Thursday, August 23, 2007

IL Child Death Review Teams

Illinois established multi-disciplinary and multi-agency Child Death Review Teams (CDRT) in 1995. They consist of a network of 9 regional teams with review and coordination by a statewide Executive Council. As related in their annual report, “in accordance with state statute this system reviews unexpected and unexplained deaths of children 17 years of age or younger”. Reviews target, in particular, deaths of children who are “known to the Department of Children and Family Services (DCFS)” as well as “the deaths of other children who died unexpectedly”.

As someone said, the CDRT system “serves as the voice of child death review in Illinois”. By means of case review and discussion utilizing a broad expertise brought by the team, recommendations are made regarding actions that might be taken to prevent similar deaths in the future. This will be particularly true with changes made with recent legislation. With its implementation not only will preventative recommendations be made to DCFS, but a new reporting mechanism is added to report to members of the state legislature for their review and possible action. I see this as a great addition to the effort to prevent childhood deaths; although there are a few other provisions in the legislation as passed for which I am waiting to see how the implementation goes.

I look forward to continued participation in this effort, 2 years on the regional level and now as a member of the Executive Council. I am a bit unique for them, because I bring not only my expertise as a Coroner, but also my years of Emergency Medicine experience, Primary Care experience, and years of experience doing child abuse and child sexual abuse evidentiary exams for the local Child Advocacy Center.


Anonymous said...

It is my understanding that the child death review teams in Illinois are composed of individuals whose appointments must be approved by the DCFS director (a political appointee) upon the recommendation of a state child protection administrator who is also the husband of a Democratic state representative from Chicago.
It would seem that many participants in these teams are likely more interested in avoiding bad publicity for the Blagojevich administration than they are in doing the hard work to determine how to prevent child maltreatment deaths....other than taking the easy way out and blaming the caseworker.

Dr. Richard Keller said...

Actually the recommendations for membership come through the individual regional teams. The resume/credentials of that individual are reviewed by the Chair of that team and then they recommend membership to the director (currently acting director) of DCFS. Individuals are added to the team based on what they can bring to the discussions (psychology background, school administration background, healthcare background) and not on politics.

Anonymous said...

The director, a political appointee, has the authority to reject recommendations, however. The process is not free of politics
and candidates do undergo political vetting.

In addition, the DCP administrator who is in charge of the Department's liaison activities
with the CDRT's is not only married to a state representative but the state representative serves on the DCFS Oversight Committee of the state Legislature. She is, in fact, responsible for oversight of her husband's liason work with the CDRT's. The administrator can, and has, intervened in team decision making including recently, when
his staff lobbied members of on one of the Chicago CDRT's to oust a team leader the Blagojevich administration found
overly critical. The team leader
was ousted.

There are some serious ethical problems here which clearly
have a potentially negative impact on the quality and impartiality
of CDRT decision-making.

Dr. Richard Keller said...

The legislation passed this last session was intended to more certainly limit the possibility of political influence and to better ensure that team recommendations are acted upon.

I can speak for my team and its lack of political influence. Since I was elected Chair, I have reviewed applications and recommended 4 individuals (it appears that the DCFS director will approve them as well). Only one of them came with a recommendation from a politician or elected official and that elected official is very Republican and not a friend to Mr. Blagojevich.