1269 AMS LONG S3029.1

HB 1269 - S AMD - 313

By Senators Long, Hargrove, Deccio and Loveland

                                                 WITHDRAWN 4/16/97

    On page 2, after line 19, insert the following:

    "Sec. 2.  RCW 70.05.170 and 1993 c 41 s 1 are each amended to read as follows:

    (1)(a) The legislature finds that the mortality rate in Washington state among infants and children less than eighteen years of age is unacceptably high, and that such mortality may be preventable.  The legislature further finds that, through the performance of child ((mortality)) death reviews, preventable causes of child mortality can be identified and addressed, thereby reducing the infant and child mortality in Washington state.

    (b) It is the intent of the legislature ((to encourage the performance of child death reviews by local health departments by providing necessary legal protections to)) that community-based, multidisciplinary child death review occur and that the confidentiality of the families of children whose deaths are ((studied, local health department officials and employees)) reviewed, using local and state child death review teams, and ((health care professionals participating)) other participants in child ((mortality)) death review ((committee)) activities be legally protected.

    (2) As used in this section, "child mortality review" means a process authorized by a local health department as such department is defined in RCW 70.05.010 for examining factors that contribute to deaths of children less than eighteen years of age.  The process may include a systematic review of medical, clinical, and hospital records; home interviews of parents and caretakers of children who have died; analysis of individual case information; and review of this information by a team of professionals in order to identify modifiable medical, socioeconomic, public health, behavioral, administrative, educational, and environmental factors associated with each death.

    (3) Until January 1, 1998, local health departments are authorized to conduct child mortality reviews.  In conducting such reviews, the following provisions shall apply:

    (a) All medical records, reports, and statements procured by, furnished to, or maintained by a local health department pursuant to chapter 70.02 RCW for purposes of a child mortality review are confidential insofar as the identity of an individual child and his or her adoptive or natural parents is concerned.  Such records may be used solely by local health departments for the purposes of the review.  This section does not prevent a local health department from publishing statistical compilations and reports related to the child mortality review, if such compilations and reports do not identify individual cases and sources of information.

    (b) Any records or documents supplied or maintained for the purposes of a child mortality review are not subject to discovery or subpoena in any administrative, civil, or criminal proceeding related to the death of a child reviewed.  This provision shall not restrict or limit the discovery or subpoena from a health care provider of records or documents maintained by such health care provider in the ordinary course of business, whether or not such records or documents may have been supplied to a local health department pursuant to this section.

    (c) Any summaries or analyses of records, documents, or records of interviews prepared exclusively for purposes of a child mortality review are not subject to discovery, subpoena, or introduction into evidence in any administrative, civil, or criminal proceeding related to the death of a child reviewed.

    (d) No local health department official or employee, and no members of technical committees established to perform case reviews of selected child deaths may be examined in any administrative, civil, or criminal proceeding as to the existence or contents of documents assembled, prepared, or maintained for purposes of a child mortality review.

    (e) This section shall not be construed to prohibit or restrict any person from reporting suspected child abuse or neglect under chapter 26.44 RCW nor to limit access to or use of any records, documents, information, or testimony in any civil or criminal action arising out of any report made pursuant to chapter 26.44 RCW.  The terms and conditions of this section shall remain in full force and effect for all activities related to child mortality review conducted by local health departments prior to January 1, 1998, and are not superseded by chapter 70.-- RCW (sections 3 through 11 of this act).

NEW SECTION. Sec. 3.  The department of health, in cooperation with local health departments and after discussion with the department of social and health services, is authorized to:

    (1) Consolidate and integrate all child death review activities;

    (2) Review child deaths, especially sudden, unexpected deaths of children from birth through seventeen years of age;

    (3) Approve protocols for consistency regarding child death reviews, for child death review teams, developed by local health departments after discussion with the regional office of the department of social and health services;

    (4) Collect and analyze standard data, including the development of a centralized child death data base;

    (5) Report strategies to reduce the incidence of unexpected child death;

    (6) Provide technical assistance and training to state and local child death review teams; and

    (7) Consider and incorporate, as appropriate, recommendations of state and local teams into agency operating procedures.

NEW SECTION. Sec. 4.  The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

    (1) "Aggregate" means statistical compilations, data, and reports that neither reveal the identity of an individual child and his or her adoptive or natural parents nor from which the identity of an individual child and his or her adoptive or natural parents can be determined with reasonable speed and accuracy either directly or by reference to other publicly available information.

    (2) "Child death review" means a systematic review of data that may include medical, clinical, and hospital records; home interviews of parents and caretakers of children who have died; analysis of individual case information; and review of this information by a multidisciplinary team of professionals in order to identify modifiable medical, socioeconomic, public health, behavioral, administrative, educational, and environmental factors associated with child death.

    (3) "Child" means a person less than eighteen years of age.

    (4) "Consistent process" means the use of a standard set of protocols that ensures the comprehensive evaluation of circumstances leading up to and all aspects of the death of a child.

    (5) "Department" means the department of health.

    (6) "Local child death review and prevention teams" or "local team" means a multidisciplinary, multiagency team, which may include, but is not limited to, professionals in the area of law enforcement, medicine, mental health, coroners/medical examiners, education, social services, chemical dependency treatment, child welfare, tribal governments, military, public health, and social work and representation from the foster parent community and the general public, who perform a comprehensive evaluation of circumstances leading up to the death of a child.

    (7) "State child death review and prevention team" or "state team" means that entity which may include, but is not limited to, the state child, youth, and family ombudsman and the state health officer, as well as professionals in the area of law enforcement, medicine, mental health, coroners/medical examiners, education, chemical dependency treatment, social services, military, tribal governments, and public health for the purposes of conducting state child death review activities.

    (8) "Unexpected death" means a death not resulting from a diagnosed terminal illness or other debilitating or deteriorating illness or condition where death is anticipated.

NEW SECTION. Sec. 5.  (1) Local health departments, after discussion with regional offices of the department of social and health services, have primary responsibility for the assurance that local child death review teams review child deaths, especially unexpected deaths of children, as long as the reviews do not impair or are not concurrent with a law enforcement investigation.  Local health departments shall serve as the appointing authority for local child death review teams.  The local child death review team shall:

    (a) Report aggregate data and activities, on an annual basis, in a consistent process to the state child death review team;

    (b) Identify and refer to the state team those cases requiring further review;

    (c) Report aggregate findings of child death reviews to appropriate local and state agencies and the state child death review team; and

    (d) Recommend strategies and solutions to local and state agencies regarding the prevention of unexpected child death.

    (2) Local teams may access all relevant records, reports, and statements for purposes of conducting child death reviews, including but not limited to:  Health care records; mental health records; chemical dependency treatment records; autopsy records; child welfare records; birth records; the birth certificate, including the confidential portion of the birth certificate; and law enforcement records; so long as release of the records does not impair a law enforcement investigation or violate Chapter 42, Code of Federal Regulations, Part 2, which governs the confidentiality of alcohol and drug abuse patient information and records, if applicable.  Records accessed by local teams are not subject to public disclosure, but information from the records may be used for statistical purposes.  Local teams may also access statistical records in the state child death review data base occurring in their jurisdiction.

NEW SECTION. Sec. 6.  (1) The department shall serve as the appointing authority for the state child death review team.  The state child death review team shall coordinate and monitor the activities of local child death review teams and shall:

    (a) Provide consultation and training to local teams as requested;

    (b) Compile and provide aggregate child death review reports;

    (c) Consider the recommendations of local teams;

    (d) Recommend strategies and solutions to state agencies regarding the prevention of unexpected child death; and

    (e) Review cases that have been identified by local teams as needing further review.

    (2) The state team may access all relevant records, reports, and statements for purposes of conducting child death reviews referred to them by the local child death review teams, including but not limited to:  Health care records; mental health records; chemical dependency treatment records; autopsy records; child welfare records; birth records; the birth certificate, including the confidential portion of the birth certificate; and law enforcement records; so long as release of the records does not impair a law enforcement investigation or violate Chapter 42, Code of Federal Regulations, Part 2, which governs the confidentiality of alcohol and drug abuse patient information and records, if applicable.  Records accessed by the state team are not subject to public disclosure, but information from the records may be used for statistical purposes.

NEW SECTION. Sec. 7.  Local and state child death review teams are authorized to conduct child death reviews in accordance with this chapter.  In conducting the reviews, the following rules apply:

    (1) All records or documents maintained by local and state teams for purposes of a child death review are confidential and not subject to public disclosure.  The records may be used solely by local and state teams for the purposes of review.  This section does not prevent a local or state team from publishing statistical compilations and reports related to the child death review, as long as the compilations and reports do not identify individual cases and sources of information.

    (2) All records or documents maintained by local and state teams for the purposes of a child death review are not subject to discovery or subpoena in any administrative, civil, or criminal proceeding.  This subsection does not restrict or limit the discovery or subpoena from a health care provider of records or documents maintained by the health care provider in the ordinary course of business, whether or not the records or documents have been supplied to a local or state team under this section.

    (3) Any summaries or analyses of records, documents, or records of interviews prepared exclusively for purposes of a child death review are not subject to discovery, subpoena, or introduction into evidence in any administrative, civil, or criminal proceeding related to the death of a child reviewed.

    (4) Local or state team employees or members of technical committees established to perform case reviews of selected child deaths shall not be examined in any administrative, civil, or criminal proceeding as to any information regarding a child death review or the existence or contents of documents assembled, prepared, or maintained for purposes of a child death review.

    (5) This section does not prohibit or restrict a person from reporting suspected child abuse or neglect under chapter 26.44 RCW, or limit access to or use of any records, documents, information, or testimony in any civil or criminal action arising out of a report made under chapter 26.44 RCW.

NEW SECTION. Sec. 8.  The department of health may adopt rules as necessary for implementation of this chapter.

NEW SECTION. Sec. 9.  This chapter may be known and cited as the child death review and prevention act.

NEW SECTION. Sec. 10.  This chapter does not supersede local regulations or initiatives that exceed the scope of the activities described in this chapter.

NEW SECTION. Sec. 11.  If any provision of this act or its application to any person or circumstance is held invalid, the remainder of this act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 12.  A new section is added to chapter 42.17 RCW to read as follows:

    Records compiled, maintained, and used by local and state child death review teams are not subject to public disclosure from local and state child death review teams.  This section should not be construed to protect records from public disclosure that ordinarily would be public records disclosable from another governmental entity.

NEW SECTION. Sec. 13.  Sections 3 through 11 of this act constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 14.  Sections 3 through 12 of this act take effect January 1, 1998.

    Sec. 15.  RCW 43.79.445 and 1995 c 398 s 9 are each amended to read as follows:

    There is established an account in the state treasury referred to as the "death investigations' account" which shall exist for the purpose of receiving, holding, investing, and disbursing funds appropriated or provided in RCW 70.58.107 and any moneys appropriated or otherwise provided thereafter.

    Moneys in the death investigations' account shall be disbursed by the state treasurer once every year on December 31 and at any other time determined by the treasurer.  The treasurer shall make disbursements to:  The state toxicology laboratory, counties for the cost of autopsies, the University of Washington to fund the state forensic pathology fellowship program, the state patrol for providing partial funding for the state dental identification system, the criminal justice training commission for training county coroners, medical examiners and their staff, and the state forensic investigations council.  The treasurer shall also make disbursements to the department of health for the purposes of sections 2 through 12, chapter . . ., Laws of 1997 (sections 2 through 12 of this act).

    The University of Washington and the Washington state forensic investigations council shall jointly determine the yearly amount for the state forensic pathology fellowship program established by RCW 28B.20.426.

NEW SECTION. Sec. 16.  The sum of two hundred fifty thousand dollars is appropriated for the biennium ending June 30, 1999, from the death investigations account to the department of health for the purposes of sections 2 through 12 of this act.  Funds unexpended on June 30, 1999, revert to the death investigations account.  This appropriation is intended to provide one-time funding only and does not obligate the legislature to funding in future fiscal periods."

HB 1269 - S AMD - 313

By Senators Long, Hargrove, Deccio and Loveland

                                                 WITHDRAWN 4/16/97

    On page 1, beginning on line 1 of the title, after "investigations;" strike the remainder of the title and insert "amending RCW 70.58.107, 70.05.170, and 43.79.445; adding a new section to chapter 42.17 RCW; adding a new chapter to Title 70 RCW; making an appropriation; and providing an effective date."

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