Last updated:  September 2008

Tory Clarke Henderson
Department of Health
Division of Community and Family Health
Office of Maternal and Child Health
P.O. Box 47800
Olympia, Washington 98504-7880
Phone:  360-236-3522
Fax:  360-586-7868
Email:  tory.henderson@doh.wa.gov

Diane Pilkey, RN, MPH
Washington State Department of Health
Maternal & Child Health
P.O. Box 47835
Olympia, Washington 98504-7880
Phone:  360-236-3526
Fax:  360-236-2323
Email:  diane.pilkey@doh.wa.gov

Website: http://www.doh.wa.gov/cfh/CDR/cdr_default.htm

Tools

• Washington Child Death Review Legislation
• Washington Child Death Review Data Form
• The HIPAA Privacy Rule and the CDR Program
• CDR Guidelines 2005

• Washington CDR Program Progress Report
• Series of Injury Prevention Recommendations Reports from CDR State Committee
• For All Our Children:  Preventing SIDS and Motor Vehicle Crash Deaths, March 2003
• Child Firearm Death Prevention, December 2003
• Childhood Drowning Prevention, June 2004
• King County CDR 2001 Annual Report
• King County CDR 2002 Annual Report
• Motor Vehicle Crashes with Child Fatalities:  Summary of Snohomish County Child Death Review Data, January 1, 1999 - October 31, 2002
• Spokane Child Death Review Reports 
• 1996-1999 
• 2000-2001
• Washington State Childhood Injury Report, September 2004

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

Administration
In 1993, local public health agencies were authorized by statute to conduct confidential child mortality reviews on a voluntary basis.  While a few agencies began conducting reviews, the Washington Child Death Review (CDR) Program was not developed as a statewide system until the passage in 1997 of a budget proviso that provided funding to Washington Dept. of Health.  The program had an annual budget of $500,000 funded from state general funds. Of that, $350,000 was contracted out to all of the local county health departments in the state to support the coordination of review teams and establish a statewide system.  At the state level, the remaining $150,000 supported 2 FTE's to coordinate a data collection and analysis system, provide training and technical assistance to local teams, disseminate recommendations and other data reports, convene a Statewide State Advisory Committee and provide oversight of the statewide program.  Funding for the program was eliminated July 2003. Some local teams continue the work and the Washington Department of Health continues to provide limited technical assistance and coordination and analysis of data. Currently, there are two state employees at .25 FTE each that provide the staffing at the state level.  Support for these positions is provided by MCH Block grant funding. 

Teams
Washington has local CDR teams only which are coordinated through local public health jurisdictions. Currently, there are 17 out of 35 teams that are continuing on some level.  The frequency of meetings varies among the teams. 

Reviews
Washington CDR teams provide retrospective reviews of all unexpected deaths to children age 17 and under except deaths due to extreme prematurity. 

Purpose
The purpose and focus of the Washington CDR review process is prevention, not investigation. 

Data
Standardized data reporting forms are completed for all reviews. The collection of data is not required by legislation or policy. Washington CDR teams have access to local and state vital statistics. Vital statistics are used to match death data with files in the CDR database to assure that all eligible deaths have been reviewed. Currently, CDR data is stored on a secure web-based application accessible to local teams through digital certificates.  Washington Department of Health assessment staff maintain the data system, assesses the aggregate data for CDR reports and provides specialized data for reports and presentations upon request. 

Annual Report
Washington produces specialized data reports but no annual report. These reports are distributed to a broad range of stakeholders. 

Prevention Initiatives
Washington CDR efforts have influenced change. Local community examples include mailings regarding burn prevention with messages about supervision; education for providers, parents and school nurses on drowning prevention as well as standards for safety at beaches; better awareness regarding suicide prevention; increased funding for traffic safety; fire detector and wood stove installation checks; and safe storage of firearms and Safe Sleep Campaigns. Examples of how CDR findings have motivated prevention activities include rule changes regarding swimming in Puget Sound, implementation of local bike helmet ordinances, SIDS prevention activities and drowning prevention activities. 

Protocols
Guidelines on confidentiality and CDR meeting protocols are in place. 

Training
Training was provided until July 2003 and was funded by the state CDR budget. Since state level funding has now been eliminated, other sources of funding for training efforts are being used.  Training on the multi-state database was provided in October 2007.  Additional training was provided in February 2008.