6.10 Reporting of a Child Death, Near Fatality or Serious Injury

Georgia State Seal

Georgia Division of Family and Children Services
Child Welfare Policy Manual

Chapter:

(6) Special Investigations

Policy Title:

Reporting of a Child Death, Near Fatality or Serious Injury

Policy Number:

6.10

Previous Policy Number(s):

N/A

Effective Date:

December 2020

Manual Transmittal:

2020-10

Codes/References

O.C.G.A. §19-7-5 Reporting of Child Abuse
O.C.G.A. §19-15-3 County Multiagency Child Fatality Review Committee
Child Abuse and Prevention Treatment Act (CAPTA)

Requirement

The Division of Family and Children Services (DFCS) will:

  1. Submit a Child Death, Near Fatality, or Serious Injury (CD/NF/SI) report within 24 hours of:

    1. Receipt of an Intake Report involving CD/NF/SI; and

      The Child Death, Near Fatality, or Serious Injury report is not required for screen-out and screen-out and refer CD/NF/SI Intake Reports.

    2. Notification of a CD/NF/SI that occurs on an active case.

    Completion of the CD/NF/SI report is not required for youth over the age of 18.

  2. Notify the Knowledge Management CD/NF/SI Review Team of screen-out or screen-out and refer Intake Reports involving CD/NF/SI in accordance with policy 3.13 Intakes: Intakes Involving Child Death, Near Fatality or Serious Injury.

  3. Assess all available information regarding the circumstances of the CD/NF/SI and the events that occurred leading up to the CD/NF/SI incident.

  4. Make a new intake report to the CPS Intake Communication Center (CICC) if maltreatment is suspected and was not previously reported.

  5. Provide supplemental information regarding the CD/NF/SI, upon request, to the Knowledge Management CD/NF/SI Review Team.

  6. Document in Georgia SHINES any child death that occurred in a family currently involved with DFCS, if that death occurred within the 12 months prior to the start of the family’s DFCS involvement, even if the circumstances of the child death were not related to maltreatment.

  7. Notify the Regional Director and DFCS Office of Communications immediately if contacted by the media concerning a CD/NF/SI (see policy 2.7 Information Management: Contact with the Media, Legislators, County Officials and Board Members).

Procedures

Reporting

The County Director/Designee will:

  1. Notify the Regional Director/Designee of the CD/NF/SI, when the county department is notified of an assigned CD/NF/SI Intake Report or becomes aware of a CD/NF/SI on an active case.

  2. Gather and assess information regarding the circumstances of the CD/NF/SI and the event(s) leading up to the CD/NF/SI:

    1. Review the intake report if one was completed;

    2. Analyze DFCS case history, if applicable;

    3. Review purposeful contacts;

    4. Contact law enforcement or other professionals who can provide direct information on the circumstances that occurred; and

    5. Obtain medical reports and evaluations to verify the circumstances and cause of the child’s death from the attending medical provider.

  3. Consult with the Social Services Supervisor (SSS) to discuss the circumstances.

    1. Determine if there are any maltreatment or safety threats identified.

    2. Determine if there are any safety concerns for any child that remains in the home and take appropriate action to ensure child safety (see policy 19.12 Case Management: Safety Plan & Management).

    3. Ensure a new intake report is made to the CPS Intake Communication Center (CICC) if maltreatment is suspected and was not previously reported (see policy 3.24 Intake: Mandated Reporters).

  4. Ensure completion of the CD/NF/SI report within 24 hours in Georgia SHINES. The CD/NF/SI report will be automatically submitted to the CD/NF/SI mailbox upon approval.

    1. Ensure the Person Detail page has been updated with the child’s date of death for reports involving a child death.

    2. Ensure the Person ID is linked to the case history. All information will be merged immediately and pre-populated onto the report.

  5. Document supplemental information (e.g., death certificates, medical records, law enforcement reports, etc.) in Georgia SHINES within 72 hours of receipt, including:

    1. New case information on the appropriate page (e.g., Contact Detail, Person Detail, Health Detail, etc.).

    2. Any additional activities/steps/tasks completed in Contacts and Summaries.

    3. Uploading to External Documentation denoting in the comments if additional steps were taken based on the results of the information.

    4. Making a new intake report to the CPS Intake Communication Center (CICC), if necessary.

Documenting Child Deaths Occurring prior to DFCS Involvement

When DFCS learns of a child death in a family within the 12 months prior to the start of DFCS involvement, even if the circumstances of the death were unrelated to maltreatment, the Social Services Case Manager (SSCM) will:

  1. Gather as much information as possible from the family about the child’s death.

    Although the death may not have been reported to DFCS at the time, the circumstances may have some relevance to the open case.

  2. Enter the deceased child’s name, date of birth, date of death, and reason for death on the deceased child’s Person Detail page in Georgia SHINES.

  3. Document the conversation with the caregiver(s) on the Contact Detail page under the Contacts/Summaries tab.

Practice Guidance

Purpose of CD/NF/SI Reporting

  1. Provide immediate notification to DFCS leadership of the child death/near fatality/serious injury of a child.

  2. Ensure all appropriate steps are being taken to ensure the safety of the victim child and any child(ren) remaining in the home.

  3. Initiate a process that will allow the Division to identify trends that may suggest changes needed to policy, practice, and procedure to improve safety for children.

The County Director is responsible for ensuring timely and accurate completion of all CD/NF/SI reports. The Regional Director is responsible for ensuring a second level review process is in place for all completed reports prior to submission to the state office.

Reporting a CD/NF/SI

Sometimes a serious injury or near fatality eventually leads to a death. When a child death occurs following a previously reported serious injury or near fatality, the CD/NF/SI report must be completed and approved in Georgia SHINES within 24 hours of receiving notification of the child’s death.

When a child dies or is seriously injured as the result of a documented pre-existing medical condition, or the death is expected and there are no additional allegations of child maltreatment, it is not necessary to complete a new intake report. When there is documented evidence to support the pre-existing condition, the County Department must complete an evaluation of the circumstances that led up to the CD/NF/SI incident and complete the CD/NF/SI report in the applicable stage in Georgia SHINES within 24 hours of receiving the notification.

When there is an Expected Death

Natural deaths due to documented medical conditions are managed by the medical professional who has been caring for the child. At the time of death, the coroner may accept the opinion of the medical professional and use his/her medical findings for the death certificate or may take possession of the body and conduct a separate investigation and autopsy. In Georgia, the county coroner usually enlists the state medical examiner to perform pediatric autopsies. However, there are instances in which natural deaths will be noted by a physician signing the death certificate without an autopsy. When no autopsy is performed, it is critical that DFCS continue to assess the circumstances of the child’s death, obtain a copy of the death certificate, and upload it into Georgia SHINES. This assessment will confirm that the death occurred resulting from a medical condition and was anticipated or expected, and that there were no allegations or suspicions of abuse or neglect related to the death.

Documenting Child Deaths Occurring Prior to DFCS Involvement

When DFCS becomes involved with a family and learns of a child death that occurred in the 12 months prior to the start of DFCS’ involvement with the family, it is important to ask questions about the death, even if that death was unrelated to abuse or neglect. The circumstances of the death may have some relevance to the open case, and it will be helpful to understand the effect of that death on the family’s functioning. It is critical to gather as much information as possible to accurately reflect information about prior child deaths within the family.

State Office Reviews

All Child Death, Near Fatality and Serious Injury (CD/NF/SI) reports are reviewed and tracked by the Knowledge Management CD/NF/SI Review Team. The team consists of DFCS staff with a high level of expertise in Child Protective Services with a focus on safety related practice. Tracking includes gathering detailed information, such as: age of caretaker (CT), prior type of agency CPS history, length of time between the CD/NF/SI event and prior case closure, and outcomes of prior reports or current report. Risk factors identified may include substance abuse, domestic violence, prenatal drug exposure, prematurity, special needs child or CT, mental health and criminal history of CT, etc.

Sometimes a more in-depth review of prior history may be warranted when there is no clear alleged maltreatment, even if the cause of death initially appears to be related to natural or accidental causes. Some benefits of the review process include:

  1. Live-learning and involvement of others in case assessment;

  2. Consulting and collaborating with internal and external partners;

  3. Identifying critical child safety issues and brainstorming on needed safety measures;

  4. Identifying trends, high risk indicators, and immediate safety needs;

  5. Identifying systemic issues and needs that can improve agency practice (for example: coding clarity, lack of substantiation on physical abuse cases where clear and convincing evidence was obtained, safety resources, or screen outs when safety concerns exist);

  6. Improving assessments; and

  7. Agency accountability and oversight.

Autopsy Reports

DFCS does not hold an investigation open for the sole purpose of waiting for an autopsy report. If all other investigative activities and services have been completed, DFCS may close the case (see policy 6.7 Special Investigations: Conducting Special Investigations of Child Death, Near Fatality, or Serious Injury). Although the investigation may be closed, efforts to obtain the final autopsy results must continue. If the original case has been closed or there was no investigation, and the autopsy report generates new information indicating maltreatment that was not previously reported or investigated or identifies parental behavior that impacted the death which was previously unknown to DFCS, then a new intake report must be submitted.

Child Deaths Not Reported to DFCS

O.C.G.A. § 19-7-5 requires that a report be made to DFCS when there is reasonable cause to believe that suspected child abuse has occurred. If DFCS learns of a child death due to circumstances or events unrelated to abuse or neglect, no intake report is required. When DFCS learns of a child death through media reports or other sources in the community, and the death was not reported to the CPS Intake Communication Center (CICC) as a child abuse or neglect referral, it is not necessary to complete the CD/NF/SI report.

Child Fatality Review Committees

The purpose of the Child Fatality Review Committee (CFRC) is to review the causes and circumstances of a child’s death and make recommendations for prevention. DFCS County Departments must designate a representative to serve on the local CFRC. County Directors or their designee shall actively engage committee members and participate in meetings of the local review committee, and share requested data to inform the committee’s findings (see policy 1.10 Administration: Child Fatality Review).

If, during a CRFC meeting, it is determined that a child death was not previously reported to DFCS and maltreatment is suspected or alleged, the County Department representative may accept the committee’s information as a new child abuse and neglect report and make an immediate report to CICC. A new intake report will then be generated in Georgia SHINES containing the committee’s information and recommendations (see policy 3.1 Intake: Receiving Intake Reports).

Near Fatality

Near fatality means as an act that, as certified by a physician, places the child in serious or critical condition. Once the child meets this criterion then the allegation of “near fatality” should be marked along with any other type(s) of maltreatment.

How to determine a near fatality:

  • Hospital records reflect that the child’s condition is serious or critical.

  • Ask the treating physician is the child’s condition serious or critical.

Serious Injury

A serious injury is one that involves substantial risk of death, extreme physical pain, disfigurement or prolonged loss or impairment of the function of a body part, organ or mental capability. Examples include burns, head trauma, blunt trauma, internal bleeding, multiple bruising and contusions, lacerations of organs, broken bones, and amputation.

Forms and Tools

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