BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 877|
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THIRD READING
Bill No: SB 877
Author: Pan (D), et al.
Amended: 2/18/16
Vote: 21
SENATE HEALTH COMMITTEE: 7-2, 4/13/16
AYES: Hernandez, Hall, Mitchell, Monning, Pan, Roth, Wolk
NOES: Nguyen, Nielsen
SENATE APPROPRIATIONS COMMITTEE: 5-2, 5/27/16
AYES: Lara, Beall, Hill, McGuire, Mendoza
NOES: Bates, Nielsen
SUBJECT: Reporting and tracking of violent deaths
SOURCE: American Federation of State, County, and Municipal
Employees
Union of American Physicians and Dentists
DIGEST: This bill requires the State Department of Public
Health (DPH) to establish and maintain the California Electronic
Violent Death Reporting System (CalEVDRS) and to collect data on
violent deaths, as specified.
ANALYSIS:
Existing law:
1)Establishes 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
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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 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.
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
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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 U.S.
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
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
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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 DPH, 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
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.
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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.
Prior Legislation
AB 540 (Pan, 2013) was substantially similar to this bill. AB
540 was held on suspense the in Senate Appropriations Committee.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee:
1)Ongoing costs of $460,000 per year for staff to oversee
contracts with counties and law enforcement organizations,
analyze data, and prepare reports (General Fund or federal
funds).
2)Ongoing costs of $300,000 for payments to counties and law
enforcement agencies to reimburse counties and law enforcement
agencies who would provide information to DPH for entry into
the tracking system (General Fund or federal funds).
Previously, DPH provided reimbursement to local government
agencies to reimburse them for the time needed to provide
information to DPH.
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SUPPORT: (Verified 5/27/16)
American Federation of State, County, and Municipal Employees
(co-source)
Union of American Physicians and Dentists (co-source)
American Academy of Pediatrics, California
American Foundation for Suicide Prevention
Child Abuse Prevention Center
National Association of Social Workers
Physicians for Social Responsibility
OPPOSITION: (Verified 5/27/16)
None received
ARGUMENTS IN 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
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circumstances of violent deaths and share that data with NVDRS.
The National Association of Social Workers writes that "we
cannot prevent violent deaths if we do not understand what is
driving them."
Prepared by:Melanie Moreno / HEALTH /
5/28/16 16:50:06
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