BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 877
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|AUTHOR: |Pan |
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|VERSION: |February 18, 2016 |
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|HEARING DATE: |April 13, 2016 | | |
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|CONSULTANT: |Melanie Moreno |
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SUBJECT : Reporting and tracking of violent deaths
SUMMARY :1. Requires DPH to establish and maintain the California
Electronic Violent Death Reporting System and to collect data on
violent deaths, as specified.
Existing law:
1)Establishes the State Department of Public Health (DPH), which
is responsible for various programs relating to the health and
safety of people in the state, including licensing health
facilities, regulating food and drug safety, and monitoring
and preventing communicable and chronic diseases.
2)Requires DPH to maintain birth, death, fetal death, still
birth, marriage and divorce records.
This bill:
1)Requires 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.
Requires DPH to contract with counties 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 to implement this bill.
3)Specifies that this bill does not limit data sources that DPH
is permitted to collect, which may include any public agency
document that may contain data on violent deaths.
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FISCAL
EFFECT : This bill has not been analyzed by a fiscal committee.
COMMENTS :
1)Author's statement. According to the author, violence is a
threat to public health and proper data could be used to
prevent violent deaths. In 1975 a national database tracking
detailed information on car deaths in the nation helped
decrease and prevent car fatalities. The data did not get rid
of cars but made them safer. SB 877 will do the same thing.
Re-creating CalEVDRS allows us to do research on how we can
best prevent violent deaths. It shows us what is working and
what is not. We cannot prevent these types of deaths if we do
not understand what is driving them. SB 877 lets us make
smarter decisions so we can prevent violence.
2)Background. According to the CDC, violence is a public health
problem that affects individuals, families, and communities
throughout the US. More than 56,000 Americans died because of
homicide or suicide in 2011, and violent deaths cost the US an
estimated $107 billion in medical care and lost productivity
every year. According to the CDC, violence can be prevented,
and accurate information about it is key to directing,
designing, implementing, and evaluating prevention efforts.
3)NVDRS. According to the CDC, NVDRS is a state-based
surveillance system that, since 2002, 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 provides data on violence trends
at national and regional levels; each state can access all of
these important data elements from one central database.
States that are funded for NVDRS operate under a cooperative
agreement with CDC to whom all violent deaths are voluntarily
reported. NVDRS funded six states initially, and in 2014 the
CDC received funding to expand the system to a total of 32
states, illustrated in the map below:
According to the CDC, the goal is to eventually include all 50
SB 877 (Pan) Page 3 of ?
states, all U.S. territories, and the District of Columbia in
the system. Descriptive data can be accessed free of charge
from a web-based system, which goes beyond providing basic
information, such as race, sex, and age, and also provides
comprehensive details on circumstances surrounding the violent
death. More detailed data from the NVDRS Restricted Access
Database (RAD) is available by request for users meeting
certain eligibility criteria. The NVDRS RAD is available for
public health research via a data sharing agreement that
places restrictions on how, when, and by whom the data may be
used.
4)CalEVDRS. According to DPH, from 2005 through 2010,
California was one of 17 states participating in NVDRS. Under
NVDRS, DPH contracted with county health departments to
collect data on violent deaths from four data sources - death
certificates, coroner/medical examiner records, law
enforcement reports, and crime laboratory records. During its
four years of data collection, the DPH compiled detailed
information on circumstances of more than 11,000 violent
deaths, including homicides and suicides in Alameda, Kern, Los
Angeles, Monterey, Riverside, Sacramento, San Francisco, San
Joaquin, San Mateo, Santa Clara, Shasta Solano, Stanislaus and
Yolo counties, which encompassed approximately 57% of the
state's total suicides and two-thirds of all homicides at the
time. According to CDPH, due to its size, decentralized
government, privacy concerns and lack of resources among law
enforcement agencies, California was unable to obtain law
enforcement and crime lab records required by NVDRS and could
not reapply for funding. However, DPH realized this
incompatibility early on in the NVDRS grant and, in its
commitment to expand the program statewide, secured funding to
develop CalEVDRS. CalEVDRS took advantage of California's
Electronic Death Registration System (CA-EDRS), which permits
counties to file death certificates. 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. To
ensure a smooth transition from NVDRS, CalEVDRS data elements
were created according to NVDRS specifications. The California
Wellness Foundation provided additional funding to reimburse
coroners for completing this supplement. Because detailed
data were not available from law enforcement, summary homicide
data from the California Department of Justice's Supplementary
Homicide Reports (SHR) were linked to provide as much
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information as possible. Once funding was ended, resources and
staffing to support local data collection and manage the state
level program were lost. According to DPH, only Los Angeles
County has been able to continue to participate in Cal-EVDRS
consistently across time.
5)Future NVDRS funding. DPH applied for the NVDRS funds in 2014
and although it had a passing score, DPH did not receive
funding because CDC did not have enough funding to support all
passing scores. CDC has issued a new Funding Opportunity
Announcement for which DPH intends to apply. The CDC
requirements have been substantively changed to make large
states more competitive (i.e., phasing in more cases over
time; not all 6,000 California violent deaths per year have to
be included), so California is likely to be competitive.
6)Previous legislation. AB 540 (Pan) of 2013 was substantially
similar to this bill. AB 540 was held on suspense in Senate
Appropriations Committee.
7)Support. The Union of American Physicians and Dentists and
the American Federation of State, County, and Municipal
Employees, write that this bill will help better 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 sources on violent deaths.
The American Academy of Pediatrics, California states that in
order to address this highly preventable public health crisis,
it is essential to understand the personal, familial, and
community conditions and behaviors that contribute to violent
childhood death. The American Foundation for Suicide
Prevention writes that to design effective violence prevention
strategies, an essential first step is to ensure the
availability of complete, accurate and timely information,
particularly with regard to populations at risk and the
circumstances and predisposing factors that contribute to
deaths from violence, and that by linking this data, CalEVDRS
can reveal new insights into the prevention of violent deaths,
insights that can be used by state public health officials to
better target their prevention activities. Physicians for
Social Responsibility writes that California claims to be a
national leader in violence prevention, and in order to make
that claim, it is imperative that the state collect complete
data on the circumstances of violent deaths and share that
data with NVDRS. The National Association of Social Workers
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writes that we cannot prevent violent deaths if we do not
understand what is driving them.
SUPPORT AND OPPOSITION :
Support: Union of American Physicians and Dentists (sponsor)
American Federation of State, County, and Municipal
Employees (sponsor)
American Academy of Pediatrics, California
American Foundation for Suicide Prevention
Child Abuse Prevention Center
National Association of Social Workers
Physicians for Social Responsibility
Oppose: None received
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