BILL ANALYSIS Ó AB 299 Page 1 Date of Hearing: May 6, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair AB 299 (Brown) - As Amended April 23, 2015 ----------------------------------------------------------------- |Policy |Health |Vote:|19 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: YesReimbursable: Yes SUMMARY: This bill requires the California Department of Public Health (CDPH) to develop a submersion incident form for nonfatal and fatal drowning events, and specifies data elements to be AB 299 Page 2 collected. It also requires first responders to complete the form for every incident and submit the form to local health departments, who in turn must submit data to CDPH, and requires local and state health departments to compile and distribute statistical information on their website annually. FISCAL EFFECT: 1)Potential one-time GF costs to CDPH for program development and to build a data collection system. There are numerous ways to construct such a system, but as the data collection is an ongoing requirement, a web-based system that allows local public health departments to upload data in a standard format would likely be an efficient solution. Depending on the design, this could cost in excess of $150,000 GF. Alternatively, CDPH could rely on manual form submittal and aggregation, but this would have higher ongoing costs and would not be cost-efficient. 2)Minor ongoing GF costs to CDPH to compile, analyze and post information, and to maintain the database. 3)There is a potential for state-reimbursable mandated costs for local health departments, but the total number of reports is likely to be small and dispersed among counties, so the likelihood of mandate claims is almost negligible. Staff estimates estimated around 1,300 reports per year statewide with full compliance, with total costs in the thousands of dollars. 4)Local public and private first responders will incur minor AB 299 Page 3 additional costs for data collection, but these costs are not reimbursable. COMMENTS: 1)Purpose. 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 that do gather this data, however, the type of information gathered is inconsistent. The author asserts that this data is necessary for policymakers to craft tailored programs to prevent the unnecessary loss of life. Drowning is the number one cause of death for toddlers. 2)Staff Comments. While it is clear data is useful for understanding why and how often near-drowning incidents occur, the value of this magnitude of data collection is unclear. Whenever data is collected, there is a cost added to the activity. It may be the case, but it is unclear that the benefit outweighs the overall cost of this data collection. Staff notes the following issues for consideration: a) To what end? Data is best collected when it is actionable and can inform practice. Will the data be used for targeted interventions in all the places it is collected? Local priorities may differ. Unless data collection informs local practice, the necessity of collecting local data in all jurisdictions is questionable. AB 299 Page 4 b) Geography. Does all the data need to be collected over the entire state, or could collection in a smaller geography provide valuable information that could inform practice statewide? The circumstances surrounding near-drownings in pools, for example, may not vary significantly from one location to another. The CDC indicates, for example, lack of supervision, lack of barriers, failure to wear life jackets, and alcohol use are known risk factors. Mandating the range of data collection in this bill statewide is only necessary if data in one locale differ substantially from data in another locale. This may indeed be the case, but should be justified. c) Frequency. In general, the periodicity with which data is reported should be as infrequent as possible to minimize workload. Some surveys are done on a biennial basis, for example, and provide a useful snapshot without the ongoing burden of data collection. Is there a clear necessity to collect data on an ongoing basis, and aggregate and report on a quarterly basis? d) Singling out one type of injury. There does not appear to be precedent for this type of data collection by first responders for public health purposes. Is near-drowning the only condition for which data collection is imperative? Does similar logic apply to falls, gun injuries, or severe burns, for example? Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081 AB 299 Page 5