BILL ANALYSIS Ó SB 877 Page 1 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 | | SB 877 Page 2 | | |Garcia, Holden, | | | | |Obernolte, Quirk, | | | | |Santiago, Weber, | | | | |Wood, McCarty | | | | | | | | | | | | ------------------------------------------------------------------ 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, SB 877 Page 3 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 SB 877 Page 4 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 SB 877 Page 5 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 SB 877 Page 6 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." SB 877 Page 7 Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0004042