Many Pennsylvania counties are failing to review the death of every child in their area, despite a 2008 state law that requires them to do so.

The problem, advocates and program participants say, is a lack of both state assistance in collecting data and time for volunteers to run the local panels.

Gov. Josh Shapiro wants the legislature to approve $2.5 million to improve this work, but it’s unclear if the request will be considered a priority this year.

The effort to study the deaths of Pennsylvania children dates back about two decades, when the state passed a law mandating counties host a local board of healthcare professionals, law enforcement officials, child protective service providers, and a coroner or medical examiner to review the deaths of every resident under the age of 21. The law was one of several initiatives spurred by the murder of Berks County toddler Maxwell Fisher in 1996.

Based on the information county boards gather, members are charged with creating strategies for local and state policymakers to prevent similar deaths.

But reports shared with Spotlight PA by the Pennsylvania Department of Health show that since 2020, roughly half of childhood deaths statewide have not been reviewed. Those lapses are especially prominent in rural counties, where local teams are more likely to falter or not exist.

Policymakers have known about the program’s issues for years.

A multiyear East Stroudsburg University evaluation of the program commissioned by the state Department of Health concluded in 2024 that the Child Death Review program is “an unfunded mandate.” It issued a long list of recommendations to rectify the program’s shortcomings, including creating regional teams for rural areas.

“Staffing turnovers and pandemic disruptions were detrimental to maintaining complete teams in many regions of Pennsylvania,” researchers wrote. “Some have since begun to rebuild while other teams have yet to meaningfully reengage in (Child Death Review).”

Still, lawmakers have failed to adopt legislation — or even introduce any, according to a search of the state General Assembly’s website — to address the issues facing the 2008 law.

The status quo could change this year.

Steven Shapiro, a pediatrician and longtime member of the Montgomery County review team, told Spotlight PA that he and fellow pediatrician Erich Batra, of Lebanon County’s review board, have been urging state officials to improve the “flawed” Child Death Review system. They want a coordinated effort to improve data collection and remove some burdens from counties’ responsibilities.

“If you just unpack how the child succumbed, then you begin to learn about how you can protect other children from enduring the same fate and parents enduring the same fate,” Shapiro said.

Shapiro’s son, Gov. Josh Shapiro, happens to be in a position to help get the program some state funding. Though the elder Shapiro said he does not “try to influence” policy when speaking with his son, some topics come up “over table talk at dinner sometimes.”

Earlier this year, for the first time, the governor proposed using a new $2.5 million from the state’s general fund to support the program. The Department of Health said in an emailed April statement that the money would be used to adopt some of the report’s recommendations. Those include adding health department staff to assist county teams with data collection and prevention strategies, creating a grant that counties could use to “enhance local CDR operations,” and expanding public education campaigns geared toward preventing child deaths.

The Department of Health’s statement did not specify how many positions would be added to improve the program’s organization.

Steven Shapiro said he and Batra are also working on a “cogent, complete and cost-effective” proposal to “redo” how the state is involved in Child Death Review data collection that would not require new legislation. He wouldn’t share details on how that new system might work, but said some funding from the state is essential.

Batra told Spotlight PA the $2.5 million in state funding the governor is proposing would be a good starting point. He envisions it helping counties with data collection and funding local prevention efforts, which can include things like adding signs at dangerous intersections, leading a smoke detector campaign in neighborhoods experiencing fires, or holding fundraisers for a local Cribs for Kids branch.

“A lot of the way Child Death Review works is what I call the intangibles,” Batra said. “It’s the community coming together and working together in a way that they might not always do on a day-to-day basis.”

But Cathleen Palm, founder of the Center for Children’s Justice and a longtime advocate for improving Child Death Review, told Spotlight PA she’s not convinced Gov. Shapiro’s funding pitch alone is a game-changer.

She said that if improving Child Death Review were truly a priority for policymakers, there would be more fanfare around the funding proposal from the Shapiro administration.

Palm also criticized lawmakers for their inaction on addressing issues within the program that have been known for years.

“Why do we create a law if we don’t want to follow it?” Palm said.

In a year where so many competing interests are fighting over a limited amount of state funds, Palm worries Shapiro’s proposal may go overlooked by lawmakers.

“Investing in improvements to the CDR process will further allow the Administration to expand public education and outreach, with a focus on preventable causes of child death,” Rosie Lapowsky, Gov. Shapiro’s spokesperson, said in a statement. “The Governor is hopeful the General Assembly shares that mission of protecting children and ensuring their safety.”

The annual proportion of reviewed child deaths plummeted during COVID-19 and has not fully rebounded, even though there has also been a reduction in the total number of deaths, according to annual reports from the Department of Health.

In the history of the review requirement, county boards have never succeeded in studying every death. The closest they got was in 2013 — statewide, about three-quarters of the 1,931 child deaths that happened that year were reviewed.

That rate dropped to an all-time low in 2019, when 43% of that year’s 1,907 child deaths were reviewed. The drop is often associated with the COVID-19 pandemic, because deaths tend to get reviewed many months after the fact.

The review rate climbed back to nearly 60% in 2023 (of 1,551 deaths), the most recent year for which data are available.

However, local teams across the state left more than 600 deaths unreviewed in 2023.

Unreviewed deaths stem directly from members being “stretched thin with resources” and being “pulled in so many different directions,” according to Christina Phillips, who organized the Child Death Review program from 2018 until her retirement earlier this year.

Phillips said she worked as a “one-person project” at the state level to coordinate with counties about which deaths to review. Part of the reason the Department of Health commissioned East Stroudsburg University to do its 2022-24 study of the program is because Phillips raised concerns, she told Spotlight PA.

Most of the people who serve on local review teams are volunteers who do this work alongside their regular paid positions. Phillips said many rural counties meet as little as once or twice a year.

What they need, she said, is help from state staff to request medical records, synthesize findings into data entry, and translate any patterns they find into prevention strategies.

Phillips said she was unsure why lawmakers have not tried to address advocates’ concerns, given they have received an annual report that highlights those problems for multiple years.

“Preventing kids from dying is never a partisan issue,” Phillips said. “Preventing kids from dying is possible if there are more resources for Child Death Review.”

East Stroudsburg University researchers sorted counties into categories: ones that already have strong review programs; ones that could improve in various ways; and ones that need to be redeveloped.

They identified 20 rural counties that should at least consider organizing under regional offices to maximize their resources, and 22 counties — 6 urban and 16 rural — that must regroup because although they experienced “sufficient deaths to justify a local team,” they saw inconsistent participation from members.

The 15 “strong” counties were a mix of urban and rural, from Philadelphia to a regional operation between Susquehanna and Wyoming Counties, according to researchers. They suggested that 10 other counties, including Allegheny, build on their current processes.

Many of the program’s issues stem from data collection. Researchers at East Stroudsburg found that facilitating data collection falls onto volunteer team chairs. In other states, like Maryland and Delaware, there are paid staff at the state level who coordinate data collection efforts prior to meetings, according to researchers.

Roy Hoffman, medical director of Philadelphia’s Fatality Review Program, told Spotlight PA that even for his team of roughly 15 city employees working on death review, data collection is “a pain” and “time-consuming.”

Philadelphia has operated its own death review group since the 1990s, Hoffman said, and saw few differences following the 2008 law.

“I can imagine for some of these smaller counties with coroners, with not having done this, this must be a big pull and hard to do,” Hoffman said.

The most recent state Child Death Review annual report, analyzing 2023 data, found that Black or African American children died at twice the rate of white children — a statistic in line with national trends.

Roughly 47% of the reviewed deaths in 2023 were caused by medical conditions, including prematurity. “External causes,” including bodily force or a weapon, accounted for about 45% of deaths that year.

Palm pointed to the Department of Health’s finding that roughly one-third of child deaths in 2023 were flagged by local teams as “preventable.”

“All of us as a society want to keep our kids alive and healthy and well,” Palm said. “In order to do that, we have to study the kids who died to figure out how we prevent the next child from dying.”

Palm wants the state to foster the same level of research toward preventing gun safety, motor vehicle crashes, drowning, accidental overdoses, and abuse or violence against kids as it and other institutions direct toward studying youth cancer rates.

Researchers at East Stroudsburg recommended that lawmakers amend current law to require a minimum number of quarterly meetings for each local team, boost training for local and state team members, mandate a specific timeframe for a death review to be completed, and require local teams to include representatives from school districts and “underrepresented community groups.”

They also urged lawmakers to reduce the age cap to trigger a mandated review, from 21 to 18, and to include an “enforcement provision” to encourage counties to participate in the program.

None of the researchers’ suggested changes to Child Death Review have been proposed in the General Assembly, according to a review of introduced bills on the legislature’s website.

The original bill establishing the program was sponsored by Republican state Sen. Lisa Baker. She told Spotlight PA in response to emailed questions that it’s likely time to reevaluate the system with input from state and local stakeholders to “address evolving needs.”

“Given children are potentially falling through the cracks, a closer examination and review of the program is certainly warranted,” Baker said.

Beth Rementer, a spokesperson for Democratic state House Majority Leader Matt Bradford, noted that the chamber passed Shapiro’s budget proposal in April, which included the $2.5 million for Child Death Review.

“We are open to discussions with the administration and stakeholders about improving the program to ensure all children are safe,” she said.

A spokesperson for Republican state Senate Majority Leader Joe Pittman did not respond to questions regarding potential changes this year to Child Death Review.

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This story was originally published by Spotlight PA and distributed through a partnership with The Associated Press.

DAUPHIN, CUMBERLAND, COUNTIES, Pa. (WHP) — PennDOT is reporting multiple road closures and hazards Saturday night as storms sweep through central Pennsylvania.

In the borough of Dauphin, a tree went into a car on 22/322 West, according to spokesperson Fritzi Schreffler.

There are several trees down on 11/15 North coming from I-81, heading to Marysville just across the Perry County line.

She also said I-81 South is closed at exit 85 for a jackknifed tractor-trailer. There are no details on injuries or other vehicles involved at this time, and the cause for the crash is unclear.

Lancaster police notified the public of a road closure in the city, saying a tree fell onto the street on the first block of E. Vine St.

You can check 511PA for live traffic conditions.

A stunning four-bedroom work of art designed by late Italian architect and loft pioneer Giuseppe “Beppe” Zambonini has just hit the market in Pennsylvania for $625,000—listing for the first time in more than two decades.

The upside-down 1987 trapezoid-style dwelling in Dingmans Ferry boasts a barrel vaulted ceiling supported by eight interior columns and is surrounded by expansive windows and decks to soak in the tranquil views of nature.

Each of the rooms was designed, not as a traditional rectangle, but as a trapezoid, a technique that was meant to maximize the amount of natural light inside the home, ensuring that each window has ample opportunity to let the sun shine through.

It was a design method that Beppe came up with while working in New York City, where he was renowned for his work creating stunning loft spaces with “theater set” walls. He then brought that technique to Pennsylvania, where he sought to design his own weekend retreat, using the hallmarks that had turned him into a legend of Big Apple architecture.

The result is a home that appears, from the outside, almost like a stack of unevenly placed shipping containers—but on the inside is a stunning, light-filled dwelling, with enormous windows that offer beautiful views of the surrounding area from every room.

“There are numerous instances in the construction where hallways, rooms, and decks are not perfectly rectangular but rather are all trapezoid in shape,” says listing agent Shaun Burger of Keller Williams Real Estate Milford.

Beppe purchased the 2.44-acre land on which the home now sits in the 1980s, before crafting a home that would be used full time by his wife and their daughter—but was close enough to New York City that he could join them on weekends.

The idyllic parcel is perched above Nyce Lake in a development that would later become known as Traces of Lattimore.

“It is only 90 minutes away from Manhattan but is a world away in terms of peacefulness and nature,” Burger noted. “There are a lot of properties here being used as second homes, but it could also be used as a primary residence.”

The unique home—which was constructed by Beppe and a team of his best students from his design school, Open Atelier of Design—drew immediate attention from design aficionados, even featuring in a play entitled “The Upside Down House” in New York and a feature film called “A Picture of You.”

In a nod to this heritage, the garage door features a design by one of Beppe’s students resembling a theater curtain that a local artist created using shades of Chinese red, gray, and white.

Burger says that with so much cultural and architectural history, the property feels as much like a piece of art as it does a residential dwelling, one that the current owner has taken great care to preserve and maintain.

“The seller is very much into the arts and feels more of a custodian of the home,” Burger shares. “He is looking to pass it along to the next steward.”

What makes the dwelling so unique is that only one column is exposed on each floor, which is highlighted by a different color in each room. In the home office, the column is red while the primary bedroom features a blue support, and a yellow column can be found in the dining room.

A third-floor loft boasts Zambonini’s signature theater set walls.

“The home itself is so unique, which is what originally attracted the seller,” he added. “There are so many Colonials, ranches, and cookie-cutter homes in the area, so it is infrequent to find a home like this where there has been so much thought put into it.”

In the 40 years since the property was built, it has changed hands on only one occasion, in 2005—when it was sold by Beppe’s wife, Claudia, to the man who owns it now for $396,000.

“I scrupulously maintained the original colors of the house, inside and out, and kept the kitchen and bathrooms as I found them,” the seller writes in the listing. “After 21 years, it is time for a new custodian to live in this significant work of art.”

According to Burger, the property would be the perfect retreat for someone who likes their privacy but also enjoys entertaining guests, offering ample room across its 2,850-square-foot design.

“It has four bedrooms and four bathrooms so it would be a nice home for someone who loves to entertain,” Burger adds. “There is plenty of space for guests.”

What’s more, the property offers the best of both worlds—surrounded by nature, but with all the convenience of proximity to nearby cities and towns.

“There are a lot of windows and sitting areas, so when you are inside, you feel like you are outside,” the listing agent says. “Dingmans Ferry is very quaint and has lots of lakes, waterfalls, hiking trails, and skiing. It’s a naturally beautiful area.

“I envision the next buyer to be an artist who will totally appreciate this work of art. The area has highly rated public schools for someone who has children. I think it will be someone who will want a getaway where they can reconnect and recharge with nature and will not want to change or renovate the home.”