Spotlight – Massachusetts

Bekah Thomas
Director of Injury Prevent and Control
250 Washington St., 4th Floor
Boston, MA 02108
Phone: (617) 624-5557

Email: Rebekah.Thomas@MassMail.State.MA.US

Justine Egan, MPH
CFR Epidemiologist
Massachusetts Department of Public Health
250 Washington Street
Boston, MA 02108
Phone: (617) 624-5518
Email: Justine.egan@state.ma.us

Program Description

Administration
The Massachusetts CDR program was established by statute (MGL C 38 Section 2) in 2000. It is an unfunded mandate, but some resources for state activities have been identified through two federal sources, the MCH Block grant and the EMS for Children grant. The state team is jointly convened by the public health department and the office of the chief medical examiner; administrative and operations functions are within the public health department. There are four Department of Public Health employees providing in-kind support and a .5 FTE dedicated Coordinator position.

Along with the CDR program, Massachusetts Department of Public Health also administers the EMS for Children project.

Teams
Massachusetts has both state and local teams which are mandatory. State statute defines team membership at both the local and state level but does not limit it. Massachusetts is a member of the New England Regional CDR Coalition.

State Team Chairperson: Henry Nields, MD, PhD, Chief Medical Examiner
According to statute, the state team falls under the jurisdiction of the state medical examiner. The team is comprised of 16 statutory members and meets every other month. The state team is co-chaired by Leonard Lee, Director of the Division of Violence and Injury Prevention at the Department of Health.

Local Teams:
According to statute, the local teams fall under the jurisdiction of the District Attorney Offices. There are 11 teams, each comprised of 10-20 members. The teams are mandated to meet at least quarterly, the larger districts meet more frequently.

The local recommendations are forwarded to the state team for review and development of action steps.

Reviews
The Massachusetts CDR team reviews deaths to children under the age of 18. Some of the larger teams do not review deaths of premature infants. There are three city-based Fetal Infant Mortality Review (FIMR) in the state that examine many of these cases. A statewide Review of Infant Mortality process has been initiated to provide higher quality reviews of medically-related infant deaths.

Purpose
The purpose of the Massachusetts CDR program is prevention, investigation, to facilitate interagency networking and collaboration and to produce recommendations for changes that will protect the health and safety of children. The program has always had a focus on public health.

Data
Several of the local teams are utilizing the National Center’s web-based reporting system for data collection. In addition, all teams are asked to complete a one page data form on all deaths that undergo a local team review. This information is entered into an ACCESS database and is used for monitoring the number and types of reviews completed throughout the state.

Massachusetts CDR has access to state vital statistics and uses the information in preparing an annual report. Additionally, the Office of Vital Statistics sends copies of death certificates to the State Medical Examiner Office which then forwards them to the local teams.

Annual Report
Massachusetts does produce an annual report. The report is distributed to state and local team members, legislators, interested parties, EMS providers and public health officials.

Prevention Initiatives
Massachusetts CDR implemented infant/child death scene investigation protocols and the distribution of safe sleep materials. MA CDR worked in conjunction with the Department of Elementary and Secondary Education to develop a memorandum for public schools that have public swimming pools located in them. MA CDR is also examining methods to enhance window fall and drowning prevention in Massachusetts.

Protocols
Massachusetts has an optional letter for local teams to use in requesting information for the review process. The State Team has provided recommended guidance/protocols for Local Teams and has developed standard processes for its own meetings.

Training
Massachusetts CDR does provide training. In the past, EMS-C has made funding available for an annual conference – the most recent of which was held in March 2013. The CDC Core VIPP Grant funds were also available to use for the annual CDR conference in 2016. However, funding for this work will become more problematic in the current fiscal environment.

Last Updated: January 2017