Massachusetts - State Spotlight


State Spotlight - Massachusetts Last updated: September 2011 Elizabeth Welch Coordinator, Child Fatality Review Team Division of Violence and Injury Prevention Massachusetts Department of Public Health 250 Washington Street, 4th Floor Boston, MA 02108 Phone: (617) 624-5448 Email: Elizabeth.Welch@state.ma.us Holly Hackman, MD, MPH Massachusetts Department of Public Health 250 Washington Street Boston, MA 02108 Phone: (617) 624-5466 Email: holly.hackman@state.ma.us Tools Massachusetts Child Death Review Legislation Reports 3rd Annual Report of Massachusetts Child Fatality Review Program Massachusetts CFR Program 5th Annual Report of Program Activity, 2005 Mortality Statistics Massachusetts Child Mortality Data, 2002 Massachusetts Child Mortality Data, 2003 Massachusetts Child Mortality Data, 2005 Massachusetts Child Mortality Data, 2006 Massachusetts Child Mortality Data, 2007 Program Description Administration The Massachusetts CDR program was established by statute (Section 2A-3) in 2000. It is an unfunded mandate, but some resources for state activities have been identified through two federal sources, the MCH Block grant and the EMS for Children grant. The state team is jointly convened by the public health department and the office of the chief medical examiner; administrative and operations functions are within the public health department. There are four Department of Public Health employees providing in-kind support and a .5 FTE is expected to be hired in the spring of 2011. Along with the CDR program, Massachusetts Department of Public Health also administers the EMS for Children project. Teams Massachusetts has both state and local teams which are mandatory. State statute defines team membership at both the local and state level but does not limit it. Massachusetts is a member of the New England Regional CDR Coalition. State Team Chairperson: Henry Nields, MD, Chief Medical Examiner According to statute, the state team falls under the jurisdiction of the state medical examiner. The team is comprised of 25 members and meets quarterly. The state team is co-chaired by Dr. Lauren Smith, the Medical Director of the Massachusetts Department of Public Health. Local Teams: According to statute, the local teams fall under the jurisdiction of the District Attorney Offices. There are 11 teams, each comprised of 10-20 members. The teams are mandated to meet at least quarterly, the larger districts meet more frequently. The local recommendations are forwarded to the state team. Reviews The Massachusetts CDR team reviews deaths to children under the age of 18. One team has started to review near-fatalities. Some of the larger teams do not review deaths of premature infants. There are three city-based Fetal Infant Mortality Review (FIMR) in the state that examine many of these cases. A statewide Review of Infant Mortality process is being developed to provide a higher quality review of medically-related infant deaths. Purpose The purpose of the Massachusetts CDR program is prevention, investigation, to facilitate interagency networking and collaboration and to produce recommendations for changes that will protect the health and safety of children. The program has always had a focus on public health. Data A few of the local teams are utilizing the National Center’s web-based reporting system for data collection. In addition, all teams are asked to complete a one page data form on all deaths that undergo a local team review. This information is entered into an ACCESS database and is used for monitoring the number and types of reviews completed throughout the state. Massachusetts CDR has access to state vital statistics and uses the information in preparing an annual report. Additionally, the Office of Vital Statistics sends copies of death certificates to the State Medical Examiner Office which then forwards them to the local teams. Annual Report Massachusetts does produce an annual report. The report is distributed to state and local team members, legislators, interested parties, EMS providers and public health officials. Prevention Initiatives CDR is currently working on implementation of infant/child death scene investigation protocols and safe sleep materials. CDR is also examining methods to enhance window fall and drowning prevention in Massachusetts. Protocols Massachusetts has a optional letter for local teams to use in requesting information for the review process. Local and State team process protocols have recently been developed and distributed. Training Massachusetts CDR does provide training. In the past, EMS-C has made funding available for an annual conference – the most recent of which was held in March 2011. However, funding for this work will become more problematic in the current fiscal environment.