Child Fatality Task Force sets 2024 agenda

Child Fatality Task Force sets 2024 agenda

By Jennifer Fernandez

Up until this week, Gerard Tate has been the sole employee of the N.C. Office of Violence Prevention.

The new office, created last year by an executive order from Gov. Roy Cooper, now also has a deputy director to help coordinate with state and local leaders to reduce violence and increase public safety using a public health approach.

However, the executive order ends next year, and the office is working with limited funding and staffing, Tate told members of the North Carolina Child Fatality Task Force last week.

“We need to make the office permanent,” he said.

The task force voted to support recurring funding for the office, one of nearly a dozen items on its 2024 action agenda, the recommendations that it includes in an annual report to the governor and General Assembly. 

The Child Fatality Task Force is made up of volunteer experts in child health and safety, state agency leaders, community leaders and state legislators. It has been working behind the scenes since 1991 to prevent child death and promote child well-being. Task force members raise awareness among lawmakers of child welfare issues, and advocate for policies to improve the health and safety of North Carolina’s children.

As a legislative study commission, the task force has worked to pass state policies to protect children. Some examples include laws mandating vehicle restraints that pushed down the number of deaths in car accidents, and supporting laws requiring smoke detectors in rental properties, which resulted in a nearly 50 percent decrease in the number of children dying in apartment fires over a decade. 

Range of issues

Issues that task force members are backing for 2024 range from supporting funding for Medicaid coverage of doulas to improve maternal health, to endorsing legislation to address social media algorithms that suck in children and can cause them harm, to further investigating paid family leave insurance.

Some recommendations continue previous work of the task force, such as support for recurring funds to hire more nurses and other health professionals. Money included in the state budget approved last year to hire an additional 120 people in school health positions is only temporary because it comes from federal COVID-19 aid. Once that money is gone, those positions are likely to go away.

Some of the recommendations cover new ground.

At last week’s meeting, Leandra Vernon of Every Baby Guilford gave the full task force an overview of the county’s Fetal and Infant Mortality Review program, which needs help accessing records to complete its reviews.

Guilford County’s mortality review program, the first in the state, launched in 2022 to gather more data about infant deaths to reduce the high rates in the county.

The county’s rate stood at 7.6 deaths per 1,000 live births in 2021, the most recent year for which data are available. 

A sign in downtown Greensboro advertising Every Baby Guilford. The county started the state’s first Fetal and Infant Mortality Review program. Credit: Jennifer Fernandez/NC Health News

That’s higher than the state’s rate of 6.8 deaths per 1,000 live births and the national rate of 5.4. It’s also higher than the rates in other large N.C. counties: Forsyth (7.2), Durham (6.2), Wake (5.5) and Mecklenburg (5.1).

In a fetal and infant mortality review, a multidisciplinary team reviews cases to find ways to improve the system. It’s not about placing blame, Vernon said. A key component is speaking with family members to help better understand what happened. 

Team members need access to any related records, but don’t have the authority to obtain them, Vernon said.

“With legislation, it would be a little bit easier if they trust that (information) is protected,” Vernon said.

Legislators have already given child fatality review teams access to this data, said task force Executive Director Kella Hatcher.

The task force voted to support legislation that would aid mortality review programs like Guilford County’s access to the information they need.

Focus areas 

The Child Fatality Task Force made the following recommendations for 2024:

Doula services: Support funding for Medicaid reimbursement of doula services throughout pregnancy and the postpartum period. Doulas are people trained to help during pregnancy, the birthing process and afterward to keep mom and baby safe and healthy. Medicaid funding could be used to provide support services and technical assistance for doulas.

Fetal and Infant Mortality Review program: Support Fetal and Infant Mortality Review legislation to grant the authority for programs to be started and to enable the reviewers to access the necessary medical records; to provide immunity protections to reviewers and review materials; and for the programs to include best practices for family interviews and community action teams.

Child care: Support growth and expansion of investments in the early child care system, including increases in child care subsidies.

School health positions: Support recurring funds to increase the number of school nurses, social workers, counselors and psychologists to support the physical and mental health of students. Currently, North Carolina is behind the rest of the country in staffing ratios for most of these professionals. The task force’s goal is to move the state toward nationally recommended ratios for these professional positions in schools. 

Office of Violence Prevention: Support recurring funding for the office, which was created in March 2022 through an executive order by Gov. Roy Cooper. That order is set to expire in 2025.

Social media: Endorse legislation that addresses addictive algorithms in social media that harm children.

Safe firearm storage: Support legislation that would remove a phrase from an existing law that has limited who can be held liable when a minor accesses a weapon that has not been stored safely. 

N.C. SAFE: Support recurring funding for N.C. SAFE campaign that educates about safe firearm storage.

Gathering information

Since the 2024 legislative year is a short one, members of the task force decided not to support legislation or funding on a number of issues, but pledged to continue gathering information to help the group craft an agenda for 2025. For 2024, the task force will investigate the following issues:

Paid family leave insurance: including information on its impact on businesses, and obtaining employer feedback.

Congenital syphilis: Get data broken down by race, ethnicity and gender; for prevention efforts and education to be culturally sensitive and appropriate; to have healthcare systems in place for routine order sets and education; to have active community education on the topic; and to better understand where mothers are getting their information to enable improved education efforts.

Fentanyl-related deaths: Seek further collaboration and information gathering on fentanyl-related deaths among children and adolescents. 

This year, the group will also monitor several issues that may end up on next year’s agenda for the General Assembly’s long session.

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