Spotlight – Texas

Amy Bailey, MPH
Texas Child Fatality Review Coordinator
Office of Injury Prevention
Texas Department of State Health Services
1100 W. 49th Street
Austin, TX 78756
Mail Code: 1922
Direct Phone: (512) 776-2311
Main Phone: (512) 776-7373
Fax: (512) 776-7856
Email: Amy.Bailey@dshs.texas.gov

Website: http://www.dshs.state.tx.us/mch/Child_Fatality_Review.shtm

Program Description

Administration
The Texas Child Fatality Review Program was established in 1995 by legislation. In the early years, it has been primarily funded by the Department of Family and Protective Services (DFPS) and the Department of State Health Services (DSHS). However, legislation passed by the Texas Legislature in May 2005 transferred responsibility, including funding, for the program completely to DSHS in FY 2007, where it has remained to the present.

Teams
Texas has both state and local CFR teams.

State Team:
The Texas State Child Fatality Review Team (SCFRT) is comprised of 25 members who meet quarterly. DSHS is responsible for assisting the SCFRT in the establishment and training of review teams, preparation of the Biennial Report, recommendations to the Governor and legislature and support of the activities of the SCFRT.

Local Teams:
Texas has 83 local teams that cover 203 of the 254 Texas counties. There are 51 counties without CFR teams. Local team leadership and membership varies from county to county.

Reviews
The death certificate is the basis for the review and is sent to local team coordinators from the DSHS Vital Statistics. They are accompanied by birth abstracts with medical information on the mother and newborn if the child is under two years of age. Texas teams aspire to review all child deaths under age 18.

Purpose
The purpose of the Texas CFR Program is to improve the response to child fatalities, provide accurate information on how and why Texas children are dying and ultimately reduce the number of preventable child deaths by taking data into prevention practice.

Data
Local teams are responsible for collecting and entering data on the child death reviews into the NCRPCD multi-state online reporting system.

Biennial Report
The Texas Child Fatality Review Coordinator works with other DSHS staff and the SCFRT Committee to write the biennial report. The biennial report is submitted to the Governor and Legislators by April 1 of even-numbered years. The report is distributed to agency heads, child advocacy organizations, the medical community, and to all members of local review teams.

Prevention Initiatives
The SCFRT Committee has actively advocated for the passage of laws that would increase child safety. The SCFRT Committee recommendations have included requirement that all newly built swimming pools have four-sided fencing; that the legal blood alcohol content (BAC) be lowered to zero for those transporting children; that law allowing for parents and guardians to provide driver education to minor children be repealed; and that a birth-match system be created to monitor infants born to parents who had a child die of abuse or whose rights were terminated due to abuse and neglect. Texas Department of Family and Protective Services created Project HIP (Helping Through Intervention and Prevention) in response to the SCFRT recommendation for a birth-match system. In this program, parents who have had their parental rights terminated due to child abuse and/or neglect within the past 2 years and have a newborn child are provided with free and voluntary services to build a positive home environment and prevent child abuse.

In the 2013 legislative session, the SCFRT recommendation about water safety resulted in a resolution to recognize April as Texas Water Safety Month for the next 10 years. The SCFRT Committee has also issued numerous position statements that have been used as the basis for prevention activities: Safe Sleep for Infants, Motor Vehicle Safety for Infants and Children; Water Safety for Children; Child Suicide; Fire and Burn Prevention for Children; Substance Abuse Dependence; Child Suicide, and Addressing Preventable Child Abuse and Neglect. The position statements are posted on the Texas CFR website.

Protocols
Texas has a child death scene investigation protocol in place.

Training
Through the generosity of the Title V program, child fatality review and injury prevention training is provided to the members of the local teams and the members of the State Committee. Historically, the conference is done in conjunction with another agency. Since 2012, the program is in partnership with Prevent Child Abuse Texas to provide annual training. In 2016-2017, local child fatality review teams received training for all team members regionally and Title V sponsored the attendance of two members per local team and of all State Committee members to a statewide injury prevention conference. In 2018, DSHS will sponsor two members per local team and all State Committee members to attend a training/meeting and conference.

Last Updated: March 2018