H.B. 862
GENERAL ASSEMBLY OF NORTH CAROLINA
Apr 25, 2023
SESSION 2023 HOUSE PRINCIPAL CLERK
H D
HOUSE BILL DRH30315-MGa-118A
Short Title: Strengthen Child Fatality Prevention System. (Public)
Sponsors: Representative K. Baker.
Referred to:
1 A BILL TO BE ENTITLED
2 AN ACT ESTABLISHING A STATE OFFICE OF CHILD FATALITY PREVENTION
3 WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF
4 PUBLIC HEALTH, TO SERVE AS THE LEAD AGENCY RESPONSIBLE FOR
5 OVERSEEING COORDINATION OF STATE-LEVEL SUPPORT FUNCTIONS FOR
6 THE ENTIRE NORTH CAROLINA CHILD FATALITY PREVENTION SYSTEM AND
7 APPROPRIATING FUNDS FOR THAT PURPOSE; ESTABLISHING A TRANSITION
8 PLAN FOR SHIFTING STATE SUPPORT OF THE CHILD FATALITY PREVENTION
9 SYSTEM TO THE STATE OFFICE OF CHILD FATALITY PREVENTION; CREATING
10 AND SUPPORTING A CENTRALIZED DATA AND REPORTING SYSTEM;
11 RESTRUCTURING EXISTING CHILD DEATH REVIEW TEAMS; MAKING
12 MODIFICATIONS AND ADDITIONS TO CHILD FATALITY PREVENTION SYSTEM
13 STATUTES TO RESTRUCTURE CHILD DEATH REVIEW TEAMS, IMPLEMENT
14 PARTICIPATION IN THE NATIONAL FATALITY REVIEW CASE REPORTING
15 SYSTEM, AND CLARIFY THE FUNCTIONS OF THE NORTH CAROLINA CHILD
16 FATALITY TASK FORCE; AND ESTABLISHING CITIZEN REVIEW PANELS.
17 The General Assembly of North Carolina enacts:
18
19 PART I. ESTABLISHMENT OF STATE OFFICE OF CHILD FATALITY
20 PREVENTION WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES,
21 DIVISION OF PUBLIC HEALTH, AND APPROPRIATING FUNDS FOR THAT
22 PURPOSE
23 SECTION 1.1.(a) Article 3 of Chapter 143B of the General Statutes is amended by
24 adding a new Part to read:
25 "Part 4C. State Office of Child Fatality Prevention.
26 "§ 143B-150.25. Definitions.
27 The following definitions apply in this Article:
28 (1) Child Fatality Prevention System. – The statewide system comprised of the
29 following:
30 a. Local Teams.
31 b. The North Carolina Child Fatality Task Force created in
32 G.S. 7B-1402.
33 c. The State Office.
34 d. Medical examiner child fatality staff.
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1 (2) Local Team. – A multidisciplinary child death review team that is either a
2 single or multicounty team responsible for performing any type of child
3 fatality review pursuant to Article 14 of Chapter 7B of the General Statutes.
4 (3) Medical examiner child fatality staff. – Staff within the Office of the Chief
5 Medical Examiner whose primary responsibilities involve reviewing,
6 investigating, training, educating, and supporting death investigations into
7 child fatalities that fall under the jurisdiction of the medical examiner pursuant
8 to G.S. 130A-383.
9 (4) State Office. – The State Office of Child Fatality Prevention established under
10 this Article.
11 "§ 143B-150.26. Establishment and purpose of State Office.
12 The State Office of Child Fatality Prevention is established within the Department of Health
13 and Human Services, Division of Public Health, to serve as the lead agency for child fatality
14 prevention in North Carolina. The purpose of the State Office is to oversee the coordination of
15 State-level support functions for the entire North Carolina Child Fatality Prevention System in a
16 way that maximizes efficiency and effectiveness and expands system capacity. The Department
17 shall determine the most appropriate placement for, and configuration of, State Office staff within
18 the Department, subject to the following limitation: medical examiner child fatality staff shall
19 continue to work under the direction of the Chief Medical Examiner and address child fatalities
20 within the jurisdiction of the medical examiner pursuant to G.S. 130A-383, while working
21 collaboratively with the State Office and Local Teams.
22 "§ 143B-150.27. Powers and duties.
23 The State Office has the following powers and duties:
24 (1) To coordinate the work of the statewide Child Fatality Prevention System.
25 (2) To implement and manage a centralized data and information system capable
26 of gathering, analyzing, and reporting aggregate information from child death
27 review teams with appropriate protocols for sharing information and
28 protecting confidentiality.
29 (3) To create and implement tools, guidelines, resources, and training, and
30 provide technical assistance for Local Teams to enable the teams to do the
31 following:
32 a. Conduct effective reviews tailored to the type of death being reviewed.
33 b. Make effective recommendations about child fatality prevention.
34 c. Gather, analyze, and appropriately report on case data and findings
35 while protecting confidentiality.
36 d. Facilitate the implementation of prevention strategies in their
37 communities.
38 (4) To work with medical examiner child fatality staff and the North Carolina
39 State Center for Health Statistics to provide Local Teams initial information
40 about child deaths in their respective counties.
41 (5) To perform research, consult with stakeholders and experts, and collaborate
42 with other organizations and individuals for the purpose of understanding the
43 direct and contributing causes of child deaths as well as evidence-driven
44 strategies, programs, and policies to prevent child deaths, abuse, and neglect
45 in order to inform the work of the Child Fatality Prevention System or as
46 requested by the Child Fatality Task Force.
47 (6) To educate State and local leaders, including the General Assembly, executive
48 department heads, as well as stakeholders, advocates, and the public about the
49 Child Fatality Prevention System and issues and prevention strategies
50 addressed by the system.
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1 (7) To collaborate with State and local agencies, nonprofit organizations,
2 academia, advocacy organizations, and others to facilitate the implementation
3 of evidence-driven initiatives to prevent child abuse, neglect, and death, such
4 as education and awareness initiatives.
5 (8) To create and implement processes for evaluating the ability of the Child
6 Fatality Prevention System to achieve outcomes sought to be accomplished
7 by the system and to report to the Child Fatality Task Force on these
8 evaluations and on statewide functioning of the Child Fatality Prevention
9 System.
10 (9) To consider opportunities to seek and administer grant and other non-State
11 funding sources to support State or local Child Fatality Prevention System
12 efforts.
13 (10) To develop guidance to inform local decisions about the formation and
14 implementation of single versus multicounty Local Teams. The guidance must
15 include a model agreement to be used between or among counties that agree
16 to be part of a multicounty Local Team."
17 SECTION 1.1.(b) There is appropriated from the General Fund to the Department
18 of Health and Human Services, Division of Public Health, the recurring sum of five hundred
19 sixty-nine thousand eight hundred eighty-five dollars ($569,885) and the nonrecurring sum of
20 eighteen thousand one hundred fifteen dollars ($18,115) for the 2023-2024 fiscal year and the
21 recurring sum of seven hundred fifty-eight thousand eight hundred eighty-five dollars ($758,885)
22 for the 2024-2025 fiscal year to be allocated and used as follows:
23 (1) Five hundred fifty-four thousand eight hundred eighty-five dollars ($554,885)
24 in recurring funds for each year of the 2023-2025 fiscal biennium for
25 operational costs to establish the State Office of Child Fatality Prevention
26 (State Office) established under Part 4C of Article 3 of Chapter 143B of the
27 General Statutes, as enacted by this section. The Department of Health and
28 Human Services may use up to five hundred fourteen thousand seven hundred
29 thirty-five dollars ($514,735) of these recurring funds for each year of the
30 2023-2025 fiscal biennium to establish up to five full-time positions within
31 the State Office.
32 (2) Eighteen thousand one hundred fifteen dollars ($18,115) in nonrecurring
33 funds for the 2023-2024 fiscal year for nonrecurring costs associated with
34 establishing the State Office.
35 (3) Up to fifteen thousand dollars ($15,000) in recurring funds for each year of
36 the 2023-2025 fiscal biennium to support the work of the Child Fatality Task
37 Force and to pay its members, staff, and consultants in accordance with
38 G.S. 7B-1414, as amended by this act.
39 (4) One hundred eighty-nine thousand dollars ($189,000) in recurring funds for
40 the 2024-2025 fiscal year shall be distributed among the State's 100 counties,
41 as determined appropriate by the Department, to support implementation of
42 the changes authorized by this act to restructure child death reviews by Local
43 Teams and to offset the costs associated with Local Team participation in the
44 National Fatality Review Case Reporting System.
45 SECTION 1.1.(c) The Department of Health and Human Services may not use the
46 funds allocated by subdivisions (b)(1) through (b)(3) of this section for any purposes other than
47 the purposes specified in those subdivisions. Counties shall not use the funds allocated by
48 subdivision (b)(4) of this section for any purposes other than the purposes specified in that
49 subdivision.
50 SECTION 1.1.(d) Subsections (b) and (c) of this section become effective July 1,
51 2023.
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1
2 PART II. TRANSITION PLAN FOR SHIFTING STATE SUPPORT OF THE CHILD
3 FATALITY PREVENTION SYSTEM TO THE STATE OFFICE, CREATING AND
4 SUPPORTING A CENTRALIZED DATA AND REPORTING SYSTEM, AND
5 RESTRUCTURING EXISTING CHILD DEATH REVIEW TEAMS
6 SECTION 2.1. It is the intent of the General Assembly to restructure North
7 Carolina's Child Fatality Prevention System in order to eliminate the silos and redundancy that
8 exist within the current system, implement centralized coordination of the system, streamline the
9 system's State-level support functions, maximize the usefulness of data and information derived
10 from teams that review child fatalities, ensure that relevant and appropriate information and
11 recommendations from teams that review child fatalities reach appropriate local and State
12 leaders, and strengthen the system's effectiveness in preventing child abuse, neglect, and death.
13 Creation and implementation of a State Office of Child Fatality Prevention is a critical element
14 of this restructuring that must be put in place to facilitate a transition to the restructuring and
15 support of Local Teams and their participation in the National Fatality Review Case Reporting
16 System (NFR-CRS). To that end, the Department of Health and Human Services is directed to
17 accomplish the following:
18 (1) Not later than July 1, 2024, the Department shall report to the Joint Legislative
19 Oversight Committee on Health and Human Services and the Fiscal Research
20 Division on the status of creating, implementing, and staffing the State Office
21 of Child Fatality Prevention. The report shall include at a minimum the status
22 of preparations for (i) transitioning to the restructuring and support of Local
23 Teams and (ii) participating in the NFR-CRS. Any management staff the
24 Department places within the State Office of Child Fatality Prevention shall
25 work with the Department to take the necessary steps toward fully staffing the
26 State Office and implementing plans that will enable the State Office to carry
27 out the powers and duties of the State Office, as described in
28 G.S. 143B-150.27, and to support a restructured Child Fatality Prevention
29 System consistent with Part III of this act. The Department shall also ensure
30 during this time that Local Teams receive State-level support either as such
31 support exists prior to the creation of the State Office or from staff within the
32 newly created State Office.
33 (2) Not later than January 1, 2025, the Department shall ensure all of the
34 following:
35 a. That the State Office of Child Fatality Prevention is sufficiently staffed
36 and prepared to carry out the powers and duties of the State Office, as
37 described in G.S. 143B-150.27, to support a restructured Child
38 Fatality Prevention System as set forth in Part III of this act.
39 b. That any contractual agreements and interagency data sharing
40 agreements necessary for participation in the NFR-CRS, as required in
41 G.S. 7B-1413.5, have been executed.
42 (3) Not later than July 1, 2025, the Department shall ensure through its State
43 Office of Child Fatality Prevention that all Local Teams have been provided
44 guidelines and training addressing their participation in the NFR-CRS, and
45 Local Teams shall begin utilizing the System for case reporting as specified
46 in G.S. 7B-1413.5.
47
48 PART III. MODIFICATIONS AND ADDITIONS TO CHILD FATALITY
49 PREVENTION SYSTEM STATUTES TO RESTRUCTURE CHILD DEATH REVIEW
50 TEAMS, IMPLEMENT PARTICIPATION IN THE NATIONAL FATALITY REVIEW
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1 CASE REPORTING SYSTEM, AND CLARIFY THE FUNCTIONS OF THE NORTH
2 CAROLINA CHILD FATALITY TASK FORCE
3 SECTION 3.1.(a) Article 14 of Chapter 7B of the General Statutes reads as
4 rewritten:
5 "Article 14.
6 "North Carolina Child Fatality Prevention System.
7 "§ 7B-1400. Declaration of public policy.
8 The General Assembly finds that it is the public policy of this State to prevent the abuse,
9 neglect, and death of juveniles. The General Assembly further finds that the prevention of the
10 abuse, neglect, and death of juveniles is a community responsibility; that professionals from
11 disparate disciplines have responsibilities for children or juveniles and have expertise that can
12 promote their safety and well-being; and that multidisciplinary reviews of the abuse, neglect, and
13 death of juveniles can lead to a greater understanding of the causes and methods of preventing
14 these deaths. It is, therefore, the intent of the General Assembly, through this Article, to establish
15 a statewide multidisciplinary, multiagency child fatality prevention system consisting of the State
16 Team established in G.S. 7B-1404 and the Local Teams established in G.S. 7B-1406. system.
17 The purpose of the system is to assess the records of selected cases in which children are being
18 served by child protective services and the records of all deaths of children child deaths in North
19 Carolina from birth to age 18 up until a child's eighteenth birthday, and with respect to these
20 cases, to study data and prevention strategies related to child abuse, neglect, and death, and to
21 utilize multidisciplinary teams to review these deaths in order to (i) develop a communitywide
22 approach to the problem of child abuse and neglect, (ii) understand the causes and contributing
23 factors