BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 877|
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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.
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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.
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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.
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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
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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
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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.
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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
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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,
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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
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