History: Pennsylvania began the process of CDR in early 1990 with the support from the Pennsylvania Departments of Health and Public Welfare, in collaboration with the Pennsylvania Chapter of the American Academy of Pediatrics. The state review team conducted state level reviews beginning in 1994 until 1998. During this time, the state team took action on its own recommendations to support the development of community-based teams. Since 1998, local teams have been county0based and are responsible for conducting reviews of children who have died who were residents of the team's county. Local Teams make recommendations on prevention strategies to their communities and to the state team.