BILL ANALYSIS Ó
SB 877
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Date of Hearing: June 28, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
SB
877 (Pan) - As Amended February 18, 2016
SENATE VOTE: 28-6
SUBJECT: Reporting and tracking of violent deaths.
SUMMARY: Requires the 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; requires DPH to contract with counties to
collect data, as specified; and, permits DPH to apply for
federal, private or foundation grants and moneys to implement
CalEVDRS.
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
drug safety, and monitoring and preventing communicable and
chronic diseases.
2)Requires the registration of each live birth, fetal death,
death, and marriage that occurs in the state.
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3)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.
4)Requires DPH, on or before January 1, 2005, to implement an
Internet-based electronic death registration system for the
creation, storage, and transfer of death registration
information.
FISCAL EFFECT: 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 (GF) or
federal funds (FF)).
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 (GF or FF). Previously, DPH provided
reimbursement to local government agencies to reimburse them
for the time needed to provide information to DPH.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, violence is a
threat to public health and proper data could be used to
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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; this bill 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. This bill lets us make
smarter decisions so we can prevent violence.
2)BACKGROUND. In 2014, more than 42,000 people died by suicide
and homicide claimed another 16,000 people. Homicide was the
third leading cause of death among one to four year olds and
15-34 year olds. As of June 19, 2016, 6,211 Americans have
died due to gun violence.
a) National Violent Death Reporting System (NVDRS). In
2002, the NVDRS was established at the federal Centers for
Disease Control and Prevention (CDC) as a surveillance
system that collects data on violent deaths from
participating states. NVDRS collects information from
death certificates, coroner or medical examiner reports,
police reports, and crime laboratories. The goal of NVDRS
is to gain a better understanding of violence, upon which
to base the development of effective public health
strategies that prevent violent injuries and fatalities.
NVDRS accomplishes this by: informing decision makers and
program planners about the magnitude trends, and
characteristics of violent deaths so that appropriate
prevention efforts can be put into place; and, facilitating
the evaluation of state-based prevention programs and
strategies. In 2008, the U.S. Congress appropriated more
than $3.2 million for CDC to continue funding the
implementation of NVDRS in 17 states. Currently, states
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participating in the NVDRS include: Alaska, Colorado,
Georgia, Kentucky, Maryland, Massachusetts, New Jersey,
Oklahoma, Oregon, Utah, Virginia, and Wisconsin.
Historically, participation in the NVDRS has been a costly
and difficult undertaking and therefore has seen little
participation by large states.
b) CalEVDRS. From 2005 to 2008, California was one of the
17 states participating in the NVDRS. The California
Violent Death Reporting System (CalVDRS) was established to
collect data from the City of Oakland, City and County of
San Francisco, and Santa Clara County. CalVDRS eventually
expanded in 2006-07 to include data collection from the
counties of Los Angeles, Riverside, Alameda, and Shasta.
During these years, DPH contracted with county health
departments to collect data on violent deaths from four
data sources: death certificates; coroner/medical examiner
records; police reports; and, crime laboratory records.
During its four years of data collection, DPH compiled
detailed information on the circumstances of more than
10,000 violent deaths, including homicides and suicides.
Participation of Alameda, Los Angeles, Riverside, San
Francisco, Santa Clara, and Shasta Counties in the system
meant that DPH had valuable information on approximately
half of the state's violent deaths during this time.
Unfortunately, due to its size, decentralized government,
privacy concerns, and lack of resources among law
enforcement agencies, California was unable to obtain law
enforcement records required by NVDRS and could not reapply
for funding. As a result, DPH developed CalEVDRS, and with
the creation of the Electronic Death Registration System in
2005, allowed counties to file death certificates online
instead of mailing paper forms, DPH was able to capture
information from coroners on violent death. In 2010, 14
counties were contributing data to the system, which
operated with funding from the California Wellness
Foundation, funding that has since expired.
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c) Federal Funding. In response to the Sandy Hook
Elementary School shootings in Newtown, Connecticut,
President Obama unveiled his plan called "Now is the Time"
which calls for public health research on gun violence.
Now is the Time states that the country needs better data
to help Americans better understand how and when firearms
are used in violent deaths and to inform future
research and prevention strategies. The President's
2014 budget included $30 million in new funding to track
gun violence and to research strategies that might prevent
it. Specifically, $20 million of these funds is
appropriated for the NVDRS to allow the CDC to expand the
system to all 50 states and the District of Columbia. DPH
confirms that the U.S. Congress has approved increased
funding for the NVDRS and the CDC has begun implementing
simplifications and other reforms to make it easier for
large states to participate. DPH is in the process of
applying for a new CDC grant in order to resume
participation in the NVDRS, which, if successful, would
begin in September of this year.
The CDC grants vary in funding level based on the
percentage of violent death cases on which a state will be
able to collect data. California has already demonstrated
that it can collect data on approximately 50% of
California's cases with 14 counties participating. DPH
estimates that data could be collected on 90 to100% of the
state's cases with 35-40 counties participating. The CDC
funding is based on a per case cost estimate of
approximately $27.50, and DPH explains that this might be
based on the smaller states that participate in NVDRS,
however it does not accurately reflect actual data
collection costs in California, which they estimate at
approximately $50 per case. While DPH cannot predict the
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level of funding that the CDC will grant California, if
any, it is estimated that at most the CDC funding could
cover approximately 33% to 50% of the costs of a
fully-developed statewide active surveillance system that
covers close to 100% of California's violent death cases.
d) University of California (UC) Gun Violence Prevention
Research Center. The 2016 State Budget includes $5 million
for the creation of a first-in-the-nation research center
on firearm violence. The funds will be used to further the
work of the currently existing UC Davis Violence Prevention
Research Program (VPRP), a multi-disciplinary program of
research and policy development focused on the causes,
consequences, and prevention of violence.
3)SUPPORT. The Union of American Physicians and Dentists and
the American Federation of State, County, and Municipal
Employees, sponsors of this bill, state 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
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prevention of violent deaths, insights that can be used by
state public health officials to better target 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 writes that "we cannot prevent
violent deaths if we do not understand what is driving them."
4)RELATED LEGISLATION. SB 1006 (Wolk) would request that the UC
Regents establish the California Firearm Violence Research
Center for purposes of conducting research related to firearm
violence and its prevention. SB 1006 is pending in the
Assembly Higher Education Committee.
5)PREVIOUS LEGISLATION.
a) AB 540 (Pan) of 2013 was substantially similar to this
bill. AB 540 was held in the Senate Appropriations
Committee.
b) AB 2250 (Nation), Chapter 587, Statutes of 2002,
requires the State Department of Health Services (now
Department of Health Care Services) to implement an
Internet-based electronic death registration system on or
before January 1, 2005.
REGISTERED SUPPORT / OPPOSITION:
Support
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American Federation of State, County, and Municipal Employees
(co-sponsor)
Union of American Physicians and Dentists (co-sponsor)
American Academy of Pediatrics, California
American Foundation for Suicide Prevention
California Academy of Family Physicians
Child Abuse Prevention Center
Health Officers Association of California
NAMI California
National Association of Social Workers
Physicians for Social Responsibility, Sacramento Chapter
San Francisco Bay Area Physicians for Social Responsibility
Opposition
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None on file.
Analysis Prepared by:Paula Villescaz / HEALTH / (916)
319-2097