BILL ANALYSIS Ó
AB 2425
Page 1
Date of Hearing: April 12, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 2425
(Brown) - As Amended April 5, 2016
SUBJECT: Public health: incident site reports.
SUMMARY: Requires the Department of Public Health (DPH) to
establish a uniform incident site report for the purpose of
unintentional injury incidents. Specifically, this bill:
1)Requires DPH, on or before June 1, 2018, to adopt standards
and protocols to establish a uniform incident site report
requirement for the collection of statewide information on
unintentional injury incidents.
2)Requires the standards and protocols to be developed in
collaboration with representatives from other health and
safety state and local agencies, first responders, fire
agencies, law enforcement agencies, public health experts, and
childhood injury prevention experts in order for DPH to
understand the details at incident sites for various types of
unintentional injury. Authorizes DPH to periodically
reconvene these representatives when necessary to modify the
standards and protocols.
3)Requires the standards and protocols to be implemented by
AB 2425
Page 2
every county for use by the appropriate local reporting
entities. Defines a reporting entity the reporting entity
identified in the standards and protocols developed by DPH.
4)Requires the standards and protocols to include the following:
a) A requirement that a reporting entity utilize an
incident site reporting best practices from an incident
site investigation protocol, specific to each type of
unintentional injury, to report information to existing
local, regional, and statewide data systems and to the
local health department; and,
b) A requirement that the county health department be
responsible for submitting the data received to the state's
EpiCenter data system, no later than 60 days after receipt
of the incident site report.
5)Defines "incident site reports" or "incident" to include,
among others, site reports or incidents that involve
unintentional injuries from drownings, near drownings, burns,
window falls, bicycle crashes, pedestrian crashes, sleep
suffocation, kids left in cars, vehicle backovers, vehicle
frontovers, sports-related activities, and poisoning.
6)Finds and declares the Legislature's intent for DPH to take a
lead role in establishing statewide best practice guidelines,
standards, and incident site information collection tools, as
specified.
EXISTING LAW:
AB 2425
Page 3
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 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; and, 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 been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, California
lacks a uniform standard for collecting data from
unintentional injury incident sites involving children and
youth ages through 19 years. Several counties have developed
best practice incident report forms, but most counties do not
have the resources to research and develop unintentional
injury incident forms and data collection, and each leading
cause of unintentional injury has important variations on what
types of incident data needs to be collected. Without uniform
collection of incident and site reporting, California does not
have the information it needs to plan for and adjust our
AB 2425
Page 4
unintentional injury prevention programs and incident
responses. The author state that this bill sets up the means
to keep California on target in its data and knowledge about
the changing underlying causes of unintentional injury.
2)BACKGROUND. The Centers for Disease Control and Prevention
reports that for 2013, there were 31 million emergency
department visits for unintentional injuries and unintentional
injuries accounted for 130,557 deaths that year. According to
DPH's Website, unintentional injury is the leading cause of
hospitalizations and deaths for California's children and
youth ages one to19 years old and the leading cause of injury
related deaths for babies and infants under one year of age.
Unintentional injury deaths result from a variety of causes
such as motor vehicle traffic crashes, falls, firearms,
drownings, suffocations, bites, stings, sports/recreational
activities, natural disasters, fires or burns and poisonings.
From 2000 to 2010, California's top three fatal unintentional
injuries include motor vehicle traffic crashes (36.2%),
poisoning and exposure to noxious substances (including drugs
and other substances) (26.7%), and falls (16.2%). These three
causes totaled 79.1% of all unintentional injury deaths. In
2010, unintentional deaths ranked as the sixth leading cause
of death in California. Males account for more unintentional
injury deaths than females. Drowning was the most common
unintentional injury cause of death for those aged one to four
years. Motor vehicle traffic crashes were the most frequent
unintentional injury deaths for those aged five to 24 years
old. Poisonings (including drugs and other substances) were
the most common unintentional injury death for people aged 25
to 64. Falls were the most prevalent unintentional injury
cause of death for individuals over 65. Due to the prevalence
of unintentional injury deaths in this country, the U.S.
Department of Health and Human Services (HHS), one of the
objectives of the Healthy People 2020 is the reduction of
unintentional injuries age-adjusted death rate to no more than
36 per 100,000 population.
AB 2425
Page 5
DPH maintains on its Website the EPICenter data system, which
includes information on overall injury surveillance and
includes data on all types of injuries that result in death,
hospitalizations, or an emergency department visit.
3)SUPPORT. The California Coalition for Children's Safety and
Health, a sponsor of this bill, state that this bill will give
California a better understanding of the underlying causes of
unintentional injuries and assist in developing a better and
more effective preventatives strategies. The California
Chapter of the American College of Emergency Physicians states
that throughout the year, emergency physicians treat patients
with injuries resulting from unintentional injury incidents
and implementing a statewide incident site report will provide
important data that will help reduce injuries by identifying
potential hazards and high risk areas.
4)OPPOSE UNLESS AMENDED. The California Chamber of Commerce and
California Attractions and Parks have taken an oppose unless
amended position and state that as currently drafted, this
bill would require employees of private businesses to complete
incident site reports for a wide range of incidents should
they occur on their property and when an employee is the first
to respond. They both believe this requirement is
impractical, inappropriate, and in some cases could actually
raise liability issues. They propose that the definition of
first responder be narrowed to include only the appropriate
publicly contracted emergency medical technician service, law
enforcement, fire department personnel, and the coroner when
appropriate.
5)OPPOSE. The Emergency Medical Services Administrators
Association of California states they are concerned that this
bill may delay the transport of critically injured patients to
trauma centers and encumber limited emergency medical services
resources by requiring personnel and providers to conduct
mandated injury prevention investigations while at the scene
AB 2425
Page 6
of a medical emergency.
6)PREVIOUS LEGISLATION.
a) AB 299 (Brown) of 2015 would have required DPH to
develop a submersion incident form to collect standardized
information regarding drowning or nonfatal-drowning events,
as specified. AB 299 died in Assembly Appropriations
Committee.
b) AB 540 (Pan) of 2013 would have authorized DPH to
establish and maintain a system for collecting data on
violent deaths in the state. AB 540 died in the Senate
Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION:
Support
California Coalition for Children's Safety and Health (sponsor)
American College of Emergency Physicians, California Chapter
The Child Abuse Prevention Center
AB 2425
Page 7
Opposition
Emergency Medical Services Administrators Association of
California
Analysis Prepared by:Rosielyn Pulmano / HEALTH / (916) 319-2097