The Review, Vol. 9, Issue 1 (Jan.-Mar. 2011)

January--March 2011 Quarterly Newsletter
Volume 9, Issue 1

"The Review" Division of Child Fatality Review
Infant Mortality a Priority for Regional State Health Officials
Excerpt from a November 3, 2010, letter from members of the Association for State and Territorial Health Officials (ASTHO) to Department of Health and Human Services Secretary Kathleen Sebelius:

"On September 9 and 10, 2010, the State Health Officials, Maternal and Child Health Directors, and Regional Health Administrators representing the states that comprise the Department of Health and Human Services (DHHS) Regions IV and VI, convened in Atlanta, Georgia, to discuss the burden of infant mortality in our regions. Each of the states in Regions IV and VI has made individual attempts to address infant mortality with limited success. Leadership in these states recognizes that a collaborative, multi-state approach is the best method to address this critical issue.

"We already have agreed to convene a "Southern Conference" on infant mortality to generate a list of actionable ideas; maximize the use of existing evidence-based, best, and/or promising practices to reduce infant mortality (e.g., consumption of folic acid, appropriate sleep position); identify opportunities within the Title V Maternal and Child Health Services Block Grant to promote collaboration and coordination between the states; and build cross-state coalitions to support efforts at the grass roots level. Additionally, the Maternal and Child Health Directors from states in Regions IV and VI will use existing data to understand trends in infant mortality at the sub-state level and will provide information to support strategic planning and tailoring efforts across states.

"Our collaborative approach aims to transcend the artificial, bureaucratic barriers that separate us. It is indeed unprecedented and presents an opportunity to achieve real change in our infant mortality rates. We are hopeful for your guidance, collaboration, and support of this initiative and would welcome an opportunity to discuss with you and your staff our ideas and opportunities for federal input and partnership."

Secretary Sebelius responded in a December 1, 2010, letter that "since the Health Resources and Services Administration (HRSA) does a tremendous amount of work in this area, [she has asked] HRSA's Administrator, Mary Wakefield, to explore how we can effectively incorporate the goal of reducing infant mortality into the activity plans of our federal grants."

We will continue to keep you informed of the developments of this infant mortality prevention partnership, and how CFR and the Georgia Infant Safe Sleep Coalition may be able to provide assistance or data for this effort.

New Child Advocate Appointed by Governor-Elect Deal

Inside This Issue

Melissa Carter resigned as the state's Child Advocate and joined the Emory Law faculty in ASTHO Collaboration 1

December 2010 as the executive director of the Barton Child Law and Policy Center. As ex-

ecutive director, Melissa will direct the instructional and policy activities of the Child Law New OCA Director 1

and Policy Clinic and the Juvenile Defender Clinic; supervises Clinic faculty, staff and stu- SUID-CR Plans

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dents; and teaches related courses. We wish her great success in her new role!

Annual Report

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Tonya Boga will be the new director of the Office of the Child Advocate. Tonya lives in Ma-

rietta and before coming to us, her practice included serving as a Juvenile Court Mediator in Legislation

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the Cobb Judicial Circuit. She has represented children as a Guardian Ad Litem in both Juve- Prevention Successes 3 nile Court and Superior Court for many years. She is a member of the National Association of Counsel For Children and has served as a member of the State Bar of Georgia's Children Upcoming Events 4

and the Courts Committee. After earning her law degree, she earned a Master of Laws degree Important Info

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from Loyola University Chicago School of Law with a concentration in child and family law.

We look forward to her leadership!

SUID Case Registry Pilot Project Plans for 2011
The Sudden Unexpected Infant Death (SUID) Case Registry Pilot Project, funded by the CDC until July 2012, will continue to provide financial support for training and technical assistance to all of Georgia's child fatality review committees. The focus of this pilot project is to find ways to standardize and improve the data collected from investigations and reporting of all unexpected infant deaths. CFR staff meet regularly to discuss opportunities and ideas offered by committee members, and we have several plans for this upcoming calendar year:
1. Program managers (Wende Parker and Malaika Shakir) will travel to counties to provide one-on-one training with committees on SUID investigations and case reporting
2. Notebook computers were requested and purchased with grant funds for 30 select county committees (those without access to the technology needed for real-time infant death data entry and case reporting). These are now being distributed to committee chairs
3. SUID investigation dolls were purchased for county coroners and select law enforcement agencies to conduct doll re-enactments and improve death scene investigations. These will continue to be distributed during the year
4. Regional training symposiums will be developed by CFR staff and held in select locations statewide to offer more comprehensive training on SUID and the CFR process to CFR committees and community advocates
5. Carri Cottengim will continue to provide support for metro counties in their review and reporting efforts
6. We have printed guidebooks for scene investigators and SUID report forms for anyone who would like copies, and USB drives were purchased with all of the training documents, forms and video pre-loaded for easy digital access and electronic sharing
7. We are now offering the SUID reporting form online for coroners and first responders (www.cfrform.questionpro.com), but continue to explore other options for this required data collection tool
Your ideas are critical to our success in this pilot project. Please contact CFR staff if you have suggestions!
Highlights from the CFR Annual Report of 2009 Deaths
The 2010 CFR Annual Report is now available. Please contact the CFR staff (ocacfr@oca.ga.gov or 404-656-4200) if you would like a copy. To reduce paper and printing costs, we will email an electronic copy of the report to agency partners, committee chairs, and members.
There were 199 infant deaths reviewed in 2009, and 319 deaths to children ages 1 to 17
Committees reported that in 54 cases, there were no agencies involved in the death scene investigation
Of the 77 children with maltreatment identified, 34 were reported as homicide deaths (44%), 12 were medical deaths (16%), eight were suicide deaths (10%), and five were infant sleep-related deaths (six percent).
When residence location was reported for infant sleep-related deaths (N=124), 53 occurred in suburban counties (43%), 40 occurred in urban counties (32%), and 31 occurred in rural counties (25%)
The most common mechanisms of reviewed unintentional injury-related deaths were due to motor vehicle, drowning and fire (138). However, children died from other preventable incidents such as being exposed to space heaters, wedged between furniture, strangulated on high chair straps, firearm incidents, deprivation of oxygen due to the "choking game", and choking on grapes/other objects
When prevention initiatives were recommended by committees after completing a child death review, these activities were most often mentioned: media campaigns (58), community safety projects (50), school programs (45), and public forums (19)
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2011 Legislative Priorities
CFR staff follow a number of legislative bills each year to keep track of important issues in our work. Here is a small sampling of bills that have been pre-filed in the Legislature for 2011:
HB 10 Child Protection Act Its intended purpose is to protect children from peeping toms; the language indicates a person could build a fence as high as necessary on a residential zoned property to prevent an outsider from an adjacent residential zoned property from looking in. Prefiled 11/15/10 by Rep. Bobby Franklin.
HB 11 Makes vaccinations voluntary as opposed to mandatory. Prefiled 11/15/10 by Rep. Bobby Franklin.
HB 23 Psychotropic Meds DHS to establish regulations regarding use of psychtropic meds for children in DFCS custody; requires DHS to have an independent clinical review team to include a child psychiatrist and not the prescriber or an employee/contractor of the child's placement; requires informed consent and consultation with an independent clinical review team prior to filling a prescription; record maintenance required; information to be submitted at judicial reviews. Prefiled 11/15/10 by Rep. Mary Margaret Oliver.
HR 9 Joint Teen Violence Study Committee creates such committee; House to appoint two members, Senate to appoint two members; Governor to appoint two members and designate one member as chair; study conditions, needs, issues, and problems related to teen violence and recommend appropriate action or legislation; shall be abolished 1/9/12. This was spurred by two attacks/murders at house parties in November 2010. Prefiled 12/15/10 by Rep. Roger Bruce.
SB 2 Georgia Government Accountability Act authorizes a committee to review state agencies at least once every eight years to ensure the agency is acting appropriately and efficiently. Prefiled 11/16/10 by Sen. Judson Hill.
We will continue to keep you informed of any legislation that is introduced and its progress at the state Capitol. If there is any legislation that is a priority to you and your office, please let us know. The CFR Panel members are often actively involved in advocating for certain bills that promote the health and safety of children. We are all in this effort together!
County Prevention Successes
Ina Allicott is a CDC Fellow assigned through the Public Health Prevention Service (PHPS) program to work with the Injury Prevention Section in the Division of Public Health. Ina is partnering with CFR Prevention Specialist Arleymah Raheem to develop a prevention toolkit for communities to implement prevention activities, which takes into account their specific regional resources and reported barriers. Each county's Prevention Readiness Assessment data will be used to inform their community prevention toolkits.
Clayton County Health Department has recently received a PHPS Fellow from the CDC for a two-year assignment. Enjoli Jones will work with Clayton County public health staff to develop an injury prevention program and coalition. She will also work with PHPS Fellow Ina Allicott to implement the recommendations made in the prevention toolkit.
Nominations for the CFR Coroner of the Year and CFR Committee of the Year will be accepted beginning in February 2011. If your coroner or committee has done great prevention or education work in 2010, please nominate them for this awesome honor! Details coming...

Together Everyone Achieves More

Please submit your stories of success or other ideas by March 15, 2011 to: OCA Division of Child Fatality Review 270 Washington St.; Suite 8101 Atlanta 30334
Phone: 404-656-4200 or Fax: 404-656-5200 or Email to: ocacfr@oca.ga.gov
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Upcoming Events

January 22-28, 2011: The 25th Annual San Diego

The Hyatt Place in Buckhead, and the Awards Break-

International Conference on Child and Family Mal-

fast will be at the Fabulous Fox Theatre! Registration

treatment. The objective of the San Diego Conference

began November 2010. Please visit

is to develop and enhance professional skills and knowl- www.safekidsgeorgia.org for information.

edge in the prevention, recognition, assessment and

March 11-12, 2011: Georgia Driver and Traffic

treatment of all forms of maltreatment including those

Safety Education Association (GDTSEA) 5th An-

related to family violence as well as to enhance investi-

nual State Conference at the Rockdale Career Acad-

gative and legal skills. Visit www.chadwickcenter.org

emy in Conyers. CEUs, PLUs, and POST credit will

for more information.

be available for sessions. For more information, visit

January 23, 2011: The APSAC Advanced Training

http://extension.caes.uga.edu/gtipi/Templates/

Institutes are being held in conjunction with the 25th

GDTSEA.htm

Annual San Diego International Conference on Child and Family Maltreatment. You must register separately
for the APSAC Institutes and the San Diego Conference.
Visit www.apsac.org for registration information.

June 15-18, 2011: Georgia Chapter of the American Academy of Pediatrics will hold their "Pediatrics by the Sea Summer Conference" at the Ritz-Carlton in Amelia Island, FL.

January 31-February 1, 2011: Safe Kids Georgia

Leadership Conference. The conference will be held at

Important Information for YOU

OCA/CFR staff are now located in new office space at 270 Washington Street, Suite 8101, Atlanta 30334. Our phone number is 404-656-4200 and our fax number is 404-656-5200. Our email address is ocacfr@oca.ga.gov.
The CFR Annual Report detailing 2009 reviewed deaths is now complete and available for distribution. Please contact CFR staff if you would like a copy. The CFR Multi-Year Trend Report will be available September 2011.
Nominations for leadership in state government: Clyde Reese has been nominated for the Commissioner of the Department of Human Services (DHS), replacing Commissioner B.J. Walker, and if approved, will be vacating his current position as Commissioner of the Department of Community Health (DCH); Harris Blackwood, a journalist and campaign adviser who is currently heading up communications for Governor-elect Deal's inaugural events, has been nominated to lead the Governor's Office of Highway Safety, replacing Bob Dallas; Amy Howell has been nominated for the next Commissioner of Georgia's Department of Juvenile Justice (DJJ), to replace Commissioner Garland Hunt; and Melvin Everson, a Gwinnett County state legislator and CFR Panel member, has been nominated to be the director of the Governor's Office of Workforce Development.
In October 2010, Pennsylvania House Bill 47 was passed, requiring hospitals and nurse midwives to educate new parents on Sudden Infant Death Syndrome and Sudden Unexpected Death of Infants, focusing on safe sleeping practices for babies. CFR is currently exploring opportunities to initiate this type of legislative prevention opportunity here in Georgia. If you would like to be a part of this initiative, or if your local hospital is currently offering this important service, please let us know.
The spring CFR training calendar is now in development. CFR staff are planning several regional committee trainings, and will offer exceptional speakers and information. Please make sure that you and all of your committee members attend one of the offered training opportunities. This year will be our best ever! Details coming soon...

OCA--Division of Child Fatality Review 270 Washington Street, Suite 8101 Atlanta, Georgia 30334
Website: www.gacfr.oca.georgia.gov