FILED SENATE
Apr 7, 2021
GENERAL ASSEMBLY OF NORTH CAROLINA
S.B. 703
SESSION 2021 PRINCIPAL CLERK
S D
SENATE BILL DRS45379-MGa-106B
Short Title: Strengthen Child Fatality Prevention System. (Public)
Sponsors: Senators Edwards and Burgin (Primary Sponsors).
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 CHILD DEATH 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 convene and facilitate a multidisciplinary data and reporting group for the
42 purpose of examining nonidentifying aggregate data and information resulting
43 from fatality reviews that is gathered by the State Office to advise the State
44 Office on reports to be produced by the State Office and what entities should
45 receive the reports.
46 (6) To perform research, consult with stakeholders and experts, and collaborate
47 with other organizations and individuals for the purpose of understanding the
48 direct and contributing causes of child deaths as well as evidence-driven
49 strategies, programs, and policies to prevent child deaths, abuse, and neglect
50 in order to inform the work of the Child Fatality Prevention System or as
51 requested by the Child Fatality Task Force.
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1 (7) To educate State and local leaders, including the General Assembly, executive
2 department heads, as well as stakeholders, advocates, and the public about the
3 Child Fatality Prevention System and issues and prevention strategies
4 addressed by the system.
5 (8) To collaborate with State and local agencies, nonprofit organizations,
6 academia, advocacy organizations, and others to facilitate the implementation
7 of evidence-driven initiatives to prevent child abuse, neglect, and death, such
8 as education and awareness initiatives.
9 (9) To create and implement processes for evaluating the ability of the Child
10 Fatality Prevention System to achieve outcomes sought to be accomplished
11 by the system and to report to the Child Fatality Task Force on these
12 evaluations and on statewide functioning of the Child Fatality Prevention
13 System.
14 (10) To consider opportunities to seek and administer grant and other non-State
15 funding sources to support State or local Child Fatality Prevention System
16 efforts.
17 (11) To develop guidance to inform local decisions about the formation and
18 implementation of single versus multicounty Local Teams. The guidance must
19 include a model agreement to be used between or among counties that agree
20 to be part of a multicounty Local Team."
21 SECTION 1.1.(b) There is appropriated from the General Fund to the Department
22 of Health and Human Services, Division of Public Health, the sum of three hundred eighty-nine
23 thousand nine hundred ninety-eight dollars ($389,998) in recurring funds for the 2021-2022 fiscal
24 year and the sum of five hundred fifty-one thousand eight hundred sixty-one dollars ($551,861)
25 in recurring funds for the 2022-2023 fiscal year to establish and operate the State Office of Child
26 Fatality Prevention (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 Human Services shall
28 not use funds appropriated in this subsection for any purpose other than the purpose specified in
29 this subsection.
30 SECTION 1.1.(c) Subsection (b) of this section becomes effective July 1, 2021.
31
32 PART II. TRANSITION PLAN FOR SHIFTING STATE SUPPORT OF THE CHILD
33 FATALITY PREVENTION SYSTEM TO THE STATE OFFICE, CREATING AND
34 SUPPORTING A CENTRALIZED DATA AND REPORTING SYSTEM, AND
35 RESTRUCTURING EXISTING CHILD DEATH REVIEW TEAMS
36 SECTION 2.1. It is the intent of the General Assembly to restructure North
37 Carolina's Child Fatality Prevention System in order to eliminate the silos and redundancy that
38 exist within the current system, implement centralized coordination of the system, streamline the
39 system's State-level support functions, maximize the usefulness of data and information derived
40 from teams that review child fatalities, ensure that relevant and appropriate information and
41 recommendations from teams that review child fatalities reach appropriate local and State
42 leaders, and strengthen the system's effectiveness in preventing child abuse, neglect, and death.
43 Creation and implementation of a State Office of Child Fatality Prevention is a critical element
44 of this restructuring that must be put in place to facilitate a transition to the restructuring and
45 support of Local Teams and participation in the National Child Death Review Case Reporting
46 System. To that end, the Department of Health and Human Services is directed to accomplish the
47 following:
48 (1) Not later than July 1, 2022, the Department shall have management staff in
49 place at the State Office of Child Fatality Prevention. The management staff
50 shall work with the Department to take the necessary steps toward fully
51 staffing the State Office and implementing plans that will enable the State
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1 Office to carry out the powers and duties of the State Office, as described in
2 G.S. 143B-150.27, and to support a restructured Child Fatality Prevention
3 System consistent with Part III of this act. The Department shall also ensure
4 during this time that Local Teams receive State-level support either as such
5 support exists prior to the creation of the State Office or from staff within the
6 newly created State Office.
7 (2) Not later than January 1, 2023, the Department shall ensure all of the
8 following:
9 a. That the State Office of Child Fatality Prevention is sufficiently staffed
10 and prepared to carry out the powers and duties of the State Office, as
11 described in G.S. 143B-150.27, to support a restructured Child
12 Fatality Prevention System as set forth in Part III of this act.
13 b. That any contractual agreements and interagency data sharing
14 agreements necessary for participation in the National Child Death
15 Review Case Reporting System, as required in G.S. 7B-1413.5, have
16 been executed.
17 (3) Not later than July 1, 2023, the Department shall ensure through its State
18 Office of Child Fatality Prevention that all Local Teams have been provided
19 guidelines and training addressing their participation in the National Child
20 Death Review Case Reporting System (NCDR-CRS), and Local Teams shall
21 begin utilizing the System for case reporting as specified in G.S. 7B-1413.5.
22
23 PART III. MODIFICATIONS AND ADDITIONS TO CHILD FATALITY
24 PREVENTION SYSTEM STATUTES TO RESTRUCTURE CHILD DEATH REVIEW
25 TEAMS, IMPLEMENT PARTICIPATION IN THE NATIONAL CHILD DEATH
26 REVIEW CASE REPORTING SYSTEM, AND CLARIFY THE FUNCTIONS OF THE
27 NORTH CAROLINA CHILD FATALITY TASK FORCE
28 SECTION 3.1.(a) Article 14 of Chapter 7B of the General Statutes reads as
29 rewritten:
30 "Article 14.
31 "North Carolina Child Fatality Prevention System.
32 "§ 7B-1400. Declaration of public policy.
33 The General Assembly finds that it is the public policy of this State to prevent the abuse,
34 neglect, and death of juveniles. The General Assembly further finds that the prevention of the
35 abuse, neglect, and death of juveniles is a community responsibility; that professionals from
36 disparate disciplines have responsibilities for children or juveniles and have expertise that can
37 promote their safety and well-being; and that multidisciplinary reviews of the abuse, neglect, and
38 death of juveniles can lead to a greater understanding of the causes and methods of preventing
39 these deaths. It is, therefore, the intent of the General Assembly, through this Article, to establish
40 a statewide multidisciplinary, multiagency child fatality prevention system consisting of the State
41 Team established in G.S. 7B-1404 and the Local Teams established in G.S. 7B-1406. system.
42 The purpose of the system is to assess the records of selected cases in which children are being
43 served by child protective services and the records of all deaths of children child deaths in North
44 Carolina from birth to age 18 up until a child's eighteenth birthday, and with respect to these
45 cases, to study data and prevention strategies related to child abuse, neglect, and death, and to
46 utilize multidisciplinary teams to review these deaths in order to (i) develop a communitywide
47 approach to the problem of child abuse and neglect, (ii) understand the causes and contributing
48 factors of childhood deaths, (iii) identify any gaps or deficiencies that may exist in the delivery
49 of services to children and their families by public agencies that are designed to prevent future
50 child abuse, neglect, or death, and (iv) identify and aid in facilitating the implementation of
51 evidence-driven strategies to prevent child death and promote child well-being, and (v) make and
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1 implement recommendations for changes to laws, rules, and policies that will support the safe
2 and healthy development of our children and prevent future child abuse, neglect, and death.
3 "§ 7B-1401. Definitions.
4 The following definitions apply in this Article:
5 (1) Additional Child Fatality. – Any death of a child that did not result from
6 suspected abuse or neglect and about which no report of abuse or neglect had
7 been made to the county department of social services within the previous 12
8 months.
9 (1a) Child Fatality Prevention System. – The statewide system comprised of the
10 following:
11 a. Local Teams.
12 b. The North Carolina Child Fatality Task Force as established in this
13 Article.
14 c. The State Office.
15 d. Medical examiner child fatality staff.
16 (2) Local Team. – A Community Child Protection Team or a Child Fatality
17 Prevention Team.A multidisciplinary child death review team that is either a
18 single or multicounty team responsible for performing any type of review
19 pursuant to this Article.
20 (2a) Medical examiner child fatality staff. – Staff within the Office of the Chief
21 Medical Examiner whose primary responsibilities involve reviewing,
22 investigating, training, educating, and supporting