About the size of Minnesota (6.4 to MN’s 5.3 million citizens), Tennessee appears to have about 4 times the child death rate of our state. Just a few years ago Tennessee ranked 43rd out of the 50 states in infant mortality.
What is most troubling to me (and I hope to all concerned citizens) is how hard Tennessee’s Department of Children’s Services fought to keep information from the public.
Were it not for the Tennessean Newspaper’s reporting on child fatalities, no one would know how bad it is for abused and neglected children in the state.
Under-trained social workers with giant caseloads, children spending 6 months or more in temporary emergency shelters, and the Departments keeping the high numbers of child deaths from the public.
Tennessee’s Department of Children’s Services needs an audit and genuine public support.
Join me in thanking the newspaper reporters at the Tennessean sticking up for abused and neglected children
Contact Anita Wadhwani at 615-259-8092 or [email protected].
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One-third of 802 TN child deaths were ‘probably preventable’
Feb 27, 2013 |
“While we are pleased to have made improvements in the review process and progress in most areas of reducing deaths, we remain disturbed that too many of our children are dying from preventable causes,” said Dr. John Dreyzehner, commissioner of the state Department of Health. / Jae S. Lee / File / The Tennessean
State health officials note it is the fewest number of child deaths they have had to report in the past five years.
Still, the new data are unlikely to shake Tennessee’s grim foothold on the top 10 list for states in the country with the highest child death rates.
Children are more likely to die in Tennessee before they reach their 18th birthday than in most other states, surpassing the national average of 52 deaths for every 100,000 children. In Tennessee, the average was closer to 66 deaths per 100,000 children, according to U.S. Centers for Disease Control and Prevention data for 2010, the most recent year that national comparison data are available. By 2011, child deaths claimed 60 of every 100,000 Tennessee children.
“While we are pleased to have made improvements in the review process and progress in most areas of reducing deaths, we remain disturbed that too many of our children are dying from preventable causes,” said Dr. John Dreyzehner, commissioner of the Department of Health.
“Most preventable child deaths involve complex societal and medical challenges, requiring a high level of collaborative efforts to make more significant differences,” he said.
The state’s annual report on child mortality comes amid increasing concern by lawmakers, child advocates and others about the role of the state’s Department of Children’s Services in investigating reports of abuse or neglect for children who later died. The controversy prompted former DCS Commissioner Kate O’Day to step down from her job earlier this month.
The Department of Health report released Tuesday noted that 38 children were subjects of open DCS investigations at the time of their deaths.
However, DCS spokeswoman Molly Sudderth said she could not confirm the number of children who died in 2011 who were subjects of DCS investigations. Those deaths are “under review,” she said. Sudderth said she could confirm only that 14 children who were in the physical custody of DCS died that year.
The department has conceded it has misreported child death numbers at least four times in the past six months. On Tuesday, Sudderth said agency officials hope to be able to give an accurate count soon.
Some progress
The report notes that the state’s child death rates have dropped 20 percent between 2007 — when 1,087 child deaths were reported — and 2011.
The report attributes drops in child deaths to a 16.8 percent decrease in sleep-related infant deaths due to suffocation and strangulation.
The report also notes that the state saw a 20 percent drop in the number of African-American child deaths in the same time period. But black children continue to be more vulnerable to deaths than children of any other race in Tennessee, according to the report.
And babies are still more likely to die than any other age group, accounting for 62 percent of all child deaths reported in 2011.
“The first year of life continues to be the most perilous for Tennessee’s children,” the report notes.
Tennessee’s high child death rate is not due to any single factor, but many of its causes can be traced back to poverty, drug abuse and mental health problems, said Linda O’Neal, executive director of the Tennessee Commission on Children and Youth. She also serves on the statewide Child Fatality Review Team, which analyzed the child death data.
“I think one of the factors is violence, which is related often to substance abuse and mental health issues,” she said. “While we rank high in these numbers, we put some of the least amount of state dollars into substance abuse treatment per capita of any state.
“Poverty is high in the state, with a little over one in four children living in poverty. And the stress of poverty, inadequate housing and other stresses in the families can contribute to substance abuse, mental health and child abuse.”
3 recommendations
The report makes three recommendations to prevent future tragedies.
First, state officials recommend an “aggressive campaign to educate infant caregivers in every county of the state on safe sleep practices, with a particular goal on reducing racial disparities.” The Department of Health recommends distributing 80,000 brochures or pamphlets giving advice on how to properly put children to sleep.
The report also recommends more presentations to middle and high school age children on safe driving. Children 10-17 account for nearly two-thirds of all children who die in motor vehicles, according to the report.
And, the report recommends more active participation by state experts in guiding child fatality review teams in each of Tennessee’s 39 judicial districts in more thoroughly and accurately reviewing child deaths.
Child deaths are first reviewed by these local teams, which include representatives from DCS, police and others, who are charged with learning and reporting as many details about child deaths as they can to state officials.
But their reports are sometimes lacking. Although DCS is represented on each fatality team, an earlier draft of the child death report noted that in more than 170 child deaths, there were no notes from DCS or others on whether the agency had been involved in the child’s family before the child’s death.
Those were among the details Department of Health officials spent months tracking to complete their analysis, according to Dr. Michael Warren, director of maternal and child health for the department.
2011 Tennessee child fatalities
The state child fatality review team examined 799 of the 802 total child deaths in 2011, with three cases unavailable for review.
| Manner of death |
Probably not preventable |
Probably preventable |
Could not be determined |
Unknown | Total |
| Natural | 420 | 26 | 28 | 25 | 499 |
| Accident | 6 | 130 | 9 | 11 | 156 |
| Homicide | 0 | 35 | 2 | 2 | 39 |
| Suicide | 3 | 7 | 1 | 2 | 13 |
| Undetermined | 11 | 37 | 27 | 5 | 80 |
| Pending | 0 | 2 | 0 | 1 | 3 |
| Unknown | 6 | 2 | 1 | 0 | 9 |
| Total | 446 | 239 | 68 | 46 | 799 |
Undetermined are cases in which the investigation of circumstances surrounding a death fail to reveal whether the death was preventable. Unknown cases are those in which information necessary to determine whether the death was preventable is unattainable or unavailable.
Source: Child Fatalities in Tennessee 2011, Tennessee Department of Health
Contact Anita Wadhwani at 615-259-8092 or[email protected].
HEALTH & HUMAN SERVICES
The Tennessee Department of Children’s Services Versus the Media
Historically, the two have never gotten along. But they need to learn to play nice if they truly want to help children.
BY: JONATHAN WALTERS | MARCH 12, 2013
JONATHAN WALTERS
Jonathan Walters is the Executive Editor of GOVERNING. He has been covering state and local public policy and administration for more than 30 years.
It’s painful to watch any children and family services system in turmoil, but the goings on in Tennessee right now might be setting a new standard for disaster. The Tennessee Department of Children’s Services (TDCS) is locked in a high-profile battle with the state’s most prominent newspaper, The Tennessean, which has published a series of articles questioning the department’s performance in analyzing and reporting on child fatalities.
This isn’t the first big controversy for TDCS, which has been in tumult going all the way back to 2000 when a NYC-based group, Children’s Rights, filed a class-action lawsuit against the agency. According to the lawsuit, TDCS — which currently serves around 9,000 kids — was doing just about everything wrong: They were placing too many kids in institutional settings and too many in “temporary” emergency shelters for sometimes six months or more. Caseworkers were buried under crushing caseloads and often weren’t adequately trained for the job in the first place. And children were being bounced from “one inappropriate foster placement to another, based not on their needs but rather on the existence of ‘slots,'” according to Children’s Rights attorneys.
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A 2001 settlement resulted in a set of 20 performance standards that the department had to meet for a full year in order to get out from under court supervision. It’s been under court supervision ever since, with governor after governor promising to clean up the mess and failing.
Now, the state legislature is involved, which is never a happy turn of events since state legislators frequently want to find somebody to blame rather than engage in a sober and sophisticated conversation about what’s wrong and how to fix it. So it’s no surprise that last month — the day before she was due to testify before the state Senate Health and Welfare Committee on TDCS’s record keeping and complaint investigation process — TDCS Commissioner Kate O’Day tossed in the towel, announcing her resignation after two years on the job.
It sounds like it was a tough two years: The Tennessean series revealed that the department has experienced severe turmoil at the top. During her two-year tenure, O’Day fired more than 70 TDCS executives. But the current crop of problems really arose when the agency tried to stonewall the paper’s request for records relating to child fatalities. TDCS agreed to release files about child deaths, but put a $55,584 price tag on the delivery of that information. After the predictable hue and cry from the media, the fee was dropped to the less-than-bargain-basement rate of $34,225 (the high price tag was due to all sorts of implausible sounding factors, including the high cost of copying, redacting and then hand delivering material that was available electronically).
But here’s the real issue, and one that’s not easily solved: In most jurisdictions around the country, the media and departments of children and family services have a long and stormy history. It starts when something bad happens to a kid and the local media finds out about it. The media proceeds to beat the stuffing out of the department, regularly driving even excellent staff to new careers and jurisdictions. So it’s no surprise that departments of children and families have a history of being less than forthcoming with the media, typically citing confidentiality as the roadblock to transparency.
Breaking this toxic dynamic is quite the task. Although there are some states, like Connecticut, where an enlightened children and family services director has made a point of reaching out to the press and the press, in turn, has, for the most part, softened its hard line against the department. But it takes a sort of harmonic convergence of an smart, in tune leader and open-minded members of the media to realize that if a key societal goal of both government and the press is safe and stable children and families, then departments of children and family services and the press both have to bring something to the game. The current spectacle playing out in Nashville is not the way to go, either for the media or for children services.
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