Last updated:  February 2008

Vacant
Montana Dept. of Public Health and Human Services
Family and Community Health Bureau
1218 E 6th Avenue
Helena, MT 59620
Phone: 406-444-3394 
Fax: 406-444-2606 

Website: http://www.dphhs.mt.gov/PHSD/family-health/ficmr/ficmr-index.shtml

Tools

• State of Montana Fetal, Infant and Child Mortality Review Reporting Tool 2005
• Montana Fetal, Infant and Child Mortality Review Legislation

• Montana 1st Annual Report, November 2002
• Montana 2nd Annual Report, December 2004
• FICMR Report Tables (Excel)

• Montana Child Mortality Data, 2002
• Montana Child Mortality Data, 2003
• Montana Child Mortality Data, 2005

Administration
Montana’s Fetal, Infant and Child Mortality Review (FICMR) program was established in 1997 by legislation. FICMR is housed out of and funded by the Montana Department of Public Health and Human Services - Maternal and Child Health. In 1998, they were awarded a grant from HRSA/MCHB to continue development and implementation of a statewide FICMR program, combining the FIMR and CDR process. It also spurred the development of a domestic violence death review process that was passed into law in 2003. Funding for the program is stable at this time, with approximately $60,000 per year from the MCH Block Grant. There is one state level employee working half time on the project. Montana' s FICMR Program also administers FIMR and SIDS programs.   Additionally, Montana is part of the Western Regional Child Death Review Coalition.

Teams
Montana has both state and local teams.  There is no statute in place for the state team but the local teams are permitted by statute.

State Team:
The team is comprised of 22 members and meets three times a year. The State Team serves in an advisory capacity to the local FICMR teams and process. They recommend policy changes and advocate for legislation when needed. This team also performs second level reviews of difficult cases when requested by the local teams. The team composition is multi-disciplinary and reflects the membership of local teams including three local team coordinators who help depict local community level issues. 

Local Teams:
There are 30 teams that review deaths for 53 counties and seven Indian tribes. Currently, they have a 92% review rate of all deaths. Because of the state’s rural population, legislation was passed in 2003 allowing for a system of regional reviews. Frontier counties that only have an occasional child death will ask an established neighboring county FICMR team to review that death and send them recommendations for prevention. The frontier county will then be responsible for follow up. This process has been extremely efficient and effective. 

Reviews
Teams in Montana review deaths to children due to all causes under the age of 18 years old. Counties receiving MCH Block Grant support from the state office are contractually required to assure review of all fetal, infant and child deaths by a Fetal, Infant and Child Mortality Review Team. 

Purpose
The purpose of the Montana FICMR Program is prevention. This has always been the focus of the program. Local review teams are led by public health nurses and offer bereavement and SIDS services, as they are able through their public health departments. 

Data
Standardized data reporting forms are completed for all reviews. State law requires this. Montana FICMR has access to state vital statistics. This information is used to assure no death has been missed. The State Team Coordinator sends a vital statistics report out quarterly to local team coordinators for quality assurance purposes. FICMR data is stored in a Microsoft Access Database and is analyzed by MCH epidemiologists. 

Annual Report
Montana produces an annual report every other year. This report is released statewide, which includes public and private health providers, legislators and service organizations. 

Prevention Initiatives
FICMR findings have influenced policy changes. Statewide examples of these changes include a requirement that a SIDS diagnosis meet the criteria of autopsy, scene investigation and review of medical history; distribution of handgun safety information during well-child checks, installation of self-locking gates on backyard pool fences and screening from providers of adolescents for risk of suicide at all routine exams as well as determining if a firearm is present in the home. Prevention activities motivated by FICMR findings include a request for every hospital to examine infant sleep position policy and model "Back to Sleep" messages in nurseries, require all licensed day care providers to know CPR, public service announcements on water safety and gun safety; graduated licensing and Yellow Ribbon campaigns. 

Protocols
Montana FICMR has a variety of protocols in place including CDR Meeting and confidentiality. 

Training
Training is provided on a routine basis. Types of training include suicide prevention, bereavement and scene investigation. The trainings are funded through a MCH Block Grant.