Bill Summaries: S703 (2021-2022 Session)

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  • Summary date: Apr 9 2021 - View summary

    Part I.

    Enacts new Part 4C to Article 3 of GS Chapter 143B, establishing the State Office of Child Fatality Prevention (State Office) within the Department of Health and Human Services, Division of Public Health (DPH), to oversee coordination of State-level support functions for the NC Child Fatality Prevention System to maximize efficiency, effectiveness, and capacity. Grants DHHS discretion over staffing of the State Office, except requires the medical examiner child fatality staff to work under the Chief Medical Examiner. Enumerates 11 powers and duties of the State Office, including creating and implementing tools, guidelines, resources and training, and provide technical assistance, to Local Teams, defines to mean a multidisciplinary child death review team that is either a single or multicounty team responsible for performing and type of child fatality review pursuant to Article 14 of GS Chapter 7B.

    Appropriates $389,998 in recurring funds for 2021-22 and $551,861 in recurring funds for 2022-23 from the General Fund to DPH to establish and operate the State Office. Effective July 1, 2021.

    Part II.

    States legislative intent to restructure the NC Child Fatality Prevention System (System) as provided. Charges DHHS with the following to implement the described legislative intent. Directs DHHS to have management staff in place at the State Office by July 1, 2022, with Local Teams receiving continuous support throughout the restructuring of the System. Requires DHHS to ensure that the State Office has sufficient staffing by January 1, 2023, to support the restructured System, with execution of any necessary contractual agreements or interagency data sharing for participation in the National Child Death Review Case Reporting System (National System) completed. Requires DHHS to ensure that by July 1, 2023, all Local Teams have been provided guidelines and training addressing their participation in the National System, and that Local Teams have begun using the System for reporting.

    Part III.

    Makes the following changes to Article 14, GS Chapter 7B, which governs the System. 

    Revises the declared State policy in GS 7B-1400 as follows. Now states legislative intent to establish a statewide multidisciplinary, multiagency child fatality prevention system to assess the records of child deaths in the State from birth up until the child's 18th birthday, to study data and prevention strategies related to child abuse, neglect, and death, and to use multidisciplinary teams to review these deaths to (1) develop a communitywide approach to child abuse and neglect; (2) understand the causes and contributing factors of childhood deaths; (3) identify any existing gaps or deficiencies in the delivery of services to children and their families by public agencies; (4) identifying and aiding in facilitating the implementation of evidence-driven strategies to prevent child death and promote child well-being; and (5) make and implement recommendations for changes to laws, rules, and policies that support safe and healthy child development. 

    Revises the defined terms set forth in GS 7B-1401 to now define Child Fatality Prevention System; Local Team; medical examiner child fatality staff; National Child Death Review Case Reporting System; State Office; and Task Force. Enacts new GS 7B-1402.5 to establish three committees with stated subject matter parameters through which the existing Child Fatality Task Force (Task Force) is to carry out its duties: a Perinatal Health Committee, an Unintentional Death Prevention Committee, and an Intentional Death Prevention Committee. Directs each committee to develop and submit recommendation to the Task Force, with the recommendations becoming final upon majority vote of the Task Force. Provides for leadership and staffing of the Task Force, and the development of Task Force policies and procedures, with four components addressed at minimum. Makes conforming deletions to GS 7B-1402.

    Replaces the duties of the Task Force under GS 7B-1403 to now require the Task Force to do the following. Requires undertaking a study of the incidences and causes of child deaths in the State as well as evidence-driven strategies for preventing future child deaths, abuse, and neglect. Details three components the study must include, such as information from subject matter experts that informs the understanding of the causes of child deaths and/or prevention strategies, as well as aggregate information and data analysis of child deaths. Charges the Task Force with advising the State Office regarding operation of a statewide system for multidisciplinary review of child deaths and implementation of evidence-driven strategies to prevent child deaths, abuse, and neglect. Places the responsibility of receiving and considering specified reports from the State Office upon the Task Force. Charges the Task Force with developing recommendations for changes in law, policy, rules or the implementation of evidence-driven prevention strategies to be included in its annual reports required under GS 7B-1412. Maintains that the Task Force can perform other studies or determinations necessary to carry out its mandate. 

    Repeals GS 7B-1404, which creates the NC Child Fatality Prevention Team. Makes conforming repeals of GS 7B-1405 and 7B-1406.

    Enacts new GS 7B-1406.5, directing each county to have its own Local Team or participate in a multicounty Local Team. Provides for county governing boards to consult with relevant local authorities specified and State Office guidance in determining whether to be a part of a multicounty team. Charges Local Teams with reviewing all child deaths of resident children under 18 in the county or counties respective to the Local Team which fall under one of nine specified categories, including violence, motor vehicle accidents, and suicide, with consultation required of the State Office when the Local Team is uncertain if the death falls within a specified category requiring review. Allows the Local Team to review deaths child deaths that fall outside of the specified categories. Allows for a Local Team to review an active case in which a child or children are being served by child protective services upon request of a director of a department of social services (dss director), and make recommendations to the Citizen Review Panel serving the area, as well as recommendations based on the review with its annual report to the county board of commissioners required under new GS 7B-1407.10. Requires Local Teams to participate in periodic training provided by the State Office, and employ best practices outlined by the State Office. 

    Makes conforming changes to GS 7B-1407 regarding Local Teams. Adds to Local Team membership to allow for a designee of the consolidated human services agency in lieu of the dss director, with the following new member requirements: an emergency medical services provider or firefighter, a district court judge, a county medical examiner, a representative of a local child care facility or Head Start program, and a parent of a child who died before reaching the child's 18th birthday (previously, these members were included as additional members when the Local Team reviews the records of additional child fatalities). Provides for the appointing authority of each new member. Authorizes the chair to invite up to five additional individuals to participate on an ad hoc basis for specific review, subject to the chair's discretion and confidentiality agreements. Allows for a staff member of the State Office to serve as an ex officio member. Requires Local Teams to meet at least twice a year (was, at least four times a year), and as frequently as necessary to fulfill the Article's requirements. Provides for meetings at the call of the chair. Requires the chair to participate in training by the State Office prior to presiding over a Local Team meeting. Makes conforming changes and deletions. 

    Enacts GS 7B-1407.5, enacting additional requirements that apply to child deaths that meet one of four stated conditions, such as the decedent being known to be reported as abused or neglected or the decedent or the decedent's family was involved with child protective services within three years preceding a child's death. Create seven additional duties of the State Office in regards to these cases, and three additional duties of Local Teams in regards to these cases.

    Enacts GS 7B-1407.6, directing the State Office to consult with perinatal health experts and participants in reviews of infant deaths to develop criteria for Local Teams to identify a subset of additional infant deaths subject to review that fall outside of required reviews under the nine categories under GS 7B-1406.5(c), as enacted, updating specified information biannually based on emerging information and data.

    Establishes four findings the must be made for each child death reviewed by a Local Team. Requires that case information for cases requiring review be entered into the National System, with authority to enter information for cases which the Local Team is permitted to review. Requires annual reporting to the board of county commissioners on recommendations for systemic improvements and needed resources to address identified gaps and deficiencies in the existing system, and requires simultaneously providing a copy of the annual report to the State Office. 

    Directs medical examiner child fatality staff to work with the State Office and Local Teams to carry out the System's purposes. Charges such staff with four responsibilities, including providing Local Teams with access to completed medical examiner reports for purposes of review. 

    Repeals GS 7B-1408, GS 7B-1409, and GS 7B-1411, which provide for a Child Fatality Prevention Team Coordinator and Community Child Protection Teams. 

    Revises GS 7B-1410, which sets forth the duties of the director of the local department of health (who is included in Local Team membership). Adds that the director must serve along with the Local Team chair as a liaison between the State Office and the Local Team to communicate information. Maintains other existing duties, with a conforming repeal relating to Team Coordinators, which are eliminated by the act. Establishes four duties of the dss director (who is included in Local Team membership), including serving along with the Local Team chair as a liaison between the State Office and the Local Team to communicate information, providing staff support for cases reviewed, quarterly reporting to the county board of social services or as the board requires, and determining whether and when to request the Local Team or a Citizen Review Panel to review an active child protective services case. 

    Revises the reporting duties of the Task Force under GS 7B-1412, now requiring annual reporting to the specified NCGA committee chairs and the Secretary of Health and Human Services, in addition to the Governor and the NCGA. Adds to the reporting requirements a summary of activities and functioning of the System as a whole. Expands the reporting requirements with respect to recommendations, and allows the Task Force to request assistance from the specified NCGA division in development fiscal information to accompany recommendations (previously required a fiscal note with the recommendations).

    Amends GS 7B-413 regarding access to records to make the provisions applicable to Local Teams, the Task Force, and the State Office staff providing technical assistance with a review. Deems the access granted subject to and limited by all relevant state and federal laws. Allows for entities to apply for a court order to compel disclosure of requested information that the entity is entitled to access under the statute which has not been received within 30 days of request. Provides for application procedures. Provides for making certain information regarding the death of a child from suspected abuse or neglect public pursuant to state and federal law. Grants Citizen Review Panels access to information related to child deaths and child death reviews of active child protective services cases under the Article when relevant to the Panel's purposes in evaluating the provision of child protective services. Make conforming changes and deletions. Makes clarifying and technical changes.

    Enacts GS 7B-1413.5, mandating use of the National System by Local Teams, the State Office, and medical examiner child fatality staff, with training, assistance and management by the State Office. Requires the State Office to provide guidance, policies and training for Local Teams on the specified parameters of the National System. Effective July 1, 2023.

    Amends GS 7B-1414 to require the chairs of the Task Force to work with the Secretary of Health and Human Services in hiring or designating staff or consultants to assist the Task Force and its committees. 

    Makes conforming deletions in GS 7B-2902, regarding disclosure in child fatality or near fatality cases. Makes conforming repeal of GS 143B-150.20. 

    Makes the above provisions effective January 1, 2023, unless otherwise provided.

    Part IV.

    Enacts GS 108A-15.20, directing DHHS, Division of Social Services (DSS) to ensure at least three citizen review panels (panels) exist which meet the federal Child Abuse Prevention and Treatment Act standards specified, operated and managed by a qualified, independent organization, with DSS assisting the organization in information, reporting, and support needs. Provides that panel membership is volunteer based. Charges panels with evaluating the extent to which the State is fulfilling its child protection responsibilities in accordance with the Child Abuse Prevention and Treatment Act State Plan by examining polices, procedures and practices of State and local agencies, and reviewing specific cases as appropriate. Includes a non-exhaustive list of other criteria panel may review, with panels choosing to review child fatalities permitted to use information and reports pursuant to new Article 14 of GS Chapter 7B. Requires the State Office and Local Teams to provide specified information upon request. Permits review of specific child protective services cases upon its own directive or upon request from the dss director. Provides for access to necessary government information, subject to specified confidentiality requirements. Directs panels to provide for public outreach and comment to assess the impact of current procedures and practices on children and families. Requires the panel to prepare and make available to the State and the public annual reports of summaries of the panels' activities and recommended improvements. Requires DSS to submit a written response to the report within six months. Effective January 1, 2023.