BILL ANALYSIS                                                                                                                                                                                                    Ó



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          SENATE THIRD READING


          SB  
          877 (Pan)


          As Amended  June 29, 2016


          Majority vote


          SENATE VOTE:  28-6


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Health          |16-0 |Wood, Maienschein,    |                    |
          |                |     |Bonilla, Burke,       |                    |
          |                |     |Campos, Chiu, Gomez,  |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Lackey, Nazarian,     |                    |
          |                |     |Olsen,                |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Ridley-Thomas,        |                    |
          |                |     |Rodriguez, Santiago,  |                    |
          |                |     |McCarty, Waldron      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |15-4 |Gonzalez, Bloom,      |Bigelow, Gallagher, |
          |                |     |Bonilla, Bonta,       |Jones, Wagner       |
          |                |     |Calderon, Daly,       |                    |
          |                |     |Eggman, Eduardo       |                    |








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          |                |     |Garcia, Holden,       |                    |
          |                |     |Obernolte, Quirk,     |                    |
          |                |     |Santiago, Weber,      |                    |
          |                |     |Wood, McCarty         |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
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          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.  


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, DPH received a tentative award of funding on July 13,  
          2016 through Centers for Disease Control and Prevention (CDC) in  
          order to resume participation in the National Violent Death  
          Reporting System (NVDRS).  The actual funding amount is not able  
          to be released until the award is official.  Assuming funds are  
          appropriated or available through private sources:




          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  
            potentially federal/private funds, if available). 


          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 potentially federal/private funds,  








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            if available).  Previously, DPH provided reimbursement to  
            local government agencies to reimburse them for the time  
            needed to provide information to DPH.


          3)DPH has an existing database that was used for such  
            reporting-however, to the extent reinstating the program  
            requires any upgrade, expansion, or ongoing maintenance of  
            CalEVDRS, there could be unknown, likely minor information  
            technology costs (GF or potentially federal/private funds, if  
            available).


          COMMENTS:  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; 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.


          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. 


          1)National Violent Death Reporting System.  In 2002, the NVDRS  
            was established at the 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  








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            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 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. 


          2)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  








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            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.


          3)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  








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            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 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.  


          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  
          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."










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          Analysis Prepared by:                                             
                          Paula Villescaz / HEALTH / (916) 319-2097  FN:  
          0004042