Chapter 3701-67 | Child Fatality Review Board

Rule 3701-67-01 | Definitions.

• Effective: June 28, 2001
• Promulgated Under: 119.03

As used in this chapter:

(A) "Cause of death" means the classification of death as listed in box 30 on the Ohio death certificate, or an equivalent box on future forms. Examples of causes include, but are not limited to, birth defects, drowning and submersion, electrocution, extreme prematurity, falls, fire and burn, firearms and weapons, pneumonia, poisoning, shaken baby syndrome, sudden infant death syndrome, suffocation and strangulation, vehicular, and other cause.

(B) "Child" means any person under eighteen years of age.

(C) "Child fatality review (CFR) board" means a county or regional board established or appointed to review deaths of children residing in the county or region for the purpose of decreasing the incidence of preventable child deaths.

(D) "Circumstance of death" means any accompanying or surrounding details of the death beyond the cause and manner of death. Examples include, but are not limited to, drowning in a bucket or house fire in rental unit.

(E) "Contributing factors" mean other factors beyond the cause and manner of death that may be partly responsible for the child's death. Examples of contributing factors include medical factors; alcohol use by parent, caretaker or child; drug use by parent, caretaker or child; tobacco use by parent, caretaker or child; use or non-use of safety devices; level of supervision; environmental factors; and mental or behavioral factors of parent, caretaker or child.

(F) "County commissioners" mean the board of county commissioners established under Chapter 305. of the Revised Code or an alternative form of county government established pursuant to Chapter 301. of the Revised Code with the responsibilities of county commissioners.

(G) "County of residence" means the county of residence as identified on the Ohio death certificate.

(H) "Department or director" means the director of the Ohio department of health or any official or employee of the department designated by the director of the Ohio department of health.

(I) "Geographic location of death" means the county in which the child was pronounced dead.

(J) "Health commissioner" means the health commissioner of a general, city or county health district or the individual with the responsibilities of a health commissioner in a city or county health district.

(K) "Manner of death" means the classification of death listed in box 32 on the Ohio death certificate, or equivalent box on future forms. The classification is limited to natural, accident, homicide, suicide, and undetermined.

(L) "Preventable" means the degree to which an individual or community could have reasonably done something that would have changed the circumstances that led to the child's death.

(M) "Public record" means any record defined in division (A)(1) of section 149.43 of the Revised Code.

(N) "Review" means a general assessment or examination of the death of a child. The review shall at least consider the cause of death; manner of death; circumstance of death; contributing factors; age; sex; race and ethnicity; and geographic location of death.

Last updated August 1, 2023 at 2:14 PM

Supplemental Information

Authorized By: –
Amplifies: –
Five Year Review Date:

Rule 3701-67-02 | Child fatality review boards.

• Effective: June 28, 2001
• Promulgated Under: 119.03

(A) In accordance with sections 307.621 and 307.622 of the Revised Code, each county in Ohio shall establish a CFR board or join a regional CFR board for the purpose of reviewing the deaths of children residing in that county.

(B) The purpose of the CFR board is to decrease the incidence of preventable child deaths by doing all of the following:

(1) Promoting cooperation, collaboration and communication between all groups, professions, agencies, or entities that serve families and children.

(2) Maintaining a comprehensive database of all child deaths that occur in the county or region served by the CFR board in order to develop an understanding of the causes and incidences of those deaths.

(3) Recommending and developing plans for implementing local service and program changes to the groups, professions, agencies or entities that serve families and children that might prevent child deaths.

(4) Advising the Ohio department of health of aggregate data, trends and patterns concerning child deaths.

Last updated August 1, 2023 at 2:14 PM

Supplemental Information

Authorized By: –
Amplifies: –
Five Year Review Date:

Rule 3701-67-03 | Child fatality review board meetings.

• Effective: August 21, 2016
• Promulgated Under: 119.03

(A) The board of county commissioners shall designate either the health commissioner that establishes the CFR board or a representative of the health commissioner to convene and be the chairperson of the CFR board. If a regional CFR board is established, the health commissioner appointed to establish the regional CFR board or his or her designee shall convene the CFR board meetings and be the chairperson of the CFR board. In any county that has a body acting as a CFR board on the effective date of this rule, the board of county commissioners of that county, in lieu of having a health commissioner establish a CFR board, shall appoint that body to function as the CFR board for the county. The body shall have the same duties, obligations, and protections as a CFR board appointed by the health commissioner. The board of county commissioners or an individual designated by the CFR board shall convene the body as required by section 307.624 of the Revised Code.

(B) If a regional CFR board includes a county with more than one health district, the CFR board meeting shall be convened in that county. If more than one of the counties participating in a regional CFR board has more than one health district, the person convening the meeting shall select one of the counties containing more than one health district as the county in which to convene the CFR board meeting.

(C) Each CFR board shall be convened at least once a year to review the deaths of all children who, at the time of death, were residents of the county or, in the case of a regional board, were residents of one of the participating counties.

(D) If a child dies in an Ohio county other than the child's county of residence, the review shall be conducted in accordance with this paragraph. For purposes of this paragraph, the CFR board with jurisdiction over the county of residence shall be referred to as the lead CFR board. The CFR board with jurisdiction over the county in which the child died shall be referred to as the secondary CFR board.

(1) Except as provided in paragraph (D)(2) of this rule, the lead CFR board shall conduct the child death review;

(2) The lead CFR board may delegate the responsibility for conducting a child death review to the secondary CFR board if the lead CFR board and the secondary CFR board both agree that the secondary CFR board will conduct the review;

(3) The lead and secondary CFR boards shall cooperate with each other to make relevant information available for the review. The CFR board which conducts the review shall provide a complete copy of the review to the CFR board not conducting the review;

(4) Regardless of which CFR board conducts the review, only the lead CFR board shall include the review information in its annual report to the department.

(E) Meetings of CFR boards established under section 307.621 of the Revised Code shall not be considered public meetings and, as such, are not subject to section 121.22 of the Revised Code.

Last updated August 1, 2023 at 2:15 PM

Supplemental Information

Authorized By: 3701.045
Amplifies: 307.621, 307.622, 307.623, 3701.045
Five Year Review Date: 2/6/2028
Prior Effective Dates: 6/28/2001, 10/5/2006

Rule 3701-67-04 | Data collection; confidentiality of records.

• Effective: August 21, 2016
• Promulgated Under: 119.03

(A) Each CFR board shall implement a system for collecting information determined necessary by the CFR board to review the deaths of children who were residents of the county, or if a regional board, one of the participating counties, at the time of death.

(B) The CFR board shall use the data collection tool or national child death review data base as designated by the director in accordance with rule 3701-67-06 of the Administrative Code. The CFR board shall review at a minimum the information required to be reported in the annual report to the department under rule 3701-67-07 of the Administrative Code.

(C) The CFR board shall maintain the data collected and any work product of the CFR board in a confidential manner. All confidential information shall be used by the CFR board and its members only in the exercise of the proper functions of the CFR board.

(D) Each CFR board shall take measures to ensure the security and confidentiality of information obtained during the course of conducting child death reviews. The CFR board shall develop and maintain written policies and procedures that address the following:

(1) Confidentiality of information that is collected or obtained in the course of conducting child death reviews.

(2) A system to assure only authorized persons are allowed unsupervised access to an area where confidential records are stored, which includes access to records stored electronically.

(3) Security measures to prevent inadvertent or unauthorized access to any records containing sufficient information that could reasonably lead to the identity of the child whose death is being reviewed.

(4) Storing, processing, indexing, retrieving and destroying information obtained in the course of conducting child death reviews.

(E) Each CFR board shall maintain child death review records for the time period required by the CFR board's retention schedule or seven years if there is no retention schedule.

(F) The CFR board shall provide each CFR board member with a copy of the policies and procedures developed under paragraph (D) of this rule. If any task of the CFR board member is delegated to another person, the CFR board member is responsible for assuring that the person who is delegated a CFR board task is familiar with the policies and procedures and has access to such policies and procedures.

Last updated August 1, 2023 at 2:15 PM

Supplemental Information

Authorized By: 3701.045
Amplifies: 307.045, 307.629
Five Year Review Date: 2/6/2028
Prior Effective Dates: 6/28/2001

Rule 3701-67-05 | Training guidelines.

• Effective: August 11, 2011
• Promulgated Under: 119.03

(A) Each CFR board shall require at least one member of the CFR board attend the annual training sponsored by the department of health. Each CFR board shall encourage all CFR board members to attend. If not all members of the CFR board attend the training, the chairperson of the CFR board shall be responsible for assuring that those CFR board members who did not attend are trained or given access to the training.

(B) The CFR training curriculum will be a combination of lectures, discussions, and team review of actual case studies and may include, but not be limited to, the following topics found in the standardized protocols and guidelines developed by the Ohio department of health and the state CFR advisory council:

(1) Overview of the CFR law and rules;

(2) CFR board membership and maintenance;

(3) CFR board operating procedures (including conducting an effective meeting);

(4) Death reviews;

(5) Role of courts and prosecutors;

(6) Data collection;

(7) Database guidelines;

(8) Annual reporting guidelines;

(9) Preventing child deaths.

Last updated August 1, 2023 at 2:15 PM

Supplemental Information

Authorized By: 3701.045
Amplifies: 3701.045
Five Year Review Date: 2/6/2028

Rule 3701-67-06 | Child fatality review information system.

• Effective: February 16, 2023
• Promulgated Under: 119.03

(A) The director shall provide a data collection tool for the review of child deaths or arrange for the use of a national child death review database. The individual data collection shall be maintained in a confidential manner.

(B) Each CFR board will use the director's data collection tool or the national child death review database to record the following information:

(1) Demographic information that includes:

(a) Age of the child;

(b) Sex of the child, identified as male or female;

(c) Race of the child, identified as black, white, native American, Asian, Alaskan native, native Hawaiian, Pacific islander, unknown or multiple;

(d) Ethnicity of the child identified as Hispanic or Latino origin; and

(e) Infant death information that includes:

(i) Gestational age;

(ii) Birth weight;

(iii) Multiple gestation;

(iv) Mother's number of pregnancies;

(v) Mother's number of live births;

(vi) Mother's number of living children;

(vii) Prenatal care provided during pregnancy of deceased infant;

(viii) Access or compliance issues related to prenatal care;

(ix) Medical conditions/complications during pregnancy;

(x) Medical complications in previous pregnancies;

(xi) Medication, drug or substance use during pregnancy;

(xii) Infant born drug exposed;

(xiii) Infant neonatal abstinence syndrome (NAS);

(xiv) Level of birth hospital;

(xv) At hospital discharge, was a case manager assigned;

(xvi) Whether mother attended postpartum visit;

(xvii) Did the infant stay in NICU more than one day;

(xviii) Did mother smoke in three months before pregnancy;

(xix) Did mother smoke at any time during pregnancy;

(xx) Was mother injured during pregnancy;

(xxi) Did mother have postpartum depression;

(xxii) Was infant ever breastfed;

(xxiii) Did infant have abnormal metabolic newborn screening results;

(xxiv) Prior to last seventy-two hours of life, did infant have history of medical conditions, symptoms, injury, vaccine administration, medications, feeding.

(2) Death related information, that includes:

(a) Year of child's death;

(b) Geographic location of death;

(c) Cause of death; and

(d) Contributing factors to death, that includes:

(i) Poisoning, overdose or acute intoxication, including:

(a) Type of substance involved;

(b) Storage location of substance;

(c) Product original container;

(d) Container child safety cap;

(e) Incident result of; and

(f) Poison control contacted.

(ii) Death related to sleeping environment, including:

(a) Was death related to sleeping/sleep environment;

(b) Incident sleep space;

(c) Position of child when put to sleep;

(d) Position of child when found;

(e) Usual sleep position;

(f) Availability of suitable sleep location;

(g) Usual sleep place;

(h) Child in new or different environment;

(i) Child placed to sleep with pacifier;

(j) Child wrapped or swaddled in blanket;

(k) Child overheated;

(l) Child exposed to second-hand smoke;

(m) Position of child's face when found;

(n) Position of child's neck when found;

(o) Status of child's airway;

(p) Objects in child's sleep environment and relation to airway obstruction;

(q) Caregiver/supervisor fell asleep when feeding child;

(r) Child sleeping in same room as caregiver/supervisor;

(s) Child sharing sleep surface with person(s) or animal(s);

(t) Reasons for sharing sleep surface; and

(u) Scene re-creation photo available.

(3) Data quality information that includes:

(a) Data entry completed for the case; and

(b) Preventability of the death.

(4) Any other information the CFR board considers relevant to the review.

(C) Individual data related to a child death review that is reported on the data collection tool or the national child death review database is not a public record under section 149.43 of the Revised Code.

Last updated February 16, 2023 at 8:29 AM

Supplemental Information

Authorized By: 3701.045
Amplifies: 3701.045, 307.626, 307.623
Five Year Review Date: 2/6/2028
Prior Effective Dates: 8/11/2011

Rule 3701-67-07 | Annual report filed with the Ohio department of health.

• Effective: August 11, 2011
• Promulgated Under: 119.03

(A) By April first of each year, each CFR board shall prepare and submit an annual report to the department of health in a manner and format that is prescribed by the director. The report shall include all of the following with respect to the child deaths in the calendar year specified by the director.

(1) The total number of child deaths in the county or region, whichever is applicable to the CFR board submitting the report;

(2) The total number of child death reviews completed by the CFR board;

(3) The total number of child death reviews not completed by the CFR board; and

(4) A summary of the demographic and death related information as specified in rule 3701-67-06 of the Administrative Code.

(B) The annual report may include recommendations for actions that might prevent other deaths, as well as any other information the CFR board determines should be included.

(C) Annual reports prepared under this section are public record and subject to section 149.43 of the Revised Code.

Last updated August 1, 2023 at 2:15 PM

Supplemental Information

Authorized By: 3701.045
Amplifies: 307.623, 307.626, 3701.045
Five Year Review Date: 2/6/2028
Prior Effective Dates: 6/28/2001

Rule 3701-67-08 | Joint annual report by Ohio department of health and children's trust fund board.

• Effective: June 28, 2001
• Promulgated Under: 119.03

(A) On or before September thirtieth of each year, the Ohio department of health and the children's trust fund board shall jointly prepare and publish a report organizing and setting forth the data contained in all reports provided by CFR boards in their annual reports from the previous calendar year. The report shall also contain any recommended changes to law and policy that might prevent future deaths.

(B) A copy of the report shall be provided to the governor, the speaker of the Ohio house of representatives, the president of the Ohio senate, the minority leaders of the Ohio house of representatives and Ohio senate, each Ohio county or regional CFR board and each Ohio county or regional family and children first council.

Last updated August 1, 2023 at 2:16 PM

Supplemental Information

Authorized By: –
Amplifies: –
Five Year Review Date: