2023-110 Audit Scope and Objectives
Fetal Death and Stillbirth Certificates
The audit by the California State Auditor will provide independently developed and verified information related to the California Department of Public Health's (CDPH) fetal death and stillbirth certificate issuing processes in conjunction with the local jurisdictions in Placer, Sacramento, and two additional counties. The audit's scope will include, but not be limited to, the following activities:
- Review and evaluate the laws, rules, and regulations significant to the audit objectives.
- Evaluate the statewide oversight of the fetal death and stillbirth certificate processes, including any relevant policies and procedures.
- To the extent possible, assess the timeliness of the fetal death and stillbirth certificate processes and determine for the most recent five years the CDPH average, statewide county average, and individual county averages of processing times for issuing such certificates. If statewide county averages are not available, determine for the most recent five years the average processing times for fetal death and stillbirth certificates for the four selected counties.
- At the four selected counties, compare and contrast the following:
- The roles and responsibilities of each agency, office, and individuals working on behalf of each agency or office involved in the fetal death and stillbirth certificate process.
- The policies and procedures used and training received by the various agencies, offices, and individuals involved in the process.
- The impact that differences in county processes or other external factors, like COVID-19, have on the amount of time it takes to process fetal death and stillborn certificates.
- The differences, if any, in the process for issuing fetal death and stillbirth certificates that exist depending on whether the fetal deaths and stillbirths happen in a hospital or at home and those that are attended by a medical provider versus those that are unattended.
- Review and assess any other issues that are significant to the audit, including identifying any improvements that would result in a more efficient timeframe for processing fetal death and stillbirth certificates.
California State Auditor's Office
3/22/2023