Spotlight – Montana

Kari Tutwiler
State FICMMR Coordinator
Maternal and Child Health/Family and Community Health Bureau
1400 East Broadway, Room A-116
Helena, MT 59620-2951
Phone: (406) 444-3394
Email: ktutwiler@mt.gov

Website: http://dphhs.mt.gov/publichealth/cdrp

Program Description

Administration
Montana’s Fetal, Infant, Child, and Maternal Mortality Review (FICMMMR) program was established in 1997 through legislation and was amended by the 2013 Legislature to include the review of maternal deaths. FICMMR is housed in the Family and Community Health Bureau (FCHB) at the MT Department of Public Health and Human Services. The State FICMMR Coordinator’s position is funded by the Title V Maternal and Child Health Block Grant (MCHBG) and State General Funds.

Teams
Montana has 31 county mortality review teams, which are defined in state statute. Due to the state’s rural population, 23 other counties utilize a neighboring county’s FICMMR team to help review their county deaths and generate evidence-based and best practice prevention recommendations. . The recipient county is responsible for implementing evidence-based or best practice prevention initiatives in their county. This model of cooperation is effective and efficient as reviews are conducted for 54 counties and six of the seven American Indian tribes.

Reviews

All causes of death of children under 18 years of age and maternal deaths are reviewed by local teams. Some fetal deaths are also reviewed by the county teams, but not all if, after completion of the screening tool, the results do not merit a team review.

Purpose
The purpose of the Montana FICMMR Program is to reduce preventable deaths.

Local review teams are led by a designated county health employee and offer a variety of prevention services: Safe sleep, seat belt, car seat installation and distracted driving education, suicide prevention, water & bicycle safety, choking hazards education, etc., and distribution of free cribs, bicycle helmets, gun locks, etc.

Data
Standardized data reporting forms are completed for all reviews via the web-based National Fatality Review Case Reporting System (NFR-CRS). Montana FICMMR works with the State Office of Vital Records to monitor deaths to assure no deaths are missed. The State FICMMR Coordinator sends a monthly vital statistics report to the local team an county leader, so they are continually updated on the deaths of their county residents. In 2013, Montana entered into a Data Use Agreement with the Michigan Public Health Institute allowing the local FICMMR review teams to enter their completed cases in the NFR-CRS. The FICMMR data recorded prior to calendar year 2013 is accessible to the State FICMMR Coordinator and the Maternal and Child Health Epidemiologist.

Prevention Initiatives
FICMMR findings have influenced local changes. Statewide examples of these changes include a requirement that a SIDS diagnosis meet the criteria of autopsy, scene investigation and review of medical history, distribution of handgun safety information during well-child checks, installation of self-locking gates on backyard pool fences, and screening from providers of adolescents for risk of suicide at all routine exams as well as determining if a firearm is present in the home. Prevention activities motivated by FICMMR findings include a request for every hospital to examine infant sleep position policy and model “Back to Sleep” messages in nurseries, require all licensed day care providers to know CPR, public service announcements on water safety and gun safety; graduated licensing and Yellow Ribbon campaigns.

Protocols
Montana FICMMR resources and protocols are available at: http://dphhs.mt.gov/publichealth/cdrp

Training
Trainings, funded through the MCHBG are provided on a quarterly or near quarterly basis. Trainings take the form of webinars, an annual training, on-going individual technical assistance, the Montana FICMMR Guidebook, and newsletters. All new county leaders receive a FICMMR #101 comprehensive training, followed by a hands-on NFR-CRS database training. On-going training and resource distribution includes:: suicide, drowning, SUID deaths motor vehicle accident and distracted driving prevention , Period of Purple Crying as well as team leadership, facilitation, meeting management, recruitment, data quality, and more.

Last Updated: March 2018