The Arizona CFR (CFR) Program was established in order to review factors in a child’s death and determine ways to reduce or eliminate any identified preventable fatalities. Legislation passed in 1993 (A.R.S. § 36-342, 36- 3501-4) authorizing the creation of the CFR Program. Data collection and case reviews began in 1994. Since 2005, the program has reviewed the death of every child in the state. The Arizona Department of Health Services’ Division of Prevention Services administers the program. The program is housed within the Bureau of Women’s and Children’s Health: Office of Injury Prevention.
The budget for the CFR program consists of both state and federal funds. The Department of Health Services assesses an additional $1 surcharge on all certified copies of death certificates to help fund the CFR program.
Arizona has both state and local CFR teams. The state and local teams are outlined according to A.R.S. § 36-3501 and 36-3502.
State Team: (Chairperson – Dr. Mary Rimsza, MD)
The team is comprised of 21 statutorily required members, meets annually and reviews the findings from the local teams in order to provide an annual report and data driven prevention recommendations each year.
Arizona has 11 Local County CFR Teams who complete reviews at the county level (second level reviews of sudden unexplained infant deaths (SUID) and maltreatment deaths are done at the State level). Teams meet as needed to complete reviews of all child deaths in their jurisdiction. However, in Maricopa County, Arizona’s largest county, the local county team has several sub-committees focusing on specific types of deaths including homicide, natural, suicide, undetermined, motor vehicle crash, and other accidents.
The Arizona CFR teams review deaths to of all children, excluding fetal (intrauterine) deaths, less than 18 years old that die in Arizona. If an Arizona resident dies outside of the state, local teams do not review the case.
To reduce preventable child fatalities through systematic, multidisciplinary, multi-agency and multi-modality review of child fatalities in Arizona through interdisciplinary training, community-based prevention education, and data-driven recommendations for legislation and public policy.
The Arizona CFR program has access to state vital statistics, and the program receives death certificates for all children who died in the state. These death certificates help trigger the review as well as provide demographic information. Arizona uses the National Database for all data reporting. Local teams enter the review data into the National Database, and the state program analyzes the data. The state program also fulfills requests for aggregate de-identified data.
Arizona produces a statutorily required annual report due to the governor by November 15 of each year. The CFR program provides the report to the governor, legislature, agency partners, the media, and local CFR teams.
CFR findings have influenced policy changes in Arizona. Statewide changes in laws have occurred because of recommendations from Arizona’s State CFR team to the legislature. Many local community policy changes have also occurred because of CFR findings. There have been ordinance changes regarding pool fencing, licensing for teen drivers, a requirement for an infant death checklist completed by law enforcement, and child safety restraints. Arizona’s CFR findings have also motivated prevention activity, most recently the launch of a statewide safe sleep prevention campaign in fall 2015.
Arizona has a variety of protocols in place including local CFR meetings, unexplained infant death investigations, second level reviews of SUID and maltreatment cases, and strict confidentiality.
Arizona CFR offers training and technical assistance for local teams and partner agencies. Quarterly meetings are held with local coordinators in which staff share information on team protocols and/or other issues related to the CFR process. Sometimes guest speakers are invited to present on a specific topic. The CFR program also provides infant death scene investigation training for local law enforcement and first responders
Last Updated: January 2019