Spotlight – Louisiana

Rosaria Trichilo, MPH
Statewide Surveillance Manager
Bureau of Family Health
Louisiana Department of Health
1450 Poydras Ave., Suite 2032
New Orleans, Louisiana 70112
Office: 504-568-3504
Email: rosaria.trichilo@la.gov

Program Description

Administration
The Louisiana State Child Death Review Program (CDR) was established in 1992 by the Louisiana Legislature, and in 2001, local Child Death Review teams were established in each of Louisiana’s nine Office of Public Health regions. The Louisiana CDR Program functions under the auspices of the Louisiana Department of Health, Office of Public Health’s Bureau of Family Health. MCH Title V Block Grant funds support the Local and State CDR.

Teams
Louisiana has both state and local CDR teams. The state level team is mandatory and local teams are permissive. Citizens serve on both the state and local level teams.

State Team: (Panel Chairperson- State Health Officer)
The Louisiana State CDR Panel is a multi-disciplinary panel of 25 members of Louisiana state and non-governmental agencies and organizations, as defined by Louisiana legislation R.S 40:2019. State CDR review findings and recommendations that result from local review in order to take state-level actions that prevent future injury or fatality, and to improve the health and safety of Louisiana’s children. The State team meets quarterly and must submit an annual report of case review findings to the Louisiana legislature.

Local Teams: (Panel Chairperson(s) – Regional Maternal and Child Health Coordinator)
In 2001, Local Child Death Review teams were established in each of Louisiana’s nine Department of Health Administrative Regions. Core panel members include representatives from the following agencies or professions: law enforcement, child protective services, District Attorney/prosecutor, medical examiner/coroner, public health, pediatrician or other family health provider, and emergency medical services. The Local CDR Panels are tasked with reviewing reports of all unexpected deaths among children 14 years and younger to better understand how and why children die. Based on their reviews, local teams are responsible for making and implementing recommendations for child safety and injury prevention, in their respective regions. Further, findings and recommendations are shared with State CDR for further action, if necessary.

Reviews
Louisiana CDR case reviews are retrospective. Death certificates on all children less than 15 years of age are received, and case selection for panel review is based on the age of the child (0 through 14 years), manner (unintentional) and cause of death (unexpected, unclear, unexplained/undetermined, or of a suspicious circumstance). Investigative reports, including autopsies and death scene investigative reports, are requested for case reviews of unexpected deaths. State CDR reviews select unexpected child deaths, while local CDR teams review all unexpected deaths in children under 15. After complete review of each case, prevention recommendations are made by the State and/or Local CDR teams, and the recommendations and case review findings are then disseminated to agencies and groups that can use this information to prevent future deaths. Case reviews are not performed on child deaths due to natural causes, child deaths under investigation by law enforcement, or cases pending/active criminal prosecution. Louisiana also has Fetal Infant Mortality Review (FIMR) and Pregnancy-Associated Mortality Review programs.

Purpose
The Purpose of the State CDR is to perform multi-disciplinary, multi-agency reviews of unexpected, unintentional child deaths of children under 15 years of age to develop a greater understanding of the causes of child deaths, preventing such deaths, and of the gaps in services and, thereby, reduce the incidence of injury and death among infants and children.

Data
The three primary CDR data sources for Louisiana are: death certificates from Louisiana Center for Health Statistics and Vital Records, investigative case reports (including the national, standardized Sudden Unexpected Infant Death Investigation reporting form), and the CDR database. The CDR case report used to collect data on child deaths in Louisiana is a standardized case report form provided by the National Center for Child Death Review. The case reports are completed by both state and local panel members. Regional Maternal and Child Health Coordinators then enter the data into the CDR database. The Bureau of Family Health’s Mortality Epidemiologist performs data analysis.

Annual Report
Louisiana is required to produce an annual report. The 2013-2015 CDR report is the most recent completed report. The report is submitted to the Governor and Louisiana legislators, disseminated to state agencies, CDR team members, partners, and is made available to the general public.

Prevention Initiatives
CDR findings have influenced the development and implementation of educational and prevention initiatives in Louisiana. Statewide and local examples of these initiatives include:

  • Revisions to Child Death Investigation law
  • Development of a Safe Sleep Subcommittee dedicated to preventing sleep related deaths in Louisiana
  • Development of a Water Safety Subcommittee dedicated to preventing drowning deaths in Louisiana

Protocols
Louisiana’s CDR Program maintains protocols for confidentiality, investigative case reporting, case reviews, and bereavement support to families.

Training
Professional development among the local CDR Program coordinators continues to be a priority. Over the past year state and local Maternal and Child Health Coordinators completed various trainings/certification courses, including Crucial Conversations, Story Telling Workshops, and have planned anti-oppression and facilitation trainings planned for 2018

Last Updated: January 2019