By THOMAS HARGROVE
Scripps Howard News Service

Idaho became the only state in the country that doesn't give special attention to the deaths of children in 2002 when the Idaho Child Death Review Team was disbanded.

"The problem was the team had no ability to obtain medical records. We didn't have subpoena powers so we couldn't do proper investigations," said Tom Shanahan, spokesman for the Idaho Department of Health and Welfare.

Without legal authority, the task force was increasingly running afoul of the federal Health Insurance Portability and Accountability Act of 1996 that requires confidentiality for personal health information. The task force had no legal right to examine hospital and coroner records involving the death of children.

So, just four years after it was created by order of the governor's office, the review team was closed down.

"We decided we better do this right," Shanahan said. "The worry was if we tried to organize another team, we'd have to abandon it."

Heading up the effort that would end Idaho's dubious status as the only state without any child death review is Boise attorney Kirtlan Naylor who was appointed chairman of the Idaho Children at Risk Task Force.

"We need child death review in this state, obviously. We need to look at the information on a child who may be the victim of homicide or abuse," Naylor said. "One obstacle we face is a lack of professional, qualified coroners who can look at these issues scientifically. Instead, we have an elected coroner system."

Under Idaho law, the only qualifications for coroner is that he or she be at least 21 years of age, a citizen of the United States and a resident for at least one year in the county where he or she is elected.

Idaho is hardly alone in allowing election of coroners with little or no medical training. A survey of all 50 state health departments by Scripps Howard News Service found that eight states have entirely elected coroners, 11 states rely on elected coroners to oversee most of their death investigations and six states have a mixture of elected coroners and appointed medical examiners, but coroners are in the minority.

Twenty-five states rely exclusively on appointed medical examiners, almost all of whom are also medical doctors.

The Scripps study found that states using medical examiners are more likely to detect cases of infant homicides and accidental asphyxiations as are states that entirely or mostly rely upon elected coroners.

The study also found that states with multiple levels of child death review, both locally and by state authorities, are detecting 27 percent more homicides and 115 percent more accidental suffocations than is Idaho.

"You don't have to convince me that not having a child death review team is a bad thing," Naylor said after reviewing the Scripps study.

He said his task force is mounting a campaign to convince the Idaho Legislature to bring reforms.

"We're trying to get some sponsorship for legislation to give authority to a medical review team so that it may legally obtain records, get it properly funded and to ensure that it will be autonomous," Naylor said. "We don't want to be the only state not to have this."