Recruit your OFR members

This module covers the overdose fatality review (OFR) team leadership roles and members, as well as how to recruit to ensure active participation by multidisciplinary members. It also covers how the OFR team fits into a larger infrastructure, including subcommittees and a governing committee.

OFR Team


OFR teams are multidisciplinary and include individuals who can share information about a decedent or contribute to the analysis of available data to make recommendations that will prevent future overdose deaths.

Like the CDC Foundation’s Public Health and Public Safety Teams (PHAST) framework, an OFR encourages multisector collaboration by using the data-driven “SOS” process. In this context, SOS stands for shared understanding, optimized capacity, and shared accountability.

  • S
    Shared understanding. OFRs increase members’ understanding of area agencies’ roles and services as well as the community’s assets and needs, substance use and overdose trends, current prevention activities, and system gaps.
  • O
    Optimized capacity. OFRs increase the community’s overall capacity to prevent future overdose deaths by leveraging resources from multiple agencies and sectors to increase system-level response.
  • S
    Shared accountability. OFRs continually monitor local substance use and overdose death data as well as recommendation implementation activities. Status updates on recommendations are shared at each OFR team meeting and with a governing committee, reinforcing accountability for action.

Common OFR Team Members

Local health department official Local law enforcement representative Medical Examiner/ Coroner Prosecutor Local human services department official
Substance use treatment provider MOUD provider Mental health social worker Pain management clinician Emergency department physician
Primary care provider Pharmacist/ Toxicologist HIDTA public health analyst Sheriff Probation and parole office
Emergency medical service provider Drug treatment court representative Patient advocate Child protective services Substance use prevention professional
School counselor Tribal elder, traditional leader Community leader Housing authority representative Harm-reduction outreach professional

Recruiting OFR Team Members


OFR teams benefit from ongoing recruitment of new members to address staff turnover, address gaps in their membership, or identify new trends.

Members may need to be recruited and engaged before being requested to provide data, participate in a review, or assist with developing or implementing a recommendation. Their perspectives and input will be valuable even if their organizations did not have direct contact with the decedent or service area related to the case. For example, a drug treatment provider has a valuable perspective on standards of care even if it did not provide services to the specific individual being reviewed. A toxicologist or pharmacist may assist with understanding the prescription drugs provided to the decedent even if he or she did not interact with that individual.

Effective recruitment is all in the details. Ideally, the OFR team facilitator will meet one on one with new recruits to prepare members for what to expect when participating on a review team by:

  • Explaining the OFR goals and reviewing overall structure.
  • Sharing stated and unstated group rules/norms.
  • Emphasizing that the purpose of the meeting is not to point fingers at other participants.
  • Addressing any data sharing or confidentiality concerns and having them sign a confidentiality agreement. A sample confidentiality agreement is included in Module 4 Resources.
  • Summarizing past and current recommendations relevant to their organization or area of work.
  • Suggesting immediate ways they can participate in developing and implementing a recommendation.

Orienting New OFR Team Members


Every team member will come to the table with different experiences, knowledge, prejudices, and ideas about substance use and its impact on his or her work and the community. It will be the facilitator’s responsibility to lead meetings in a way that elevates all voices, addresses stigma or misinformation, and neutralizes tensions. To prepare for this task, the team facilitator may expect each member to obtain certain knowledge or training ahead of participating in an OFR team meeting.

Recommended trainings include the following:

Since death investigations vary by jurisdiction, it may be beneficial for OFR team members to learn more about the local death investigation process and the roles they play with information available from the medical examiner’s/coroner’s office and local law enforcement agencies.

OFR Resources

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