SENATE COMMITTEE ON APPROPRIATIONS

Senator Anthony Portantino, Chair

2019 - 2020 Regular Session

AB 656 (Eduardo Garcia) - Office of Healthy and Safe Communities

Bill Summary:

Assembly Bill 656 would, subject to available funding, create the Office of Healthy and Safe Communities within the Department of Public Health (CDPH), which would develop, implement, and monitor a statewide violence prevention strategy.

Fiscal Impact:

• Department of Public Health (CDPH). $2.4 million General Fund in FY 2019-20, and ongoing, for 13.0 permanent positions and additional contract costs to establish a new Office, consolidate and administer various violence prevention grant programs, coordinate across statewide departments, develop an interactive community engagement strategy, and implement a California plan for violence prevention. For more detail on personnel classifications and workload justification, please see Staff Comments.
• Department of Housing and Community Development (HCD). $93,000 for the first year, and $86,000 for the second fiscal year, and ongoing, for 0.5 PY Specialist I to assist the Office in developing comprehensive violence prevention strategy. For every ten PYs of program staff, it will need one PY of administrative division professional staff to support program operations.

Background:

According to the May 207 Prevention Violence in California: Vol. 1: “Communities of color are disproportionately impacted; concentrated, segregated areas of poverty grow; and community resilience and trust is diminished resulting in persistent inequities.” The publication identifies several forms of violence, such as child or elder maltreatment, intimate partner violence teen dating violence, gun violence, gang violence, community violence and trauma, workplace violence, hate crimes and terrorism. Also according to CDPH, in 2014, approximately $11 billion in medical costs and lost productivity (over 27,000 hospitalizations and 154,000 emergency department visits for violence injuries) were associated with violence.

The CDPH’s Safe and Active Communities Branch engages in a number of efforts to study, prevent, and reduce violence in communities, including the following:

• Violence Prevention Initiative (VPI): An intradepartmental effort, involving the Center for Healthy Communities, the Fusion Center, Center for Healthy Families, and the Office of Health Equity, reviewing violence from a public health perspective using public health approaches to safer communities. The CDPH Violence Prevention Initiative (VPI) seeks to reduce violence and create safer and healthier communities for all Californians. According to the department, public health recognizes violence as preventable, and seeks to address underlying causes to prevent violence through a four-step process: defining and monitoring the problem (e.g., data of violence-related injuries and deaths), identifying risk and protective factors, developing and testing prevention strategies, and sharing best practices.
• Essentials for Childhood Initiative: Utilizes the Collective Impact framework to promote safe, stable, nurturing relationships and environments for children, families, and communities. (Funded by CDC).
• All Children Thrive California: A three-year, equity-focused initiative appropriated through the Budget Act of 2018 to support families through evidence-based programs and services that build community resilience, reduce adversity and trauma, and advance conditions that allow children to thrive. (Funded by the Mental Health Services Fund).
• California Violent Death Reporting System: Collects information on the circumstances surrounding violent deaths (e.g., homicides) from multiple data sources (Medical Examiners/Coroners and law enforcement). (Funded by CDC).
• Rape Prevention and Education Program: Supports rape crisis centers to conduct community-based strategies such as bystander intervention, community mobilization, and school-based education to prevent first-time perpetration and victimization of sexual violence. (Funded by CDC).
• Domestic Violence Training and Education Program: Promotes safe, healthy, and equitable relationships through youth leadership and community mobilization activities conducted by domestic violence service organizations. (Funded by the Domestic Violence Fund).

Proposed Law:

AB 656 would establish the Office of Health and Safe Communities within the CDPH. The bill includes the following provisions, among others:

• Requires the Governor to appoint the Director of the Office, who must perform specified duties including assembling an advisory committee, as specified, develop a strategy to consolidate or align violence intervention and prevention programming funds, create a learning community of practice from research and data, and create a community engagement strategy.
• Specifies membership of the advisory committee to include representatives from communities heavily impacted by violence, from various state entities (Strategic Growth Council, California State University or the University of California), community organizations, local governments, and advocacy organizations.
• Provides the bill must only be implemented if appropriate funding, as determined by CDPH, is made available to the department after legislative appropriation or other sources.

Related Legislation: SB 934 (Allen), 2018, would have created the California Violence Intervention and Prevention Grant Program to be administered by the Board of State and Community Corrections. The bill would require the Board, if funding was appropriated, to award competitive grants, as specified, to cities and community organizations for the purpose of violence intervention and prevention, as specified. The bill was held on the Senate Appropriations Committee suspense file.

Staff Comments: Staff anticipates all costs would be borne by the General Fund.

• $251,000 for 1.0 CEA of $251,000 to oversee and manage the Office, and $109,000 for 1.0 Executive Assistant.
• $186,000 for 1.0 Health Program Manager III to provide oversight and direction on policies, projects, and standards for the initiative; and serve as liaison to other state agencies.
• $212,000 for 1.0 Research Scientist V (Social/Behavioral) to conduct epidemiological research, data acquisition and organization, apply scientific methods, statistical and conceptual analysis, and act as scientific advisor.
• $156,000 for 1.0 Health Program Specialist II to guide and consult on evidence-informed and evidence-based practices; develop logic models; develop and implement statewide communication plans; and conduct statewide convening.
• $313,000 for 2.0 Health Education Consultant III to conduct statewide outreach, education, training and technical assistance activities; and to assess statewide needs, including strategic plans and professional training and education.
• $289,000 for 2.0 Health Program Specialist I to analyze current research and evaluation data; facilitate communications; assist with required documentation and reporting; and monitor performance of subcontractors.
• $408,000 for 3.0 Associate Governmental Program Analysts to conduct fiscal analyses to assure appropriate program expenditure authority; manage contracts and budgets; and compile data for program progress reports.
• $93,000 for 1.0 Office Technician to provide clerical support.
• Up to $343,000 in additional contract costs for meeting facilitation.

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SENATE COMMITTEE ON PUBLIC SAFETY

Senator Nancy Skinner, Chair

2019 - 2020 Regular

Bill No: AB 656 Hearing Date: July 9, 2019

Subject: Office of Healthy and Safe Communities

HISTORY

Source: The Alliance for Boys and Men of Color

Prior Legislation: AB 97 (Ting), the Budget Act of 2017

SB 934 (Allen), 2018, failed passage in Senate Appropriations

Support: California Pan-Ethnic Health Network; California Partnership to End Domestic Violence; California Peace Alliance/ Department of Peacebuilding Campaign; City of Sacramento; Community Coalition; Community Health Councils; Fathers & Families of San Joaquin; Flourish Agenda; Future Without Violence; Greenlining Institute; Human Impact Partners; Latino Coalition for a Healthy California; LIVE FREE; Los Angeles County Democratic Party; Los Angeles Neighborhood Land Trust; MILPA; National Center for Youth Law; PICO California; Prevention Institute; Public Health Advocates; Urban Peace Institute; Youth Leadership Institute

Opposition: None known

Assembly Floor Vote: 60 - 13

PURPOSE

The purpose of this bill is to establish the Office of Healthy and Safe Communities, under the direction of the State Department of Public Health, which would provide a comprehensive violence prevention strategy and expand access to community-based programs for Californians who are at risk for involvement in violence.

Existing law declares the Office of Emergency Services as the appropriate state agency to contract for programs addressing the root causes of violence. (Pen. Code § 14111.)

Existing law declares legislative intent to be the following:

1. To develop community violence prevention and conflict resolution programs, in the state, based upon the recommendations of the California Commission on Crime Control and Violence Prevention, that would present a balanced, comprehensive educational, intellectual, and experiential approach toward eradicating violence in our society; and,
2. That these programs shall be regulated, and funded pursuant to contracts with the Office of Emergency Services. (Pen Code § 14112.)

Existing law states that first priority shall be given to programs that provide community education, outreach, and coordination, and include creative and effective ways to translate the recommendations of the California Commission on Crime Control and Violence Prevention into practical use in one or more of the following subject areas:

1. Parenting, birthing, early childhood development, self-esteem, and family violence, to include child, spousal, and elderly abuse;
2. Economic factors and institutional racism;
3. Schools and educational factors;
4. Alcohol, diet, drugs, and other biochemical and biological factors;
5. Conflict resolution; and,
6. The media. (Pen. Code § 14114, subd. (a).)

Existing law states that first priority programs may additionally provide specific direct services or contract for those services in one or more of the program areas as necessary to carry out the recommendations of the commission when those services are not otherwise available in the community and existing agencies do not furnish them. (Pen. Code, § 14115.)

Existing law requires OES to promote, organize, and conduct a series of one-day crime and violence prevention training workshops around the state, as specified. (Pen. Code § 14119.)

This bill states the intent of the Legislature to enact the Office of Healthy and Safe Communities, under the direction of the State Department of Public Health, to provide a comprehensive violence prevention strategy and to promote and expand the use of, and access to, community-based programs for Californians who are exposed to, involved with, or at risk for involvement in violence. It is the further intent of the Legislature to direct this office to consolidate and administer various violence prevention grant programs and promote the creation of alternatives to incarceration.

This bill creates the Office of Healthy and Safe Communities (OHSC).

This bill declares that the Governor shall appoint the Director of the OHSC.

1. The Director of the OHSC shall perform all the following duties:
   1. Hire and manage a staff team and consultants to execute the duties of the OHSC.
   2. Assemble an advisory committee.
   3. Develop, implement, and monitor a California vision and plan for violence prevention, safety, and healing with clear systems change goals aligned with funding to drive population-level results for decreasing exposure to violence among California’s most vulnerable people and places, including all of the following activities:
      1. Connect the vision and plan described in this paragraph to the Governor’s strategies for youth development, criminal and juvenile justice reform, health care services, and other related areas of opportunity.
      2. Develop a strategy and plan for the consolidation, coordination, or alignment of funding for violence intervention and prevention programming.
      3. Identify and integrate trauma-centered diagnostic tools, such as early and periodic screening, diagnosis, and treatment services, to support violence prevention, intervention, and healing.
      4. Create an interactive community engagement strategy that prioritizes the voices of people directly impacted and doing the work to prevent violence and promote peace and healing in communities.
   4. Create a learning community of practice that includes community meetings and the sharing of promising practices, research, data, and innovative approaches to violence intervention and prevention throughout California, including both of the following activities:
      1. Supporting coordination and sharing among counties and cities that are advancing a violence prevention strategy.
      2. Tracking and monitoring data and research on violence statewide and in communities throughout California.
   5. Strengthen the professionalization of community violence intervention and prevention as a licensed occupation.
   6. Facilitate the coordination and alignment of programming across statewide departments and agencies, such as the State Department of Public Health, the Department of Corrections and Rehabilitation, the Department of Housing and Community Development, and the State Department of Education, with the potential to support violence intervention and prevention goals utilizing a social determinants of health orientation program that is inclusive of those who are exposed to violence, who have caused harm, and who have been harmed.

This bill states that the Director of the OHSC shall establish an advisory committee to inform and guide the execution of the duties of the OHSC. The President pro Tempore of the Senate and the Speaker of the Assembly shall jointly appoint the membership of the advisory committee and shall do so in a manner that reflects the diversity of California and the complexity of violence. The advisory committee shall be comprised of the following persons:

1. Three representatives from communities heavily impacted by violence.
2. One representative from the Strategic Growth Council.
3. One representative from the State Department of Public Health Office of Health Equity.
4. One representative from the California State University or University of California systems.
5. Three representatives from community organizations working to promote healing and peace.
6. Three representatives from local governments advancing violence prevention strategies.
7. Two representatives from advocacy organizations advancing prevention, healing, and peace.
8. The director shall serve as a member of the advisory panel.

This bill states this chapter shall be implemented by the State Department of Public Health only if appropriate funding, as determined by the department, is made available to the department upon appropriation by the Legislature or other sources for the purpose of implementing this chapter.

COMMENTS

1. Need for This Bill

According to the author:

California is drastically behind when it comes to assigning public funding to effective evidence-based solutions to address violence. Additionally, the funds that do exist along with the current policies respond to violence primarily through the criminal legal and child welfare systems in a reactionary fashion, rather than a preventative one.

1. Department of Public Health Violence Prevention Initiative (VPI)

According to DPH, it assembled an internal task force to focus on violence as a public health risk and explore and clarify the role and contribution of governmental public health in preventing violence in all its forms. This resulted in the establishment of the VPI. The goal of the VPI is to reduce violence and create safer and healthier communities for all Californians, with the purpose of elevating violence as a priority, integrating and aligning efforts across multiple DPH programs, and framing the public health role in addressing violence.

AB 656 also aims to establish a violence prevention driven office within the Department of Public Health.

1. California Violence Intervention and Prevention (CalVIP) Grant Program

From 2007 to 2017, California’s budget acts appropriated $9.215 million per year to operate the California Gang Reduction, Intervention and Prevention (CalGRIP) program, which provided matching grants to cities for initiatives to reduce youth-and gang-related crime. The budget acts between 2007 and 2017 guaranteed $1 million annually for the City of Los Angeles, with the remainder distributed to other cities of all sizes through a competitive application process, overseen by BSCC. In the 2017 Budget Act, the CalGRIP program, which was restructured to CalVIP, shifted the program away from initiatives targeting gang crime and affiliation toward a narrower and more objective focus on evidence-based violence prevention programs.

CalVIP funds may be used for violence intervention and prevention activities, with preference given to applicants that propose programs that have been shown to be the most effective at reducing violence. Preference was also given to applicants in cities or regions disproportionately affected by violence. City grantees must establish a coordinating and advisory council to prioritize the use of the funds and commit to collaborating with other jurisdictions and agencies with the goal of reducing violence in the city and adjacent areas. The maximum grant provided is $500,000, and at least two will be awarded to cities with populations less than 200,000 people. At least 20% of funds a city receives must go to community-based organizations. Cities must match 100% of the grant money received

Funding for 2019-20 is $30 million with $3 million for competitive grants to cities with populations of 40,000 or less and $1 million set-aside for the City of Los Angeles. From 2020-21 onwards, funding is slated to be $9 million with $1 million set-aside for Los Angeles. The California Board of State and Community Corrections (BSCC) will produce a Legislative Report on this program in March 2020.

This bill will also allocate grant funding to violence prevention community based organizations.

1. Related Legislation

AB 1603 (Wicks) codifies the CalVIP Program. AB 1603 passed the Senate Public Safety Committee by a vote of 7-0 on June 25, 2019.

1. Argument in Support

According to Public Health Advocates:

The OHSC will seek to outline a vision for healing, justice, safety and peace that utilizes the research and evidence from the fields of human and youth development, public health, and community building. Practices that are trauma-informed, culturally appropriate, community centered, and utilize a social determinants of health framework that acknowledges generational trauma, the legacy of sexism, racism, and colonialism is the most effective way to reduce and end violence and promote peace, healing, and safety.

In order for California to stop cycles of violence, a prevention-oriented approach with inter-connected and coordinated strategies, and equitable funding for individuals and communities with the greatest need is required. Public Health Advocates co-sponsors and strongly supports the enactment of AB 656 and we respectfully ask for your support.

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SENATE COMMITTEE ON HEALTH

Senator Dr. Richard Pan, Chair

BILL NO: AB 656

SUBJECT: Office of Healthy and Safe Communities

SUMMARY:

Creates the Office of Healthy and Safe Communities in the Department of Public Health to develop, implement, and monitor a California vision and plan for violence prevention, safety, and healing with goals aligned with funding to drive population-level results for decreasing exposure to violence among California’s most vulnerable people and places.

Existing law:

1. Establishes the Department of Public Health (DPH), which is responsible for various programs relating to the health and safety of Californians, including licensing health facilities, regulating food and drug safety, and monitoring and preventing communicable and chronic diseases. [HSC §131000, et seq.]
2. Establishes the Office of Health Equity (OHE) within DPH, which is tasked with reducing health and mental health disparities to vulnerable communities and to advise and assist other departments in increasing access and quality of culturally and linguistically competent health and mental health services. [HSC §131019.5(b)]
3. Requires DPH to create and maintain the California Electronic Violent Death Reporting System (CalEVDRS). Requires DPH to collect data on violent deaths as reported from data sources, including but not limited to, death certificates, law enforcement reports, and coroner or medical examiner reports. Requires DPH to post on its website a summary and analysis of the collected data. [HSC §131230]

This bill:

1. Creates the Office of Healthy and Safe Communities (OHSC) under the direction of DPH. Requires the Governor to appoint the Director of OHSC. Requires the Director to:
   1. Hire and manage a staff team and consultants to execute the duties of the OHSC;
   2. Assemble an advisory committee;
   3. Develop, implement, and monitor a California vision and plan for violence prevention, safety, and healing with clear systems change goals aligned with funding to drive population-level results for decreasing exposure to violence among California’s most vulnerable people and places, including:
      1. Connect the vision and plan described in this bill to the Governor’s strategies for youth development, criminal and juvenile justice reform, health care services, and other related areas of opportunity;
      2. Develop a strategy and plan for the consolidation, coordination, or alignment of funding for violence intervention and prevention programming;
      3. Identify and integrate trauma-centered diagnostic tools, such as early and periodic screening, diagnosis, and treatment services, to support violence prevention, intervention, and healing; and,
      4. Create an interactive community engagement strategy that prioritizes the voices of people directly impacted and doing the work to prevent violence and promote peace and healing in communities.
   4. Create a learning community of practice that includes community meetings and the sharing of promising practices, research, data, and innovative approaches to violence intervention and prevention throughout California, including supporting coordination and sharing among counties and cities that are advancing a violence prevention strategy and tracking and monitoring data and research on violence statewide and in communities throughout California;
   5. Strengthen the professionalization of community violence intervention and prevention as a licensed occupation; and,
   6. Facilitate the coordination and alignment of programming across statewide departments and agencies, such as DPH, the Department of Corrections and Rehabilitation, the Department of Housing and Community Development, and the State Department of Education, with the potential to support violence intervention and prevention goals utilizing a social determinants of health orientation program that is inclusive of those who are exposed to violence, who have caused harm, and who have been harmed.
2. Requires the Director of the OHSC to establish an advisory committee to inform and guide the execution of the duties of the OHSC. Requires the advisory committee to be selected by the President pro Tempore of the Senate and the Speaker of the Assembly in a manner that reflects the diversity of California and the complexity of violence. Requires the Director to be a member of the advisory committee and to also be comprised of:
   1. Three representatives from communities heavily impacted by violence;
   2. One representative from the Strategic Growth Council;
   3. One representative from the OHE;
   4. One representative from the California State University or University of California;
   5. Three representatives from community organizations working to promote healing and peace;
   6. Three representatives from local governments advancing violence prevention strategies; and,
   7. Two representatives from advocacy organizations advancing prevention, healing, and peace.
3. Requires this bill to be implemented only if appropriate funding, as determined by the DPH, is made available upon appropriation by the Legislature or other sources. Requires the State Public Health Officer to file a written notice with the Legislature when DPH makes this determination.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, costs likely in the range of $1 million to $2 million General Fund ongoing, to staff the Surgeon General and the OHSC and for contract activities to support the assigned duties. The scope and reach of both offices would scale to available resources. Costs to other departments and agencies with which the OHSC would interact are expected to be minor and absorbable.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, violence occurs in relationships, homes, schools, communities, and throughout places where people are confined. These different environments and forms -- from state violence to interpersonal violence--require separate, but coordinated, intersectional strategies to address the factors that contribute to violence at every stage of life. California policymaking and funding have ignored the inter-related nature of different forms of violence, the factors which cause violence, the nuanced environments in which it occurs, and the strategies necessary to promote healing. Because of this, the programs that do exist are woefully inadequate, underfunded, and limited to suppression and intervention at best. Stopping the cycle of violence requires a prevention-oriented approach, inter-connected, and coordinated strategies and funding commensurate with the need and size of the people and places that need these supports.
2. Background. According to the Centers for Disease Control and Prevention (CDC), different forms of violence—child abuse and neglect, youth violence, intimate partner violence, sexual violence, elder abuse and suicidal behavior—are interconnected and often share the same root causes. Several decades of research, prevention, and services have revealed a lot about the different forms of violence and how to prevent and respond to them. One fact clearly emerging from this body of work is that the different forms of violence are strongly interconnected. For example, victims of one form of violence are likely to experience other forms of violence. People who have been violent in one context (e.g., toward peers) are likely to be violent in another context (e.g., toward dating partners). The different forms of violence share common consequences that have health effects across the lifespan such as mental, emotional, physical or social problems. Finally, different forms of violence share common risk and protective factors.
3. Violence in California. According to a May 2019 DPH report, non-fatal violence-related injuries resulted in over 20,000 hospitalizations and over 171,000 emergency department visits in California in 2017. For every 2,000 deaths in due to homicide in 2017, there were approximately 143,000 emergency department visits for injuries due to assault. For every 4,000 deaths due to suicide, there were approximately 34,000 emergency department visits for injuries due to self-harm. Violent deaths (homicide and suicide) are a major public health concern in California that can have immediate and long-term impacts on individuals, families, and entire communities. Over the last decade, more than 60,000 Californians died from either homicide or suicide. In 2017, there were nearly 6,500 violent deaths among California residents (4,323 suicides and 2,113 homicides). Suicides and homicides are leading causes of premature death and are the second and third leading causes of death, respectively, among adolescents and young adults ages 15 to 24. In addition to the human tragedies associated with violent deaths, there are also tremendous economic costs. Based on only medical and work-loss costs, violent deaths result in estimated costs of $8 billion per year in California ($4.9 billion due to suicides and $3.1 billion due to homicides).
4. DPH’s Violence Prevention Initiative (VPI). According to DPH, it assembled an internal task force to focus on violence as a public health risk and explore and clarify the role and contribution of governmental public health in preventing violence in all its forms. This resulted in the establishment of the VPI. The goal of the VPI is to reduce violence and create safer and healthier communities for all Californians, with the purpose of elevating violence as a priority, integrating and aligning efforts across multiple DPH programs, and framing the public health role in addressing violence. According to a 2017 VPI report, exposure to violence has a negative impact on many individual health outcomes. Witnessing or experiencing violence increases the risk of mental health issues and chronic diseases. Violence is also associated with infectious diseases. Violence contributes to these negative health outcomes through trauma and toxic stress. It is also associated with an increase in unhealthy risk behaviors, including alcohol and substance abuse, tobacco use, physical inactivity, early initiation of sexual activity and multiple partners, aggression, revenge seeking behavior, and gang involvement. Trauma extends beyond the individuals who are exposed to violence. There are also serious social and economic consequences of violence for families and communities, and when violence becomes a common occurrence, entire communities can experience trauma on a collective level. Violence is experienced not only as injury but as psychic trauma to individuals and communities and can lead to a breakdown of social networks, social relationships, and positive social norms across the community. Violence and the fear of violence hinder access to basic human needs such as food, shelter, education, and employment.
5. California Violence Intervention and Prevention (CalVIP) Program. The 2017-18 Budget Act provided $1 million to the City of Los Angeles and $8.215 million for other cities and community-based organizations (CBOs) to compete for up to a $500,000 grant under the CalVIP Program, which is administered by the California Board of State and Community Corrections (BSCC). CalVIP funds may be used for violence intervention and prevention activities, with preference given to applicants that propose programs that have been shown to be the most effective at reducing violence. Preference was also given to applicants in cities or regions disproportionately affected by violence. City grantees must establish a coordinating and advisory council to prioritize the use of the funds and commit to collaborating with other jurisdictions and agencies with the goal of reducing violence in the city and adjacent areas. City grantees must also pass through a minimum of 50% of their grant funds to one or more CBOs. A total of $9.2 million was awarded to ten cities and ten CBOs (Cohort 1) for a two-year grant period (May 1, 2018 to April 30, 2020). The 2018-19 Budget Act appropriated an additional $9 million. In addition to the $1 million set-aside for the City of Los Angeles, an additional eight cities and seven CBOs (Cohort 2) were funded for a two-year grant period (September 1, 2018 to August 31, 2020). Funding for 2019-20 is $30 million with $3 million for competitive grants to cities with populations of 40,000 or less and $1 million set-aside for the City of Los Angeles. From 2020-21 onwards, funding is slated to be $9 million with $1 million set-aside for Los Angeles. The BSCC will produce a Legislative Report on this program in March 2020.
6. Double referral. This bill has been double referred. Should it pass this Committee, it will be referred to the Senate Public Safety Committee.
7. Related legislation. AB 18 (Levine) codifies the CalVIP Program and imposes a $25 excise tax on the purchase of firearms. AB 18 was held on the Assembly Appropriations Committee suspense file.

AB 166 (Eduardo Garcia) requires the Department of Health Care Services to establish a five-year violence intervention pilot program, provided by qualified violence professionals, in at least eight counties by January 1, 2021. Establishes requirements for qualified violence prevention professionals, the training for the professionals, and the entities contracting with or employing the professionals. AB 166 passed this Committee by a vote of 7-2 on June 19, 2019.

AB 1603 (Wicks) codifies the CalVIP Program. AB 1603 passed the Senate Public Safety Committee by a vote of 7-0 on June 25, 2019.

1. Prior legislation. SB 934 (Allen of 2018) would have codified the CalVIP grant program. SB 934 was held on the Senate Appropriations Committee suspense file.
   
2. AB 97 (Ting, Chapter 14, Statutes of 2017) the Budget Act of 2017, among other provisions, provided more than $9 million to the BSCC to administer CalVIP grants to cities and CBOs for violence intervention and prevention activities.
3. Support. Supporters write that through the creation of the OHSC, California has an opportunity to advance a bold shift toward violence prevention by emphasizing asset-based empowerment approaches to peacemaking, restorative justice, healing and safety, and advancing community prevention and intervention strategies that heal and restore people and ensure all communities are full of the opportunities necessary for their residents to thrive and be well. The OHSC will seek to outline a vision for healing, justice, safety and peace that utilizes the research and evidence from the fields of human and youth development, public health, and community building. Practices that are trauma-informed, culturally appropriate, community centered, and utilize a social determinants of health framework that acknowledges generational trauma, the legacy of sexism, racism, and colonialism is the most effective way to reduce and end violence and promote peace, healing, and safety. In order for California to stop cycles of violence, a prevention-oriented approach with inter-connected and coordinated strategies and equitable funding for individuals and communities with the greatest need is required.
4. Policy comment. While there is a recognized need for a reduction in violence and safer communities, there are existing efforts towards this end through the VPI, using a public health lens (as this bill proposes to do); CalVIP, which has dedicated funding and clear violence prevention goals; and, CalEDVRS, which is modeled after the CDC’s National Violent Death Reporting System and has the sole goal of violence prevention by compiling comprehensive data for decision-makers and program planners to develop and tailor violence prevention efforts. Additionally, the OHE is tasked with reducing disparities in vulnerable communities in part through building of cross-sectoral partnerships. This bill would create an additional program towards these same goals. The author may wish to instead amend this bill to require increased coordination by existing initiatives already focusing on violence prevention.

SUPPORT AND OPPOSITION:

Support: Alliance for Boys and Men of Color (cosponsor)

Fathers & Families of San Joaquin (cosponsor)

Flourish Agenda (cosponsor)

Latino Coalition for a Healthy California (cosponsor)

LIVE FREE (cosponsor)

MILPA (cosponsor)

Prevention Institute (cosponsor)

Public Health Advocates (cosponsor)

Urban Peace Institute (cosponsor)

California Pan-Ethnic Health Network

California Partnership to End Domestic Violence

California Peace Alliance/ Department of Peacebuilding Campaign

City of Sacramento

Community Coalition

Community Health Councils

Futures Without Violence

Greenlining Institute

Having Our Say Coalition

Human Impact Partners

Latino Coalition for a Healthy California

Los Angeles County Democratic Party

Los Angeles Neighborhood Land Trust

National Center for Youth Law

PICO California

Youth Leadership Institute

Oppose: None received

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ASSEMBLY THIRD READING

ATR Bill Id:AB 656

Author:(Eduardo Garcia)

As Amended Ver:May 16, 2019

Majority vote

SUMMARY:

Establishes the Office of Healthy and Safe Communities (OHSC) under the direction of the California Surgeon General and the Governor, to provide a comprehensive violence prevention strategy.

Major Provisions

1. Creates OHSC under the supervision of the California Surgeon General.
2. States that the Governor and the Surgeon General shall appoint a director of the OHSC.
3. Requires the Director of the OHSC to establish an advisory committee to inform and guide the execution of the duties of the OHSC.
4. States that the advisory committee shall be selected by the President pro Tempore of the Senate and the Speaker of the Assembly and shall reflect the diversity of California and the complexity of violence.
5. Declares that it is the intent of the Legislature in enacting this chapter to create the Office of Healthy and Safe Communities, under the direction of the California Surgeon General and the Governor, to provide a comprehensive violence prevention strategy and to promote and expand the use of, and access to, community-based programs for Californians who are exposed to, involved with, or at risk for involvement in violence. It is the further intent of the Legislature to direct this office to consolidate and administer various violence prevention grant programs and promote the creation of alternatives to incarceration.

COMMENTS:

According to the Author:

"Violence occurs in relationships, homes, schools, communities, and throughout places where people are confined. These different environments and forms -- from state violence to interpersonal violence require separate, but coordinated, intersectional strategies to address the factors that contribute to violence at every stage of life. California policymaking and funding have ignored the inter-related nature of different forms of violence, the factors which cause violence, the nuanced environments in which it occurs, and the strategies necessary to promote healing. Because of this, the programs that do exist are woefully inadequate, underfunded, and limited to suppression and intervention at best. Stopping the cycle of violence requires a prevention-oriented approach, inter-connected, and coordinated strategies and funding commiserate with the need and size of the people and places that need these supports.

"California needs an Office of Healthy and Safe Communities (OHSC). Inspired by Governor Newsom’s Executive Order N-02-19 which appoints a Surgeon General to advise the Governor on policy to address the root causes of health inequities, the OHSC will be overseen by the Surgeon General as the proposed office aligns with the purpose of this new role and position."

Arguments in Support:

According to the Public Health Advocates: "Through the creation of the Office of Healthy and Safe Communities (OHSC), California has an opportunity to advance a bold paradigm shift in violence prevention by emphasizing asset-based empowerment approaches to peacemaking, restorative justice, healing and safety, and advancing community prevention and intervention strategies that heal and restore people and ensure all communities are full of the opportunities necessary for their residents to thrive and be well."

Arguments in Opposition:

None.

FISCAL COMMENTS:

According to the Assembly Appropriations Committee, costs likely in the range of $1 million to $2 million General Fund ongoing, to staff the Surgeon General and the OHSC and for contract activities to support the assigned duties. The scope and reach of both offices would scale to available resources. Costs to other departments and agencies with which the OHSC would interact are expected to be minor and absorbable.

VOTES:

ASM PUBLIC SAFETY: 6-1-1

YES: Jones-Sawyer, Bauer-Kahan, Kamlager-Dove, Quirk, Santiago, Wicks

NO: Lackey

ABS, ABST OR NV: Diep

ASM HEALTH: 11-0-4

YES: Wood, Aguiar-Curry, Bonta, Burke, Carrillo, Limón, McCarty, Nazarian, Ramos, Rodriguez, Santiago

ABS, ABST OR NV: Mayes, Bigelow, Flora, Waldron

ASM APPROPRIATIONS: 14-4-0

YES: Gonzalez, Bloom, Bonta, Calderon, Carrillo, Chau, Diep, Eggman, Gabriel, Eduardo Garcia, Maienschein, Petrie-Norris, Quirk, Robert Rivas

NO: Bigelow, Brough, Fong, Obernolte

UPDATED:

VERSION: May 16, 2019

CONSULTANT: Matthew Fleming / PUB. S. / (916) 319-3744 FN: 0000838

Date of Hearing: May 1, 2019

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 656

Author:(Eduardo Garcia) – As Amended Ver:March 21, 2019

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill creates the Office of Healthy and Safe Communities (OHSC), to be overseen by the Office of the California Surgeon General, to develop, implement and monitor a vision and plan for violence prevention and to perform other functions.

It also appropriates $6 million from the General Fund for the 2019-20 fiscal year for purposes of this bill and for the director of the OHSC to establish an advisory committee.

FISCAL EFFECT:

$6 million GF for fiscal year 2019-20 and an unknown amount, likely in the range of $1 million to $2 million GF ongoing, to staff the Surgeon General and the OHSC and for contract activities to support the assigned duties. The scope and reach of both offices would scale to available resources. Costs to other departments and agencies with which the OHSC would interact are expected to be minor and absorbable.

COMMENTS:

1. Purpose. This bill seeks to provide a comprehensive violence prevention strategy and to promote and expand the use of, and access to, community-based programs for Californians who are exposed to, involved with or at risk for involvement in violence. It also states intent to direct the surgeons general’s office to consolidate and administer various violence prevention grant programs and promote the creation of alternatives to incarceration.
2. Background. Among public health professionals, violence is clearly recognized as a public health problem. In 2015, the California Department of Public Health (CDPH) launched the Violence Prevention Initiative (initiative) by linking efforts of many programs to elevate violence prevention as a departmental priority. Key functions of the initiative include providing actionable data and serving as a convener to facilitate engagement across sectors, systems and initiatives. There is a rich literature on successful public health approaches in general and for violence prevention specifically. Some of the factors for success in addressing public health problems include ensuring the dissemination and consistent implementation of evidence-based interventions, rigorous monitoring and evaluation, partnerships, communication, and political commitment.
3. Surgeon General. On January 21, 2019, Governor Newsom appointed pediatrician Dr. Nadine Burke Harris to the newly created role of state surgeon general. According to the governor’s press release announcing the appointment, Dr. Burke Harris will urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children, with a focus on adverse childhood experiences and toxic stress. According to a 2016 National Academy for State Health Policy (NASHP) report, four states have adopted a state surgeon general model including Arkansas, Florida, Michigan and Pennsylvania. Though roles and responsibilities vary widely across states, state surgeons general have all been physicians who typically serve in an advisory capacity to the state health commissioner, the governor or both are usually charged with providing a voice on public health issues.
4. Related Legislation. AB 887 (Kalra), pending in this committee, also codifies the role of the state surgeon general but places the Office of Health Equity, currently located within CDPH, under the surgeon general’s office.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: April 23, 2019

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:AB 656

Author:(Eduardo Garcia) – As Amended Ver:March 21, 2019

SUBJECT: Office of Healthy and Safe Communities.

SUMMARY: Establishes the Office of Healthy and Safe Communities (OHSC), to be overseen by the California Surgeon General (SG), to among other functions, develop, implement, and monitor a vision and plan for violence prevention. Specifically, this bill:

1. Creates the OHSC and requires the SG to oversee it.
   
2. Requires the Governor and SG to appoint the Director of OHSC.
   
3. Requires the Director of OHSC to perform all of the following duties:
   1. Hire and manage a staff team and consultants to execute the duties of the OHSC;
   2. Assemble an advisory committee as specified in 4) below.
   3. Develop, implement, and monitor a California vision and plan for violence prevention, safety, and healing with clear systems change goals aligned with funding to drive population-level results for decreasing exposure to violence among California’s most vulnerable people and places, including all of the following activities:
      1. Connect the vision and plan described in this bill to the Governor’s strategies for youth development, criminal and juvenile justice reform, health care services, and other related areas of opportunity;
      2. Develop a strategy and plan for the consolidation, coordination, or alignment of funding for violence intervention and prevention programming;
      3. Identify and integrate trauma-centered diagnostic tools, such as early and periodic screening, diagnosis, and treatment services, to support violence prevention, intervention, and healing; and,
      4. Create an interactive community engagement strategy that prioritizes the voices of people directly impacted and doing the work to prevent violence and promote peace and healing in communities.
   4. Create a learning community of practice that includes community meetings and the sharing of promising practices, research, data, and innovative approaches to violence intervention and prevention throughout California, including both of the following activities:
      1. Supporting coordination and sharing among counties and cities that are advancing a violence prevention strategy; and,
      2. Tracking and monitoring data and research on violence statewide and in communities throughout California.
   5. Strengthen the professionalization of community violence intervention and prevention as a licensed occupation.
   6. Facilitate the coordination and alignment of programming across statewide departments and agencies, such as the State Department of Public Health (DPH), the Department of Corrections and Rehabilitation, the Department of Housing and Community Development, and State Department of Education, with the potential to support violence intervention and prevention goals utilizing a social determinants of health orientation program that is inclusive of those who are exposed to violence, who have caused harm, and who have been harmed.
4. Requires the Director of the OHSC to establish an advisory committee to inform and guide the execution of the duties of the OHSC.
   
5. Requires the advisory committee to be selected by the President pro Tempore of the Senate and the Speaker of the Assembly and to reflect the diversity of California and the complexity of violence.
   
6. Specifies the membership of the advisory committee as follows:
   1. Three representatives from communities heavily impacted by violence;
   2. One representative from the Strategic Growth Council;
   3. One representative from the DPH Office of Health Equity (OHE);
   4. One representative from the California State University or University of California systems;
   5. Three representatives from community organizations working to promote healing and peace;
   6. Three representatives from local governments advancing violence prevention strategies; and,
   7. Two representatives from advocacy organizations advancing prevention, healing, and peace.
      
7. Appropriates $6 million from the General Fund for the 2019-20 fiscal year for purposes of this bill.
   
8. States the intent of the Legislature to create the OHSC to provide a comprehensive violence prevention strategy and to promote and expand the use of, and access to, community-based programs for Californians who are exposed to, involved with, or at risk for involvement in violence.
   

EXISTING LAW:

1. Establishes DPH, which is responsible for various programs relating to the health and safety of Californians, including licensing health facilities, regulating food and drug safety, and monitoring and preventing communicable and chronic diseases.
   
2. Establishes within DPH, the OHE which is tasked with reducing health and mental health disparities to vulnerable communities and advise and assist other departments in increasing access and quality of culturally and linguistically competent health and mental health services.
3. Requires DPH to create and maintain the California Electronic Violent Death Reporting System (CalEVDRS). Requires DPH to collect data on violent deaths as reported from data sources, including but not limited to, death certificates, law enforcement reports, and coroner or medical examiner reports. Requires DPH to post on it internet website a summary and analysis of the collected data. Authorizes DPH to enter into a contract with a local agency to collect the violent death data.
4. Permits a law enforcement agency 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.

FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, violence occurs in relationships, homes, schools, communities, and throughout places where people are confined. These different environments and forms of violence - from state violence to interpersonal violence require separate, but coordinated, intersectional strategies to address the factors that contribute to violence at every stage of life. California policymaking and funding have ignored the inter-related nature of different forms of violence, the factors which cause violence, the nuanced environments in which it occurs, and the strategies necessary to promote healing. The author states that because of this, the programs that do exist are woefully inadequate, underfunded, and limited to suppression and intervention at best. The author concludes that stopping the cycle of violence requires a prevention-oriented approach, inter-connected, and coordinated strategies and funding commiserate with the need and size of the people and places that need these supports.
   
   California needs an OHSC. Inspired by Governor Newsom’s Executive Order N-02-19 which appoints a Surgeon General to advise the Governor on policy to address the root causes of health inequities, the OHSC will be overseen by the SG as the proposed office aligns with the purpose of this new role and position.
2. BACKGROUND. The Centers for Disease Control and Prevention defines violent death as a death that results from the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community. Annually, in the United States, seven people per hour die a violent death. According to data from the National Vital Statistics System, more than 19,000 people were victims of homicide and almost 45,000 people died by suicide in 2016 alone (the most recent data available). The economic costs (medical care and lost work) are also staggering with suicide costing the $57 billion and homicide costing $30 billion.
   1. Violence Prevention Initiative in California. In 2015, DPH launched the Violence Prevention Initiative (initiative) by linking efforts of many programs to elevate violence prevention as a departmental priority. Key functions of the initiative include providing actionable data and serving as a convener to facilitate engagement across sectors, systems, and initiatives.
      
      DPH points out that the public health approach to violence prevention focuses on the following four-step process: i) define and monitor the problem; ii) identify risk and protective factors; iii) develop and test prevention strategies; and, iv) assure widespread dissemination of effective practices.
      
      As the first step in defining and monitoring the problem of violence in California, a March 2019 report published by DPH entitled “Preventing Violence in California: Data Brief 1: Overview of Homicide and Suicide Deaths in California,” indicates that over the last decade, more than 60,000 Californians died from either homicide or suicide. In 2017, there were nearly 6,500 violent deaths, 4,323 of which were from suicides, and 2,113 from homicides. Non-fatal violence-related injuries also resulted in over 20,000 hospitalizations and over 171,000 emergency department visits. The greatest number of homicides occur among adolescents and young adults ages 15-24; and the greatest number of suicides occur among adults ages 45-54. Exposure to violence has negative impact on many individual health outcomes, increasing the risk of mental health issues, chronic and infectious diseases due to trauma and toxic stress. Based on only medical and work-loss costs, violent deaths result in estimated costs of $8 billion per year in California, with $4.9 billion of these costs due to suicides and $3.1 billion due to homicides.
   2. Models for State SG (SSG). This bill would require the SG to oversee the OHSC. On January 21, 2019, Governor Newsom appointed Dr. Nadine Harris Burke as the state’s first SG, a pediatrician, whose work links adverse childhood experiences and toxic stress with harmful effects to health later on in life. The SSG model is not unique to California.
      
      In January 2016 the National Academy for State Health Policy (NASHP) published a report entitled “Advancing Healthcare Transformation Through a State Surgeon General Mode: Opportunities and Challenges”. The publication was a product of a September 2015 meeting to identify opportunities and challenges for a SSG model by exploring key issues including roles, responsibilities, governance, financing and sustainability.
      
      According to the report, four states have adopted the SSG model including Arkansas, Florida, Michigan, and Pennsylvania (uses the term “physician general”). In these states, the SSGs have all been physicians who serve in an advisory capacity to the state health commissioner and/or the governor and are usually charged with providing a strong voice to public health issues. In these four states, the governors also appointed the SSGs, and former SSGs reported that they mostly served in non-partisan advisory roles within state government. Below is a brief discussion of the SSG models in these four states:
      1. Arkansas. The Arkansas SSG model was implemented in 2007 when the state decided to rename the governor’s chief health officer to SSG to distinguish this role from that of the state health officer and health director. The position was eventually codified in law, requiring the SSG to be a physician in good standing who serves as a cabinet-level advisor to the Governor and provides guidance on health policy topics including insurance coverage, high risk management, disease prevention and health promotion strategies across state agencies. The SSG is not part of the health department. Since 2007, two SSGs have served in Arkansas.
      2. Florida. Florida established a SSG in 2007, and the position is also codified in statute. The Florida SSG serves a dual role as the director of the health department and the SSG. The SSG is also appointed by the governor and is a physician with experience in public health administration. Since creation, two SSGs have served in Florida.
      3. Michigan. Michigan appointed the first SSG in 2003 to strengthen the state’s public health infrastructure due to multiple years of budget cuts to public health initiatives. Appointed by the governor, Michigan’s SSG mirrors the responsibilities of the US Surgeon General, and serves as the state’s chief public health advocate, and medical advisor. The Michigan SSG reported both to the governor and health department director. The SSG position was not codified in statute, and the position has been vacant since 2010.
      4. Pennsylvania. Pennsylvania’s Physician General was established in 1996, and is appointed by the governor. Codified in statute, the physician general is within the health department, and reports to the health department secretary and sits on four licensing boards. Similar to Michigan, the Physician General serves as medical advisor and public health advocate.

NASHP specifies that prior to adopting an SSG model, states should evaluate their health infrastructure and needs to determine if the SSG could support population health improvement goals without duplicating the roles of other leading health officials or reducing funding available to other state agencies and departments. The following key considerations emerged from the 2015 meeting:

• • 1. States could benefit from a physician leader who is not bound by day-to-day administrative duties to bridge public health with other sectors and advance population health goals;
       
    2. SSGs could best serve a state in three primary capacities: as a medical advisor, a public health advocate, or a health strategist;
       
    3. SSGs should have a clearly defined job description to avoid potential overlap of responsibilities or authority with other state health officials; and,
       
    4. To effectively serve in this post, SSGs need access to adequate resources that do not diminish the resources available to other state agencies.
       
  1. California Violence Intervention and Prevention (CalVIP) Program. The 2017 State Budget Act provided $1 million to the City of Los Angeles and $8.215 million for other cities and community-based organizations (CBOs) to compete for up to a $500,000 grant under the CalVIP Program. CalVIP funds may be used for violence intervention and prevention activities, with preference given to applicants that propose programs that have been shown to be the most effective at reducing violence. Preference was also given to applicants in cities or regions disproportionately affected by violence. To comply with the authorizing statute, city grantees must establish a coordinating and advisory council to prioritize the use of the funds and commit to collaborating and coordinating with area jurisdictions and agencies with the goal of reducing violence in the city and adjacent areas. City grantees must also pass through a minimum of 50% of their grant funds to one or more CBOs. A total of $9.2 million was awarded to 10 cities and ten CBOs (Cohort 1) for a two-year grant period beginning May 1, 2018 and ending April 30, 2020. The 2018 State Budget Act appropriated an additional $9 million for this program. In addition to the $1 million set-aside for the City of Los Angeles, an additional eight cities and seven CBOs (Cohort 2) were funded for a two-year grant period beginning September 1, 2018 and ending August 31, 2020. The Board of State and Community Corrections will produce a Legislative Report on this program in March 2020.

1. SUPPORT. The Alliance for Boys and Men of Color, PICO California, the California Partnership to End Domestic Violence, Human Impact Partners, and Prevention Institute state that with this bill, California has an opportunity to advance a bold shift toward violence prevention by emphasizing asset-based empowerment approaches to, and advance community prevention and intervention strategies that heal and restore people and ensure communities thrive.
2. RELATED LEGISLATION.
   1. AB 166 (Gabriel) requires Medi-Cal to provide coverage for violence preventive services, as defined, provided by a qualified violence prevention professional for a Medi-Cal beneficiary who meets specified criteria. AB 166 is pending in Assembly Health Committee.
   2. AB 656 (Eduardo Garcia) revises the organization of the OHE by requiring the Governor to appoint a SG, as a public entity within the Governor’s direct executive authority, to oversee the OHE. AB 656 is pending in Assembly Health Committee.
   3. AB 18 (Levine), would also codify the CaVIP Program, and imposes a $25 excise tax on the purchase of firearms. AB 18 is pending in Assembly Appropriations Committee.
   4. AB 1603 (Wicks), codifies the CalVIP Program, established by the Budget Act of 2017. AB 1603 is pending in Assembly Appropriations Committee.
3. PREVIOUS LEGISLATION.
   1. SB 934 (Allen) of 2018 would have codified the CalVIP grant program. SB 934 died in the Senate Appropriations Committee.
      
   2. AB 97 (Ting), Chapter 14, Statutes of 2017, the Budget Act of 2017, among other provisions, provided more than $9 million to the Board of State and Community Corrections to administer CalVIP grants to cities and CBOs for violence intervention and prevention activities.
      
4. DOUBLE-REFERRAL. This bill is double-referred. It passed out of the Assembly Public Safety Committee on a 6-1 vote.
5. POLICY COMMENTS.
   1. Where should OHSC be placed? As drafted, this bill creates the OHSC as a stand-alone entity. Given the functions of the OHSC, the Committee may wish to consider whether OHSC should be part of a health or correctional department of the state.
   2. Should the OHSC oversee or coordinate the CalVIP Program? As mentioned above, the CalVIP Program administers grants that can be used for violence intervention and prevention activities, with preference given to applicants that propose programs that have been shown to be the most effective at reducing violence. Since the goal of this bill is to develop, implement, and monitor a vision and plan for violence prevention, the administration of the CalVIP may be appropriately placed with the OHSC.
   3. Should the SG oversee the OHSC? Over three months ago, the Governor appointed California’s first SG. According to a press release on the appointment of Dr. Nadine Harris Burke, the SG will “urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children. Her work will focus on combating the root causes of serious health conditions, like adverse childhood experiences and toxic stress and using the platform of Surgeon General to reach young families across the state.” On April 2, 2019, the California Health and Human Services Agency announced that the SG will conduct a statewide listening tour to raise awareness about the link between adverse childhood experiences, toxic stress and serious health conditions. As NASPH indicated above, a key consideration in the appointment of the SG includes an evaluation of the state’s health infrastructure and needs so as not to duplicate the roles of other leading health officials. Currently, the State Public Health Officer/Director of DPH oversees six Centers, including the Center for Healthy Communities, which among other functions, is tasked with preventing and controlling injuries, violence, deaths, and diseases related to behavioral, environmental, and occupational factors, and promoting and supporting safe and healthy environments in communities and workplaces. Although the duties and functions of the OHSC are broader than DPH as it relates to violence, to avoid duplicating the roles of existing health officials, should the state be given the opportunity to evaluate its health infrastructure before establishing new functions for the SG?
   4. Role of SG. As this bill moves forward, the author may wish to work with the Administration to further clarify and define the role of the SG and the OHSC; and the author of AB 887 (Kalra) which also establishes new functions for the SG.

REGISTERED SUPPORT / OPPOSITION:

Support

Alliance for Boys and Men of Color (sponsor)

California Black Health Network

California Pan - Ethnic Health Network

California Partnership to End Domestic Violence

California Peace Alliance/ Department of Peacebuilding Campaign

City Of Sacramento

Fathers & Families of San Joaquin

Flourish Agenda

Human Impact Partners

Latino Coalition for a Healthy California

Motivating Individual Leadership for Public Advancement

Office of Healthy and Safe Communities
PICO California

Prevention Institute
Public Health Advocates

Urban Peace Institute

Youth Leadership Institute

Opposition

None on file.

Analysis Prepared by: Rosielyn Pulmano / HEALTH / (916) 319-2097

Date of Hearing: April 9, 2019

Counsel: Matthew Fleming

ASSEMBLY COMMITTEE ON PUBLIC SAFETY

Reginald Byron Jones-Sawyer, Sr., Chair

ABPCA Bill Id:AB 656

Author:(Eduardo Garcia) – As Amended Ver:March 21, 2019

SUMMARY:

Establishes Office of Healthy and Safe Communities (OHSC) under the direction of the California Surgeon General and the Governor, which would provide a comprehensive violence prevention strategy. Specifically, this bill:

1. Creates OHSC under the supervision of the California Surgeon General.
   
2. States that the Governor and the Surgeon General shall appoint a director of the OHSC.
   
3. States that the duties of the Director of the OHSC shall be all of the following:
   
   1. Hire and manage a staff team and consultants to execute the duties of the OHSC;
      
   2. Assemble an advisory committee as described in Section 8782;
      
   3. Develop, implement, and monitor a California vision and plan for violence prevention, safety, and healing with clear systems change goals aligned with funding to drive population-level results for decreasing exposure to violence among California’s most vulnerable people and places, including all of the following activities:
      
      1. Connect the vision and plan described in this paragraph to the Governor’s strategies for youth development, criminal and juvenile justice reform, health care services, and other related areas of opportunity.
         
      2. Develop a strategy and plan for the consolidation, coordination, or alignment of funding for violence intervention and prevention programming.
         
      3. Identify and integrate trauma-centered diagnostic tools, such as early and periodic screening, diagnosis, and treatment services, to support violence prevention, intervention, and healing.
         
      4. Create an interactive community engagement strategy that prioritizes the voices of people directly impacted and doing the work to prevent violence and promote peace and healing in communities;
         
   4. Create a learning community of practice that includes community meetings and the sharing of promising practices, research, data, and innovative approaches to violence intervention and prevention throughout California, including both of the following activities:
      
      1. Supporting coordination and sharing among counties and cities that are advancing a violence prevention strategy;
         
      2. Tracking and monitoring data and research on violence statewide and in communities throughout California;
         
   5. Strengthen the professionalization of community violence intervention and prevention as a licensed occupation; and,
      
   6. Facilitate the coordination and alignment of programming across statewide departments and agencies, such as the State Department of Public Health, the Department of Corrections and Rehabilitation, the Department of Housing and Community Development, and State Department of Education, with the potential to support violence intervention and prevention goals utilizing a social determinants of health orientation program that is inclusive of those who are exposed to violence, who have caused harm, and who have been harmed.
      
4. Requires the Director of the OHSC to establish an advisory committee to inform and guide the execution of the duties of the OHSC.
   
5. States that the advisory committee shall be selected by the President pro Tempore of the Senate and the Speaker of the Assembly and shall reflect the diversity of California and the complexity of violence.
   
6. States that the advisory committee shall be comprised of a specified group of persons from various agencies, organizations and community representatives
7. Appropriates six million dollars ($6,000,000) from the General Fund for the 2019–20 fiscal year.
   
8. Declares that it is the intent of the Legislature in enacting this chapter to create the Office of Healthy and Safe Communities, under the direction of the California Surgeon General and the Governor, to provide a comprehensive violence prevention strategy and to promote and expand the use of, and access to, community-based programs for Californians who are exposed to, involved with, or at risk for involvement in violence. It is the further intent of the Legislature to direct this office to consolidate and administer various violence prevention grant programs and promote the creation of alternatives to incarceration.

EXISTING LAW:

1. Makes the following legislative findings:
   
   1. The incidence of violence in our state continues to present an increasing and dominating societal problem that must be addressed at its root causes in order to reduce significantly its effects upon our society.
      
   2. As an initial step toward that goal, the Legislature passed Assembly Bill No. 23 of the 1979–80 Regular Session which created the California Commission on Crime Control and Violence Prevention which was charged with compiling the latest research on root causes of violence, in order to lay the foundation for a credible, effective violence eradication program.
      
   3. The commission produced a final report in 1982 entitled “Ounces of Prevention,” which established that long–term prevention is a valuable and viable public policy and demonstrated that there are reachable root causes of violence in our society.
      
   4. The report contains comprehensive findings and recommendations in 10 broad categorical areas for the removal of individual, familial, and societal causal factors of crime and violence in California.
      
   5. The recommendations in the report are feasible and credible, propose an effective means of resolving conflict and removing the root causes of violence in our society, and should be implemented, so that their value may be provided to our citizenry.
      
   6. It is in the public interest to translate the findings of the California Commission on Crime Control and Violence Prevention into community-empowering, community-activated violence prevention efforts that would educate, inspire, and inform the citizens of California about, coordinate existing programs relating to, and provide direct services addressing the root causes of, violence in California.
      
   7. The recommendations in the report of the commission can serve as both the foundation and guidelines for short-, intermediate-, and long-term programs to address and alleviate violence in California.
      
   8. It is in the public interest to facilitate the highest degree of coordination between, cooperation among, and utilization of public, nonprofit, and private sector resources, programs, agencies, organizations, and institutions toward maximally successful violence prevention and crime control efforts.
      
   9. Prevention is a sound fiscal, as well as social, policy objective. Crime and violence prevention programs can and should yield substantially beneficial results with regard to the exorbitant costs of both violence and crime to the public and private sectors.
      
   10. The Office of Emergency Services is the appropriate state agency to contract for programs addressing the root causes of violence. (Pen. Code §§ 14110 – 14111.)
       
2. Declares legislative intent to be the following:
   
   1. To develop community violence prevention and conflict resolution programs, in the state, based upon the recommendations of the California Commission on Crime Control and Violence Prevention, that would present a balanced, comprehensive educational, intellectual, and experiential approach toward eradicating violence in our society; and,
      
   2. That these programs shall be regulated, and funded pursuant to contracts with the Office of Emergency Services. (Pen Code § 14112.)
      
3. States that first priority shall be given to programs that provide community education, outreach, and coordination, and include creative and effective ways to translate the recommendations of the California Commission on Crime Control and Violence Prevention into practical use in one or more of the following subject areas:
   
   1. Parenting, birthing, early childhood development, self-esteem, and family violence, to include child, spousal, and elderly abuse;
      
   2. Economic factors and institutional racism;
      
   3. Schools and educational factors;
      
   4. Alcohol, diet, drugs, and other biochemical and biological factors;
      
   5. Conflict resolution; and,
      
   6. The media. (Pen. Code § 14114, subd. (a).)
      
4. States that first priority programs may additionally provide specific direct services or contract for those services in one or more of the program areas as necessary to carry out the recommendations of the commission when those services are not otherwise available in the community and existing agencies do not furnish them. (Pen. Code, § 14115.)
   
5. States that second priority shall be given to programs that conform to the same requirements as first priority programs, except that the educational component shall not be mandatory in each subject area, but shall be provided in at least three of those areas, and the programs shall provide specific direct services or contract for services in one or more program areas. (Pen. Code, § 14116.)
   
6. States that each program shall have a governing board or an interagency coordinating team, or both, of at least nine members representing a cross section of existing and recipient, community-based, public and private persons, programs, agencies, organizations, and institutions. Specifies the duties of the governing board or coordinating team. (Pen. Code, § 14117.)
   
7. Requires the Office of Emergency Services (OES) prepare and issue written program, fiscal, and administrative guidelines for the contracted programs that are consistent with this title, including guidelines for identifying recipient programs, agencies, organizations, and institutions, and organizing the coordinating teams. (Pen. Code § 14118, subd. (a).)
   
8. Requires OES to promote, organize, and conduct a series of one-day crime and violence prevention training workshops around the state, as specified. (Pen. Code § 14119.)
   
9. States that programs will be funded, depending on the availability of funds for a period of two years, with OES required to provide 50 percent of the program costs, to a maximum amount of fifty thousand dollars ($50,000) per program per year. The recipient shall provide the remaining 50 percent with other resources which may include in-kind contributions and services. (Pen. Code, § 14120.)

FISCAL EFFECT:

Unknown

COMMENTS:

1. Author's Statement: According to the author, “Violence occurs in relationships, homes, schools, communities, and throughout places where people are confined. These different environments and forms -- from state violence to interpersonal violence require separate, but coordinated, intersectional strategies to address the factors that contribute to violence at every stage of life. California policymaking and funding have ignored the inter-related nature of different forms of violence, the factors which cause violence, the nuanced environments in which it occurs, and the strategies necessary to promote healing. Because of this, the programs that do exist are woefully inadequate, underfunded, and limited to suppression and intervention at best. Stopping the cycle of violence requires a prevention-oriented approach, inter-connected, and coordinated strategies and funding commiserate with the need and size of the people and places that need these supports.

“California needs an Office of Healthy and Safe Communities (OHSC). Inspired by Governor Newsom’s Executive Order N-02-19 which appoints a Surgeon General to advise the Governor on policy to address the root causes of health inequities, the OHSC will be overseen by the Surgeon General as the proposed office aligns with the purpose of this new role and position.”

1. CalVIP Grant Program: The 2017 State Budget Act provided $1 million to the City of Los Angeles and $8.215 million for other cities and CBOs to compete for up to $500,000 each. This Act provided that CalVIP funds could be used for violence intervention and prevention activities, with preference given to applicants that proposed programs that have been shown to be the most effective at reducing violence and to applicants in cities or regions disproportionately affected by violence.
   
   Statute required city grantees to establish a coordinating and advisory council to prioritize the use of the funds, commit to collaborating and coordinating with area jurisdictions and agencies with the goal of reducing violence in the city and adjacent areas and to pass through to CBOs a minimum of 50 percent of their grant award. $9,215,000 was awarded to ten cities and ten CBOs (Cohort 1) for a two-year grant cycle that began on May 1, 2018 and ends on April 30, 2020. The 2018 State Budget Act appropriated an additional $9 million for this program. In addition to a $1 million set aside for the City of Los Angeles, an additional eight cities and seven CBOs (Cohort 2) were funded for a two-year grant cycle that began on September 1, 2018 and ends on August 31, 2020.
   
2. Governor Newsom Executive Order N-02-19: On January 7, 2019, Governor Newsom signed executive order N-02-19 that created the position of Surgeon General of California. (available at: https://www.gov.ca.gov/wp-content/uploads/2019/01/EO-N-02-19-Attested-01.07.19.pdf.) The Governor then appointed Dr. Nadine Burke Harris as California’s first-ever attorney general. (AP, California Governor Appoints First-Ever Surgeon General, Jan. 22, 2019, available at: https://www.nbcnews.com/health/health-news/california-governor-appoints-first-ever-surgeon-general-n961341.) Dr. Harris is a pediatrician, entrepreneur, and CEO of the Center for Youth Wellness in San Francisco. (Id.)

This bill would create the Office of Healthy and Safe Communities (OHSC) under the supervision of the new Surgeon General. OHSC would be tasked with developing, implementing, and monitoring a statewide vision and plan for violence prevention, safety, and healing.

1. The Need for this Bill: Existing law provides for community-based violence prevention programs. In 1984, the Legislature established Title 10 to the Penal Code, entitled “Community Violence Prevention and Conflict Resolution.” That law allows for grants to be given to programs that provide community education, outreach, and coordination, and include creative and effective ways to translate the recommendations of the California Commission on Crime Control and Violence Prevention. More recently, the California Violence Intervention and Prevention Program (CalVIP) was established by AB 97, the Budget Act of 2017. CalVIP funds may be used for violence intervention and prevention activities, with preference given to applicants that propose programs that have been shown to be the most effective at reducing violence. This would create a comprehensive, statewide approach above and beyond the efforts taking place at the local, community level. According to materials provided by the author, similar offices have been established in the states of Washington, Massachusetts, and Maryland.
   
2. Argument in Support: According to the Public Health Advocates: “Through the creation of the Office of Healthy and Safe Communities (OHSC), California has an opportunity to advance a bold paradigm shift in violence prevention by emphasizing asset-based empowerment approaches to peacemaking, restorative justice, healing and safety, and advancing community prevention and intervention strategies that heal and restore people and ensure all communities are full of the opportunities necessary for their residents to thrive and be well.”
   
3. Related Legislation:
   
   1. AB 1603 (Wicks), would codify the California Violence and Intervention Program established by the Budget Act of 2017. AB 1603 is set for hearing on April 9th in the Assembly Public Safety Committee.
      
   2. AB 18 (Levine), would also codify the California Violence and Intervention Program established by the Budget Act of 2017 and impose a $25 excise tax on the purchase of firearms. AB 18 is set for hearing on April 9th in the Assembly Public Safety Committee.
      
4. Prior Legislation: AB 97 (Ting), the Budget Act of 2017, among other things, provided more than nine million dollars ($9,000,000) to the Board of State and Community Corrections for the purpose of administering grants to cities and community-based organizations for violence intervention and prevention activities.

REGISTERED SUPPORT / OPPOSITION:

Support

Motivating Individual Leadership For Public Advancement (Co-Sponsor)
Public Health Advocates (Co-Sponsor)
California Peace Alliance/ Department of Peacebuilding Campaign

Opposition

None

Analysis Prepared by:

Matthew Fleming / PUB. S. / (916) 319-3744