BILL ANALYSIS �
AB 845
Page 1
Date of Hearing: April 30, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 845 (Cooley) - As Amended: April 18, 2013
SUBJECT : Shaken Baby Syndrome
SUMMARY : Requires the State Department of Social Services (DSS)
to develop and implement, by January 1, 2015, the Shaken Baby
Syndrome Education Program.
Specifically, this bill :
1)Requires DSS, in consultation with the State Department of
Public Health, the Department of Justice, First 5 California,
and other interested stakeholders to develop and implement the
Shaken Baby Syndrome Education Program (Program), by July 1,
2015, which is required to provide information about the
syndrome based on scientific and evidence based practices.
2)Requires DSS, in consultation with the indicated state
departments and other stakeholders, to develop a process for
county selection and select the counties to participate in the
Program, provided that the counties are eligible and volunteer
to participate.
3)Requires DSS, in designing the Program, to implement evidence
based practices related to providing information and education
to new parents and caregivers of newborns and young infants
when selecting and developing materials, providing materials
to parents and caregivers, and developing an implementation
plan to expand the program statewide, as specified.
4)Requires DSS to submit a report to the Legislature evaluating
the effectiveness of the Program, as specified, by January 1,
2020.
5)Provides that the Program and process for its development
shall be funded using money from the Children's Trust Fund and
prohibits the use of General Fund dollars.
6)Authorizes DSS to accept and expend other private funds that
are donated to DSS for purposes of developing or implementing
the Program.
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7)Provides that the Program shall be in effect for no more than
five years and establishes a January 1, 2020 sunset date to
that end.
EXISTING LAW
1)Establishes a statewide public awareness campaign to
distribute information and instructional materials, as
specified, in an effort to prevent the occurrence of injuries
and deaths among infants and children as a result of shaken
baby syndrome.
2)Requires health facilities to provide information and
instructional materials pertaining to shaken baby syndrome to
parents or guardians of each newborn upon discharge from the
health facility, and requires midwives to provide the
information and instructional materials to the parents or
guardians of a newborn in the event of a home birth attended
by a midwife.
3)Requires DSS to provide information and instructional
materials pertaining to shaken baby syndrome free of charge to
child care providers upon licensure and during site visits.
4)Provides that health facilities, midwives, and child care
providers are only required to provide information or
instructional materials pertaining to shaken baby syndrome
when they have been supplied with the information or
materials, and prohibits any legal cause of action against a
health facility, midwife, or child care provider for not
providing the specified information or instructional
materials.
5)Provides that persons or agencies responsible for providing
information and materials related to shaken baby syndrome are
not required to provide duplicative or redundant informational
and instructional materials.
6)Establishes the State Children's Trust Fund in the State
Treasury, as specified, and provides that money in the Fund,
upon appropriation by the Legislature, shall be allocated to
the DSS for the purpose of funding child abuse and neglect
prevention and intervention programs, and allows DSS to
promote the Fund and seek charitable contributions for it, as
specified.
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FISCAL EFFECT : Unknown
COMMENTS : Shaken Baby Syndrome (SBS) is the term used to
describe the severe trauma and physical abuse an infant or young
child suffers while being violently shaken. Numerous research
studies show that inconsolable crying, which is a known natural
part of a baby's development, is the primary trigger for
caregivers to become frustrated, lose control and violently
shake a baby. According to the National Center on Shaken Baby
Syndrome, it is estimated that 1,200 to 1,400 children in the US
are injured by shaking every year, including over 300 babies who
die every year due to shaking. It is important to note that
these estimates may be lower than actual numbers due to the lack
of external physical injuries, in many cases, and the fact that
symptoms in infants-vomiting, crying and fussiness-are similar
to those for concussions. When a baby has been shaken but
doesn't show signs of seizure, respiratory difficulty or visible
head trauma, medical professionals may focus on other causes of
the resulting symptoms and not readily detect that the baby was
a victim of SBS.
Consequences of Shaken Baby Syndrome
The effects of shaking a baby are amplified due to their neck
muscles not being fully developed and their heads being
relatively large compared to the rest of their bodies, making up
about 25% of their total body weight. When babies are shaken,
their brains often rotate in their skulls, which results in
internal bleeding and pressure around the brain, torn blood
vessels feeding the brain, and retinal bleeding. This can
result in seizures, vomiting, extreme irritability, broken
bones, cardiac arrest, and death. Approximately 25% of all SBS
victims die as a result of their injuries. For children who
experience this abuse but do not die, approximately 80% are left
with permanent disabilities and life-long care needs with high
medical costs. These long term consequences can include
paralysis, learning and physical disabilities, seizures,
behavior disorders, speech and hearing impairments, blindness,
cerebral palsy, and severe cognitive impairments.
Because SBS is the result of child abuse, children who are
victims of SBS enter the child welfare system as a means of
protecting the children from further abuse. In addition to the
physical, mental and developmental damage that a victim of SBS
might experience, placement in the child welfare system creates
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costs to the state, which are only compounded by the children's
potential need for specialized medical and developmental
services throughout their lifetime.
State Children's Trust Fund (SCTF)
The SCTF was established in 1983 specifically for the purpose of
funding child abuse and neglect prevention. Funds are
administered by the Office of Child Abuse Prevention, and
include a portion of specialty license plate revenue from the
Child Health and Safety Fund, voluntary income tax donations,
and a portion of birth certificate fees. The primary goal of
the Fund is to allocate resources for large-scale public
awareness, education and prevention campaigns around child abuse
prevention, including those that focus on Shaken Baby Syndrome.
Need for the bill
According to the author, "SBS is 100% preventable and most often
occurs in a moment of lost control with the abuser not
understanding the consequences of his or her actions. While
current law requires hospital staff to distribute SBS materials
to new parents if they are provided, it does not specify who
shall provide SBS materials to the hospitals, the quality of the
materials, or the method of delivery. This results in many
communities having insufficient information to give new parents
concerning SBS. Other states have shown that an evidence-based
SBS education program can dramatically reduce the number of SBS
incidences."
The author also states that a similar program implemented by Dr.
Mark Dias and his colleagues in upstate New York resulted in a
50% reduction of SBS cases per year. The Upstate New York SBS
Education Program is based on the premise that if parents are
provided information and education about SBS at the correct
time, they will know what steps to take to prevent SBS
themselves, and can be effective advocates in disseminating the
information to all other adults who care for their child.
Through the program, parents receive both written and video
materials about the dangers of violently shaking an infant
before leaving the hospital, and are then asked to voluntarily
sign a commitment statement affirming that they have received
and understand the material. Parents receive additional
materials about SBS during their child's first doctor's visit.
Current SBS prevention efforts in California
The existing requirements for the distribution of SBS education
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and prevention materials were established by AB 3760 (Speier),
Chapter 1176, Statutes of 1994. DSS, the State First 5
Commission, and some county First 5 commissions currently engage
in some SBS-prevention efforts, and there are also local, state
and national non-profit organizations dedicated to educating
families and caretakers about the dangers of SBS. This bill
does not eliminate any of the existing requirements for health
facilities and midwives to provide SBS-related materials to new
parents or guardians, or the requirement for DSS to provide such
materials to child care providers. However, rather than
continuing to rely on local efforts that are not necessarily
consistent from one county to another, it would centralize
responsibility within DSS for developing and implementing an
evidence-based awareness and education program in selected
counties, after which DSS would design a plan for statewide
implementation. This bill would give DSS, in consultation with
other stakeholders, broad discretion over the development and
implementation of efforts under the program with the goal of
reducing the incidence of SBS across the state.
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PRIOR LEGISLATION :
SB 825 (Padilla) 2008 was substantially similar to this bill and
would have created a time-limited public education program for
the prevention of Shaken Baby Syndrome.
SB 468 (Padilla) 2007 would have established a pilot public
education program for the prevention of Shaken Baby Syndrome in
up to 10 counties.
AB 3760 (Speier), Chapter 1176, Statutes of 1994 established the
requirement for health facilities, midwives and DSS to
disseminate informational materials about SBS, free of charge,
and only when those materials are provided to those individuals
or entities.
REGISTERED SUPPORT / OPPOSITION :
Support
Child Abuse Prevention Center (CAP Center) - Sponsor
California Family Resource Association (CFRA)
Judge Talmadge R. Jones, (Ret.) Superior Court Judge of
Sacramento County
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089