State Spotlight - Louisiana


Last updated:  April 2011

Kristie Bardell, MPH
MCH Program Monitor
Louisiana Office of Public Health
1450 Poydras St., Room 2032
New Orleans, LA 70112
Phone: (504) 568-3504
Fax: (504) 568-3503
Email: Kristie.Bardell@La.Gov



Tools

Reports
Mortality Statistics Program Description

Administration
The Louisiana State Child Death Review Program (CDR) was established in 1992 by the Louisiana Legislature, and in 2001, local Child Death Review teams were established in each of Louisiana’s nine Office of Public Health regions. The Louisiana CDR Program functions under the auspices of the Louisiana Department of Health and Hospitals, Office of Public Health’s Title V MCH Program. The State CDR efforts and the MCH Title V Block Grant funds support the Local CDRP efforts.

Teams
Louisiana has both state and local CDR teams. The state level team is mandatory and local teams are permissive. Citizens serve on both the state and local level teams.

State Team: (Panel Chairperson- State Health Officer)
The Louisiana State CDR Panel is a multi-disciplinary panel of 25 members of Louisiana state and non-governmental agencies and organizations, as defined by Louisiana legislation R.S 40:2019. The State Child Death Review Panel reviews all unexpected deaths among children age 14 years and younger, including SIDS (sudden infant death syndrome) to better understand the cause and contributing risk factors. Review findings are also used to take action to prevent other deaths and to improve health and safety of Louisiana’s children. The State team meets at least quarterly each year and must also submit an annual report of case review findings to the Louisiana legislature.

Local Teams: (Panel Chairperson(s) – Local CDR Panel Coordinator )
In 2001, Local Child Death Review teams were established in each of Louisiana’s nine Department of Health and Hospitals Administrative Regions. Core panel members include representatives from the following agencies or professions: law enforcement, child protective services, District Attorney/prosecutor, medical examiner/coroner, public health, pediatrician or other family health provider, and emergency medical services. The Local CDR Panels are tasked with reviewing reports of all unexpected deaths among children 14 years and younger to better understand how and why children die. Based on their reviews, local teams are responsible for making and implementing recommendations for child safety and injury prevention, in their respective regions.

Reviews
Louisiana CDR case reviews are retrospective. Death certificates on all children less than 15 years of age are received, and case selection for panel review is based on the age of the child (0 through 14 years), manner (unintentional) and cause of death (unexpected, unclear, unexplained/undetermined, or of a suspicious circumstance). Investigative reports, including autopsies and death scene investigative reports, are requested for case reviews of unexpected deaths. Select unexpected child deaths and all SUIDs (sudden unexpected infant deaths) are reviewed by the State CDR teams, and the non-SUID unexpected deaths are reviewed by the local CDR teams. After complete review of each case, prevention recommendations are made by the State and/or Local CDR teams, and the recommendations and case review findings are then disseminated to agencies and groups that can use this information to prevent future deaths. Case reviews are not performed on child deaths due to natural causes, suicides, homicides, child deaths under investigation by law enforcement, or cases pending/active criminal prosecution. Louisiana also has Fetal Infant Mortality Review (FIMR), Pregnancy Associated-Mortality Review, and Child Abuse & Maltreatment review programs.

Purpose
The Purpose of the State CDRP is to perform multi-disciplinary, multi-agency reviews of unexpected, unintentional child deaths of children under 15 years of age to develop a greater understanding of the causes of child deaths, preventing such deaths, and of the gaps in services and, thereby, reduce the incidence of injury and death among infants and children.

Data
The three primary CDR data sources for Louisiana are: death certificates from Louisiana Center for Health Statistics and Vital Records, investigative case reports (including the national, standardized SUIDI case reporting form), and the CDR case review database. The CDR case report used to collect data on child deaths in Louisiana is a standardized case report form provided by the National Center for Child Death Review. The case reports are completed by both state and local panel members. The data are then entered into the CDR database by the State CDR Panel Coordinator. Data analysis is performed by the public health epidemiologist for the CDR Program.

Annual Report
Louisiana is required to produce an annual report. The 2010 CDR report, reflecting case reviews of deaths from 2002-2007 is currently being reviewed for publication. The report is submitted to the Governor and Louisiana legislators, disseminated to state agencies, CDR team members, partners, and is made available to the general public.

Prevention Initiatives
CDR findings have influenced the development and implementation of educational and prevention initiatives in Louisiana. Statewide and local examples of these initiatives include:
  • Implement culturally competent SIDS risk reduction and safe sleep public education campaigns such as "This Side Up" and "Give Your Baby Space"
  • Child Passenger Safety- Car seat inspections and child passenger safety education
  • Fire Safety education
  • Bereavement support for families who lost an infant to SIDS or undetermined causes
Protocols
Louisiana’s CDR Program maintains protocols for confidentiality, investigative case reporting, case reviews, and bereavement support to families.

Training
Professional development among the local CDR Program coordinators continues to be a priority. Over the past year state and local CDR coordinators completed various trainings/certification courses: the University of Delaware’s Injury Prevention Basic Certification course; TEACH-VIP injury prevention and control curriculum; National Child Passenger Safety Technician certification course; and Louisiana’s Child Care Health Consultant training.