1. The North Carolina Child Fatality Task Force & its role in the NC Child Fatality Prevention System
Kella Hatcher
Executive Director
NC Child Fatality Task Force
Children’s Services Committee
September 12, 2018

2. The Child Fatality task Force is part of a larger statewide child fatality prevention system
Every county in NC participates in the CFP System; every county DSS has a role.

3. 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.

4. Three main components to NC cfp systeM
Local Teams
State Team
Task Force

5. Primary process for recommendations Per Statute*
Community Child Protection Teams (CCPTs)
Local Teams
CCPTs
CFPTs
(fatality reviews)
State Child Fatality Prevention Team
Child Fatality Task Force
(Policy Only)
Child Fatality Prevention Teams (CFPTs)
recommendations
Aggregated findings & recommendations
recommendations
Board of County
Commissioners
Board of County Commissioners
*In addition to this process per statute, policy and practice also result in certain recommendations being routed as appropriate to additional individuals and organizations.
Reports & recommendations
See Article 14 of NC Juvenile Code

6. The “policy arm” of the State’s Child Fatality Prevention System
NC Child Fatality Task Force: Legislative study commission created via statute in 1991
The “policy arm” of the State’s Child Fatality Prevention System
Does NOT review individual cases
35 Members:
20 Appointed;
11 Ex Officio
(State agency & community leaders, experts in child health & safety, 10 legislators)

7. 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

8. Three Task Force Committees work to create a yearly “Action agenda”
Full CFTF
Intentional Death Prevention
Perinatal Health
Unintentional Death Prevention
Committees rely on CFTF members AND community volunteers.

9. Task Force Process Components
Public meetings between legislative sessions
Committees propose recommendations to full Task Force
Stakeholder or work groups may be convened to address or examine in-depth a particular issue
Ongoing information sharing and collaboration among experts and community partners

10. Sources of Issues Coming Before the CFTF
Issue application process
Relevant national or statewide initiatives
Data concern or deeper dive with certain child death data
Carry-over policy issues
State Team reports or recommendations
Updates and education
Monitored items with relevant activity
Study or stakeholder groups convened or endorsed by CFTF

11. Informed Policy-makers
Child Death Data
Released by the Task Force
Examined by the Task Force
Used to inform Task Force recommendations
Good Data
Informed Policy-makers
Good
Policy

12. Leading Causes of Child Death (ages 0-17), North carolina Residents 2016
Cause of Death
Total Deaths
Perinatal Conditions
452
Illnesses
270
Birth Defects
204
Unintentional Injuries
201
Homicide 51
Suicide 44
All Other
138
TOTAL DEATHS
1,360
Source: NC DHHS North Carolina State Center for Health Statistics

13. Source: NC DHHS North Carolina State Center for Health Statistics

14. 1992-2016 Trends in North Carolina Resident Child Death Rates
by Race/Ethnicity, Ages Birth Through 17 Years
Rate for African American is twice that of White Non Hispanics over time
African American rate in 2016 is 23% greater than White Non Hispanic rate in 1992
Source: NC DHHS North Carolina State Center for Health Statistics

15. 2007-2016 Trends in North Carolina Resident Child Death Rates
for Selected Natural Causes of Death, Ages Birth Through 17 Years
Source: NC DHHS North Carolina State Center for Health Statistics

16. 2016 n.c. resident child deaths due to suicide (TOTAL 44 deaths)
By Means
By Age Group
Source: NC DHHS North Carolina State Center for Health Statistics

18. Intentional death prevention Committee
2018 Agenda
Legislation to strengthen infant safe surrender law
Legislation to require suicide prevention training and risk referral protocol in schools (HB 285; HB 894)
Funding of $5 million to add 100 school nurses in high need communities
Funding for three-year lead suicide prevention coordinator
Fund school social worker consultant position at DPI
Studying during current meeting cycle:
Child sex abuse prevention training for child care workers
Child abuse and neglect reporting & education about mandatory reporting
Carry-over items from 2018

19. CFTF Accomplishments: a few highlights among many . . .
Graduated Driver License Program & various teen driver safety measures
Strengthened Sex Offender Registry
Laws addressing smoke alarms & CO detectors
Child passenger safety laws, school bus safety laws
Law requiring child-proofing and labeling for E-cig nicotine liquid containers
Measures to combat opioid epidemic (improved CSRS, access to overdose reversal drug, safe disposal)
Safe Sleep awareness
Support for programs providing child maltreatment prevention, diagnosis, and treatment
Infant Safe Surrender Law
Pulse Oximetry Newborn Screening (for certain congenital heart conditions)
A longer list of accomplishments is posted on the CFTF website:

20. More about the NC child fatality prevention system
Who does what?

21. Local Teams: CCPTs & CFPTs
Must 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
CFPT
Reviews “additional” types of deaths when CCPT determines it will not review additional cases
Most teams
are blended
See N.C.G.S §7B-1406

22. Local team Reports, findings, recommendations
CCPTs
Activity reports go to local DSS board
BCC rec’s go to NC DSS (per policy)
End of Year Report to NC DSS (per policy)
Both
Submit any recommendations to Board of County Commissioners
Advocate for system improvements and needed resources where gaps and deficiencies exist
CFPTs
Activity reports go to local board of health
Reports on findings and rec’s go to Team Coordinator(state-level) who submits aggregated findings to State Team & other Local Teams

23. Support for Local Teams
CCPTs
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 CCPT Consultant in NC DSS supports this training)
A CCPT State Advisory Board was formed by NC DSS and it facilitates CCPT reporting
CFPTs
Local Health Department Directors distribute procedures, maintain records, provide staff support, facilitate reports, etc.
A Team Coordinator at NC DPH
provides general support, procedures, training, reporting
provides statistical information on child deaths to CFPTs
Receives and sends reports from CFPTs
evaluates impact of local efforts

24. State Child Fatality Prevention Team (State Team)
State Team is required to review deaths of children attributed to child abuse or neglect or when decedent reported as abused or neglected
In practice, State Team also reviews other types of child fatalities in NC that are investigated by the statewide Medical Examiner System
OCME Child Fatality staff review all child deaths investigated by the statewide medical examiner system
State Team also provides technical assistance to local teams, receives local team information, and makes reports and recommendations to Task Force.
See G.S. §7B-1404, -05; State Team website:

25. BUT WAIT! THERE’S MORE. . .
Three organizations that are not part of the Article 14 statutes addressing the Child Fatality Prevention System have a connection to the system:
NC Child Fatality Review Team (DSS Intensive Reviews)
CCPT State Advisory Board
Federally required Citizen Review Panels

28. Child Fatality Prevention System Summit April 9th and 10th, 2018
First-of-its-kind event bringing together over professionals from across the state.
Participants learned from state and national experts, state leaders, and shared best practices and challenges.
Local and state initiatives were launched focused on strengthening the CFP System.

29. Post-Summit work currently taking place
Focus is on three areas:
System Structure
CFP Data
Support and Collaboration for Child Death Review Teams of all Types
Tapping local and state-level stakeholders as well as national experts and resources
Simultaneous evaluation/report from Center for Support of Families
Work is being reported back to Child Fatality Task Force who may make recommendations to Governor and General Assembly

30. How to learn more
CFTF Website:
CFTF Annual Report has other details
Fact sheets for many legislative items available on CFTF website
Issue applications are typically due annually, in August or September
New meeting cycle just started– meetings are public and meeting materials are on CFTF website
Join the CFTF list (let me know: