Missouri Child Fatality Review Program - Background

Missouri’s Child Fatality Review Program (CFRP) was implemented in January 1992, after a study identified the need for a child fatality examination and review process.

• 1989-1990: A cooperative study between the Department of Social Services, the Department of Health and Senior Services and the University of Missouri finds that a significant number of child deaths (ages birth - 5) are not being accurately reported and causes of death were not being adequately investigated/reported
• August 1990: Department of Social Services appointed a task force to further study child fatalities and House Bill 185 was drafted based off the task force recommendations
• May 1991: House Bill 185, which established a statewide county-based system of child fatality review panels, was passed
• June 1991: Missouri Governor John Ashcroft signed House Bill 185 into law
• August 28, 1991: The law (RSMo 210.192) became effective
• January 1, 1992: Missouri’s Child Fatality Review Program implemented

About the Law

RSMo 210.192, et al., requires that all 114 Missouri counties and the City of St. Louis establish a multidisciplinary CFRP panel to examine the deaths of all children (birth – 17) that occur in Missouri:

• Counties have been grouped into seven regions
• Each region has a regional coordinator that offers oversight, technical assistance and systemic evaluation
• The State Technical Assistance Team (STAT) assists the regions and individual panels with expert training and investigative assistance
• A state CFRP panel provides oversight and makes recommendations for change and refinement to STAT

It also provides a mechanism for the legal exchange of information between cooperating disciplines and agencies:

• Every child death is evaluated
• If the death meets specific criteria, it is referred to the county’s CFRP panel
• Unlike an inquest, no vote or consensus of opinion is sought at the conclusion of the panel review
• This is not an attempt to criminalize all child deaths, but to obtain a more accurate and timely determination of cause of death and an appropriate community response

About the CFRP Panels

CFRP panels are made up of local professionals who bring their own expertise and skills to the review and attempt to help identify cause and circumstances of child deaths. The panel’s value is measured by the improvement in services provided by participating disciplines.
Conclusions made after a child fatality review can be used to:

• Determine trends
• Target prevention strategies
• Identify specific family/community needs
• Support criminal justice intervention (when appropriate)

All CFRP information is confidential. CFRP findings are shared through appropriate channels and become valuable statistics linked to the Department of Health and Senior Services birth and death records and the Children’s Division Central Child Abuse Registry. STAT reviews this information and helps to identify needs and prevention strategies.
CFRP panel members attend annual training sessions (coordinated by STAT), and additional regional in-service and individual CFRP panel training is also provided. CFRP awareness and educational presentations are available to professional and community/civic organizations through STAT.

Child Fatality Review Program Goals

The Child Fatality Review Program aims to:

• Establish more accurate causal determinations in child deaths
• Develop uniform, consistent and retrievable data collection involving on-going surveillance of all childhood fatalities
• Provide relevant training to each professional involved in child protection
• Initiate state and local community activities to prevent childhood injuries and fatalities
• Facilitate the linkage of identified patterns and trends in child death with agencies and organizations influencing and developing education and deterrent/prevention strategies