Missouri’s Child Fatality Review Program was established in 1991 by legislation. Its annual budget is $161,700 which is for E&E and is funded through general revenue, plus additional grants. Missouri also has an additional $950,000 for personal services. Funding from year to year is somewhat stable, but is subject to Governor’s reserve and budget cuts. The program is housed out of the Social Services. There are 21 full-time, state-level unit employees and one part-time medical consultant, of which five are directly involved with the Child Fatality Review Program (one each out-posted to the Kansas City and St. Louis metro areas). Missouri’s CDR efforts also include the State Technical Assistance Team, which focuses on child abuse, sexual abuse, exploitation and fatality investigations.
Missouri has both state and local teams.
State Team: (Chairperson – Harold Bengsch)
The Team is comprised of 24 members appointed by the Department Director and meets bi-annually. This panel is responsible for providing oversight and making recommendations to the Department of Social Services and the State Technical Assistance Team. The State Team also has a subcommittee which has reviewed and reported on all 2014 Child Abuse and Neglect deaths.
Missouri requires each of its 114 counties, and the City of St Louis, to have a multidisciplinary Child Fatality Review Panel. There are 115 teams comprised of seven or more child protection community team members that meet per reviewable death.
The Missouri CDR teams review deaths that occur to children under the age of 18. Missouri offers prevention resources, community assistance, bereavement and SIDS services as well. These services are provided primarily at the community level.
The purpose of the Missouri CDR team is prevention, provision of services, exchange of confidential information for investigative purposes and evaluation for improved practices, policies and procedures by individual agencies. This has always been the focus.
Prior to 2011, standardized data reporting forms were completed for all reviews; in 2011, Missouri converted reporting processes to the National CDR Internet-based case reporting system. The only required paper document is the Child Fatality Review Program Final Report, which is the only open-record document and is required by state legislation and policy. Missouri CDR has access to state vital statistics and child abuse and neglect reporting systems, using this information to link with their data reporting tools. Data is stored in various ways, paper copies are filed, data is entered into an in-house Access database and National CDR Internet-based data reporting system. Data is analyzed through Microsoft Excel and Access software, and department mainframe system queries.
Missouri does produce an annual report. The latest annual report available is for 2017. The report is distributed to a mandatory distribution list which includes government officials and CFRP panel members and is available online at http://www.dss.mo.gov/re/cfrar.htm.
CDR findings have influenced policy changes. Statewide and local examples of these changes include: a focus in the areas of child fatalities and serious injury prevention, provision of services, crimes and punishment, training and investigation. Prevention activities motivated by CDR findings include training on prevention of child fatalities in the areas of sudden unexpected infant death, unintentional injuries, driver safety programs, fire safety programs, gun safety programs, Safe Crib/Safe Sleep programs and Never Shake A Baby programs. CDR staff actively participates with several multidisciplinary prevention coalitions around the state. Missouri CDR efforts have been evaluated by the University of Missouri Research Program.
Missouri CDR has a variety of protocols in place including child death investigation, confidentiality, and the CDR meeting.
Training is provided on a routine basis. Types of training include: individual county-based CDR operational training, CDR program-related and prevention-based presentations, and support for the field-level intervention/investigative community to help realistically convert policy into practice. The trainings are funded with Department funds, the Criminal Justice Act and the Missouri Children’s Trust Fund.
Last Updated: January 2019