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Child deaths in Montana

In this 2015 file photo, April Hall, seated at left, whose granddaughter was killed by the mother's boyfriend in June 2011, and Robin Castle, second from left, a licensed clinical professional counselor, meet with Gov. Steve Bullock, seated third from left, to demand improvements in the state Division of Child and Family Services, in Helena. A review of 14 child deaths in Montana from July 2015 to November 2016 concluded that most died of abuse or neglect, with several common factors that should have raised red flags with child protection workers.

A state commission in 2018 reviewed the fatalities of 12 children who were reported to the state Child and Family Services Division within a year of the child's death, including seven infants.

That's according to a report released Monday by the state Department of Justice.

The number is the same as in 2017. It covers children under the age of 18 and is only the third report of its kind produced in Montana.

The first done by the Office of the Child and Family Ombudsman, which reviews child deaths, found 14 children died in a 16-month period from July 2015 to November 2016. The report is produced by the Children’s Justice Bureau’s Child Fatality Review Team.

Of the 2018 deaths, one was charged as deliberate homicide and another as negligent homicide.

Two deaths were suicide. Another three were accidental, including one incident of co-sleeping where the parent had a history of drug use. 

Two deaths happened from medical complications. The report says the children went through withdrawal after birth, which may have contributed.

The cause of one death was undetermined after an autopsy and the final two are still under investigation.

In the 12 cases where a child died, there were eight surviving siblings. Of those, five were removed from their homes following the fatality.

Drug use by parents was identified in seven of the cases. Of those, five involved methamphetamine use. Domestic violence was identified in four cases.

Five of the children were male; seven were female. Six were white, three were American Indian, one was black and the others were not identified by race.

The report comes on the opening day of the Montana Legislature. In the 2017 legislative session, lawmakers took aim at helping ease problems within the state’s Child Protective Services Division that came to a head two years ago. The state health department has also implemented several changes and new programs trying to ensure the safety of children.

Two years ago lawmakers created a 17-member commission, including legislators, law enforcement, attorneys, parents and others, that would review child deaths. 

The state health department has struggled to deal with an increase of children in care — in 2008, there were 1,507; by 2015 there were 3,179. The department says the number of children entering care has stabilized in recent months. Methamphetamine use by parents has fueled the number of severe child abuse cases and fatalities.

Under a state law, child fatalities must be reported by the Child and Family Services Division, which is a part of the Department of Public Health and Human Services, within a business day. Deaths that must be reported include any child who has been the subject of a report or investigation into abuse or neglect, who was in out-of-home care at the time of the death or who had received services as part of a voluntary protective services agreement.

Health department Director Sheila Hogan said Monday the department recently received the report and is reviewing it. Hogan also said data from the Casey Family Programs shows Montana has one of the lowest child abuse and neglect fatality rates per capita in the nation.

" ... There is still much work to do. That is why over the last two years, (the health department) has launched several new targeted efforts and we are seeing positive results," Hogan said.

That includes the First Years Initiative, which focuses on preventing child abuse, neglect and fatalities from children ages 0-3.

The program is a partnership between local health departments, nonprofits and the state Child and Family Services Division. It includes home visitors who are paired with families that have a high need for child safety, as well as a safe-sleep campaign for infants and efforts to reach out to women before they give birth. The department is also working with the Montana Healthcare Foundation to provide prenatal and postpartum services for women with substance use disorders.

"These, along with our other department initiatives, are making a true impact to protect Montana kids," Hogan said.

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The report found several instances in the death cases where Child and Family Services did not complete required tasks or practices.

Suspected child abuse and neglect is reported through a centralized intake in the Child and Family Services Division, where it is categorized and reviewed to see if an investigation is warranted.

Child protection specialists must send letters to parents after investigations, informing them if claims of abuse or neglect are substantiated, founded or unsubstantiated.

In one death case the Children's Justice Bureau reviewed, a letter saying allegations of abuse were found unsubstantiated was sent seven months after the investigation was closed — and one month after the child died.

In two death cases, reports made to the Centralized Intake Bureau did not result in an investigation or a family functioning assessment. Another case was categorized as information only.

Two additional reports of abuse or neglect were put into the information-only category despite the reports coming from law enforcement or a doctor or being for a child under the age of 3.

Not all issues in the report were under control of the Child and Family Services Division. In at least two cases, two people who knew of child abuse and neglect concerns never made reports to the division’s centralized intake. The concerns eventually discovered were consistent with how the child died. And in at least one of those cases, the person who did not make the report was a mandatory reporter, such as a doctor or law enforcement.

The Department of Justice makes a dozen recommendations based on the review.

This includes the health department collaborating on two statewide public education campaigns, one about safe sleep practices and one about reporting suspected abuse and neglect.

The report also calls for procedures to make sure all reports received by centralized intake where a fatality occurs are reviewed. The team also wants to see the Child and Family Services Division create a time frame and assessment tools for sending letters about the results of investigations.

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