1. Child Fatality/Near Fatality Reviews

2. Statutory Authority • On July 3, 2008, Pennsylvania Governor Edward G. Rendell signed Senate Bill 1147, Printer’s Number 2159 into law. • This amendment to the CPSL, known as Act 33 of 2008, was effective December 30, 2008 • Requires that child fatalities and near fatalities be reviewed at both the state and local levels.

3. Near Fatality • “An act that, as certified by a physician, places a child in serious or critical condition.” • Includes an alleged abusive act or failure to act. • Written certification is not required; verbal certification is acceptable. • Must be clear when asking the question of whether the case is a near fatality so as to not use the medical field’s definition for “near-fatal.” • Question should be, “ has a physician certified that the child is in serious or critical condition as a result of an alleged abusive act or failure to act?”

4. Local Reviews • Team must be convened when a report is substantiated or if a status determination has not been made within 30 days by the county children and youth agency of the oral report to ChildLine • Act 33 enumerates members of teams • The team may not be chaired by the county agency and must submit a report to DPW within 90 days • DPW must respond to the report within 45 days

5. a staff person from the county agency; a member of the advisory committee of the county agency; a health care professional; a representative of a local school, educational program or child care or early childhood development program; a representative of law enforcement or the district attorney; an attorney-at-law trained in legal representation of children or an individual trained under 42 Pa.C.S., Section 6342 (relating to court-appointed special advocates); a mental health professional; a representative of a children’s advocacy center that provides services to children in the county (this must not be an employee of the county agency however); the county coroner or forensic pathologist; a representative of a local domestic violence program; a representative of a local drug and alcohol program; an individual representing parents; and any individual whom the county agency or child a fatality or near fatality review team determines is necessary to assist the team in performing its duties. Review Team must include at least 6 members broadly representative of the county with expertise in child abuse and neglect

6. Review The team is responsible for reviewing: • the circumstances of the child’s fatality or near fatality resulting from suspected or substantiated child abuse; • the delivery of services to the abused child, the child’s family and/or the perpetrator provided by the county agency in each county where the child and family resided within the 16 months preceding the fatality or near fatality; • the services provided to the child, the child’s family and the perpetrator by other public and private community agencies or professionals (these services include services provided by law enforcement, mental health services, programs for young children, programs for children with special needs, drug and alcohol programs, local schools and health care providers); • relevant court records and documents related to the abused child and the child’s family; and • the county agency’s compliance with statutes and regulations and with relevant policies and procedures of the county agency.

7. Report Content This report must include information pertaining to the following: • deficiencies and strengths in compliance with statues and regulations and services to children and families; • recommendations for changes at the state and local levels on reducing the likelihood of future child fatalities and near fatalities directly related to child abuse and neglect; • recommendations for changes at the state and local levels on monitoring and inspection of county agencies; and • recommendations for changes at the state and local levels on collaboration of community agencies and service providers to prevent child abuse and neglect.

8. DPW Review • DPW is required to conduct an independent review • Report must be completed within 6 months of the date of the oral report to ChildLine • Regional Offices conduct reviews and participate in local review

9. DPW Review Team • Development of a DPW fatality/near fatality review team whose purpose is to: • ensure in-depth and expedited reviews of Child Death and Near Fatalities that are registered through ChildLine as a result of suspected child abuse to: • Identify strengths and promising practices at the local and regional level; • Identify questions or gaps in information gathered at the local and regional level; • Determine if findings are consistent with the information provided in the reports at the local and regional level; • Identify common themes across the state, counties and regions; • Recommend systemic change, and • Provide county specific recommendations. • discuss and provide feedback related to Certification and De-Certification of Near Fatality Reports.

10. De-certification/Certification • De-certification is in regard to cases that were initially reported to be a near fatality, however; through the investigation process is determined that the case was not a near fatality as originally reported. • Will occur only in limited circumstances. • Notification by the county to the regional office who will in turn discuss the case with the state fatality review team. • Examples: • Investigation reveals medical evidence which determines injuries due to natural causes or an underlying medical condition, not suspected child abuse. • Errors were made in obtaining information during the initial report. • The converse can also happen when a case was not originally certified as a near fatality, but becomes a near fatality during the investigation due to the child falling into serious or critical condition, as determined by the physician, as a result of an act of suspected child abuse. • The county agency must immediately notify ChildLine regarding the physician’s determination. • ChildLine will immediately notify the appropriate OCYF Regional Office thereby starting the fatality review process.

11. Public Disclosure • Act 33 of 2008 allows for the release of confidential information to the public by DPW during the course of the fatality or near fatality investigation. The information that may be released during the initial course of investigation includes: • The identity of the child; • If the child was in the custody of a public or private agency and the identity of that agency; • The identity of the public or private agency under contract with a county agency to provide services to the child and the child’s family in the child’s home prior to the fatality or near fatality; • A description of services provided by the public or private agency; and • The identity of any county agency that convened a child fatality or near fatality review team in respect to the victim child. • County agencies are not permitted to release information to the public until their report is finalized.

12. Public Disclosure (continued) • The final reports completed by DPW and the county agency must also be released to the public. Upon release of the report, identifying information must be removed from these reports with the exception of: • The identity of the deceased child; • If the child was in the custody of a public or private agency and the identity of that agency; • The identity of the public or private agency under contract with a county agency to provide services to the child and the child’s family in the child’s home prior to the fatality or near fatality; and • The identity of any county agency that convened a child fatality or near fatality review team in respect to the victim child. • The only exception that permits the withholding of the release of these reports is when the district attorney certifies that the reports release may compromise a pending criminal investigation or proceeding. • The DA must complete the certification, which lasts for 60 days. • An additional 60 day certification must be initiated by the DA if they feel the release of the information may continue to compromise a pending criminal investigation or proceeding.

13. Public Disclosure (continued) • DPW will be posting the local review team reports, DPW’s response to these report and DPW’s report on the DPW website to facilitate release to the public. • As required by Act 146 of 2006 • Quarterly submissions of summaries of substantiated child fatality and near fatality reports to the Governor and General Assembly, to be issued in: • May • August • November • Final quarterly summary, as well as a full summary of every substantiated fatality and near fatality for the calendar year with updates on the previous quarterly submissions as appropriate will be included in the Annual Child Abuse Report.