BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 877| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- UNFINISHED BUSINESS Bill No: SB 877 Author: Pan (D), et al. Amended: 8/18/16 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 SENATE FLOOR: 28-6, 6/1/16 AYES: Allen, Beall, Block, Cannella, De León, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Moorlach, Nguyen, Pan, Roth, Wieckowski, Wolk NOES: Bates, Berryhill, Fuller, Huff, Nielsen, Vidak NO VOTE RECORDED: Anderson, Gaines, Morrell, Pavley, Runner, Stone ASSEMBLY FLOOR: 63-15, 8/23/16 - See last page for vote SUBJECT: Reporting and tracking of violent deaths SOURCE: American Federation of State, County, and Municipal Employees Union of American Physicians and Dentist 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. SB 877 Page 2 Assembly Amendments (1) require DPH to post a summary and analysis of the collected data on their Web site; (2) permit law enforcement agencies, to the extent that funding is available, to report to DPH data on the circumstances surrounding all violent deaths from investigative reports and, if available, laboratory toxicology reports to be used by DPH for the limited purpose of conducting public health surveillance and epidemiology. Require aggregate data to be public, but individual identifying information to remain confidential. Require the collected data to be based on the data elements of the National Violent Death Reporting System (NVDRS) of the federal Centers for Disease Control and Prevention (CDC); (3) define "violent death" as a death resulting from the use of physical force or power against oneself, another person, or a group or community, and include, but is not limited to, homicide, suicide, legal intervention deaths, unintentional firearm deaths, and undetermined intent deaths; (4) require DPH to enter into a contract, grant or other agreement with local agencies, rather than counties, to collect the data. Permit DPH to enter into such an agreement with a local agency to collect the data from other local agencies if specified conditions are met; (5) require the data collected to be limited to data that local agencies are authorized to collect within their respective jurisdictions; and (6) require local agencies entering into an agreement to collect data based on existing or new data elements required by CalEVDRS only to the extent that resources are made available. 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 drug safety, and monitoring and preventing communicable and chronic diseases. SB 877 Page 3 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 defined and 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 local agencies to collect this data. Permits DPH to enter into such an agreement with a local agency to collect the data from other local agencies if specified conditions are met. 2)Permits law enforcement agencies, to the extent that funding is available, to report to DPH data on the circumstances surrounding all violent deaths from investigative reports and, if available, laboratory toxicology reports to be used by DPH for the limited purpose of conducting public health surveillance and epidemiology. Requires aggregate data to be public, but individual identifying information to remain confidential. Requires the collected data to be based on the data elements of the NVDRS. 3)Requires the data collected to be limited to data that local agencies are authorized to collect within their respective jurisdictions. 4)Requires local agencies entering into an agreement to collect data based on existing or new data elements required by CalEVDRS only to the extent that resources are made available. 5)Permits DPH to apply for grants provided under NVDRS and to accept private or foundation moneys to implement this bill. SB 877 Page 4 6)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. 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. 1)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 SB 877 Page 5 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. 2)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 SB 877 Page 6 Homicide Reports 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. 3)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. Comments 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." FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: No According to the Assembly Appropriations Committee, DPH received a tentative award of funding on July 13, 2016 through the CDC in order to resume participation in the NVDRS. The actual funding amount is not able to be released until the award is official. SB 877 Page 7 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, 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). SUPPORT: (Verified 8/23/16) American Federation of State, County, and Municipal Employees (co-source) Union of American Physicians and Dentist (co-source) American Academy of Pediatrics, California American Foundation for Suicide Prevention Center California Academy of Family Physician Child Abuse Prevention Center Health Officers Association of California National Alliance on Mental Illness National Association of Social Workers Physicians for Social Responsibility SB 877 Page 8 Physicians for Social Responsibility, San Francisco OPPOSITION: (Verified8/23/16) 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 Center 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 writes that "we cannot prevent violent deaths if we do not understand what is driving them." ASSEMBLY FLOOR: 63-15, 8/23/16 AYES: Achadjian, Alejo, Arambula, Atkins, Baker, Bloom, Bonilla, Bonta, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Roger Hernández, SB 877 Page 9 Holden, Irwin, Jones-Sawyer, Lackey, Levine, Linder, Lopez, Low, Maienschein, McCarty, Medina, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Waldron, Weber, Williams, Wood, Rendon NOES: Travis Allen, Bigelow, Brough, Dahle, Beth Gaines, Gallagher, Grove, Harper, Jones, Mathis, Mayes, Melendez, Patterson, Wagner, Wilk NO VOTE RECORDED: Hadley, Kim Prepared by:Melanie Moreno / HEALTH / (916) 651-4111 8/23/16 20:14:27 **** END ****