BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 540
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          Date of Hearing:  April 23, 2013

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
                      AB 540 (Pan) - As Amended:  April 9, 2013
           
          SUBJECT  :  Reporting and tracking of violent deaths.

           SUMMARY  :  Establishes in state law the California Electronic  
          Violent Death Reporting System (CalEVDRS) within the Department  
          of Public Health (DPH) and requires DPH to collect data on  
          violent death, as specified.   Specifically,  this bill  :  

          1)Requires DPH to establish and maintain CalEVDRS.  

          2)Requires DPH to do all of the following:
             a)   Collect data on violent deaths as reported from data  
               sources, including, but not limited to, death certificates,  
               law enforcement reports, and coroner or medical examiner  
               reports;
             b)   Contract with county health departments to collect data  
               specified in a) above;
             c)   Apply for grants provided under the National Violent  
               Death Reporting System (NVDRS) of the federal Centers for  
               Disease Control and Prevention (CDC) for purposes of  
               implementing this bill.

          3)States that nothing in this bill is to be construed to limit  
            data sources from which DPH can collect, including any public  
            agency document that contains data on violent deaths.

          4)States legislative findings and declarations on violent  
            deaths.

           EXISTING LAW  :  

          1)Requires the registration of each live birth, fetal death,  
            death, and marriage that occurs in the state.

          2)Requires that deaths be registered with the local registrar of  
            births and deaths in the district in which the death was  
            officially pronounced or the body was found, within eight  
            calendar days after death and prior to any disposition of the  
            human remains.  









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          3)Requires DPH, on or before January 1, 2005, to implement an  
            Internet-based electronic death registration system for the  
            creation, storage, and transfer of death registration  
            information.

          4)Requires a physician and surgeon, physician assistant, funeral  
            director, or other person to immediately notify the coroner  
            when he or she has knowledge of a death that occurred or has  
            charge of a body in which death occurred under any of the  
            following circumstances: without medical assistance, during  
            the continued absence of the attending physician and surgeon,  
            where the attending physician and surgeon or the physician  
            assistant is unable to state the cause of death; where suicide  
            is suspected; following an injury or an accident; under  
            circumstances as to afford a reasonable ground to suspect that  
            the death was caused by the criminal act of another.  

           FISCAL EFFECT  :  This bill has not yet been analyzed by a fiscal  
          committee.
           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  According to the author, violence is a  
            significant public health problem in the US.  According to the  
            CDC, each year more than 18,000 people are murdered and over  
            32,000 end their own lives.  Hospital emergency departments  
            treat an average of 55 people for injuries every minute,  
            millions of dollars are spent on treatment, and millions more  
            are lost due to lost productivity.  This bill codifies and  
            expands the current CalEVDRS and requires DPH to collect data  
            on violent deaths.  Recently, President Obama's Fiscal Year  
            2014 budget included $20 million for the expansion of CDC's  
            NVDRS, and by requiring DPH to apply for grants awarded by the  
            NVDRS allows California to participate in this system and get  
            data on the magnitude, trends, and characteristics of violent  
            deaths.  Data on violent deaths that would be collected by DPH  
            would assist policy makers and communities in determining  
            appropriate prevention and education efforts.  

           2)BACKGROUND  .  

              a)   Impact of Violence  .  According to the CDC, violence is  
               the threat or intentional use of physical force or power  
               against oneself, another person, or a group or community  
               that results in injury, death, psychological harm, or  
               deprivation.  It is a significant public health problem in  








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               the US.  More than 38,000 people died by suicide in the US  
               in 2010, and homicide claimed another 16,000 people.  The  
               CDC further notes that the total costs associated with  
               nonfatal injuries and deaths due to violence in 2000 were  
               more than $70 billion.  Most of this cost ($64.8 billion or  
               92%) was due to lost productivity.  However, an estimated  
               $5.6 billion was spent on medical care for the more than  
               2.5 million injuries due to interpersonal and self-directed  
               violence.  

              b)   NVDRS  .  In 2002, the NVDRS was established as a  
               surveillance system that pulls together data on violent  
               deaths.  NVDRS collects information from death  
               certificates, coroner or medical examiner reports, police  
               reports, and crime laboratories.  The ultimate goal of  
               NVDRS is to provide communities with a clearer  
               understanding of violent deaths so these deaths can be  
               prevented.  NVDRS accomplishes this by:  informing decision  
               makers and program planners about the magnitude, trends,  
               and characteristics of violent deaths so that appropriate  
               prevention efforts can be put into place; and facilitating  
               the evaluation of state-based prevention programs and  
               strategies.  In 2008, Congress appropriated more than $3.2  
               million for CDC to continue funding the implementation of  
               NVDRS in 17 states.  Currently, states participating in the  
               NVDRS include: Alaska, Colorado, Georgia, Kentucky,  
               Maryland, Massachusetts, New Jersey, Oklahoma, Oregon,  
               Utah, Virginia, and Wisconsin.  
              
              c)   Reporting and Tracking of Violent Deaths in California  .   
               From 2005-2008, California was one of the 17 states  
               participating in the NVDRS.  The California Violent Death  
               Reporting System (CalVDRS) was established to collect data  
               from the City of Oakland, City and County of Santa  
               Francisco, and Santa Clara County.  CalVDRS eventually  
               expanded in 2006-2007 to include data collection from the  
               counties of Los Angeles, Riverside, Alameda, and Shasta.   
               During these years, DPH contracted with county health  
               departments to collect data on violent deaths from four  
               data sources - death certificates, coroner/medical examiner  
               records, police reports, and crime laboratory records.   
               During its four years of data collection, DPH compiled  
               detailed information on the circumstances of more than  
               10,000 violent deaths, including homicides and suicides.   
               Participation of Alameda, Los Angeles, Riverside, San  








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               Francisco, Santa Clara, and Shasta Counties in the system  
               meant that DPH had valuable information on approximately  
               half of the state's violent deaths during this time.   
               Unfortunately, due to its size, decentralized government,  
               privacy concerns, and lack of resources among law  
               enforcement agencies, California was unable to obtain law  
               enforcement records required by NVDRS and could not reapply  
               for funding.  As a result, DPH developed CalEVDRS, and with  
               the creation of the Electronic Death Registration System in  
               2005 which allowed counties to file death certificates  
               online instead of mailing paper forms, DPH was able to  
               capture information from coroners on violent death.  As of  
               2010, 14 counties are contributing data on the system.  The  
               California Wellness Foundation currently funds the system  
               but according to DPH, this funding is about to expire.  

              d)   President Obama's 2014 budget  .  In response to the Sandy  
               Hook Elementary School shootings in Newtown, Connecticut,  
               President Obama unveiled his plan called Now is the Time  
               which calls for public health research on gun violence.   
               Now is the Time states that the country needs better data  
               to help Americans better understand how and when firearms  
               are used in violent deaths and to inform future research  
               and prevention strategies.  The President's 2014 budget  
               includes $30 million in new funding to track gun violence  
               and to research strategies that might prevent it.   
               Specifically, $20 million of these funds is appropriated  
               for the NVDRS to allow CDC to expand the system to all 50  
               states and the District of Columbia.  
                 
           3)SUPPORT  .  According to the American Federation of State,  
            County and Municipal Employees and the Union of American  
            Physicians and Dentists, this bill will better help  
            policymakers understand the circumstances and risk factors  
            that lead to violent deaths in California through the use of  
            innovative, efficient data collection from the richest data on  
            violent deaths.  The sponsors  both state that it is important  
            to recognize that gun violence is a public health concern and  
            we should track information and data regarding violent death  
            in order to better prevent them.  

           4)AUTHOR'S AMENDMENTS  .  The author would like to amend this bill  
            to allow DPH to accept private or foundation moneys to  
            implement this bill. 









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           REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          American Federation of State, County and Municipal Employees,  
          AFL-CIO (cosponsor)
          Union of American Physicians and Dentists (cosponsor)
          American Foundation for Suicide Prevention
          Child Abuse Prevention Center

           Opposition 

           None on file.
           
          Analysis Prepared by  :    Rosielyn Pulmano / HEALTH / (916)  
          319-2097