds from the NC settlement with Juul Labs, Inc to DPH for tobacco and nicotine dependence prevention activities targeted at youth and young adults: $13 million nonrecurring.

• Not addressed in Senate budget.

Workplace supports:pregnancy and lactation accommodations; kin care and safe days leave (endorse)

• S 633 = H 514 addressed pregnancy and lactation accommodations but did not advance, did not make crossover

• H 875 addressed kin care and safe days leave but did not advance, did not make crossover

Highlights of two bills not related to CFTF agenda that impact child deaths & child well-being

Session Law 2021-110 (HB 96) related to pharmacist authorization for dispensing, delivering, and administering certain treatment and medications

Among its provisions: • Law allows an immunizing pharmacist to

dispense, deliver, or administer self-administered oral or transdermal contraceptives pursuant to certain requirements related to record keeping, notification of patient’s provider, etc.

• Immunizing pharmacist may also administer to a patient any prescribed, self-administered injectable medication.

• If pharmacist administers or dispenses a hormonal contraceptive, the pharmacist shall counsel the patient about preventative care . . .

Medicaid for 12 months postpartum

The Senate budget continues Medicaid coverage for pregnant women for 12 months postpartum.

The House budget does not include this extension.

Kella Hatcher, JDExecutive Director, NC

Child Fatality Task Force

CFTF Director’s Report

At its core, CFTF work is about

MAKING KIDS A PRIORITY

Highlights of ED Activities

2021 CFTF Annual Report – access on home page of CFTF website

Represent CFTF in more than a dozen stakeholder groups/steering committees

Work to advance administrative items on CFTF Action Agenda

Child Fatality Prevention System strengthening work

Presentations, materials, and meetings to educate about CFTF, CFP System, CFTF recommendations

Legislative education, monitoring, reporting

Media: press inquiries, press releases

State Team 2021 recommendations to be heard in committees

• Firearm safety/safe storage education and awareness and focus on social drivers that relate to gun deaths

• Funding to increase numbers of school nurses, social workers, counselors, psychologists

• Strengthen child abuse and neglect reporting education and awareness and prioritize resources to strengthen CPS intake and assessment

• Expanded efforts to prevent sleep-related infant deaths including expanded program funding and a statewide campaign

• Support for community-based programs supporting families’ health and well-being through addressing impacts of social determinants of health

• Focus on upstream issues (ACES/screening/social determinants of health) in mental health

• Support DPI efforts to implement statewide data system

• Funding for full toxicology in all medical examiner jurisdiction child fatalities

CFTF Administrative Items

• Strengthen training on child abuse and neglect awareness and reporting for health care providers and law enforcement

• Child Passenger Safety Study – Occupant Protection Task Force

• Work on rear seat restraints and strengthening education for teens/driver ed

• Lead suicide prevention coordinator role• Follow implementation of School Mental

Health Policy related to strengthening school/community connections to address student mental health

Changes in format for meetings; issue prioritization and administrative work

Goal to have less time spent on presentations, more time for discussion

Committee role in prioritizing issues for study

Committees determine 2-3 legislative recommendations

More emphasis on what CFTF can accomplish administratively (work that doesn’t involve legislation)

Ten minutebreak!

Committee Reports

Kella Hatcher, JD

Executive Director

NC Child Fatality Task Force

Overview of Child Fatality Prevention System, CFTF Role, System Strengthening Efforts

Charge of State Child Fatality Prevention System [via Article 14 of NC Juvenile Code]

Develop a communitywide approach to child abuse and neglect;

Study and understand causes of childhood death;

Identify gaps in service delivery in systems designed to prevent abuse, neglect, and death; and

Make and implement recommendations for laws, rules, and policies that will support the safe and healthy development of our children and prevent future child abuse, neglect, and death.

MAIN COMPONENTS OF CURRENT NC CFP SYSTEM: FOUR TYPES OF REVIEW TEAMS PLUS TASK FORCE

NC Child Fatality

Task Force

State Child Fatality

Prevention Team

Two Types of

Local Review Teams

State Child Fatality Review Team

These three components addressed in Article 14 of Juvenile Code

This component addressed in G.S. §143B-150.20

Uses local team members

Policy only; no case reviews

One case may be reviewed by three different types of teams

Each type of team handles data, information, and reporting differently; minimal data is collected

Task Force Responsibilities

• Study, analyze, and report on incidences and causes of child death

• Develop a system for multidisciplinary review of child deaths

• Receive and consider reports from State Team

• Perform other studies and evaluations as needed in order to carry out its mandate

• Submit annual report to the Governor and General Assembly with recommendations for changes to any law, rule, or policy that it has determined will promote the safety and well-being of children

[See G.S. §7B-1403, -1412]

*This graphic was created in 2018 and this ED position is now at DHHS

*

CurrentSystem Structure

CurrentSystem Process

Journey of CFP Strengthening Work

Initial 2017 discussions led to two-day Child Fatality Prevention System Summit April 2018: gathering of over 200 people & local team input

Post-Summit work involved research on other states’ CFP systems, consultation with national experts, stakeholder discussions

CFTF recommendations addressing CFP System strengthening adopted in the Child Welfare Reform Plan from the Center for Support of Families

CFTF recommendations were addressed in 2019 Appropriations Act which did not become law (HB 825 was included in HB 966)

NCDHHS has continued work to move recommendations forward because they are aligned with DHHS priorities and were part of Child Welfare Reform Plan; this work has included convening of stakeholder group by NCIOM

Why are we (still!) talking about this?

CFP statute says the Task Force shall develop a system for multidisciplinary review of child deaths & study the operation of local teams . . .

• The Task Force met this obligation in the early 1990s when the system was first set up

• Thirty years later (now!) the Task Forcehas an important role in ensuring a strongmultidisciplinary review system andeffective operation of local teams

• A CFP System that is not optimized is a weak link in protecting children from child death and maltreatment

• CFP System strengthening recommendations made by CFTF in 2019, 2020, 2021

• Legislation has been introduced but has not advanced

SB 703 addresses CFTF recommendations

• Creates a State Office of Child Fatality Prevention (State Office) that brings state-level support together in one place within DHHS to coordinate and support the work of the statewide system with an emphasis on supporting local child death review teams; appropriates recurring funding to establish and operate office and support system.

• Restructures the system of team reviews of child deaths in NC to do the following:• Combines the functions of the existing four types of review teams into local county

teams & allows counties to choose whether to be a single or multi-county team. • Allows for the addition of needed experts to participate in a particular review on an ad

hoc basis. • Eliminates state-level teams while State Office staff and medical examiner child fatality

staff help local teams carry out functions previously performed by state teams.• Articulates special requirements for the State Office and for local review teams for

reviews of deaths related to abuse or neglect or where a child was known to child protective services.

SB 703 addresses CFTF recommendations (continued)

• Implements a centralized electronic data and information system that includes North Carolina joining 45 other states to participate in the National Child Death Review Case Reporting System (that is web-based and free to use)

• Requires the Task Force to receive and consider local team information (reports addressing aggregate data, information, findings and recommendations resulting from local team reviews).

• Changes the types of deaths required to be reviewed to be according to categories of death where reviews are most likely to yield prevention opportunities; reviews of other deaths optional.

• Formalizes the current structure of the Task Force and expands the scope of its reporting to include the functioning of the whole CFP System; expands on state leaders who must receive the Task Force report.

• Requires NC DSS to ensure the existence of at least three federally required Citizen Review Panels that evaluate policies, procedures, and practices of State and local child protection agencies; requires that panels be operated and managed by organization independent from DSS; requires an annual report by panels that is made public. [The effect of these provisions is to put federal requirements in state law and enable DSS to discontinue using all 100 Community Child Protection Teams to satisfy federal requirements for Citizen Review Panels while ensuring that panels have appropriate access to and protection of information.]

Local Review Teams

Counties choose to be single or multi-county teams

One team for all types of reviews, but different procedures, required participants, and degree of state-level assistance for different types of reviews (e.g.abuse/neglect or infants).

Review info goes into national data system

Makes local reports (e.g. to County Commissioners) which also go to State CFPOffice

State Office of Child Fatality Prevention

Whole-system coordination & technical support for local teams

Centralized Information System including use of national data system

Fatality Review & Data Group looks at aggregate local team info & OCME info to be liaison of info going to Task Force

State Office Staff report on whole system functioning

Aggregate information & recs from local teams is reported

NC Child Fatality Task

ForceStudies data from local teams & other sources

Makes policy recommendations & reports on whole CFP system to General Assembly, Governor, other state leaders

Proposed Model Strengthens Team Reviews, Data, State-level Support, Reporting

Citizen Review Panels: Evaluates CPS functioning

CAN deaths:7-Day Internal

Reviews by State DSS

Ultimate Goal: Prevent Child Deaths & Maltreatment; Support Child Safety & Wellbeing

• OPTIMIZE LOCAL TEAM EFFORTS: CFP State Office structure, and eliminating duplication supports local teams to optimize work and facilitate local prevention efforts to save lives and prevent maltreatment.

• DATA TO UNDERSTAND TRENDS: A sophisticated data system that collects richer layers of data makes reviews more valuable and facilitates understanding and reacting to what’s happening locally and in NC.

• ADDRESSING INFANT MORTALITY: System strengthening involves best practice attention to infant deaths at a time when North Carolina’s infant mortality rate has been among the worst dozen in the nation, disparities persist, and infant deaths make up two-thirds of all child deaths.

• ENSURING USE OF INFORMATION LEARNED: Ensuring that information/recommendations from reviews reaches appropriate agencies and leaders is critical to making reviews effective.

• MORE STATE-LEVEL PREVENTION WORK: CFP State Office provides a structure for facilitating or implementing various prevention initiatives, including efforts to seek grant opportunities.

CCPTMust review deaths involving

suspected abuse or neglect where there was CPS

involvement/report within previous 12 mos., as well as

selected active CPS cases

May review “additional” types of deaths

CFPTReviews

“additional” types of deaths

when CCPT determines it

will not review additional

cases

Local Teams: CCPTs & CFPTs in every county

Most teamsare blended

See N.C.G.S §7B-1406

Local teams consist of community leaders; teams are rich in expertise & ripe for collaboration needed to strengthen health and safety in their communities.

• Local Social Services• Local Health

Department• Law Enforcement• District Attorney• Local Community

Action Agency• Local School

Superintendent• County Board of Social

Services• Mental Health

• Guardian ad Litem• Health Care Provider• Emergency medical or

firefighter• District Court Judge• County Medical

Examiner• Local childcare facility

or Head Start• Parent of child who

died

Local team reports, findings, recommendations

CCPTsActivity reports go to

local DSS board

BCC rec’s go to NC DSS (per policy)

End of Year Report to NC DSS (per policy) [Note: no case-specific information reported]

BothSubmit any

recommendations to Board of County Commissioners (BCC)

Advocate for system improvements and needed resources where gaps and deficiencies exist

CFPTsActivity reports go to

local board of health

Reports on findings and rec’s from reviews go to Team Coordinator (state-level DPH) who submits aggregated findings to State Team

Support for Local TeamsCCPTs

County DSS Directors provide general support, procedures, training, reporting, etc.

NC Division of Social Services has ongoing responsibility for training materials for local CCPTs (a consultant in NC DSS is assigned to this work)

A CCPT State Advisory Board was formed by NC DSS and it facilitates CCPT reporting aimed at meeting federal law for Citizen Review Panels

CFPTsLocal Health Department Directors

distribute procedures, maintain records, provide staff support, facilitate reports, etc.

A Team Coordinator at NC DPH By provides general support,

procedures, training, reporting provides statistical information on

child deaths to CFPTs Receives and sends reports from

CFPTs; provides aggregate info to State CFPT

Local Team Panel Discussion

• Jennie Kristiansen, Chatham Co. DSS Director and Chair of combined CCPT/CFPT• Paige Rosemond, Wake Co. Human Services Child Welfare Director, CCPT member • Bruce Robistow, Halifax Co. Health Director and CFPT Chair• George Bryan, Chair of Forsyth Co. CCPT and Chair of CCPT Advisory Board

Meeting of the North Carolina Child Fatality Task Force ...

Documents

Transcript of Meeting of the North Carolina Child Fatality Task Force ...