Spotlight – Nebraska

Director:
Dr. Tom Williams
Chief Medical Officer
Nebraska Health and Human Services System
301 Centennial Mall South, PO Box 95026
Lincoln, NE 68509-5026
Email: Tom.Williams@nebraska.gov

Coordinator:
Shannon Twist
Lifespan Health Unit
Nebraska Health and Human Services System
301 Centennial Mall South, PO Box 95026
Lincoln, NE 68509-5026
Phone: 402-471-0552
Fax: 402-471-7049
Email: Shannon.Twist@nebraska.gov

Website: http://dhhs.ne.gov/publichealth/Pages/lifespanhealth_cdrteam_index.aspx?

Tools

Reports

Mortality Statistics

Program Description

Administration
The Nebraska Child and Maternal Death Review Team (NCMDRT) was established in 1993 by legislation, with authority for maternal deaths added in 2013. Funds from the MCH Block Grant support the program with an annual budget of $70,000. Funding for the program is year-to-year. The program is housed out of the Nebraska Department of Health and Human Services. There are 1.2 FTEs that staff the program and .25 in kind staff. Nebraska is a member of the Midwest Regional CMDR coalition.

Teams
Nebraska has a state level review team.

State Team: (Chairperson – Dr. Tom Williams)
The team is comprised of 15 members and meets quarterly. The NCDMRT is a retrospective process. The Department of Vital Records is responsible for providing the NCMDRT coordinator with death certificates for all Nebraska residents under the age of 18, with matched birth certificates for infants. The information is screened and organized by cause of death into eight discrete categories, with one overlapping category related to caretaker abuse or neglect. A request is then made to hospitals, county attorneys and other sources for records concerning the deaths of the children. Once all the information is collected, cause-specific workgroups review the deaths. The full CDMRT, as needed, reviews selected cases. These might include complicated medical cases, child abuse and neglect and any others that might benefit from a broader review.

Beginning in January, 2014, maternal death certificates are identified through the pregnancy checkbox on death certificates, and through matching live birth and fetal death certificates to death certificates of women of childbearing age. Resulting information is tabulated and added to the annual CMDRT report. Medical records are requested for maternal deaths that appear to be related to a medical condition, and then reviewed by a separate maternal review workgroup. Case review information will be aggregated on a 5-year basis, and included in that year’s annual report.

Local Teams:
Local infant death review teams, following the FIMR model, are operating in Douglas County (Omaha), and in a five county area in northeast Nebraska.

Reviews
The Nebraska State CMDR team reviews deaths to women within 365 days of a pregnancy, and deaths to children under the age of 18 years old.

Purpose
The purpose of the Nebraska CMDR Program is prevention.

Data
Standardized data reporting forms are completed for all reviews. This is not a required function by state legislation or policy. Nebraska has been participating in the National Center for the Review and Prevention of Child Deaths Case Reporting System.

Nebraska CMDR has access to state vital statistics. The information is extracted from birth and death certificates for purposes of case review. CMDR data are stored in a database and are analyzed by SAS.

Annual Report
Nebraska does produce an electronic annual report based on unreviewed Vital Statistics data from death certificates. A comprehensive report based on CMDRT reviews of deaths is produced approximately every two years. All reports are distributed to the Governor, state legislature, team members and on request; they are also posted to the Nebraska CMDRT website.

Prevention Initiatives
CMDR findings have influenced policy changes. A statewide example of this is graduated drivers licensing. Lots of work is centered on preventing sleep-associated infant deaths.

Protocols
Nebraska CMDR has a variety of protocols in place including CMDR Meeting and confidentiality.

Training
Training is not provided.

Last Updated: January 2017