Existing law authorizes each county to establish an interagency child death review team to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases. Existing law also authorizes each county to develop a protocol to be used as a guideline by persons performing autopsies on children to assist coroners and other persons who perform autopsies in the identification of child abuse or neglect, in the determination of whether child abuse or neglect contributed to death or whether child abuse or neglect had occurred prior to but was not the actual cause of death, and in the proper written reporting procedures for child abuse or neglect, including the designation of the cause and mode of death.

This bill would make the provisions described above mandatory for each county. By increasing the duties of counties, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Date of Hearing: April 20, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 1737

Author:(McCarty) – As Introduced Ver:February 1, 2016

Urgency: No State Mandated Local Program: Yes Reimbursable: Yes

SUMMARY:

This bill requires counties to establish interagency child death review teams to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases.

FISCAL EFFECT:

Significant reimbursable state mandated cost in the $4 million range (GF). Sacramento County, a midsize county, has identified annual cost of approximately $75,000 to conduct the activities required in AB 1737; however, they currently do those activities for other counties as well. If one assumes an average of $25,000 for the smallest 20 counties, an average of $70,000 for the next other 28 counties, and an average of $150,000 for the 10 largest counties, the cost would be $3.96 million. The state will be required to reimburse even the counties that currently have a program.

COMMENTS:

1. Background/Puropose. Current law allows, but does not require, counties to do both:
2. Establish interagency child death review teams to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases, but does not require counties to establish child death review teams. If a team is created, the death review is required to report, at least annually, conclusions, recommendations, and aggregate satistiacal data.
3. Develop a protocol, in consultation with a specified group, which may be used as a guideline by persons performing autopsies on children in order to assist coroners and other persons who perform autopsies in the identification of child abuse or neglect, in the determination of whether child abuse or neglect contributed to death or whether child abuse or neglect had occurred prior to but was not the actual cause of death, and in the proper written reporting procedures for child abuse or neglect, including the designation of the cause and mode of death.

This bill would require each county to establish an interagency child death review team to assist local agencies in identifying and reviewing suspicious child deaths, and require the county to develop an autopsy protocol. Because the bill mandates that each county create a team, the corresponding report by the child death review team would also be mandatory.

According to the author, an annual child death report is to provide vital information should children be dying of similar reasons in one county compared to another. The annual report will identify how and why children die, to facilitate the creation and implementation of strategies to prevent future deaths.

1. Support/Opposition. Sierra Health Foundation, in support, argues that “requiring each county to have an active child death review team will create uniformity across the state; with accurate data this information could be used to create public awareness campaigns and reduce the number of child deaths much like our efforts here in Sacramento County.” There is no opposition

Analysis Prepared by: Pedro Reyes / APPR. / (916) 319-2081

Date of Hearing: April 6, 2016

ASSEMBLY COMMITTEE ON LOCAL GOVERNMENT

Susan Talamantes Eggman, Chair

ABPCA Bill Id:AB 1737 (

Author:McCarty) – As Introduced Ver:February 1, 2016

SUBJECT: Child death investigations: review teams.

SUMMARY: Requires counties to establish interagency child death review teams to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases.

EXISTING LAW:

1. Allows each county to establish an interagency child death review team to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases.
2. States that interagency child death review teams have been used successfully to ensure that incidents of child abuse or neglect are recognized and other siblings and nonoffending family members receive the appropriate services in cases where a child has expired.
3. Allows each county to develop a protocol that may be used as a guideline by persons performing autopsies on children to assist coroners and other persons who perform autopsies in the identification of child abuse or neglect, in the determination of whether child abuse or neglect contributed to death or whether child abuse or neglect had occurred prior to but was not the actual cause of death, and in the proper written reporting procedures for child abuse or neglect, including the designation of the cause and mode of death.
4. Allows, in developing an interagency child death review team and an autopsy protocol, each county, working in consultation with local members of the California State Coroner’s Association and county child abuse prevention coordinating councils, to solicit suggestions and final comments from persons, including, but not limited to, the following:
   1. Experts in the field of forensic pathology;
   2. Pediatricians with expertise in child abuse;
   3. Coroners and medical examiners;
   4. Criminologists;
   5. District attorneys;
   6. Child protective services staff;
   7. Law enforcement personnel;
   8. Representatives of local agencies which are involved with child abuse or neglect reporting;
   9. County health department staff who deals with children’s health issues; and,
   10. Local professional associations of persons described in a) through i), above.
5. Provides that records exempt from disclosure to third parties pursuant to state or federal law shall remain exempt from disclosure when they are in the possession of a child death review team.
6. Requires, no less than once each year, each child death review team to make available to the public findings, conclusions, and recommendations of the team, including aggregate statistical data on the incidences and causes of child deaths, and requires, in its report, that the team withhold the last name of the child that is subject to a review or the name of the deceased child’s siblings, unless the name has been publicly disclosed or is required to be disclosed by state law, federal law, or court order.
7. States that it is the duty of the California State Child Death Review Council to oversee the statewide coordination and integration of state and local efforts to address fatal child abuse or neglect and to create a body of information to prevent child deaths.

FISCAL EFFECT: This bill is keyed fiscal.

COMMENTS:

1. Bill Summary. Current law allows, but does not require, each county to establish an interagency child death review team, and requires that child review death team to compile a report containing findings, conclusions, and recommendations, including aggregate statistical data on the incidences and causes of child deaths.

This bill would require each county to establish an interagency child death review team to assist local agencies in identifying and reviewing suspicious child deaths, and require that county to develop an autopsy protocol. Because the bill mandates that each county create a team, the corresponding report by the child death review team would also be mandatory.

This bill is author-sponsored.

1. Author’s Statement. According to the author, “Child review death teams in California began as informal gatherings of concerned parents and professionals [who] wanted to take proper steps in order to review child deaths and learn from them in order to save other children’s lives. In 1988, California legislation was enacted to establish child death review teams in order to investigate suspicious child deaths and facilitate communication among the various entities that could provide useful information for the annual report.

“AB 1737 aims to increase accountability and transparency and as a community improve protection services for children. The purpose of producing an annual child death report is to provide vital information should children be dying of similar reasons in one county compared to another. With no data of common occurrences, county officials do not have accurate information to link these occurrences and therefore prevent future deaths. This bill requires all counties to produce an annual child death review report in order to identify how and why children die, to further facilitate the creation and implementation of strategies to prevent future deaths.”

1. Background. The primary purpose of child death review teams is to prevent future child deaths. At the county level, these teams produce educational materials so that the more common causes of child death can be prevented. For example, according to the author, in Sacramento “The Sacramento County Child Death Review Team, which reviews the deaths of every child that dies in Sacramento County, has used the report’s findings in order to create public awareness campaigns. The recommendations have translated to the Shaken Baby Syndrome Prevention Campaign, the Infant Safe Sleep Campaign, and the Drowning Prevention Campaign to reduce preventable deaths.” However, each county’s experience is different. This is where statewide child death review can help prevent counties from duplicating efforts.
   
   The statewide Child Death Review Council is responsible for collecting data and information from the counties and turning it into reports to the public and Legislature. Part of the statutory scheme that created child death review teams included creation of the Child Death Review Council "to coordinate and integrate state and local efforts to address fatal child abuse or neglect, and to create a body of information to prevent child deaths." (Penal Code Section 11174.34(a)(1).) The Child Death Review Council is required to "[a]nalyze and interpret state and local data on child death in an annual report to be submitted to local child death review teams with copies to the Governor and the Legislature, no later than July 1 each year. Copies of the report shall also be distributed to California public officials who deal with child abuse issues and to those agencies responsible for child death investigation in each county. The report shall contain, but not be limited to, information provided by state agencies and the county child death review teams for the preceding year." (Penal Code Section 11174.34(d)(1).) Therefore, a report analyzing the data collected by each local child death review team is currently a public document. Requiring each local child death review team to also make public its own data appears to be consistent with the overall objectives of the teams, i.e., creating a body of information on the causes of child deaths to help prevent such tragedies. Increased transparency may also enhance the public's trust in local child death review.
2. State Mandate. This bill contains language that says that if the Commission on State Mandates determines that the bill contains costs mandated by the state, then reimbursement to local agencies for those costs shall be made, as specified.
3. Arguments in Support. Sierra Health Foundation, in support, argues that “requiring each county to have an active child death review team will create uniformity across the state; with accurate data this information could be used to create public awareness campaigns and reduce the number of child deaths much like our efforts here in Sacramento County.”
4. Arguments in Opposition. None on file.
5. Double-Referral. This bill was heard by the Public Safety Committee on March 15, 2016, and passed on consent.

REGISTERED SUPPORT / OPPOSITION:

Support

American Academy of Pediatrics, California

Legal Advocates for Children & Youth

National Association of Social Workers, California Chapter

Sierra Health Foundation: Center for Health Program Management

The Child Abuse Prevention Center

Opposition

None on file

Analysis Prepared by: Debbie Michel / L. GOV. / (916) 319-3958

Date of Hearing: March 15, 2016

Consultant: Matt Dean

ASSEMBLY COMMITTEE ON

, Sr., Chair

ABPCA Bill Id:

Author:() – As Ver:February 1, 2016

SUMMARY: Requires counties to establish interagency child death review teams to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases.

EXISTING LAW:

1. Allows counties to establish interagency child death review teams to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases, but does not require counties to establish child death review teams. (Pen. Code, § 11174.32.)
2. States that interagency child death teams have been used successfully to ensure that incidents of child abuse or neglect are recognized and other siblings and non-offending family members receive the appropriate services in cases where a child has expired. (Pen. Code, § 11174.32(a).)
3. States that each county may develop a protocol that may be used as a guideline by persons performing autopsies on children to assist coroners and other persons who perform autopsies in the identification of child abuse or neglect, in the determination of whether child abuse or neglect contributed to death or whether child abuse or neglect had occurred prior to but was not the actual cause of death, and in the proper written reporting procedures for child abuse or neglect, including the designation of the cause and mode of death. (Pen. Code, § 11174.32(b).)
4. States that in developing an interagency child death team and an autopsy protocol, each county, working in consultation with local members of the California State Coroner's Association and county child abuse prevention coordinating councils, may solicit suggestions and final comments from persons, including, but not limited to, the following:
   1. Experts in the field of forensic pathology;
   2. Pediatricians with expertise in child abuse;
   3. Coroners and medical examiners;
   4. Criminologists;
   5. District attorneys;
   6. Child protective services staff;
   7. Law enforcement personnel;
   8. Representatives of local agencies which are involved with child abuse or neglect reporting;
   9. County health department staff who deals with children's health issues; and
   10. Local professional associations of persons described in paragraphs (1) to (9), inclusive. (Pen. Code, § 11174.32(c).)
5. Clarifies that records exempt from disclosure to third parties pursuant to state or federal law shall remain exempt from disclosure when they are in the possession of a child death review team. (Pen. Code, § 11174.32(d).)
6. Requires each child death review team to make available to the public findings, conclusions and recommendations of the team, including aggregate statistical data on the incidences and causes of child deaths. The team is required to withhold the child’s last name unless certain exceptions apply. (Pen. Code, § 11174.32(e).)

FISCAL EFFECT: Unknown

COMMENTS:

1. Author's Statement: According to the author, "AB 1737 aims to increase accountability and transparency and as a community improve protection services for children. The purpose of producing an annual child death report is to provide vital information should children be dying of similar reasons in one county compared to another. With no data of common occurrences, county officials do not have accurate information to link these occurrences and therefore prevent future deaths. This bill requires all counties to produce an annual child death review report in order to identify how and why children die, to further facilitate the creation and implementation of strategies to prevent future deaths.”
   
2. Background: According to the background submitted by the author, “the child death review teams in California began as informal gatherings of concerned parents and professionals that wanted to take proper steps in order to review child deaths and learn from them in order to save other children’s lives.
   
   “In 1988, California legislation was enacted to establish child death review teams in order to investigate suspicious child deaths and facilitate communication among the various entities that could provide useful information for the annual report.
   
   “Today, the Centers for Disease Control and Prevention, recorded over 23,000 infant deaths in the United States for 2014. In California, the Department of Social Services (CDSS) reported that 88 child fatalities resulted from abuse and/or neglect for 2014, but a complete summary of child death reports had not been finalized at the time the data was collected. Despite efforts to produce an annual child death report, there are only an estimated 22 active child death review teams throughout the state, leaving many counties without a reporting mechanism. We believe that one reason for the lack of participation in every county is due to a lack of existing law’s explicit requirement to report. It is the intent of this legislation to create uniformity among counties by requiring all to produce an annual child death report in hopes of learning from past deaths and prevent future ones.”
   
   The primary purpose of child death review teams is to prevent future child deaths. At the county level, these teams produce educational materials so that the more common causes of child death can be prevented. For example, according to the author, in Sacramento “The Sacramento County Child Death Review Team, which reviews the deaths of every child that dies in Sacramento County, has used the report’s findings in order to create public awareness campaigns. The recommendations have translated to the Shaken Baby Syndrome Prevention Campaign, the Infant Safe Sleep Campaign, and the Drowning Prevention Campaign to reduce preventable deaths.” However, each county’s experience is different. This is where statewide child death review can help prevent counties from duplicating efforts.
   
   The statewide child death review council is responsible for collecting data and information from the counties and turning it into reports to the public and Legislature. Part of the statutory scheme that created child death review teams included creation of the Child Death Review Council "to coordinate and integrate state and local efforts to address fatal child abuse or neglect, and to create a body of information to prevent child deaths." (Penal Code Section 11174.34(a)(1).) The Child Death Review Council is required to "[a]nalyze and interpret state and local data on child death in an annual report to be submitted to local child death review teams with copies to the Governor and the Legislature, no later than July 1 each year. Copies of the report shall also be distributed to California public officials who deal with child abuse issues and to those agencies responsible for child death investigation in each county. The report shall contain, but not be limited to, information provided by state agencies and the county child death review teams for the preceding year." (Penal Code Section 11174.34(d)(1).) Therefore, a report analyzing the data collected by each local child death review team is currently a public document. Requiring each local child death review team to also make public its own data appears to be consistent with the overall objectives of the teams, i.e., creating a body of information on the causes of child deaths to help prevent such tragedies. Increased transparency may also enhance the public's trust in local child death review.
   
   Finally, as the author stated, “Some child death review teams create elaborate, comprehensive reports, while other child death review teams do not report anything at all. Because of the wide discrepancy of reporting, the statewide council cannot get a full picture of what is occurring statewide. While all child death review teams are coming to important conclusions about local child fatalities, not all of the review teams are communicating the information to the public, which contradicts the basic premise for having them. How can child death review teams reduce future preventable child deaths if no one knows that child death review teams do?” This bill, by mandating child death review teams, would certainly increase the information available to counties and the public.
   
3. Argument in Support: According to the Sierra Health Foundation, “In 2009, Sacramento County Child Death Review Team found that in Sacramento County African American children die at twice the rate of other children. Appropriately, this news was cause for considerable alarm. Perhaps even more disturbing was the recognition that a significant disparity in African American child death rates has persisted in the county for 20 consecutive years. The revelation of this long term trend and the underwhelming response it previously generated served as a call to action for Sacramento County’s African American community, and for all Sacramentans who care about the health and well-being of all children.

“We are not reacting to a single fatality, as devastating as that is. This data has allowed us to analyze child mortality rates and causes over time which revealed that child mortality in Sacramento is about more than improving child welfare or reducing violence in communities. In short, interventions beyond child protective services and law enforcements were needed. This would not be the case without the data provided by the Child Death Review Team. Consequently, we have been able to identify six focus neighborhoods with the highest level of disproportionality and the four leading causes of those deaths, which include infant sleep-related deaths, perinatal conditions, child abuse and neglect homicides and third-party homicides. Additionally, we have been able to create strategic and implementation plans with specific steps to reduce the African American child death rate 10-20% by 2020. And despite the fact that data shows the alarming disparity impacting African American children and families, we are consciously focused on developing responses that support the safety and well-being of all children.

“Requiring each county to have an active child death review team will create uniformity across the state; with accurate data this information could be used to create public awareness campaigns and reduce the number of child deaths much like our efforts here in Sacramento County.”

1. Related Legislation: AB 2083 (Chu) would authorize the voluntary disclosure of specified information, including mental health records, criminal history information, and child abuse reports, by an individual or agency to an interagency child death review team. AB 2083 is pending hearing in this committee.
   
2. Prior Legislation:
   
   1. SB 39 (Migden), Chapter 468, Statutes of 2007, required that juvenile case files that pertain to any child who died as the result of child abuse or neglect shall be released to the public, subject to certain limitations set forth in the bill. The bill would also add specified attorneys to the persons allowed access to a juvenile case file.
      
   2. AB 1668 (Bowen), Chapter 813, Statutes of 2006, provided that interagency child death review team records that are exempt from disclosure to third parties pursuant to state or federal law remain exempt from disclosure when they are in the possession of a child death review team; provides confidentiality provisions for child death review teams; and provided that each child death review team shall annually make available to the public findings, conclusions and recommendations of the team, including aggregate statistical data on the incidences and causes of child death.
      
   3. SB 525 (Polanco), Chapter 1012, Statutes of 1999, added more state and private entities to the members of the California State Child Death Review Council, specified additional duties for the council and the Department of Justice in connection with gathering and tracking information regarding child deaths from abuse or neglect, and specified additional duties for the State Department of Health Services in connection with tracking child abuse information in specified state data systems.
      
   4. AB 4585 (Polanco), Chapter 1580, Statutes of 1988, authorized counties to establish interagency child death teams and autopsy protocol.
      

REGISTERED SUPPORT / OPPOSITION:

Support:

Sierra Health Foundation

Opposition:

None

Analysis Prepared by: