The Review, Vol. 6, Issue 4 (Oct.-Dec. 2008)

October-December 2008 Quarterly Newsletter Volume 6, Issue 4

"The Review" Office of Child Fatality Review

CFR is Affected by the State Budget Crisis
As you may have heard in recent months, the state of Georgia is experiencing a budget shortfall due to lower than expected state revenues. The projected deficit is about $1.6 billion in the current year's budget (according to a memo released by the Georgia Budget and Policy Institute in August). This deficit is forcing all state agencies to immediately cut back their internal budgets to accommodate the decrease in available funds. The Governor's deficit reduction plan includes reducing or eliminating state employee salary increases, suspending the homeowner's tax relief grants to counties, suspending agency hiring of new and/or replacement positions, and suspending all agency purchases of motor vehicles, supplies, equipment, and printing. The Office of Child Fatality Review is also required to cut back expenses to help support the state budget in this time.

Our contribution to reduce spending will focus primarily on our travel and publication activities. In previous years, our staff traveled throughout the state to talk to you and your teams about the latest research, data, trends, and prevention programs for child fatalities and child abuse protocols. These statewide training classes will still occur during the remainder of this fiscal year (through June 2009), but in a different format to better accommodate all agencies affected by reduced travel budgets. We are currently working toward implementing web-based or computer-assisted training tools to facilitate training and educational opportunities for you.

We will also reduce spending on printing and postage by moving the quarterly newsletter and Annual Report to a webbased platform. We will no longer print and mail these publications to you, so you will need to access them through our website (www.gacfr.dhr.georgia.gov). The newsletter is available on the first day of January, April, June, and October of each year. The Annual Report is available during the first week of January every year. We will also email these to you so that you receive them as soon as they are published.

If the budget crisis continues, CFR may have to identify other cuts that will bring our office expenses in line with the Governor's proposals. We will work very hard to avoid any cuts to service and support for our teams, and we will continue to identify alternatives that ensure the service and support functions do not experience interruptions. If you have suggestions to help us identify innovative alternatives to ensure that our service and support continues for your team, please let us know. Your ideas could help other county CFR and CAP teams too!

Get in touch with us...

If you need to send any information to us (i.e. Child Fatality Investigation Program

fatality reports, abuse protocols, supplemental Rachelle Carnesale

information), please mail items directly to our 770-490-2112

post office box. Address all items to:

(racarnesale@dhr.state.ga.us)

Georgia Child Fatality Review PO Box 801369 Acworth, GA 30101

Child Fatality Prevention Specialist
Arleymah Raheem (araheem@dhr.state.ga.us) 770-528-3995

Please note the correct email and phone numbers for our staff. Give us a call anytime!

Program Managers
Wende Parker (wrparker@dhr.state.ga.us) 770-528-3998

OCFR Director Eva Pattillo (eva_p@bellsouth.net)

Malaika Shakir (mashakir@dhr.state.ga.us) 770-528-3999

Inside this issue

CFR Budget Update 1

Staff Contact Info

1

Policies in Georgia

2

County Compliance 2

Kids Count Data

3

County Compliance 3

Prevention Efforts 3

Upcoming Events

4

CFR Timelines

4

Policies in Georgia: Fire Safety Guidelines
A new feature of this newsletter will be to inform you of policies and regulations around certain products and activities that may affect you and the work that you do with children and families. In order to bring you the most up-to-date information on rules, requirements, and policies enacted to keep kids safe from injury and death, we will be researching a different topic in each issue. If you would like to contribute to this article series at any time, please contact the Office.
Currently, Georgia Code Section 25-2-40 states that smoke detectors are required in all dwellings and dwelling units. The Code requires that every dwelling and every new dwelling unit within an apartment, house, condominium, and townhouse and every motel, hotel, and dormitory shall be provided with an approved listed smoke detector installed in accordance with the manufacturer's recommendations and listing, and that approved battery operated smoke detector shall be maintained in good working order.
The smoke detector shall be mounted on the ceiling or wall at a point centrally located in the corridor or area giving access to each group of rooms used for sleeping purposes. Where the dwelling or dwelling unit contains more than one story, detectors are required on each story including cellars and basements, but not including uninhabitable attics; provided, however, that hotels and motels which are protected throughout by an approved supervised automatic sprinkler system installed in accordance with the rules and regulations of the Commissioner shall be exempt from the requirement to install smoke detectors in interior corridors but shall be subject to all other applicable requirements imposed under Code Section 25-2-13. (emphasis added)
The Code allows hotels, motels, and nursing homes to be exempt from having installed smoke alarms in patient rooms or interior corridors if they have an approved automatic sprinkler system. Failure to maintain a working smoke alarm in a residence or residential facility will result in a warning, followed by a maximum fine of $25. A property owner or tenant who fails to maintain a working smoke alarm (in direct violation of the Code) shall not be considered negligent or liable by the courts.
In addition, Georgia Code Section 8-2-50 states that owners of buildings more than two stories in height shall provide more than one exit from each story of the building by stairways on the inside or outside of the building (i.e. fire escape), if the owner utilizes any level above the second story as a factory or workshop.
In 2007, the State of Georgia adopted the International Fire Code (2006 edition) as the Georgia State Minimum Standard Code. The Minimum Standard Code establishes regulations and protections from fire hazards, including a requirement that portable fire extinguishers be installed in all buildings, structures, and facilities falling under the Rules and Regulations of the Safety Fire Commissioner. However, the Code does not apply to one and two-family dwellings or one and two-family townhomes that are separated by a two-hour fire wall.
CFR County Compliance for 2007 Fatality Reports
Earlier this year, 2007 death lists were sent to all circuits in an effort to keep you abreast of child deaths that have occurred in your county. Although we work very hard to keep an accurate account of deaths as they occur, we also need your help. It is imperative that you work with your coroners to obtain information related to child deaths and notify our office whenever you become aware of a death. Most counties have already submitted all 2007 CFR reports for their respective areas and we truly appreciate your diligence. However, there are still several CFR reports that have not been submitted for various reasons. We are here to serve as a support to you so please let us know if we can provide any assistance with submitting reports. If you are one of the following counties, please call our office and speak with your program manager:
Bryan, Chatham, Columbia, Dawson, Effingham, Glynn, Long, Richmond Program Manager Wende Parker 770-528-3998
Bibb, Carroll, Clayton, Cobb, Fayette, Haralson, Harris, Mitchell, Muscogee, Polk Program Manager Malaika Shakir 770-528-3999
We will be sending out a 2008 preliminary death list to your circuits soon! Be on the lookout for it within the next few days.
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The 2008 Kids Count Data Book Has Arrived!
We anxiously await the report that Kids Count publishes each year. That report tells us how well we are doing in so many areas of child and family well-being. Sometimes we see an increase from our ranking compared to a previous year, sometimes there is a decline. Here is a brief snapshot of some well-being indicators for children in Georgia from their research of selected indicators in 2006. We are improving in some areas, and need more work in others. For a full copy of the report, with state and county comparisons, visit their website at www.kidscount.org or contact your local Family Connection Collaborative. --After more than ten years of declines, the rate of teen pregnancies and teen births increased in 2006 while repeat births to teens mothers before age 20 declined. Overall, there are 25 counties with a teen birth rate better than the national average. -- Georgia's infant mortality rate is among the nation's worst. African-American infants were nearly twice as likely to die as white infants. --The rate of babies born weighing less than 5.5 pounds increased for all races, with black infants at highest risk. --Child abuse and neglect declined for the second year in a row in 2006. --Georgia ranks 27th in the rate of child deaths (21.1 per 100,000 in 2006). This is our best national ranking of all the Kids Count measures.
CFR Team Recommendations
One of the primary purposes of convening a multi-disciplinary review team is to champion legislative and community ideas for promoting the health, safety, and overall well-being of our children. Many of you have provided recommendations to our office (either by way of verbal communication or by completing the designated section of the CFR form). This information is presented to the Child Fatality Review Panel, which is comprised of both state and local legislators, upper level administrators, and a host of high ranking officials who aid in making significant changes in our legislative system.

We value your voice and welcome your feedback! Please continue to advocate for ways to enhance the lives of our children, and support communities where they can thrive.
Prevention Efforts in 2008 - Product Recalls

In July and August 2008, the Consumer Product Safety Commission issued several product recalls and safety alerts for consumers involving infant and child bedding:
The LaJolla Boat Bed and Pirates of the Caribbean Twin Trundle Beds, both products of Bayside Furniture (sold at Costco and furniture retail stores nationwide), were recalled due to a failure of the lid supports on the toy chests to prevent the lid from closing too quickly, posing an entrapment and strangulation hazard. CPSC was alerted to this product hazard by the Placer County (California) Child Fatality Review Team in response to the strangulation death of a 22-month old boy when the chest lid fell on the back of his head and entrapped his neck on the edge of the chest.
This a great example of the power that child fatality review teams have, when they determine that a death is preventable and take action! You can do it too!!

The Simplicity 3-in-1 and 4-in-1 Convertible "close-sleeper" bedside bassinets pose a strangulation risk to infants from entrapment in the metal bars of the bassinet. Several retail stores have voluntarily agreed to recall the product and provide a refund or store credit upon return including Wal-Mart, Toys R Us, Kmart, Big Lots, Target, Bed Bath and Beyond, Kohl's, Burlington Coat Factory, and JC Penney.
Simplicity Drop Side Cribs are recalled due to sizing problems with the crib's hardware (the drop side can come off the tracks). When the drop side detaches or partially detaches, it creates a hazardous gap, which can lead to infant entrapment and suffocation. This crib was sold by department stores, children's stores and mass merchandisers nationwide from January 2005 - August 2008 (price ~ $150 - $300). Consumers can return the product for a full refund or store credit.

Do you have a great program or idea that you want to share? Let us know and share your story with others! We look forward to hearing from you!

Together Everyone Achieves More

Please submit your stories of success or other ideas by December 12, 2008 to: The Office of Child Fatality Review PO Box 801369 Acworth, Georgia 30101
www.gacfr.dhr.georgia.gov
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Upcoming Events

October 5-7, 2008: Seventh North American Conference on December 10-12, 2008: The 14th Annual Maternal and

Shaken Baby Syndrome held in Vancouver, Canada. Visit

Child Health Epidemiology Conference will be held in At-

www.dontshake.org for more information.

lanta at the Crowne Plaza Ravinia Hotel. Early registration

fee is $275. Visit www.cdc.gov/reproductivehealth/MCHEpi

October 15-18, 2008: The Safe Kids Worldwide - Child Injury for information.

Prevention Conference will be held in Washington, DC. To

register or for more information, visit www.safekids.org.

January 2009: Next meeting of the Georgia Infant Safe

Sleep Coalition (GISSC). This is a newly formed group of

October 25-29, 2008: American Public Health Association individuals dedicated to the policy, education, and practice of

(APHA) hosts the 136th Annual Meeting in San Diego, CA. infant safe sleep. We have people from many disciplines in-

Visit www.apha.org for registration information.

volved - pathologists, midwives, nurses, and child advocates

from agencies that you know and work with every day.

November 6-7, 2008: The 5th Annual International Bullying If you are interested in joining this coalition, or if you would

Prevention Association Conference will be held in Indianapo- like your agency/office to participate, please contact Sarah

lis, IN. Visit their website at www.stopbullyingworld.org for O'Leary (saoleary@dhr.state.ga.us) or Rachelle Carnesale

information.

(racarnesale@dhr.state.ga.us) for information.

November 14, 2008: The 8th Annual Child Abuse and Neglect March 30-April 4, 2009: The 17th Annual National ConferConference sponsored by Children's Healthcare of Atlanta will ence on Child Abuse and Neglect (NCCAN) will be held in be held at the Marriott Evergreen Conference Resort in Atlanta. Atlanta. Conference details will be available at For information, call 404-785-7722 or email the coordinator at www.childwelfare.gov. onlineeducation@choa.org.

CFR Deadlines and Timelines
A preliminary list of child deaths that occurred in 2008 will be sent to your chairperson shortly. Please contact our office if you need assistance identifying child deaths for review. Your program manager will be able to assist you.

All county fatality review reports for child deaths that occurred in 2008 should be submitted using our online reporting form. This can be found on our website at www.gacfr.dhr.georgia.gov. If you have any problems using the CFR online reporting system or if you need more information to complete your committee reviews, please contact the Office at 770-528-3988.

A review report should be submitted to our office within 65 days (about 13 weeks) of receiving notification of the child's death. If you are experiencing difficulties obtaining information for review (e.g. autopsies or medical records), or scheduling a review meeting with your team members, please request assistance from our office staff.

Please remember that the Office of Child Fatality Review recognizes a coroner and a CFR team for their commitment to the state of Georgia each year. Our staff is currently working on a survey tool to implement this contest online for the 2008 year. Please stay tuned as we hope to have this functioning before the end of the year. In the meantime, continue working on activities that promote safety and injury prevention, so that you could win the award in April 2009! Winners will receive a lovely trophy and an official Georgia Senate recognition.

Coroners and CFR Chairs/Designees: It is very important when a child dies in your county, but does not reside there, that you provide the residence county with the correct information as soon as possible so they can conduct a timely review. Too many CFR chairpersons are unaware of children who die while visiting another county because the cross-county communication is lacking. Toward the end of the reporting year, many of these county teams are considered non-compliant and we hear so many complaints that it is due to not knowing about a death. Please help the CFR teams in other counties by sharing any information that you have on a child's death so that they can do their work, and also work with your local vital records office to obtain routine information regarding child deaths.

In an effort to facilitate information sharing, we have developed this newsletter to bring us closer. Knowing that our goal is the protection of children and the prevention of child deaths, we want to include your experiences and ideas to improve the quality of services we provide. Please contact us with any suggestions on how to make the
Office of Child Fatality Review process helpful to you.