Amy Davis, MPH
Bureau of Maternal, Child and Family Health
Ohio Department of Health
246 North High Street, 6th Floor
Columbus Ohio 43215
Recognizing the need to better understand why children die, in July 2000, Governor Bob Taft signed into law the bill establishing the Child Fatality Review (CFR) program for Ohio. Local boards in each county are mandated to review all deaths from all causes to children under 18 years of age. The mission is to reduce the incidence of preventable deaths in Ohio. The Ohio Department of Health (ODH) and the Ohio Children’s Trust Fund are responsible for administration and program support of CFR. A full-time state coordinator is employed by ODH.
The annual budget for the Ohio CFR program is about $150,000. This includes the salaries of all staff involved, training and producing an annual state report. There are 1.25 FTE’s at the state level. Funding for the program comes from the MCH Block Grant.
Ohio has 88 local boards and a state advisory committee.
State Advisory Committee:
The State CFR Advisory Committee was established in April 2002 to assist in moving the process ahead in Ohio. The purpose of this committee is to review Ohio’s child mortality data and CFR data to identify trends in child deaths; to provide expertise and consultation in analyzing and understanding the causes, trends and system responses to child fatalities in Ohio; to make recommendations in law, policy and practice to prevent child deaths in Ohio; to support CFR and recommend improvements in protocols and procedures; and to review and provide input for the annual report. The committee membership represents diverse professions, state agencies and external partners.
All reviews are conducted by 88 county boards that meet at least once per year.
Ohio’s CFR boards review deaths from all causes to children younger than 18 years of age. By law, boards may review child deaths retrospectively (deaths that occurred one year in the past) or concurrently (deaths that occurred in the current year). Due to increasing demand for the most current data, beginning in 2014, all boards began reviewing deaths in the year in which the death occurred.
Ohio established a CFR Program to better understand how and why children die and to take action to prevent other child deaths. The purpose of the local Child Fatality Review boards is to reduce the incidence of preventable child deaths.
Ohio uses the national Child Death Review Case Reporting System. Each local board enters case data into a Web-based system which allows ODH to access data for aggregate state reports.
Ohio produces an annual state report, which is distributed as required by law to elected state officials and to additional interested parties. The report includes review findings for all causes of death as well as recommendations and initiatives for prevention of further deaths. The report is available on the ODH Web site. Many of the local teams produce county level reports.
More than half of the 88 counties reported over 100 examples of successful implementation of CFR recommendations. Details about initiatives can be found in the state annual report.
- Sleep-related Deaths: The largest number of initiatives reported deal with reducing the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths. A variety of programs target minority families, grandparents, caregivers, health professionals and the whole community with risk reduction messages that include Back to Sleep, and the risks of inappropriate bedding and bedsharing. Many of these initiatives are on-going, being incorporated into existing programs such as prenatal clinics, Help Me Grow (HMG) and Special Supplemental Food Program for Women, Infants and Children (WIC). Efforts to reach the whole community include the use of billboards, displays at fairs and festivals and distribution of educational materials at popular sites for families such as zoos, playgrounds and family restaurants. Agency policies are adapted to institutionalize practices that reinforce safe sleep behaviors. Recent legislation spurred by CFR findings requires hospitals to screen for the availability of a safe sleep space before discharging a newborn infant, and to provide a safe crib if one is needed.
- Child Abuse and Neglect: The CFR process can identify opportunities for improvement in programs and policies to prevent child abuse and neglect. Responsibility for prevention activities is shared among all the member agencies. The Ohio Children’s Trust Fund (OCTF) helps fund community based primary and secondary child abuse prevention programs using evidence based curricula.
- Suicide: The need for youth suicide prevention is also being addressed as a result of the CFR process. In many counties, CFR findings are shared with county suicide prevention coalitions and task forces to focus on awareness of suicide and develop strategies to reduce the factors that increase the risk of suicide, identify youth at risk and increase the availability of mental health services.
- Vehicular Injuries: Vehicular crashes continue to be a leading cause of injury and death to children. Many local CFR boards were involved in efforts to pass Ohio’s Distracted Driving law which took effect in August 2012. Boards are active in educating families about the new law, in addition to Ohio’s Booster Seat law and Graduated Driver License law. In addition to continued efforts in most counties to improve teen driver education and infant car seat programs, local CFR boards are addressing specific issues regarding vehicular deaths in their community.
- Infant Deaths: Although only 12 percent of infant deaths were deemed preventable, CFR boards recognize the detrimental effects of unhealthy lifestyles and poor prenatal care on the lives of infants. In response to needs identified through the reviews of infant deaths, many counties have launched collaborative efforts to reduce infant mortality. Typical partners include HMG, WIC, Child and Family Health Services projects, local physicians, schools and other health and social service providers.
- Substance Abuse: The misuse and abuse of prescription drugs and other substances harms youth and children, who suffer intentional or accidental overdose and prenatal exposure as well as inadequate care and supervision when adults use. Local CFR boards have joined with other community agencies to combat this epidemic and protect children.
- General Health and Safety: Countywide collaborations and partnerships produced many programs to increase the general health and safety of children.
- Systems Improvements: One of the goals set by Ohio law for CFR is to promote cooperation, collaboration and communication among all groups that serve families and children. The CFR process continues to have a positive impact on participating agencies. Many boards report an increase in cooperation and understanding between participating agencies and some have developed written policies to facilitate communication. The review process stimulates discussion about existing services in communities, identifying gaps in services, access to service barriers, the need to maximize use of existing services and opportunities for increased collaboration.
Ohio has a CFR meeting protocol in place.
Training for local review teams is organized by the Ohio Department of Health in partnership with the Ohio Children’s Trust Fund and experienced CFR teams.
Last Updated: January 2019