July 21, 2014

A Legislative Perspective on the Kentucky General Assembly with State Representative Rick Rand

FRANKFORT – From a historical perspective, one of our country’s greatest success stories over the last century has been the steep decline in childhood mortality.

Between 1907 and 2007, the number of children who did not make it to their fifth birthday dropped from about 1,400 out of every 100,000 to less than 30, according to the U.S. Department of Health and Human Services. For those ages five to 14, the mortality rate went from 307 to 15.

The goal is to move these numbers closer to zero, of course, and the state is always looking for ways it can better protect our children. The good news is that we have seen some sustained success in recent years.

Last fall, for example, the Department for Public Health reported that Kentucky’s childhood fatality rate in 2011 was a fifth lower than it was in 2006.

We also have seen the number of children who die in motor vehicle accidents decline significantly, which is due in large part to relatively new state laws that lengthen the time for teenagers to qualify for an unrestricted driver’s license, that keep cell phones out of the hands of drivers under 18 and that increase use of booster seats.

One area needing more attention is our infant mortality rate, which accounts for nearly two-thirds of all deaths of children under 18. While Kentucky tracked the national average for much of the last decade, we unfortunately began outpacing it around 2008. The biggest group at risk are infants born prematurely.

Over the last two decades, the state has ramped up efforts to better track the causes of childhood fatalities and how we can make improvements. In 1996, the Department for Public Health formed a panel to review all childhood deaths in which such officials as coroners are involved, and that panel works closely with more than 80 county-level task forces.

Two years ago, meanwhile, the state authorized the External Child Fatality and Near Fatality Review Panel, which takes a look at cases where abuse and neglect are suspected as the cause of death or severe injury, another area where we unfortunately exceed the national average.

This panel is comprised of 20 members who represent such groups as judges, doctors, social workers, legislators and the Kentucky Domestic Violence Association. The state’s current two-year budget provides $420,000 annually so that members have the staff and resources they need to better review the cases, each of which has hundreds of pages of material, and to make recommendations.

A study by the General Assembly’s Program Review and Investigations Committee found that this panel “appears to be unique” among the states the committee took a look at, given the panel’s independence from the executive branch and the fact that it also investigates near deaths.

Overall, Kentucky loses about 30 children a year on average because of abuse and neglect, and another 50 nearly die. That represents about one-half of one percent of the approximately 15,000 children who the Cabinet for Health and Family Services determine are abused or neglected.

Not surprisingly, domestic violence, criminal history, substance abuse and lack of access to mental health services are cited by the review panel as chief underlying causes behind these cases. The panel also recommends better communication between law enforcement agencies and healthcare providers who are on the front line in finding and treating abuse.

With that in mind, the General Assembly passed a new law this year that calls for more medical training to better spot pediatric head trauma caused by abuse. This addition to continuing-education requirements affects pediatricians, radiologists, family practitioners and emergency room/urgent treatment doctors.

Like the nation, Kentucky has come a long way in protecting our children, but there is always room for improvement. If you know of a child who is being mistreated, I strongly encourage you to contact officials who can help. That can include calling the state’s child protection hot line, which is 1-877-597-2331.

If you have any questions or suggestions about this issue, or any other affecting the state, you can always reach me by writing to Room 366B, Capitol Annex, 702 Capitol Avenue, Frankfort KY 40601; or you can email me at Rick.Rand@lrc.ky.gov.

To leave a message for me or for any legislator, call toll-free at 800-372-7181. For those with a hearing impairment, the number is 800-896-0305.

I hope to hear from you soon.

Paid for by Rick Rand for State Representative, Regina Rand, Treasurer