1-1  By:  Zaffirini, Rosson                                S.B. No. 1485
    1-2        (In the Senate - Filed March 13, 1995; March 21, 1995, read
    1-3  first time and referred to Committee on Health and Human Services;
    1-4  April 18, 1995, reported adversely, with favorable Committee
    1-5  Substitute by the following vote:  Yeas 8, Nays 0; April 18, 1995,
    1-6  sent to printer.)
    1-7  COMMITTEE SUBSTITUTE FOR S.B. No. 1485               By:  Zaffirini
    1-8                         A BILL TO BE ENTITLED
    1-9                                AN ACT
   1-10  relating to the child fatality review team committee and child
   1-11  fatality review teams.
   1-13        SECTION 1.  Chapter 264, Family Code, as added by H.B. No.
   1-14  655, Acts of the 74th Legislature, Regular Session, 1995, is
   1-15  amended by adding Subchapter F to read as follows:
   1-16                 SUBCHAPTER F.  CHILD FATALITY REVIEW
   1-17        Sec. 264.501.  DEFINITIONS.  In this subchapter:
   1-18              (1)  "Bureau of vital statistics" means the bureau of
   1-19  vital statistics of the Texas Department of Health.
   1-20              (2)  "Child" means a person younger than 18 years of
   1-21  age.
   1-22              (3)  "Committee" means the child fatality review team
   1-23  committee.
   1-24              (4)  "Council" means the Children's Trust Fund of Texas
   1-25  Council.
   1-26              (5)  "Department" means the Department of Protective
   1-27  and Regulatory Services.
   1-28              (6)  "Health care provider" means any health care
   1-29  practitioner or facility that provides medical evaluation or
   1-30  treatment, including dental and mental health evaluation or
   1-31  treatment.
   1-32              (7)  "Meeting" means an in-person meeting or a meeting
   1-33  held by telephone or other electronic medium.
   1-34              (8)  "Preventable death" means a death that may have
   1-35  been prevented by reasonable medical, social, legal, psychological,
   1-36  or educational intervention.  The term includes the death of a
   1-37  child from:
   1-38                    (A)  intentional or unintentional injuries;
   1-39                    (B)  medical neglect;
   1-40                    (C)  lack of access to medical care;
   1-41                    (D)  neglect and reckless conduct, including
   1-42  failure to supervise and failure to seek medical care; and
   1-43                    (E)  premature birth associated with any factor
   1-44  described by Paragraphs (A) through (D).
   1-45              (9)  "Review" means a reexamination of information
   1-46  regarding a deceased child from relevant agencies, professionals,
   1-47  and health care providers.
   1-48              (10)  "Review team" means a child fatality review team
   1-49  established under this subchapter.
   1-50              (11)  "Unexpected death" includes a death of a child
   1-51  that, before investigation:
   1-52                    (A)  appears to have occurred without
   1-53  anticipation or forewarning; and
   1-54                    (B)  was caused by trauma, suspicious or obscure
   1-55  circumstances, sudden infant death syndrome, abuse or neglect, or
   1-56  an unknown cause.
   1-57        Sec. 264.502.  COMMITTEE.  (a)  The child fatality review
   1-58  team committee is composed of:
   1-59              (1)  a person appointed by and representing the state
   1-60  registrar for the bureau of vital statistics;
   1-61              (2)  a person appointed by and representing the
   1-62  director of protective services for families and children of the
   1-63  department;
   1-64              (3)  a person appointed by and representing the
   1-65  director of the bureau of epidemiology of the Texas Department of
   1-66  Health;
   1-67              (4)  a person appointed by and representing the
   1-68  executive director of the council; and
    2-1              (5)  individuals selected under Subsection (b).
    2-2        (b)  The members of the committee who serve under Subsections
    2-3  (a)(1) through (4) shall select the following additional committee
    2-4  members:
    2-5              (1)  a criminal prosecutor involved in prosecuting
    2-6  crimes against children;
    2-7              (2)  a sheriff;
    2-8              (3)  a justice of the peace;
    2-9              (4)  a medical examiner;
   2-10              (5)  a police chief;
   2-11              (6)  a pediatrician experienced in diagnosing and
   2-12  treating child abuse and neglect;
   2-13              (7)  a child educator;
   2-14              (8)  a child mental health provider;
   2-15              (9)  a public health professional;
   2-16              (10)  a child protective services specialist;
   2-17              (11)  a sudden infant death syndrome family service
   2-18  provider;
   2-19              (12)  a neonatologist;
   2-20              (13)  a child advocate; and
   2-21              (14)  a chief juvenile probation officer.
   2-22        (c)  Members of the committee selected under Subsection (b)
   2-23  serve two-year terms that expire on February 1 of each
   2-24  even-numbered year.
   2-25        (d)  Members selected under Subsection (b) must reflect the
   2-26  geographical, cultural, racial, and ethnic diversity of the state.
   2-27        (e)  An appointment to a vacancy on the committee shall be
   2-28  made in the same manner as the original appointment.
   2-29        (f)  Members of the committee shall select a presiding
   2-30  officer from the members of the committee.
   2-31        (g)  The presiding officer of the committee shall call the
   2-32  meetings of the committee, which shall be held at least quarterly.
   2-33        (h)  A member of the committee is not entitled to
   2-34  compensation for serving on the committee but is entitled to
   2-35  reimbursement for the member's travel expenses as provided in the
   2-36  General Appropriations Act.  Reimbursement under this subsection
   2-37  for a person serving on the committee under Subsection (a)(1) or
   2-38  (3) shall be paid from funds appropriated to the Texas Department
   2-39  of Health.  Reimbursement for other persons serving on the
   2-40  committee shall be paid equally from funds appropriated to the
   2-41  department and funds appropriated to the council.
   2-42        Sec. 264.503.    PURPOSE AND DUTIES OF COMMITTEE AND
   2-43  SPECIFIED STATE AGENCIES.  (a)  The purpose of the committee is to:
   2-44              (1)  develop an understanding of the causes and
   2-45  incidence of child deaths in this state;
   2-46              (2)  identify procedures within the agencies
   2-47  represented on the committee to reduce the number of preventable
   2-48  child deaths; and
   2-49              (3)  promote public awareness and make recommendations
   2-50  to the governor and the legislature for changes in law, policy, and
   2-51  practice to reduce the number of preventable child deaths.
   2-52        (b)  To ensure that  the committee achieves its purpose, the
   2-53  department, the council, and the Texas Department of Health shall
   2-54  perform the duties specified by this section.
   2-55        (c)  The department shall:
   2-56              (1)  recognize the creation and participation of review
   2-57  teams;
   2-58              (2)  promote and coordinate training to assist the
   2-59  review teams in carrying out their duties;
   2-60              (3)  assist the committee in developing model protocols
   2-61  for:
   2-62                    (A)  the reporting and investigating of child
   2-63  fatalities for law enforcement agencies, child protective services,
   2-64  justices of the peace and medical examiners, and other
   2-65  professionals involved in the investigations of child deaths;
   2-66                    (B)  the collection of data regarding child
   2-67  deaths; and
   2-68                    (C)  the operation of the review teams; and
   2-69              (4)  develop and implement procedures necessary for the
   2-70  operation of the committee.
    3-1        (d)  The council shall promote education of the public
    3-2  regarding the incidence and causes of child deaths, the public role
    3-3  in preventing child deaths, and specific steps the public can
    3-4  undertake to prevent child deaths.  The committee shall enlist the
    3-5  support and assistance of civic, philanthropic, and public service
    3-6  organizations in the performance of the duties imposed under this
    3-7  subsection.
    3-8        (e)  The Texas Department of Health shall:
    3-9              (1)  collect data under this subchapter and coordinate
   3-10  the collection of data under this subchapter with other data
   3-11  collection activities; and
   3-12              (2)  perform annual statistical studies of the
   3-13  incidence and causes of child fatalities using the data collected
   3-14  under this subchapter.
   3-15        (f)  The committee shall issue annual reports on the
   3-16  committee's activities, including findings and recommendations
   3-17  relating to each purpose and duty of the committee described by
   3-18  this section.  Not later than December 1 of each even-numbered
   3-19  year, the committee shall publish the report and submit a copy of
   3-20  the report to the governor, lieutenant governor, and speaker of the
   3-21  house of representatives.
   3-22        Sec. 264.504.  MEETINGS OF COMMITTEE.  (a)  Except as
   3-23  provided by Subsections (b), (c), and (d), meetings of the
   3-24  committee are subject to the open meetings law, Chapter 551,
   3-25  Government Code, as if the committee were a governmental body under
   3-26  that chapter.
   3-27        (b)  Any portion of a meeting of the committee during which
   3-28  the committee discusses an individual child's death is closed to
   3-29  the public and is not subject to the open meetings law, Chapter
   3-30  551, Government Code.
   3-31        (c)  Information identifying a deceased child, a member of
   3-32  the child's family, a guardian or caretaker of the child, or an
   3-33  alleged or suspected perpetrator of abuse or neglect of the child
   3-34  may not be disclosed during a public meeting.
   3-35        (d)  Information regarding the involvement of a state or
   3-36  local agency with the deceased child or another person described by
   3-37  Subsection (c) may not be disclosed during a public meeting.
   3-38        (e)  The committee may conduct an open or closed meeting by
   3-39  telephone conference call or other electronic medium.  A meeting
   3-40  held under this subsection is subject to the notice requirements
   3-41  applicable to other meetings.  The notice of the meeting must
   3-42  specify as the location of the meeting the location where meetings
   3-43  of the committee are usually held.  Each part of the meeting by
   3-44  telephone conference call that is required to be open to the public
   3-45  shall be audible to the public at the location specified in the
   3-46  notice of the meeting as the location of the meeting and shall be
   3-47  tape-recorded.  The tape recording shall be made available to the
   3-48  public.
   3-49        (f)  This section does not prohibit the committee from
   3-50  requesting the attendance at a closed meeting of a person who is
   3-51  not a member of the committee and who has information regarding a
   3-52  deceased child.
   3-53        Sec. 264.505.  ESTABLISHMENT OF REVIEW TEAM.  (a)  A
   3-54  multidisciplinary and multiagency child fatality review team may be
   3-55  established for a county to review child deaths in that county.  A
   3-56  review team for a county with a population of less than 50,000 may
   3-57  join with an adjacent county or counties to establish a combined
   3-58  review team.
   3-59        (b)  Any person who may be a member of a review team under
   3-60  Subsection (c) may initiate the establishment of a review team and
   3-61  call the first organizational meeting of the team.
   3-62        (c)  A review team may include:
   3-63              (1)  a criminal prosecutor involved in prosecuting
   3-64  crimes against children;
   3-65              (2)  a sheriff;
   3-66              (3)  a justice of the peace or medical examiner;
   3-67              (4)  a police chief;
   3-68              (5)  a pediatrician experienced in diagnosing and
   3-69  treating child abuse and neglect;
   3-70              (6)  a child educator;
    4-1              (7)  a child mental health provider;
    4-2              (8)  a public health professional;
    4-3              (9)  a child protective services specialist;
    4-4              (10)  a sudden infant death syndrome family service
    4-5  provider;
    4-6              (11)  a neonatologist;
    4-7              (12)  a child advocate; and
    4-8              (13)  a chief juvenile probation officer.
    4-9        (d)  Members of a review team may select additional team
   4-10  members according to community resources and needs.
   4-11        (e)  A review team shall select a presiding officer from its
   4-12  members.
   4-13        Sec. 264.506.  PURPOSE AND DUTIES OF REVIEW TEAM.  (a)  The
   4-14  purpose of a review team is to decrease the incidence of
   4-15  preventable child deaths by:
   4-16              (1)  providing assistance, direction, and coordination
   4-17  to investigations of child deaths;
   4-18              (2)  promoting cooperation, communication, and
   4-19  coordination among agencies involved in responding to child
   4-20  fatalities;
   4-21              (3)  developing an understanding of the causes and
   4-22  incidence of child deaths in the county or counties in which the
   4-23  review team is located;
   4-24              (4)  recommending changes to agencies, through the
   4-25  agency's representative member, that will reduce the number of
   4-26  preventable child deaths; and
   4-27              (5)  advising the committee on changes to law, policy,
   4-28  or practice that will assist the team and the agencies represented
   4-29  on the team in fulfilling their duties.
   4-30        (b)  To achieve its purpose, a review team shall:
   4-31              (1)  adapt and implement, according to local needs and
   4-32  resources, the model protocols developed by the department and the
   4-33  committee;
   4-34              (2)  meet on a regular basis to review child fatality
   4-35  cases and recommend methods to improve coordination of services and
   4-36  investigations between agencies that are represented on the team;
   4-37              (3)  collect and maintain data as required by the
   4-38  committee; and
   4-39              (4)  submit to the bureau of vital statistics data
   4-40  reports on deaths reviewed as specified by the committee.
   4-41        (c)  A review team shall initiate prevention measures as
   4-42  indicated by the review team's findings.
   4-43        Sec. 264.507.  DUTIES OF PRESIDING OFFICER.  The presiding
   4-44  officer of a review team shall:
   4-45              (1)  send notices to the review team members of a
   4-46  meeting to review a child fatality;
   4-47              (2)  provide a list to the review team members of each
   4-48  child fatality to be reviewed at the meeting;
   4-49              (3)  submit data reports to the bureau of vital
   4-50  statistics not later than the 30th day after the date on which the
   4-51  review took place; and
   4-52              (4)  ensure that the review team operates according to
   4-53  the protocols developed by the department and the committee, as
   4-54  adapted by the review team.
   4-55        Sec. 264.508.  REVIEW PROCEDURE.  (a)  The review team of the
   4-56  county in which the injury, illness, or event that was the cause of
   4-57  the death of the child occurred, as stated on the child's death
   4-58  certificate, shall review the death.
   4-59        (b)  On receipt of the list of child fatalities under Section
   4-60  264.507, each review team member shall review the member's records
   4-61  and the records of the member's agency for information regarding
   4-62  each listed child.
   4-63        Sec. 264.509.  ACCESS TO INFORMATION.  (a)  A review team may
   4-64  request information and records regarding a deceased child as
   4-65  necessary to carry out the review team's purpose and duties.
   4-66  Records and information that may be requested under this section
   4-67  include:
   4-68              (1)  medical, dental, and mental health care
   4-69  information; and
   4-70              (2)  information and records maintained by any state or
    5-1  local government agency, including:
    5-2                    (A)  a birth certificate;
    5-3                    (B)  law enforcement investigative data;
    5-4                    (C)  medical examiner investigative data;
    5-5                    (D)  juvenile court records;
    5-6                    (E)  parole and probation information and
    5-7  records; and
    5-8                    (F)  child protective services information and
    5-9  records.
   5-10        (b)  On request of the presiding officer of a review team,
   5-11  the custodian of the relevant information and records relating to a
   5-12  deceased child shall provide those records to the review team.
   5-13        Sec. 264.510.  MEETING OF REVIEW TEAM.  (a)  A meeting of a
   5-14  review team is closed to the public and not subject to the open
   5-15  meetings law, Chapter 551, Government Code.
   5-16        (b)  This section does not prohibit a review team from
   5-17  requesting the attendance at a closed meeting of a person who is
   5-18  not a member of the review team and who has information regarding a
   5-19  deceased child.
   5-20        (c)  Except as necessary to carry out a review team's purpose
   5-21  and duties, members of a review team and persons attending a review
   5-22  team meeting may not disclose what occurred at the meeting.
   5-23        (d)  A member of a review team participating in the review of
   5-24  a child death is immune from civil or criminal liability arising
   5-25  from information presented in or opinions formed as a result of a
   5-26  meeting.
   5-27        Sec. 264.511.  USE OF INFORMATION AND RECORDS;
   5-28  CONFIDENTIALITY.  (a)  Information and records acquired by the
   5-29  committee or by a review team in the exercise of its purpose and
   5-30  duties under this subchapter are confidential and exempt from
   5-31  disclosure under the open records law, Chapter 552, Government
   5-32  Code, and may only be disclosed as necessary to carry out the
   5-33  committee's or review team's purpose and duties.
   5-34        (b)  A report of the committee or of a review team or a
   5-35  statistical compilation of data reports is a public record subject
   5-36  to the open records law, Chapter 552, Government Code, as if the
   5-37  committee or review team were a governmental body under that
   5-38  chapter, if the report or statistical compilation does not contain
   5-39  any information that would permit the identification of an
   5-40  individual.
   5-41        (c)  A member of a review team may not disclose any
   5-42  information that is confidential under this section.
   5-43        (d)  Information, documents, and records of the committee or
   5-44  of a review team that are confidential under this section are not
   5-45  subject to subpoena or discovery and may not be introduced into
   5-46  evidence in any civil or criminal proceeding, except that
   5-47  information, documents, and records otherwise available from other
   5-48  sources are not immune from subpoena, discovery, or introduction
   5-49  into evidence solely because they were presented during proceedings
   5-50  of the committee or a review team or are maintained by the
   5-51  committee or a review team.
   5-52        Sec. 264.512.  GOVERNMENTAL UNITS.  The committee and a
   5-53  review team are governmental units for purposes of Chapter 101,
   5-54  Civil Practice and Remedies Code.  A review team is a unit of local
   5-55  government under that chapter.
   5-56        SECTION 2.  (a)  The executive directors of the Children's
   5-57  Trust Fund of Texas Council and the Department of Protective and
   5-58  Regulatory Services shall jointly call a meeting of the individuals
   5-59  to serve on the child fatality review team committee under
   5-60  Subdivisions (1) through (4), Subsection (a), Section 264.502,
   5-61  Family Code, as added by this Act, to be held not later than
   5-62  October 1, 1995.  Those members of the committee shall select the
   5-63  members to serve under Subsection (b), Section 264.502, Family
   5-64  Code, as added by this Act, not later than December 1, 1995.
   5-65        (b)  The initial members of the committee are appointed to
   5-66  serve terms expiring February 1, 1996.
   5-67        (c)  The first meeting of the child fatality review team
   5-68  committee that includes members selected under Subsection (b),
   5-69  Section 264.502, Family Code, shall be held not later than
   5-70  January 1, 1996.
    6-1        SECTION 3.  This Act takes effect only if the 74th
    6-2  Legislature, at its regular session, enacts H.B. No. 655 and that
    6-3  bill becomes law.  If that legislation does not become law, this
    6-4  Act has no effect.
    6-5        SECTION 4.  This Act takes effect September 1, 1995.
    6-6        SECTION 5.  The importance of this legislation and the
    6-7  crowded condition of the calendars in both houses create an
    6-8  emergency and an imperative public necessity that the
    6-9  constitutional rule requiring bills to be read on three several
   6-10  days in each house be suspended, and this rule is hereby suspended.
   6-11                               * * * * *