BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 540
AUTHOR: Pan
AMENDED: June 18, 2013
HEARING DATE: June 26, 2013
CONSULTANT: Valderrama
SUBJECT : Reporting and tracking of violent deaths.
SUMMARY : Permits the Department of Public Health to establish
and maintain the California Electronic Violent Death Reporting
System and to 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.
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.
3.Requires Department of Public Health (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; or, under
circumstances as to afford a reasonable ground to suspect that
the death was caused by the criminal act of another.
This bill:
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1.Permits DPH to establish and maintain the California
Electronic Violent Death Reporting System (CalEVDRS) and to
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.
Permits DPH to contract with county health departments to
collect this data.
2.Permits DPH to apply for grants provided under the National
Violent Death Reporting System (NVDRS) of the federal Centers
for Disease Control and Prevention (CDC) and to accept private
or foundation moneys for purposes of implementing this bill.
3.Prohibits anything in this bill from being construed to limit
data sources that DPH can collect, which may include any
public agency document that may contain data on violent
deaths.
4.Makes a number of legislative findings and declarations
related to violent deaths and the NVDRS.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, if DPH establishes the program, there would be costs
of approximately $275,000 for fiscal year (FY) 2013-14 and
$469,000 for FY 2014-15. Costs including necessary staffing,
operating expenses, and contracting costs to obtain data. The
contracting costs are estimated at an average of $25 per record,
though actual costs may vary depending on whether a record is
copied and sent to DPH or is entered by the source.
PRIOR VOTES :
Assembly Health: 13- 5
Assembly Appropriations:12- 0
Assembly Floor: 53- 23
COMMENTS :
1.Author's statement. 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
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DPH to apply for grants awarded by the NVDRS, it 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.Violence. According to the World Health Organization (WHO),
violence takes the lives of more than 1.5 million people
annually across the globe: just over 50 percent due to
suicide, some 35 percent due to homicide, and just over 12
percent as a direct result of war or some other form of
conflict. Overall, violence is among the leading causes of
death worldwide for people between the ages of 15 and 44
years. The CDC indicates that violence accounts for
approximately 51,000 deaths annually in the US.
A 2009 series of reports collectively entitled Violence
Prevention: the evidence, performed by the WHO in conjunction
with Liverpool John Moores University, argues that since the
1980s, a wide range of public health practitioners,
researchers and systems have taken on the task of
understanding the roots of violence and preventing its
occurrence. They state that the experience and the scientific
studies conducted by these public health researchers clearly
demonstrate that violence can be prevented and its impact
reduced, in the same way that public health efforts have
prevented and reduced pregnancy-related complications,
workplace injuries, and infectious disease.
3.NVDRS. According to the CDC, NVDRS is a state-based
surveillance system that links data from law enforcement,
coroners and medical examiners, vital statistics, and crime
laboratories to assist each participating state in designing
and implementing tailored prevention and intervention efforts.
NVDRS defines a death due to violence as "a death resulting
from the intentional use of physical force or power against
oneself, another person, or against a group or community."
NVDRS collects information about homicides, suicides, deaths
by legal intervention-excluding executions-and deaths of
undetermined intent.
NVDRS is incident-based and includes information about victims,
suspects, the relationship between the victim and the suspect,
circumstances surrounding the death, and the method of injury.
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The ultimate goal of NVDRS is to provide communities with a
clearer understanding of violent deaths so they can be
prevented. NVDRS accomplishes this goal by informing decision
makers and program planners about the magnitude, trends, and
characteristics of violent deaths so appropriate prevention
efforts can be put into place and providing data to help
monitor and evaluate state-based prevention programs and
strategies.
4.Violent death reporting in California. From 2005 through
2008, California was one of 17 states participating in the
NVDRS, funded by the CDC. Under NVDRS, 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. According to DPH, due to its size, privacy concerns
and lack of resources among law enforcement agencies,
California was unable to obtain the law enforcement records
required by NVDRS and therefore did not reapply for funding.
DPH maintains that they realized this incompatibility early on
in the NVDRS grant and secured separate funding to develop
CalEVDRS in order to continue California's violent death
reporting.
CalEVDRS uses California's Electronic Death Registration System
(CA-EDRS), created in 2005 to allow counties to file death
certificates online instead of mailing paper forms. Using
funds from The David and Lucile Packard Foundation, DPH
created a violent death supplement to death certificates in
CA-EDRS, which captures information from coroners on violent
death. CalEVDRS data elements were created according to NVDRS
specifications and can be transmitted to NVDRS if CDC desires
them. Law enforcement data for homicides are linked using
Supplementary Homicide Reports from the California Department
of Justice.
5.Sharing data. According to DPH, counties can share their data
but they are not obligated to. Most coroner offices
voluntarily have agreed to share their coroner data and some
sheriff offices and police departments have also agreed to
share their investigative and toxicology reports; however DPH
has received letters from some sheriff offices and police
departments declining to participate in the program. While
this bill does not require these agencies to share data, DPH
argues it would provide counties with more justification as to
why they should voluntarily agree to share data.
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6.Future NVDRS funding. DPH is not certain what the eligibility
requirements for the next round of NVDRS grant funding will be
but they do intend to apply. DPH believes they will be
eligible and will be able to get enough county law enforcement
agencies to cooperate to make the program a success. If this
bill were to become law, DPH indicates they would likely cite
the law as part of their application.
7.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.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees, AFL-CIO (co-sponsor)
Union of American Physicians and Dentists (co-sponsor)
American Foundation for Suicide Prevention
California Medical Association
The Child Abuse Prevention Center
Oppose: None received.
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