Multiagency review of nonfatal child injury for child abuse

Multiagency review teams are being developed for nonfatal/severe child injury. About 1,000 child death review teams exist in multiple countries, but, the child needs to die. Nonfatal severe abuse adds the potential for intervention after injury but before death. Systematic intake will add cases that are missed today. The ICAN National Center for Child Fatality Review is working with other states that have some nonfatal review. An LA County pilot program is developing with plans for other counties. A working model with initial data will be available for APHA, presentation. Teams will be connected to hospitals with multiple agencies participating in case selection. Intake would consider all ages but focus under age two on hospitalized head trauma. That could begin with about 3800 California children < 2y/o a year hospitalized for injury, including about 250 coded as assault injury in hospital discharge data. Los Angeles County will add a model multiagency data base to find other agencies who have served the same family. Teams will include health, CPS, public health, law enforcement, fire EMT, prosecutors, schools and mental health. Additional services will include grief and trauma support for surviving siblings. Acute hospitals will be augmented by child burn centers and neuro-rehab units. Other considerations include incestuous pregnancy, abandoned newborn, unexplained HIV and unexplained developmental disability. Hospital discharge data will provide a measure of hospital activity with child injury that can be matched to child abuse reports. Health professionals and health data will provide tools for prevention.