This proposed law could help experts prevent overdose, child and domestic violence deaths

Wisconsin lawmakers are considering a law to standardize fatality review boards, which bring together experts to study specific types of deaths and try to prevent them in the future.

The legislation, known as Assembly Bill 188, would cover reviews of suicides, homicides and infant deaths, as well as any deaths resulting from unintentional injury, car crashes, overdoses, child abuse, child neglect or stillbirth.

Advocates also are pushing for domestic violence homicides to be specifically included.

Under the proposal, the Department of Health Services would be required to help coordinate and provide support to any fatality review teams set up by counties, a local health department or a tribal health department.

The bill also would authorize review teams to access records from certain sources, such as law enforcement, health care providers and schools.

The Assembly Committee on Health, Aging and Long-Term Care had a public hearing on the bill this week. Here's what you need to know:

Who can participate in a fatality review board?

These reviews can bring together representatives from dozens of agencies and organizations.

They can include the local health department, medical examiner's office, Department of Children and Families, law enforcement, Department of Corrections, medical and mental health providers, the local district attorney's office, circuit or municipal court, schools and universities, and social service agencies, among others.

What does a fatality review board do?

The board members go through records from the various agencies and piece together a timeline of what led up to a person's death. They try to identify gaps in systems or services and then propose policy solutions to fix them.

The goal is to dig deeper than demographic statistics of deaths and circumstances and get to the why of what happened.

For example, an annual report on the scope of domestic violence-related deaths in Wisconsin provides data on how many victims were fatally shot by someone who was legally banned from having a gun. A fatality review would seek to answer how the person got the gun — whether it came from a straw purchase or private sale, if it was already owned and supposed to be turned over to the court, or some other factor.

What if the process uncovers wrongdoing or negligence?

Under the proposed state law, the board's members and those who attend the board's meetings must sign a confidentiality agreement.

Those who attend are prohibited from testifying in any civil or criminal action related to information specifically obtained through the team's meetings.

Are the board's findings made public?

The proposal allows board members to share some information and aggregate data, but it cannot contain any identifying information of the victim, including name, age or address.

The review board's meetings are closed to the public, but the team can decide to have a public meeting to share summary findings and recommendations.

Do other states use these review boards?

Yes.

The majority of states already have legislation that addresses specific fatality review types, such as domestic violence fatality and overdose death reviews.

Don't these boards already exist in Wisconsin?

Yes.

Child death and opioid overdose review boards are just two common examples from across the state.

The Milwaukee Homicide Review Commission, which has been in operation since 2005, is another example. That commission currently is leading a "sentinel review" of all the agencies that had contact with Bobbie Lou Schoeffling, who was killed in a homicide last summer. The charged suspect is her ex-boyfriend.

The review is coming after a Milwaukee Journal Sentinel investigation that found police, probation agents and prosecutors missed the full scope of an escalating series of domestic violence allegations in the final 10 months of Schoeffling's life.

Why do the existing review board teams support this law?

Having a state statute governing the process makes it easier for those agencies to share confidential information with each other.

Right now, different corporation counsels — the attorneys who represent local counties — have interpreted state laws differently when it comes to data sharing.

"We've heard directly and regularly from local teams that there is a shared need for legislation that clarifies the development and operation of fatality review teams," said Constance Kostelac, director of the Milwaukee Homicide Review Commission and director of the division of data surveillance and informatics at the Medical College of Wisconsin.

Why do advocates want to add a specific review board for domestic violence homicides?

The proposal does not include domestic-violence homicides, specifically, or require such a team to be created.

"The language ... leaves us concerned that if funding is not appropriated, then DHS may choose not to implement a Domestic Violence Fatality Review Team due to some financial restraints," said Jenna Gormal of End Domestic Abuse Wisconsin.

In 2021, nearly one in six domestic violence deaths in the U.S. occurred in Wisconsin, according to the National Coalition Against Domestic Violence. And although data is still being analyzed, the number of statewide domestic violence homicides in 2022 is set to be the highest it's ever been in 20 years of tracking the information, Gormal said.

"This constitutes a public health crisis and we believe requires a robust review process so that we can prevent future deaths," she said.

At least 46 states have domestic violence fatality review boards, according to Neil Websdale, who serves as director of the Family Violence Center at Arizona State University and director of the National Domestic Violence Fatality Review Initiative.

Are there other types of deaths that could be added to the bill?

The Department of Health Services has asked for the legislation to include maternal death reviews.

The state already reviews those deaths using federal funding and adding it to the proposed law would make sure resources are being used efficiently, officials said.

How can these boards help prevent future deaths?

In Winnebago County, for example, a child death review board determined car-crash injuries were the main cause of unexpected death in local youth, said Teresa Paulus, a retired public health nurse who served as the board's chairwoman for 14 years.

The team researched best practices and successfully instituted a program for parents on how to teach their kids safe driving that partnered with schools and hospitals, she said.

"Motor vehicle crash injuries are down," Paulus said. "I'm not saying that's the only reason but I think our work has helped with that."

How much would this cost?

The Department of Health Services estimates the program will require four full-time employees at an annual cost of about $317,000.

What comes next?

The Assembly Committee on Health, Aging and Long-Term Care is still considering amendments to the bill and has not yet scheduled a vote.

Contact Ashley Luthern at ashley.luthern@jrn.com. Follow her on Twitter at @aluthern.