BILL ANALYSIS Ó
AB 299
Page 1
Date of Hearing: April 21, 2015
ASSEMBLY COMMITTEE ON HEALTH
Bonta, Chair
AB
299 (Brown) - As Amended April 13, 2015
SUBJECT: Public health: drownings.
SUMMARY: Requires the Department of Public Health (DPH) to
develop a submersion incident form to collect standardized
information regarding drowning or nonfatal-drowning events, as
specified. Requires local law enforcement entities, fire
departments, or first responders to complete the form for every
drowning or nonfatal-drowning incident and submit the form to
DPH. Specifically, this bill:
1)Requires DPH to develop, by regulation, a submersion incident
form to be used for local entities to report drowning and
nonfatal drowning incidents including, at least, the following
categories entitled:
a) "Basic Incident Information," including date, time,
address, and type of dwelling, as specified;
b) "Victim Information," including age, gender, race or
ethnicity, where the victim was last seen, the estimated
length of time submerse, the type of clothing worn by the
victim, whether a flotation device was worn by the victim,
and a question about additional circumstances such as
drugs, alcohol, trauma, or preexisting conditions that led
to or were involved in the incident;
c) "Water Source Information," including a description of
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the site, water clarity, water depth, water type, as
specified, whether there were toys or objects in the water,
and, if applicable, whether the pool or spa was built
before 1998;
d) "Adult Supervision," including a description of who the
supervisor was at the time of the incident, their
relationship to the victim, whether a child protective
services referral was made and by whom, whether the
submersion was witnessed, and whether there was a trained
lifeguard on duty;
e) "Barrier Information," describing the presence of water
or other barriers, or alarms, and additional questions
about these barriers; and,
f) "Classes / Emergency Preparation," including whether
rescue equipment was near the water, whether
cardiopulmonary resuscitation (CPR) was performed, and by
whom, whether the victim ever took swim classes, whether
the victim was dead on the scene, and additional questions
pertaining to the training of the person giving CPR, and
type of CPR used.
2)Requires the form developed in 1) above to be completed by
every local law enforcement entity, fire department, or other
first responder at the scene for each person who is treated or
hospitalized for respiratory distress from submersion or
immersion in liquid that the entity, department, or first
responder provides services or investigates.
3)Requires the completed form in 1) above to be submitted to
DPH.
4)Specifies that the form in 1) above is not required for
persons rescued and released who do not have signs or symptoms
of respiratory distress.
5)Requires DPH and each local county health department to
compile and distribute statistical information on drowning and
nonfatal drowning incidents annually and post the reports on
their Website by February 1 of each year.
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6)Requires the form to be made available by DPH on its internet
Website; requires each city, county, or city and county to use
the form as their official form. Permits local jurisdictions
to affix their own seal and contact information to the form.
7)Defines, for the purposes of this bill, drowning, nonfatal
drowning, and first responder.
EXISTING LAW:
1)Authorizes the DPH to establish public swimming pool
regulations, in order to meet current health and safety
practices, standards and operational requirements.
2)Under the Harbor and Navigation Code, requires the Division of
Boating and Waterways to collect data from accidents that
occur in boats. Requires the operator of every recreational
vessel to file a written report whenever a boating accident
occurs which results in death, disappearance, injury that
requires medical attention beyond first aid, total property
damage in excess of $500, or complete loss of a vessel.
FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, this bill
seeks to gather uniform data on drowning and nonfatal-drowning
events that would be submitted to the county and state for the
use of drowning prevention education programs. While the
death certificate filled out when a drowning results in a
fatality provides some data on these events, no such data is
gathered for near-drowning events. It is at the discretion of
local municipalities to create a drowning report form and
gather data, and most do not gather such data. The
information gathered may vary from county to county and among
those, the type of information gathered is inconsistent. The
author asserts that this data is necessary for policymakers to
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craft tailored programs to prevent the unnecessary loss of
life.
2)BACKGROUND. According to DPH, drowning takes the lives of
more California toddlers than any other kind of accident.
Children one to four years old are at greatest risk. Most of
these drowning events take place at the homes of parents,
relatives, or neighbors. Children who manage to survive a
"near drowning" (also described as a nonfatal drowning) often
suffer permanent brain damage from lack of oxygen. According
to the Department of Developmental Services, victims of near
drowning accidents often experience disabilities for the
remainder of their lives. These include central nervous
system damage contributing to varying levels of brain damage,
resulting in loss of memory, seizures, learning disabilities,
paralysis, and sometimes coma. The surviving victims may also
experience a lifetime of multiple medical problems including
respiratory, cardiovascular, and neuromuscular disorders.
3)CURRENT DATA COLLECTION. DPH states that it currently
collects a limited amount of information on drowning and near
drowning incidents through its standard vital statistics
surveillance efforts using death, hospital, and emergency
department administrative records. The vital statistics and
medical records data on drowning incidents are available from
DPH in several ways. The Safe and Active Communities Branch
maintains the EpiCenter - California Injury Data Online - as a
user-friendly 24/7 query system that allows users to get basic
drowning and near drowning data and create custom tables on
the related demographics (e.g. county, age, gender,
race/ethnicity). It can be accessed online at
http://epicenter.cdph.ca.gov. The Office of Vital Records
also provides access to the death data and the Office of
Statewide Health Planning and Development maintains the
hospital and Emergency Department discharge data.
DPH states that it does not collect data from first responders
for any type of injury. First responder data are collected
through the local Emergency Medical Services agencies and
reported to state (i.e., California Emergency Medical Services
Agency) and national sources.
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4)Submersion Incident Report Form Project. According to
information provided by the author, Riverside and San
Bernardino Counties have implemented successful drowning data
collection programs that were used as the model for this bill.
Riverside County Injury Prevention Services identified the
need for more extensive and meaningful data to better
understand how and why drowning tragedies occur. In 2004,
with First 5 funding, the Submersion Incident Report Form
(SIRF) was developed in coordination with the SafeKids, Inland
Empire organization, Riverside Public Health Agency, and the
Drowning Prevention Network.
The SIRF Project is a data collection project that utilizes
first response agencies (law enforcement, fire departments,
paramedics, emergency medical technicians) to report key
information from all fatal and non-fatal drowning incidents
that occur in Riverside County. Data are collected on adult
and child victims. San Bernardino County started using SIRF
in 2007. However, the use of the SIRF in San Bernardino and
Riverside Counties is not mandatory and many drowning and
nonfatal drownings go unreported. The program consists of
pre-hospital first responders filling out the form and
submitting it to local county health departments. San
Bernardino County Health Department is starting to transition
to collecting data. Inland Empire Safe Kids currently
collects the data. The data are then reviewed by the local
drowning prevention coalition and then a plan is developed to
focus their efforts on areas that have special events
especially with limited budgets.
The program allows them to track and notice changes in
drowning incidents and take the necessary steps to reduce
drowning events. For example, if they notice a spike in
drownings at a lake, they will either sponsor a billboard or
host a "Water Safety Day" to raise awareness in the area.
With the drowning prevention awareness day, they'd look for
deficiencies that need to be addressed: swim lessons; CPR;
education; etc. Being able to decrease drownings also saves
the local and state governments significant amounts of funds
by not having to treat drowning and non-fatal drowning
victims. The federal Centers for Disease Control and
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Prevention reported in 2000 the annual cost spent on non-fatal
drownings in the U.S. is $87 billion.
5)SUPPORT. The Rialto Fire Department, sponsor of this bill,
points out that current data collection on drowning incidents
has no uniformity, if collected at all. Because of this,
valuable data are lost that could help reduce preventable
deaths. The Health Officers Association of California states
that drownings and near-drownings are a serious public health
incident that local health officers are working to combat
every day. A statewide report on drowning and near-drowning
events would afford ample opportunities for health officers,
among other public health leaders, to thoroughly review the
circumstances surrounding drowning-related deaths and injuries
to effectively intervene and reduce the occurrence of these
tragic incidents.
6)PREVIOUS LEGISLATION. AB 3305 (Setencich), Chapter 925,
Statutes of 1996, enacts the Swimming Pool Safety Act to
require sellers of single-family homes to disclose, effective
July 1, 1997, whether a swimming pool or spa has a specified
fence, cover, or other safety feature and requires that
swimming pools constructed after January 1, 1998 must have
specified safety features.
7)POLICY COMMENTS.
a) Time vs benefit. While the data collected would
certainly be valuable to future drowning-prevention
efforts, the time required to accurately fill out this form
might put undue burden on first responders. How will the
entity bill or receive reimbursement for the time spent
filling out the form?
b) Is this overprescriptive? It is valuable to have clear
legislative intent when directing a state agency to
promulgate a new regulation, but this bill may be
overprescriptive in the specificity of the language. Why
have DPH promulgate regulations if the exact language to be
used on the form is already specified?
8)SUGGESTED AMENDMENTS.
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a) Duplication of efforts. As drafted, this bill requires
first responders to submit completed forms to both local
health departments and DPH. This bill also requires both
local health departments and DPH to perform statistical
analysis of incidents annually. The author may wish to
consider whether this is unnecessary duplication of
efforts.
b) Time frame for reporting. This bill does not specify a
time frame in which first responder entities must submit
the forms to DPH, although it does require analysis of the
data annually. The author should amend this bill to
clarify the timeframe required for first responder entities
to submit completed forms.
c) Definition of first responder. First responder is used
and defined in other parts of the Health and Safety Code.
For consistency, the author should amend this bill to use a
previously established definition of first responder
instead of creating a new one.
REGISTERED SUPPORT / OPPOSITION:
Support
Rialto Fire Department (sponsor)
American College of Emergency Physicians, California Chapter
California Coalition for Children's Safety and Health
California Collaboration for Youth
Health Officers Association of California
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Lifeguards Without Borders
Safe Kids California
Safe Kids San Diego
Starfish Aquatics Institute
Stew Leonard III Water Safety Foundation
Opposition
None on file.
Analysis Prepared by:Dharia McGrew/HEALTH/(916) 319-2097