HomeMy WebLinkAboutAgenda - 01-21-2025 ; 6-c - New Legislation for Local Community Child Protection Team (CCPT) Child Fatality Prevention Team (CFPT) 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: January 21, 2025
Action Agenda
Item No. 6-c
SUBJECT: New Legislation for Local Community Child Protection Team (CCPT)/Child
Fatality Prevention Team (CFPT)
DEPARTMENT: Health & Social Services
ATTACHMENT(S): INFORMATION CONTACT:
Implementation of Legislative Changes to Quintana Stewart, Health Director, 919-245-
Strengthen the Child Fatality Prevention 2412
System Session Law 2023-134, Section Lindsey Shewmaker, DSS Director, 919-
9H.15.(e) 245-2817
2024 Orange County Child Fatality Team
Roster
PURPOSE: To receive an update on new legislation that seeks to strengthen the State's child
fatality prevention system, and to approve the continuation of the current structure of a single
Orange County local CCPT/CFPT.
BACKGROUND: Session Law 2023-134, Section 9H.15 directed the North Carolina Department
of Health and Human Services (NCDHHS)to create a new State Office of Child Fatality Prevention
in order to strengthen the State's Child Fatality Review System for preventing child fatalities and
maltreatment. Along with the creation of a new State office, the legislation lays out a broad
restructuring of child fatality review systems statewide, with the goal of streamlining processes,
preventing child deaths, and promoting child well-being.
Team membership is nearly the same within the new legislation. Required positions continue to
be the following:
• Director of the county department of social services or the director of the consolidated
human services agency
• Additional staff member of the county department of social services or the consolidated
human services agency
• Director of the local department of public health
• Local law enforcement officer
• Attorney from the district attorney's office
• Executive director of the local community action agency, or designee
• Superintendent of each local school administrative unit located in the county, or designee
• Member of the county board of social services
• Local mental health professional
• Local guardian ad litem coordinator, or designee
• Local health care provider
• Emergency medical services provider or firefighter
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• District court judge
• County medical examiner
• Representative of a local childcare facility or Head Start program
• Parent of a child who died before reaching the child's eighteenth birthday
Prior to the new legislation, the Board of County Commissioners (BOCC) could appoint up to five
(5) additional members from the community to serve on the team. From 2018 until present day,
there is no record indicating any additional team member appointments from the BOCC. The
current team roster is attached. The team currently has 4 vacant positions from the required list.
Team Chair Shannon Barnes has sent out invitations for the attorney position, executive director
of local community action agency and district court judge. The team continues to recruit for a
parent representative. As of January 2025, the additional BOCC-appointed positions are to be
replaced by up to five (5) individuals that the Local Team Chair can invite to serve as ad hoc
members for a specific child fatality review to enhance the effectiveness of the review.
The legislation makes the following changes to required reviews:
• Local Teams are no longer required to do active child protective services case reviews
(formally a CCPT objective), but may elect to do such reviews at the request of the Director
of the county department of social services.
• Local Teams are no longer required to review every death of a resident child. Instead, Local
Teams shall review all deaths of resident children under age 18 that fall into one of the
following categories below (and may elect to review additional deaths that fall outside these
categories).
1. Undetermined causes
2. Unintentional injury
3. Violence
4. Motor vehicle incidents
5. Sudden unexpected infant death
6. Suicide
7. Deaths not expected in the next six months*
8. Deaths related to child maltreatment or child deaths involving a child or child's family
who was reported to or known to child protective services*
9. A subset of additional infant deaths that fall outside of the above categories,
according to guidelines set by NCDHHS*
*Criteria and guidelines will be established by NCDHHS to further define these
categories.
The new legislation also requires local teams to prepare to participate in the National Fatality
Review - Case Reporting System (NFR-CRS).
• Local Teams are legislatively required to begin using the NFR-CRS on July 1, 2025.
• Appropriate data use agreements are being developed and will have to be in place prior to
implementation.
• The Office of Child Fatality Prevention will provide training to Local Teams on the use of
the NFR-CRS prior to July 2025.
• The Office of Child Fatality Prevention will also provide guidance and ongoing technical
assistance related to use of the NFR-CRS.
• Once enough data is collected in the NRF-CRS, the Office of Child Fatality Prevention will
analyze and report on aggregate data from the NFR-CRS.
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FINANCIAL IMPACT: In the State's fiscal year 2025 budget, Local Teams received funding
allocated through the Division of Child & Family Wellbeing (DCFW) Agreement Addendum (AA)
352. Orange County received $804 for FY 2025. An additional one-time, separate Division of
Public Health (DPH) Agreement Addendum 701 ($189,000 distributed among all Local Teams)
will focus on implementation of the National Fatality Review- Case Reporting System (NFR-CRS)
as required by legislation. Orange County received $1,935 for FY 2025.
The final goal is a singular Agreement Addendum that includes all funding (combined from AA
352 and AA 701) starting in FY 2026.
ALIGNMENT WITH STRATEGIC PLAN: This item supports:
• GOAL 2. HEALTHY COMMUNITY
OBJECTIVE 7. Invest in services and programs that improve the health and quality of life
of the community (e.g., recreation and public open spaces, arts, etc.)
RECOMMENDATION(S): The Manager recommends that the Board approve the
recommendation of the Health Director and Social Services Director to continue with the single
County CCPT/CFPT structure.
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Implementation of Legislative Changes to
Strengthen the Child Fatality Prevention System
Session Law 2023-134, Section 9H.15.(e)
STAB
KY 20.1
� �ARiL eZ.1776 �
Report to the
Joint Legislative Oversight Committee on
Health and Human Services
and
Fiscal Research Division
by
North Carolina
Department of Health and Human Services
August 20, 2024
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1. Background
Session Law 2023-134, Section 9H.15 directed the North Carolina Department of Health and
Human Services (NCDHHS) to create a new State Office of Child Fatality Prevention in order to
strengthen the state's Child Fatality Review System for preventing child fatalities and
maltreatment. Along with the creation of a new state office,the legislation lays out a broad
restructuring of child fatality review systems statewide, with the goal of streamlining processes,
preventing child deaths, and promoting child well-being. The key components from this
legislation that affirms the state's shared vision and commitment in North Carolina include the
following:
• Creates a new Office of Child Fatality Prevention within NCDHHS' Division of Public
Health. Five new positions were created to perform the following roles within the
restructured Child Fatality Prevention System:
o Coordinate the work of the statewide Child Fatality Prevention System.
o Implement and manage a centralized data and information system capable of
gathering, analyzing, and reporting aggregate information from child death review
teams with appropriate protocols for sharing information and protecting
confidentiality.
o Create and implement tools, guidelines, resources, and training and provide
technical assistance to Local Teams to enable them to:
■ Conduct effective reviews which are tailored to the type of death being
reviewed.
■ Make effective recommendations about child fatality prevention.
■ Gather, analyze, and appropriately report on case data and findings, while
protecting confidentiality.
■ Facilitate the implementation of prevention strategies in their
communities.
o Work with the North Carolina Division of Social Services,North Carolina Office
of the Chief Medical Examiner's child fatality staff, and the North Carolina State
Center for Health Statistics to provide Local Teams initial information about child
deaths in their respective counties.
o Perform research, consult with stakeholders and experts, and collaborate with
other organizations and individuals for the purpose of understanding the direct
and contributing causes of child deaths as well as evidence-driven strategies,
programs, and policies to prevent child deaths, abuse, and neglect in order to
inform the work of the Child Fatality Prevention System.
o Collaborate with the Division of Social Services to determine the manner in
which information from internal fatality reviews conducted by the Division of
Social Services can appropriately inform Local Team reviews of these cases.
o Educate State and local leaders, including the members and staff of the North
Carolina General Assembly, executive branch department heads, as well as
stakeholders, advocates, and the public, about the Child Fatality Prevention
System, and issues and prevention strategies addressed by the system.
o Collaborate with State and local agencies, nonprofit organizations, academia,
advocacy organizations, and others to facilitate the implementation of
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evidence-driven initiatives to prevent child abuse, neglect, and death, such as
education and awareness initiatives.
o Create and implement processes for evaluating the ability of the Child Fatality
Prevention System to achieve outcomes to be accomplished by the system, and to
report to the Child Fatality Task Force on these evaluations and on statewide
functioning of the Child Fatality Prevention System.
o Consider opportunities to seek and administer grant and other non-State funding
sources to support State or local Child Fatality Prevention System efforts.
o Develop guidance to inform local decisions about the formation and
implementation of single versus multicounty Local Teams.
• Consolidates teams across the state to focus on streamlined local-level reviews
o The current system structure includes two types of local review teams in every
county plus two types of state review teams—more than 200 teams. This includes
local Child Fatality Prevention Teams (local CFPT), local Community Child
Protection Teams (local CCPT), a State Child Fatality Review Team, and a State
Child Fatality Prevention Team.
o The new legislation merges current Community Child Protection Teams and
Child Fatality Prevention Teams in each county to form a single,unified Local
Team, with the option to be a single-county team or a multi-county team. It also
eliminates the two state review teams currently conducting state-level reviews
with support from NCDHHS.
• Amends the requirements related to deaths requiring review. Teams are required to
review all deaths in the following categories: undetermined, unintentional injury,
violence, motor vehicle, child abuse or neglect/CPS involvement, sudden and unexpected
infant deaths, suicide, deaths not expected in next six months. Teams are also required to
review a subset of infant deaths that do not fall within these categories according to
criteria set by the new state office.
• Restructure the System of Review and Support for Maltreatment-Related Deaths
o The legislation assigns responsibility to the North Carolina Division of Social
Services to restructure Citizen Review Panels. The federal Child Abuse
Prevention and Treatment Act (CAPTA) (42 U.S.C. 5106) requires each state to
maintain a minimum of three Citizen Review Panels to provide systems-level
monitoring and recommendations related to child welfare practice. Historically,
North Carolina has met this requirement through its 100 Community Child
Protection Teams (CCPT), which operate in each county. Under the new
legislation,North Carolina can restructure its Citizen Review Panels into a
statewide or regional approach that can better meet the oversight and
recommendation role intended for the Citizen Review Panels. The panels must be
operated and managed by a qualified organization that is independent from any
State or county department of social services The specific structure of the new
Citizen Review Panels can be determined by NC DSS in partnership with this
external managing entity, as long as the new structure meets the federal
requirement to maintain a minimum of three panels.
e The legislation also eliminates DSS-led intensive reviews focusing on one Local
Team review and expands the review of child maltreatment deaths and deaths of
children known to child protective services. The legislation outlines a structure in
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which the new State Office oversees state coordination maltreatment-involved
child deaths.
• Enters North Carolina into the National Fatality Review- Case Reporting System(NFR-
CRS)
o NFR-CRS is operated and maintained by The National Center for Fatality Review
and Prevention(The National Center). The National Center makes the system
available for free with appropriate legal agreements in place and is currently in
use, in some capacity, in 48 states.
o Local Teams, the State Office, and Medical Examiner child fatality staff are
required to utilize NFC-CRS for the purpose of collecting, analyzing, and
reporting on information learned through child death reviews.
2. Status Update
In accordance with SL 2023-134, Section 9H.15.(e),NCDHHS is submitting this report to the
Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research
Division on the progress being made to implement the law and to strengthen the state's Child
Fatality Prevention System. The table below provides a summary of the progress to date as well
as the remaining key tasks for each of the main objectives in SL 2023-134.
The required changes are the largest in the history of our Child Fatality Prevention System. And
ensuring these changes are implemented correctly is critical to the safety of North Carolina's
children. A significant amount of work has been done since SL 2023-134 was signed into law in
October 2023. NCDHHS recognizes the importance of this work and is working to complete all
legislatively mandated tasks expeditiously, while also allocating the necessary time to ensure that
North Carolina is adequately prepared for this restructuring of our child fatality prevention
system. NCDHHS is committed to working quickly and efficiently, but also taking the time
necessary to fulfill the objectives of this legislation:
• implementing centralized coordination of the system,
• streamlining the system's State-level support functions,
• maximizing the use of data,
• ensuring that relevant and appropriate information and recommendations from Local
Teams reach the appropriate local and State leaders.
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The table below outlines the work completed thus far and the remaining tasks to be implemented.
Requirement Progress to Date Remaining Key Tasks Legislative
Due Date
The State Office • Developed organization • Complete recruitment and hiring 1/1/2025
of Child Fatality structure for new State process for all new State Office
Prevention is Office positions, including Director
sufficiently . Mapped out roles and • Incorporate the Regional Support
staffed responsibilities and Model for technical assistance and
and prepared to developed job support for local teams for child
carry out the descriptions maltreatment and DSS-involved
powers and . Established all new death reviews.
duties of the positions • Develop tools, guidelines, and
State Office, as • Established and posted training for local teams
described in Director position for • Develop policies and procedures
G.S. 143B- recruitment regarding local reviews
150.27. . Reviewed candidates and
began scheduling
interviews for Director
position
• Created plan to move
existing position to new
State Office
• Determined best practices
for maltreatment-
involved death reviews
• Consulted local
stakeholders on local
process
Appropriate • Identified appropriate • Finalize funding allocation formula 1/1/2025
funds to Local vehicle(s) to allocate • Finalize new Agreement
Teams funding Addendum for LHDs with
• Developed funding appropriate budget allocated for
allocation formula, each county
engaging the NC
Association of Local
Health Directors for
input.
• Drafted scope of work for
agreement and processing
Agreement Addendum
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Requirement Progress to Date Remaining Key Tasks Legislative
Due Date
Ensure the • Analyzed previous • Conduct solicitation for third party 1/1/2025
existence of at recommendations to manage creation and operation
least three • Developed approach to of multiple Citizen Review Panels
Citizen Review conduct solicitation for . Evaluate solicitation responses and
Panels pursuant third party to manage select best value thirdp arty
to creation and operation of
requirements set multiple Citizen Review • Onboard awarded third party to
forth in CAPTA Panels design new Citizen Review Panel
that are . Submitted proposed RFA structure
operated and • Implement new Citizen Review
managed by a Panel structure, according to third
qualified party design
organization
that is
independent
from any State
or county
Department of
Social Services
Execute any . Working through legal, • Execute Data Use Agreement(s) 1/1/2025
contractual privacy/ security, and IT for NFR-CRS
agreements and considerations as we • Finalize which stakeholder will be
interagency data work with National responsible for entering which data
sharing
agreements Center on requirements elements into NFR-CRS
necessary for and agreements needed to . Finalize and execute applicable
participation in utilize the NFR-CRS. contractual agreements and
the NFR-CRS, . Determined initial fields interagency data sharing
as required in to provide to NFR-CRS agreements at State and local level
G.S. 713-1413.5 and began determining
which stakeholders will
enter information into
NFR-CRS
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Requirement Progress to Date Remaining Key Tasks Legislative
Due Date
Ensure through • Determined priority •Develop and deliver guidance and 7/1/2025
its State NFR-CRS fields to be training to prepare local teams to
Office of Child prioritized for data entry begin using NFR-CRS
Fatality . Began creating data entry •Identify and provide appropriate
Prevention that
all Local Teams Workflow for NFR-CRS access to identified users that will
have been between multiple need to interact with NFR-CRS
provided responsible parties
guidelines and
training
addressing their
participation in
the NFR-CRS
Local Teams • Developed DHHS • Develop documentation and 1/1/2025
transition workgroups to address training materials to provide to
to Single Team the considerations of Local Teams to reflect restructured
structure and system components under teams
state teams team and review • Develop and execute
cease operating reorganization communication plan to Local
• Released initial Teams
communication to local • Deliver training to Local Teams
stakeholders regarding
transitions initiated by
legislation
3. Factors Effecting Implementation
There are multiple factors which add complexity to the process of implementing the
requirements contained in SL 2023-134. NCDHHS is committed to following applicable state
and federal laws, state HR, IT, and procurement requirements, and engaging the appropriate
partners to remain compliant with applicable requirements and deliver optimal outcomes. Listed
below are examples of these complex factors involved with large system changes required to
strengthen our Child Fatality Prevention System.
1. Filling the new positions in the State Office of Child Fatality Prevention requires
NCDHHS to follow the State's process to create and gain approval of new positions, and
then follow the procedures to post positions and evaluate candidates. Following the
established processes enables qualified candidates to be selected to fill the newly created
positions.
2. In order for the State to share highly sensitive data with the National Center,NCDHHS
must follow the processes established by the NC Department of Information Technology
and the NCDHHS Privacy and Security Office to gain advanced approval to have State
data hosted outside of the State's infrastructure. This requires NCDHHS to collect
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information from the National Center about their system's security protocols and features
to enable the State to adequately assess the level of the National Center's data and
privacy protection. Because of the sensitivity of the system security settings and
safeguards, the National Center requires the State to sign a Non-Disclosure Agreement
before the National Center shares this information with the State. Once this information is
shared,NCDHHS will review and go through the NC Department of Information
Technology's Exception Request Process to gain approval to share the State's data with
the National Center. Although these required steps take time, they are essential to help
protect the highly sensitive data being shared with the National Center and comply with
all established data and information sharing requirements.
3. The specific data that has been requested to be entered into the NFR-CRS comes from
multiple elements of the Child Fatality Prevention System. This requires coordination
across these elements to confirm the availability of resources at the state and county level
to enter the data into the NFR-CRS. NCDHHS will then need to follow established
processes to grant identified users access to the NFR-CRS and then provide them with
sufficient training. Taking the time to complete appropriate change management
activities will help prepare the state and county level resources to successfully participate
in the NFR-CRS to help prevent future child fatalities.
4. NCDHHS is engaging with its Office of Procurement and Grants (and adhering to the
state's procurement process)to establish at least three Citizen Review Panels pursuant to
the federal requirements set forth in the Child Abuse Prevention and Treatment Act
(CAPTA)that are operated and managed by a qualified organization that is independent
from any State or county department of social services. The time it takes to develop a
solicitation that captures well the State's needs, conduct a solicitation to enable
organizations to submit compelling and innovative solutions, evaluate responses, and
negotiate the final agreement helps NCDHHS select the best-value organization to
support implementing and operating Citizen Review Panels effectively.
4. Conclusion
NCDHHS is committed to implementing a strong and effective Child Fatality Prevention
System. We recognize the significant benefits that will come to our state from a new coordinated
infrastructure to help support effective local teams' reviews. While a significant amount of work
has been done to-date, we acknowledge there is still complex and challenging work ahead.
NCDHHS remains focused on ensuring that this work is completed and that we build a lasting
system that will achieve the critical goal of preventing child deaths.
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2024 Orange County Child Fatality Team Roster
Position Name Email
DSS Director Lindsey Shewmaker Ishewmaker@orangecountync.gov
DSS Staff Brittany Mann bmann@orangecountync.gpv
Health Director Quintana Stewart gstewart@orangecountync.gov
Team Chair/Review Shannon Barnes, OCHD sbarnes@orangecountync.gov
Coordinator Family Home Visiting
Supervisor
Local law enforcement Mari Hall, Chapel Hill PD mhall@townofchapelhill.org
Attorney from the district vacant
attorney's office
Superintendent of each local Avis Barnes, Orange County avis.barnes@orange.k12.nc.us
school district or designee Schools Social Worker
Tracy Sanders, Chapel Hill- tsanders(cbchccs.k12.nc.us
Carrboro City Schools Nurse
Member of the county board Oscar Fleming oscar.f[eming(cbunc.edu
of social services
Local mental health Laurie Williamson,Alliance [williamsonCa)alliancehealthplan.org
professional System of Care Coordinator
Local guardian ad [item Nicole Roman, GAL District nicole.m.roman(a)nccourt"
coordinator or the Administrator
coordinator's designee.
Local health care provider Holly Gross, UNC Hospitals holly.gross unchealth.unc.edu
Beacon Team
Emergency medical services Landon Weaver, Community [weave rCo)oran gecountync.gov
provider or firefighter, Paramedic Coordinator
County medical examiner Genevieve Lynch-Sachs, genevieve.ncme0bgmail.com
County Medical Examiner
Representative of a local child Tamara Dempsey-Tanner, tdempseytanner@orangesmartstart.org
care facility or Head Start M.Ed, CCHC-C/E
program
Executive director of a local Vacant
community action agency, or
designee
District court judge Vacant
Parent of a child who died Vacant
before age 18