State Spotlight - Virginia

Last updated:  April 2010

Virginia Powell, Ph.D.
Coordinator, State Child Fatality Review
Office of the Chief Medical Examiner
737 North 5th Street, Suite 301
Richmond, VA 23219
Phone: 804-205-3854
Fax:  804-786-1877
Email: Virginia.Powell@vdh.virginia.gov

Website: http://www.vdh.virginia.gov/medExam/childfatality.htm

Tools
 Reports
Mortality Statistics Program Description

Administration
Virginia’s Child Fatality Review Program was established by statute in 1994. It has an annual budget of approximately $85,000 that is funded by the MCH Block grant.  Funding for the program is on a year to year basis. The program is housed in the Office of the Chief Medical Examiner, which is part of the state health department. There is one paid state employee and three-five local employees that staff their local program on a voluntary basis.

Teams
Virginia has both state and local teams. The Citizen’s Review Panel is included in Virginia’s CDR efforts.

State Team:
The team is comprised of 23 members and meets six times a year. Most of their meeting time is spent reviewing cases. By statute, the team has access to all records related to the decedent child.  State team meetings must be advertised as public but are closed when cases are discussed. Before the meeting takes place, state team members are divided into groups that read individual case files. At the meeting, groups present case information to the entire team. The team then determines the degree of preventability of the case and generates ideas for intervention. The team uses a consensus model to agree on preventability. When the state team develops recommendations, the CFR coordinator calls the agency that the recommendation will affect, discusses the impact of the recommendation on the agency, and reports back to the team. This process supports stronger targeted recommendations.

Local Teams:
There are three teams, each comprised of approximately 25 members. The teams meet either monthly or quarterly.

Reviews
By statute, the Virginia Child Fatality Review State Team can review the following kinds of deaths to children under 18 years of age: (1) violent and unnatural child deaths; (2) sudden child deaths occurring within the first eighteen months of life and (3) those fatalities for which the cause or manner of death was not determined with reasonable medical certainty. By statute, the Virginia local or regional CFR teams review deaths to children under 18 years of age. But the Team does not review all child deaths for every year.  Instead, the Virginia State team selects categories of child death – caretaker homicide or motor vehicle - for each review.

Purpose
The purpose of the Virginia CFR Program is prevention. Teams have always focused on prevention and public health interventions.

Data
Standardized data reporting forms are not completed for all reviews. The collection of data is not required by legislation or policy. Virginia’s CFR has access to state vital statistics. Vital statistics are used to place reviewed child deaths within the context of all child deaths in the state. CFR data is stored on a computer and is analyzed using SPSS.

Annual Report
Virginia produces a report at the conclusion of each review. This report is distributed to injury prevention groups, FIMR, domestic violence advocates, police chiefs, sheriff departments, medical examiners, social services directors, child protective services supervisors, members of the Virginia General Assembly, Commonwealth’s Attorneys, SAFE KIDS coalitions and other child advocate organizations.

Prevention Initiatives
Virginia CFR efforts have influenced policy changes. Statewide examples of this include a legislative change requiring stiffer civil penalties for violations of child safety restraint laws and the addition of emergency medical services personnel to the list of mandated reporters.  Local community examples include community level education on SIDS and co-sleeping, collaboration with Drive Smart Virginia on safe driving among teenagers, shaken baby awareness campaign through a local hospital and collaboration with branches of the military on preventing child abuse and neglect among military families. Examples of how CFR findings have motivated prevention activities include a re-invigorated safe sleep campaign through the Virginia Department of Health, a review of child suicides led to the development of a statewide youth suicide prevention plan and review of caretaker homicides led to an initiative to educate local health department personnel about shaken baby syndrome.

Protocols
Virginia has confidentiality and CFR meeting protocols in place.

Training
Training is not provided.