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HomeMy WebLinkAboutMINUTES - 11051996 - D3 T, TO: BOARD OF SUPERVISORS F&HS-04 sE L Contra FROM: FAMILY AND HUMAN SERVICES COMMITTEE 's Costa r.; ` oa County DATE: October 28, 1996 �y REPORT ON IMPLEMENTATION OF THE VIOLENCE PREVENTION SUBJECT: ACTION PLAN AND ITS RELATIONSHIP TO THE REPORT ON FIREARM INJURIES SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. REFER to the Finance Committee the issue of providing sufficient funding to the Health Services Department to permit the implementation of the Countywide Violence Prevention Action Plan, including the issuance of mini- grants to community organizations to implement elements of the Plan. 2. REFER the reports from the Health Services Department to the Policy Forum and the County Administrator to encourage further collaboration among all departments which are involved in the prevention of community violence. 3. ENDORSE all of the recommendations contained in the attached report. 4. REMOVE this item as a referral to our Committee. BACKGROUND: On May 21, 1996, the Board of Supervisors approved a report from our Committee on this subject which included the following recommendations: CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMM E APPROVE OTHER SIGNATURES ACTION OF BOARD ON November 5, 1996 AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSENT ------------- ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED November 5, 1996 Contact: PHIL TCHELOR,CLERK OF THE BOARD OF cc: See Page 3 PERS AND COUNTY A ISTRA R D ,3 F&HS-04 Recommendations regarding the Violence Prevention Action Plan: 1. DIRECT the Health Services Director to identify ways in which the Board of Supervisors could create a Coordinator position for the Violence Prevention Action Plan and fund it,without having to take the funds from another program, including the possibility of sharing the cost among the County, cities and school districts. 2. DIRECT the Health Services Director to identify ways in which the Board of Supervisors could establish a program of mini-grants and matching grants in the area of prevention and fund it, without having to take the funds from another program. 3. DIRECT the County Administrator to agenda a report from the Health Services Director on the above recommendations at a time when our Committee can dedicate sufficient time to the subject to have an in-depth discussion of the need to adequately fund our prevention programs. Recommendations regarding the Firearm Injury Reporting. Surveillance & Tracking Report (FIRST 1. DIRECT the Health Services Director to present the report on Firearm Injuries to the Police Chiefs' Association and seek their comments on the extent to which the information seems to be valid, useful and what recommendations they would have for further follow-up. 2. DIRECT the Health Services Director to present the report on Firearm Injuries to the School District Superintendents and County Superintendent of Schools and seek their comments on the extent to which the information seems to be valid,useful and what recommendations they would have for further follow-up. 3. Recognizing that both pro and anti-gun advocates have firmly held views on this subject, indicate the interest of this Committee in identifying effective strategies and programs which will reduce the incidence of firearms injuries and DIRECT the County Administrator to seek input from all interested parties on what actions by the Board of Supervisors would be most likely to be effective in reducing the incidence of firearm injuries,and, in particular,with reducing the incidence of suicides and unintentional injuries by firearms. 4. DIRECT the Health Services Director to prepare a two or three page paper which describes a timeline over the next 3 to 5 years which discusses whether funding will be available to continue this type of research, whether we can expect to expand the research to do linkage to public safety data bases and whether we can gain an ability to track weapons. 5. DIRECT the County Administrator to schedule a further discussion of this subject with our Committee at which reports on all of the above recommendations can be presented and considered. On October 28, 1996, our Committee met with the Public Health Director, Wendel Brunner, M.D.; the Director of the Prevention Program, Susan Leahy and Cassandra Youngblood from the Prevention Staff; representatives from Crisis & Suicide Intervention, Battered Women's Alternatives, Healing Our Nation from Violence, Legal Community Against Violence, Kaiser Permanente and the 1996-97 Grand Jury. Dr. Brunner and Ms. Leahy reviewed the attached reports and noted that it is not possible to go much further with the implementation of the Action Plan until a full time Coordinator can be appointed. Most grants which are now available are limited to domestic violence. There is very little money available for community violence prevention activities. A portion of the Coordinator position could be funded with existing Matemal and Child Health funds, but the balance would have to come from the County General Fund. Ms. Leahy estimated that she would need between $250,000 and $350,000. -2- F&HS-04 Ms. Leahy noted that staff has met with the Police Chiefs' Association and they were very helpful in providing input about priority areas in which attention should be given. Staff will be meeting with a group of educators on November 4, 1996 to make a similar presentation and seek their input and support. John Batson from Crisis & Suicide Intervention commented in support of the report and the additional problems which are created by the use of guns to commit suicide. Juliet Leftwich of the Legal Community Against Violence noted that her organization has available copies of gun control ordinances which are in use in other jurisdictions and which have been tested by a variety of court challenges. Ellen Schwartz of Healing Our Nation from Violence, Richard Thomson of Kaiser and Valerie Rusted of BWA also provided supportive comments on the importance of funding the Action Plan. Supervisor Smith noted that the Saturday Night Special ban was pending with the Board of Supervisors currently and asked how much money would be required to make a reasonable start at implementing the Action Plan. This was when Ms. Leahy provided the estimate of $250,000 to $350,000. Dr. Brunner noted that staff are working with a variety of community organizations to raise funds for the mini-grants. Our Committee believes that staff has done an outstanding job given the lack of funding which is available. We are supportive of the efforts which have been made and recognize that little else can be accomplished without adequate funding. We are, therefore, recommending that this report be referred to the Finance Committee to attempt to find some means of providing sufficient funds to bring a full time Coordinator on board and provide funding for a program of mini-grants. Because community violence prevention is not a problem which is the province of a single program or department, we are asking that the report also be referred to the Policy Forum and the County Administrator in an effort to insure better collaboration, cooperation and information sharing between departments. Our Committee has reviewed the recommendations contained in the report and believe that all of them are appropriate and should be supported by the Board of Supervisors. cc: County Administrator Finance Committee (Via Tony Enea) Health Services Director Public Health Director Susan Leahy, Director, Prevention Program, HSD Policy Forum (Via Sara Hoffman) -3- D, gE L Contra Costa County = O� Health Services Department Public Health Division n� Administrative Offices +Illilll %� 597 Center Avenue,Suite 200 Martinez,California 94553 (510)313-6712 Sy`q,cdu TO: Family &Human Services Committee Supervisor Jeff Smith, District 2 Supervisor Mark DeSaulnier, District 4 FROM: Wendel Brunner, M.D. Director of Public Health DATE: October 23, 1996 SUBJECT: REPORT ON THE STATUS OF THE IMPLEMENTATION OF THE VIOLENCE PREVENTION PLAN AND FOLLOW UP REPORT ON FIREARM INJURIES The Health Services Department was directed on May 13 and May 22, 1996 to report to the Family &Human Services Committee on the status of the Violence Prevention Action Plan and the report from the Health Services Department on firearm injuries in Contra Costa. The enclosed extensive report developed by staff from the Community Wellness&Prevention Program provides a response to these requests. Countywide Action Plan Part A of the report deals with the countywide Action Plan for violence prevention. The report includes a summary of recent community violence prevention activities, and then addresses the request to identify ways in which the Board of Supervisors can create a position to coordinate the Violence Prevention Action Plan and establish a program of mini-grants and matching grants. The Health Services Department has looked intensively for outside sources of funding to advance these programs. We have had some success in working with the private community to develop resources for community mini-grants. Kaiser Permanente has committed to raising mini-grant funds for the 1997 Increase the Peace Month, and we are working with other Bay Area hospitals around the community benefit requirements of SB 697 to encourage their support for violence prevention. Most of the existing county violence prevention staff are funded by the State Health Department specifically for domestic violence issues, and we currently have few resources to devote to community violence prevention. Increased activity in this area from the Health Department requires the establishment of an Action Plan Coordinator. We are currently negotiating with the State Maternal and Child Health Branch to modify our State MCH budget to allow partial funding for such a position, but additional resources will be necessary. The Board of Supervisors has expressed its commitment to violence prevention, but we are aware that the pressure of competing priorities is intense. Family & Human Services Committee Supervisors DeSaulnier/Smith October 23, 1996 Page 2 Firearm Injury Prevention Part B of the report describes firearm injury prevention activities. We are asked to report on possible additional studies linking public safety databases as a follow-up to our FIRST Report released last Spring. We are consulting with the Contra Costa Police Chiefs Association, whose collaboration was essential for implementing the FIRST Report. We are currently working on a second report, Gender Differences in Homicide in Contra Costa County,which we expect to be completed over the next several months. The attached report identifies a number of other areas for further data development. Evaluation of Violence Prevention Efforts The Board of Supervisors asked us to make efforts to identify effective strategies to reduce the incidence of firearm injuries, and in particular look at methods for evaluating programs' effectiveness. The need to evaluate programs aimed at reducing violence is particularly important, because this is an area where the problems are many and strategies proven to be effective are few. Appendix I summarizes research conducted by staff over the last few months into violence prevention programs throughout the country. In particular, we were interested in the evaluation components of those programs to see whether actual effectiveness could be demonstrated. Evaluating the effectiveness of community programs is very difficult,but is of increasing importance in a time of great needs and limited resources. We have used some of our State Maternal and Child Health funding as well as other grant sources to bring Dr. Chuck McKetney into the Health Services Department, especially to assist in planning and evaluation of family and community programs. Dr. McKetney comes to us from the School of Public Health Center for Family and Community Health, and has both a Ph.D. in Epidemiology and a Master's in Health Education. Chuck will enhance the capability of the Health Services Department to plan and evaluate community health programs in a variety of areas. Recommendations: Section III of the report identifies a number of areas and recommendations for violence prevention activities. Those recommendations include community and provider education,media advocacy and public information, collaboration and coalition building, and finally policy and legislative activities. Preventing community and domestic violence is a major public health issue, and also a major challenge to our communities. The causes of community and domestic violence are multiple; preventing violence will require a combination of many different strategies and approaches. Particularly with a problem as complex and difficult to confront as violence, we must develop new, effective,and quantitative ways to evaluate our programs, so we can concentrate efforts on strategies whose effectiveness can be proven. WB:ah Attachment cc: William Walker, M.D., Health Services Director Report Part A - County Wide Action Plan For Violence Prevention From The Health Services Department To The Family And Human Services Committee October 28, 1996 Summary Of Violence Prevention Project Activities Since Last Report: Community Violence Prevention: Project activities since the last Family and Human Services Committee include: • Continued facilitate the process of Increase the Peace becoming an institutionalized county venue for violence prevention. Previously identified community regional partners have committed their time and resources to make a successful county partnership. Current project goals include producing a public information campaign to increase community awareness and hosting a skill building conference for community advocates. The ITP steering committee has expanded to include both last year's regional coordinators, Juvenile Justice commissioners, along with community leaders, and Kaiser Permanente. Kaiser has demonstrated its vested interest in the success of ITP through donations to regional committees and has committed to raising funds for ITP and providing match dollars. • Staff represented the Health Services Department in support of the East Bay Public Safety Corridor effort to pass firearm injury prevention polices in the corridor cities. The Community Violence Prevention Coordinator testified at Contra Costa city hearings and submitted copies of the FIRST report for the public record. • Formal release of the FIRST (Firearm Injury Reporting Surveillance and Tracking) report accompanied by community presentations. Recommendations for further study and implementation of violence prevention programs are discussed in the Firearm Injury Prevention section of this report. Staff are also monitoring gun show activity via our connection with Cease-fire Contra Costa, which has identified the potential gun show ban as its prime area of concern. • Completed the Tools for Violence Prevention notebook. This notebook will be useful as a reference guide for community agencies that are creating or enhancing existing violence prevention programs. The Violence Prevention Project will also use sections of the notebook as a companion piece to the Action Plan for Violence Prevention, giving concrete examples of how to implement some of the Plans 25 recommendations. • Worked to maintain relations with the PACT coalition, the East County Violence Prevention Task Force, convened by Delta 2000, and Cease-fire, the firearm injury prevention and policy coalition made up of residents from different regions of the county. The Community Violence Prevention Coordinator also provided assistance and leadership in youth programs related to violence prevention, including the Teen 1 Dia Initiatives Project and Youth Vote '96, a project of the Contra Costa County Youth Commission. Domestic Violence Prevention Project Activities: This project is funded by the California Department of Health Services. Project staff funded by this grant include a full time coordinator and .60 of the violence prevention manager. Project activities since the last Family and Human Services Committee include: • Facilitated the implementation of a new coalition in Contra Costa County as part of the March of Dimes of the Greater Bay Area's Prevention of Battering During Teen Pregnancy Project. • Actively represented the Health Services Department on the county's Advisory Council Against Domestic Violence by participating on the ACAD Executive Committee, chairing the Data Committee, and participating on the Community Education, Resources, and Prevention Committee. • Co-sponsored, together with Battered Women's Alternatives and the county Sheriff, a rally to kick-off October as "Domestic Violence Awareness Month" (also drafted a resolution adopted by the Board of Supervisors on October 1 recognizing October as "Domestic Violence Awareness Month"). • Developed a Domestic Violence Training Plan for the Health Services Department to guide training on effective use by HSD staff of the county's Guidelines for Domestic Violence Screening and Reporting. Conducted and analyzed a training needs assessment of HSD staff to inform this training. • Completed within the California Department of Health Services Primary Care & Family Health Division's 1996-98 Injury Prevention Plan's, domestic violence objectives for CDHS statewide clinical and health education programs. • Completed the Domestic Violence Brief Intervention Model for Use in the Perinatal Setting, developed by the Comprehensive Perinatal Services Program's Domestic Violence Task Force. • Completed the Tools for Ending Teen Relationship Violence, developed through the collaborative efforts of participants in the Adolescent Family Life Program's Violence and Substance Abuse Prevention Project. • Coordinated and participated on a panel at the California Department of Social Services' "Fathers, Families, and Communities", conference looking at opportunities for collaboration on relationship violence prevention and intervention among youth 2 D,) programs serving males and females. • Coordinated a presentation on domestic violence intervention in the context of substance abuse treatment/counseling service provision at the first national Harm Reduction Conference, Oakland, CA. II. Funding For The County Wide Action Plan For Violence Prevention: Action Item 1: "...HSD to identify ways in which the Board of Supervisors can create a position to coordinate the Violence Prevention Action Plan..." and; Action Item 2: "...HSD to identify ways in which the Board of Supervisors can establish a program of mini-grants and matching grants...". Current Funding Efforts (Since May, 1996): Partnering With Area Hospitals: The Violence Prevention Manager has been meeting with hospitals throughout the County to identify if any of the SB 697 community benefit funds can be utilized to fund implementation of the Action Plan. This bill requires that community hospitals develop needs assessments and provide support for community health improvement efforts by sponsoring activities and directing funding back to communities. In Contra Costa, all the area hospitals identified violence prevention as a priority. Initial contacts were made to orient the hospitals to past and current violence prevention efforts and the Action Plan, along with funding objectives. The hospitals have indicated that their primary commitment is to directly fund community based organizations rather than the County/Action Plan. Many hospitals did express interest in the Health Department's domestic violence efforts. One area that the hospitals are particularly interested in is assisting the County Health Services Department to leverage funds for the proposed mini-grant program. Kaiser Permanente has committed to raising mini-grant funds for the 1997 Increase The Peace Month. Proposal Development: One proposal and one letter of intent were developed and sent to funding agencies. Both a full proposal which was sent to the City of Concord for working with Jim Hernandez on a violence prevention and firearm injury prevention curriculum and a letter of intent to the Wellness Foundation Violence Prevention Initiative for firearm injury prevention policy activities were not funded. The Department is reviewing the call for applications to the California Endowment. One project being considered includes the Action Plan in the proposal. Currently, staff are 3 reviewing the guidelines to determine which program within the Department is the best fit for this application. A local community endowment, the Knight-Ridder Foundation, has announced its intention to fund a Youth Violence Prevention Initiative. Proposals will be reviewed on an invitation only basis. The county will need to bring the Action Plan to the attention of Foundation staff in order to be considered under the initiative. The Public Health Division has secured the services of a resource development firm to develop a long range funding plan for all the public health-based prevention programs. One top priority in this process is to explore new sources of violence prevention funding. The firm will commence work in the winter of 1996-1997, at which time foundations who may be interested in funding concepts such as the plan. Establishing An Action Plan Coordinator Position And Determine A Funding Mechanism For The Plan: The Health Services Department is still very interested in moving forward with hiring a staff person in the VPP to oversee the implementation of the Action Plan. To that end, the Department is exploring whether part of the funding for the position could be allocated by the Family, Maternal and Child Health Budget. The Department feels-it could support a half time position but would need to locate additional funds for a full time position. Determining A Funding Mechanism For The Action Plan: On August 9, 1996 The Board Of Supervisors unanimously approved, that one-half to one percent of the County's general fund revenues should fund violence prevention programs. The matter was then referred Finance Committee. With some additional fudning, the Public Health Division would have increased ability to leverage and match a county commitment with foundation and other sources of funding. The Health Services Department can contribute a small proportion of the funds for the Action Plan Coordinator, making up the balance with the general fund. The Action Plan position, in turn, could work to develop partnerships with foundations, corporations, and cities to match the initial County contribution and immediately set off an initial mini-grant program to community-based agencies to implement the recommendations found in the Plan. With additional baseline support, staff could take the following steps: • Match the Health Services Department's contribution to the Action Plan Coordinator to hire a full-time coordinator. • Develop new proposals that request that community foundations match the county contribution. 4 • Request that cities dedicate a modest amount to match the county funding. • Develop a campaign to reach out to area corporations to fund the mini-grant program. Financial Mechanisms To Explore For The Action Plan: In addition to acting on the Board Order to set aside a percentage of the general fund to sustain baseline activities, fees and sales tax mechanisms, although politically challenging to achieve, could also be explored. Examples include: • Establish a sales tax or gross receipts tax on handguns and firearms. • Establish a sales tax on ammunition. Summary: In essence, the Department currently finds itself in a difficult situation with regard to implementing the Action Plan. While the commitment remains, most existing staff are dedicated to the domestic violence prevention grant award and cannot dedicate the real time needed to move this issue forward. Until the Department can bring on an Action Plan Coordinator, even part time, it is unlikely that ongoing dedicated time will be available to develop the necessary funding proposals, develop the partnerships required, or sustain the sophisticated level of program development that will be required to implement the Plan. 5 Part B - Firearm Injury Prevention From The Health Services Department To The Family And Human Services Committee October 28, 1996 The report that follows addressees the Action Items generated during the May 13, 1996 Family and Human Services Committee of the Contra Costa Board of Supervisors. The report first introduces background and information on key areas for firearm injury research and then presents Health Services Department recommendations on programs and strategies that may be effective in reducing homicide, suicide, and unintentional injury and death from firearms. Finally, the report presents recommendations, based on the findings in the FIRST report, obtained from the School Superintendents, the Police Chief's Association, and the East County Violence Prevention Task Force. I. Action Item 4: "...describe a time line over the next three to five years which discusses whether funding will be available to continue this type of(firearm) research, whether we can expect to expand the research to do linkage to public safety data bases and whether we can gain the ability to track weapons." Background: The purpose of the Community Wellness & Prevention Program data projects has been to provide the Contra Costa County Health Services Department and its community partners with a better understanding of the size, scope, and effects of violent injury in order to better plan injury prevention programs and policy. Data are critical in assessing the extent of violent injuries and developing appropriate programs and policies. With accurate data, public health practitioners can identify communities most at risk for violence, implement prevention strategies, and evaluate the impact and the outcomes of their work. Data can also provide individuals and organizations involved in violence prevention with a better understanding of the risk factors for violent injuries. To date, the Community Wellness & Prevention Program has produced three data reports highlighting the local problem of violent injury, including the role of firearms. In 1992, the Program produced a baseline study entitled: The Status Report of Childhood Injury, using California Department of Health Services, vital statistics data and available hospital discharge data from the Office of Statewide Health Planning and Development. This report found that firearms were the leading cause of injury death in the county for children ages ten to 19. In October 1994, the Program released its Profile of Violent Injury in Contra Costa. This study analyzed violent injury (including domestic violence and suicide) as it affected all age groups and ethnicities. In addition to the public health injury morbidity and mortality data used previously, this report also included for the first time data from the California Justice Department and the Contra Costa County Coroner's Office. Contra Costa County's Firearm Injury Reporting, Surveillance and Tracking (FIRST) 6 Project was one of the first firearm injury surveillance systems to be implemented in the United States. Funded by a one and a half year grant from the State of California Emergency Medical Services Authority and published by the Health Services Department, the Profile of Firearm Injuries and Death in Contra Costa County: A Report of the Firearm Injury Reporting, Surveillance and Tracking (FIRST) Project describes the firearm injuries and deaths that occurred in the county between July 1, 1993 and June 30, 1994. Program Evaluation: The Community Wellness and Prevention Program also has a keen interest in evaluating the effectiveness of HSD violence prevention efforts. Past evaluation efforts have included an evaluation of the PACT project, which was the primary funded violence prevention project coordinated by the Health Services Department. Staff are currently developing an evaluation for the Domestic Violence Prevention Projects efforts to prevent domestic violence through training and interventions with health care providers. Evaluation staff also provide technical assistance to local community based organizations to help them better understand how to evaluate programs and document the effectiveness of their efforts. Current Violence Data Projects: CW&PP's Health Data and Program Evaluation Unit plans to continue its support of the HSD's violence prevention programs by providing descriptive, ongoing epidemiologic analysis and technical assistance on evaluation design and implementation. Currently, CW&PP plans include: • To continue the use of injury morbidity and mortality data within program planning and evaluation. Firearm injury deaths and hospitalized injuries will be monitored using available data sets. Victim residence data will be used to examine and map communities at greatest risk of firearm injury. • To release in the Winter of 1996 the report: Gender Differences in Homicide in Contra Costa County, a study utilizing 12 years worth of the Federal Bureau of Investigation's Uniform Crime Reporting data. The report will include recommendations for local domestic violence prevention programs and policies. • To collaborate with the Contra Costa County Sheriff's Office on implementation of its COPS domestic violence prevention grant, especially on data collection and linkage to other public safety databases, and on use of domestic violence data collected within their county wide surveillance system. This project is set to come on line in the Winter of 1996. • To continue to seek opportunities to collaborate or integrate efforts with other HSD data collection efforts, such as the Healthy Neighborhoods Project and the North 7 Richmond Center for Health. Through the needs assessment and community surveys conducted by these efforts, there may be opportunities to replicate, at a local level, statewide Behavioral Risk Factor survey questions regarding gun ownership, gun storage, weapon use for self defense, domestic violence screening, weapon carrying by students on school grounds, or youth fighting. • To participate in the work of the East Bay Corridor's Violence Prevention Project which includes collaboration with Alameda and Contra Costa County law enforcement agencies on firearm/weapon tracking projects. Resource Development: CW&PP's Health Data and Program Evaluation Unit has both the capacity and desire to continue doing primary data collection projects, such as FIRST. Projects like these give CW&PP the most control in designing research questions to meet specific program planning and evaluation needs. Understandably, implementing original research projects often requires much greater resources than projects utilizing existing/secondary data sources. The Public Health Division looks for resources to support data projects in an ongoing fashion. All resources for data funding have come from outside sources, including the California Department of Health Services and the Emergency Medical Services Authority. In new program proposals, attempts are made to build in both baseline data collection and evaluation. However, granting agencies prefer to fund program interventions rather than original research. Over the next three to five years, it would be reasonable to expect the HSD to prepare and submit proposals to funding sources, such as the Centers for Disease Control and Prevention, who are interested in original research. Original research projects often require full time staffing (in addition to existing data analysis staff), as well as special computer equipment. Results are not immediate; there is often a lagtime between study design/data collection and data analysis. CW&PP will continue to seek resources from public and private funding sources interested in supporting local violence research projects. Firearm-Related Data And Research Projects Which Would Require Additional Resources: • To evaluate domestic violence protocols in place within Contra Costa hospitals and public health clinics. Establish the reporting rate for domestic violence-related injuries seen in Contra Costa hospitals, and determine barriers to reporting suspected or confirmed injuries. To replicate the FIRST Project at a cost of approximately $100,000 per year. Re- establishing the reporting relationships and surveillance system for an additional year would allow comparisons to be made over time. Changes in firearm injury and death 8 r rates could be determined, as well as any changes in the profile of circumstances, perpetrators, and victims. • To research how Contra Costa County youth obtain and/or illegally purchase guns, their reasons/attitudes about possessing guns, etc. Depending on available resources, this research could be done through focus groups, surveys, or interviews. Findings would support policies/programs designed to limit illegal youth access to firearms. • To design and implement an evaluation of the recently passed residential gun dealer ordinance. This would require a collaboration with Community Development, cities, and the ATF. II. Action Item 3: "...identify effective strategies and programs which will reduce the incidence of firearm injuries...and, in particular, will reduce the incidence of suicide and unintentional injuries by firearms." Based on three injury studies produced by the Health Services Department, the VPP presents below its recommendations for the preventing firearm morbidity and mortality from a public health perspective. The recommendations are organized along the levels of the Spectrum of Prevention. These program and policy recommendations, should they be implemented, should also have well-constructed evaluations and ongoing baseline data collection to assess their overall effectiveness. The recommendations, along with the input provided during the October 28, 1996 hearing, will provide an excellent body of advisory input for pursuing program efforts. Health Services Department Recommendations For The Prevention Of Firearm Morbidity And Mortality: Background. Because firearms are involved in the highest proportion of intentional injury and death in the county, most past and existing HSD and community based violence prevention have focused in large part on firearms. This report focuses specifically on recommendations for firearm injury prevention that could be implemented in a Health Services Department based program in collaboration with community based organizations, law enforcement and policy makers. For that reason, staff have included only those recommendations specifically pertaining to firearm as the mechanism of the injury. The reader should keep in mind, however, that the Health Services Department strongly supports all of the recommendations made in the County wide Action Plan For Violence Prevention and believes that, when funded and implemented, the Action Plan will have a significant impact on reducing the number of deaths and injuries caused by firearms. In addition to the HSD's program history of the Health Services Department in this area, (VPP) staff conducted research from June to August 1996 on national and local firearm injury, suicide prevention and unintentional injury programs, undertook 9 literature reviews, interviewed local violence prevention program staff, and drew on the previous program experience of the Health Services Department to address the above action item. In all, 50 programs were contacted (the full list of contacts is attached for review). Staff requested information on the nature of the program and on whether or not the program has been evaluated, the nature of the evaluation, and the findings from any evaluation conducted (the review of evaluated programs is also attached for review). 1. Prevention Of Homicide & Assault By Firearms: Community And Provider Education Recommendations: • Facilitate application of the Straight Talk About Risks (STAR) curriculum within school and community based settings. Of all of the programs that VPP staff reviewed, this curriculum developed by Hand Gun Control Inc., is the most comprehensive. The curriculum is skill and behavior based, aiming to increase awareness . Youth who are involved in the program are given hands- on strategies to practice; designed to increase their ability to apply prevention- related behaviors to potentially lethal situations. The curriculum is adaptable to local conditions and need and is available in English and Spanish. The curriculum can be implemented with youth ranging from kindergarten through the 12th grade. Evaluation of STAR: STAR conducted a formative evaluation in school districts in California and New Jersey, using focus groups and teacher surveys. The formative evaluation found that 83% of K-2 grade teachers, 92% of third to fifth grade teachers, 95% of sixth to eighth grade teachers, and 100% of high school teachers surveyed would use the program again. The STAR program has an outcome oriented evaluation projected to begin in 1996 and extend for a number of years. Curriculum research revealed that a majority of the violence prevention programs do not undergo evaluation that would identify successful components and tangible outcomes. The availability of an evaluation is an additional reason for recommending the STAR curriculum. Media Advocacy And Public Information Recommendations: • Support implementation of community needs assessment in areas of the county with high rates of firearm violence. Many programs utilize this tool, including those within the Public Health Division. The Health Services Department could then collaborate with such programs to link violence prevention messages with those of existing programs. An example of this is seen in a youth leadership group which conducted a needs assessment of a neighborhood in Richmond. Developed by a community-based agency, program participants noted which areas of their neighborhood were safe and which were 10 D -3 not. They then went about identifying existing resources to create safety within the most crime-ridden areas. • Promote messages of peace emphasizing the dangers of firearms through bus placards, cable television, radio, and print media. Utilize work already produced by numerous community agencies schools, and state and nationwide firearm injury prevention organizations. • Link with Youth Radio program in Alameda county to promote Contra Costa County youth expressions of peace and support for firearm violence prevention. • Expand the annual Increase the Peace campaign to provide year-round messages about the need to prevent firearm injuries and death through community newsletters and op-ed pieces. Collaboration & Coalition Building Recommendations: • Maintain existing collaborative relationships with the PACT Coalition; Cease- fire Contra Costa , and the East County Violence Prevention Task Force. Develop relationships with members of the Central County Increase the Peace campaign planning body. • Maintain relationship with the Safefutures project. Participate by finding opportunities to integrate firearm injury prevention into program plans and strategies. • Pursue additional collaboration by establishing an advisory network with representation from the Center to Prevent Handgun Violence, county school districts, the Safe Futures Project, the East Bay Public Safety Corridor and community based organizations in order to implement the STAR curriculum in school and community settings. Integration of the STAR curriculum should also be informed by collaboration with the County Director of Alternative Education, Drug, Alcohol, and Tobacco Education (DATE) Coordinators, County Office of Education, law enforcement, cities, probation, juvenile justice, community-based organizations, the Ceasfire Coalition, Healthy Start Coordinators, and county wide youth leadership groups such as the Tobacco Youth Task Group, Teen Initiative Project, East Bay Public Safety Corridor Youth Leaders, and County Youth Commission. Policy And Legislative Recommendations: Background: • Existing policy to restrict access to firearms by youth includes the title 11 D.3 residential gun dealer ordinance passed by the Board of Supervisors and the Cities of Antioch, El Cerrito, Hercules, Lafayette, Pinole, Richmond, and San Pablo. • The East Bay Public Safety Corridor is working to pass to a ban on the sale of Saturday Night Special handguns. The policy has been passed in the Cities of El Cerrito, Richmond and San Pablo. Eight cities in Alameda County have also passed the policy, as has San Francisco. An ordinance requiring that trigger locks be sold with all guns has been passed in three Alameda county cities; in two Contra Costa cities, and Contra Costa County (a summary of the status of firearm related-policies in Contra Costa County is attached to this report). • The East Bay Public Safety Corridor is working to pass gross receipts sales tax to all items sold in gun shops. San Francisco has already passed such an ordinance; and the Cities of Berkeley, Oakland and San Leandro are now considering the gross receipts sales tax ordinances. • The Board of Supervisors has passed a resolution to request that the State Fairgrounds Board restrict gun shows on the public fairgrounds in Antioch. Recommendations: • Continue to collaborate with and support the policy efforts of the East Bay Public Safety Corridor to pass the Saturday Night Special weapons ban, the gross sales receipt tax, and the trigger lock requirements. • Work with the Board of Supervisors and Mayors to introduce the Saturday Night Special Ban, the gross sales receipt tax, and the trigger lock requirements in Central and East regions of the County. • Continue to support the Board of Supervisors ban on the holding of gun shows at the Antioch Fairgrounds. Continue to provide data on the status of the problem of firearm injury at Fairgrounds Board hearings. • Review the State initiatives and firearms legislation to be introduced by Assemblyman Caldera at the beginning of the new legislative session. VPP staff interviews with staff from Assemblyman Caldera's office indicate that two key bills may be introduced during the next session, including efforts to limit Saturday Night Specials and pursue legislation to allow "home rule" and lift state preemption for firearm regulation. Based on this review, develop recommendations for a Board of Supervisors position on the legislation. Prevention Of Suicide By Firearms: 12 Background: Based on the finding in the FIRST report, the Health Services Department is very interested in increasing capacity to prevent suicide and suicide attempts among those at highest risk for suicide. VPP staff research on existing programs indicate that the etiology of suicide is very complex and very few studies exist discussing the effectiveness of education and policy prevention regarding suicide. Staff review of the literature in this revealed that, (1) because of the relationship of suicide and depression, community linkages between suicide prevention programs and existing community mental health are strongly encouraged; (2) while there is evidence that restricting access to guns and drugs and reducing other risk factors for suicide, e.g., alcohol can help prevent suicide, few programs use this approach in their suicide prevention curricula. VPP staff met with Brian Surgue, the Community Education Director from Contra Cost Crisis and Suicide Intervention Services (CCCSIS), to present the findings from FIRST to explore what activities are currently in place in the community, and encourage increased collaboration between CCCSIS, the Public Health Division, and other programs with an interest in suicide prevention. CCCSIS has a long history of offering school-based suicide prevention presentations to high school students. From 1984 to 1989, CCCSIS helped to found two Health Services Department-based coalitions, the Alternatives to Violence and Abuse Coalition and the Unemployment Resources Task Force. The CCCSIS Executive Director and Community Education Coordinator have both indicated their interest in attending the October 28 Committee to provide input into the suicide prevention recommendations. Community And Provider Education Recommendations: • Explore the delivery of educational messages through physician counseling, per the American Academy of Pediatrics recommendations to parents regarding the safe storage of guns and ammunition. • Develop an HSD-CCCSIS partnership to implement training for health care, youth service , and mental health providers on causes and risk factors for suicide among various populations. • Explore replication of the Monterey County Health Department's (MCHD) suicide and unintentional injury prevention program. MCHD has developed a gun storage education and trigger lock coupon program that is directed at parents who have guns in their homes and health care providers. The program educates health department staff on the dangers of suicide and unintentional 13 firearm-related injuries. MCHD also works with local gun dealers to offer 25% off trigger lock coupons to health care providers, including WIC, and distributes the coupons to parents via a local coalition. • Adopt the STAR curriculum as discussed above with a component emphasizing educational messages to ten to 14 year olds on how to behave and respond when they find a firearm in the home, school, or other community setting. Media Advocacy And Public Information Recommendations: • Expand Increase The Peace to include agencies that provide services to adults, parents, and youth in the highest risk age groups for suicide. Assist agencies in promoting suicide prevention messages to their constituencies. Emphasize the lethality of guns in suicide attempts. Collaboration & Coalition Building Recommendations: • Seek funding for a HSD-community collaboration to prevent injuries to the elderly, such as that described in a proposal recently denied CDC funding. • Increased collaboration with Crisis and Suicide Intervention and Health Services, with an emphasis on prevention programs in Public Health and Mental Health. • Identify and pursue collaborations with agencies that serve the older population of the county to increase awareness that older white males are at greatest risk in Contra Costa County for suicide attempts. • Explore the establishment of crisis intervention teams to address the contributing factors to suicide. • Explore the establishment of collaborative programs to help youth cope with crisis which might cause depression, such as peer counseling/mediation in schools and drug and alcohol awareness/intervention, as per the CDC's recommendation that no program be implemented in a vacuum, but in conjunction with other support services. Policy And Legislative Recommendation: • Support the efforts of the East Bay Public Safety Corridor to pass trigger lock requirements, which will limit access to firearms of children and youth who may be suicidal. 14 Prevention Of Unintentional Firearm Injury: Background: Based on the three studies conducted by the Health Services Department, the most recent of which is being the FIRST report, unintentional shootings make up only 8% of the total cases of firearm injury and death in Contra Costa. The age group most at risk for unintentional shooting are ten to 14 year old males. There are limited policies and no local programs in place that address youth access to firearms. Children are most likely to be injured in their own home or in the home of an acquaintance where there is easy access to a loaded firearm. Therefore, the key audience for education and public information messages are both the youth and their parents or other family members. Community And Provider Education Recommendations: • Explore the delivery of educational messages through physician counseling, per the American Academy of Pediatrics recommendations to parents regarding the safe storage of guns and ammunition. • As stated above, explore replication of the Monterey County Health Department's (MCHD) suicide and unintentional injury prevention program. • Adopt the STAR curriculum. As above, with a component to emphasizing educational messages to ten to 14 year olds on how to behave and respond when they find a firearm in the home, school, or other community setting. Media Advocacy And Public Information Recommendations: • Expand Increase The Peace to include agencies that provide service to adults, parents, and youth in the highest risk age groups for unintentional firearm injury. Assist agencies in promoting unintentional firearm injury messages to their constituencies. • Use media advocacy approaches to support policies directed at increasing the safe storage of firearms and the sale and use of trigger locks. • Use public information strategies to promote unintentional educational messages to providers, parents and youth in the highest risk age groups for unintentional firearm injury. • Support efforts to reduce the current level of violent media and television programming directed towards young children and promote increased media and programming that includes conflict resolution scenarios. 15 D3 • Support the American Academy of Pediatrics recommendations on informing parents of the dangers of keeping guns in homes where young children live. Identify and collaborate with Academy branches in Contra Costa county to increase public awareness. Collaboration And Coalition Building Recommendations: • Increase collaboration between the Violence Prevention Project, the Childhood Injury Prevention Coalition (CIPC), and Handgun Control Inc. to provide advisory input into any unintentional firearm injury prevention programs that are initiated. • Involve CIPC and its 40 member agencies in the annual Increase The Peace campaign. • Distribute via CIPC information to providers and parents on the problem of unintentional firearm injury, the groups most at risk and how the use of trigger locks and safe storage can reduce the number of unintentional firearm injuries. Policy & Legislative Recommendation: • To prevent suicide and unintentional injury, explore the development of gun storage polices recommended by the American Academy of Pediatrics to prevent access to firearms by youth and children and to prevent the theft of firearms from private homes, including the use of strong boxes and separation of the guns from ammunition. Conclusion: All of these recommendations can become vital input into local programming. The Health Services Department has prioritized funding for the implementation of the Action Plan as the first area for resources, followed by funding for firearm injury policy and education programs. Since the establishment of the Violence Prevention Project, the Health Services Department has primarily addressed the prevention of intentional assault and homicide by firearms because over 90% of firearm deaths in Contra Costa County are homicides. However, the Department is interested in increasing its capacity to address suicide and unintentional shootings and developing new partnerships to address these injury areas. The current barriers to implementation at this time remain the same as those addressed in the May 7, 1996 report to the Family and Human Services Committee. The first barrier is related to funding. The Violence Prevention Project from its founding was funded exclusively by State and Federal sources. With the loss of those funds and lack of additional funding, the VPP project has suffered significant set-backs in its ability to maintain existing program efforts and initiated new ones based on our recent data. The second barrier, also related to 16 D. 3 funding, is that of having in adequate staff to maintain collaborative coalitions and networks of violence prevention practitioners in the community. As was stated in the May 7 report, the HSD is working to maintain some minimal staffing and is working on a resource development plan for violence prevention. 1 III. Action Item 1 and 2: "...Health Services Director to present the report on Firearm Injuries (FIRST) to the Police Chiefs' Association and seek their comments on the extent to which the information seems to be valid, useful and what recommendations they would have for further follow up....Present the FIRST report to the School District Superintendents and County Superintendent of Schools and seek their comments...". Staff contacted the Police Chiefs' Association and the County Superintendent of schools in June to set dates to present the FIRST report. Both groups were interested in receiving the presentation. Contact was made with the Superintendent of Schools shortly after the May Family and Human Services Committee. The Superintendent requested that the presentation be deferred until the new Superintendent, Dr. Ovick, came on board in September. Dr. Ovick, felt that the Superintendents were not the only audience for input into the FIRST report and requested that VPP staff also present to educators who work more directly with the student population. Thus, he referred the matter to the Director of Alternative Education, Bianca Bloom. The VPP has continued to work with Ms. Bloom to schedule a presentation. Unfortunately, this presentation could not be scheduled until November 4, 1996. The recommendations generated from this presentation will be forwarded to the Family and Human Services Committee (see attached). Because VPP staff did not have the opportunity to obtain recommendations from the school, the FIRST report was presented to the East County Community Action Coalition, a body made up of non-profits and community members who meet to address community needs in East Contra Costa. They had a strong interest in the findings and indicated that the data was relevant and useful to their work. A. Recommendations For Firearm Injury Prevention Made By The Police Chief's Association: The FIRST Report was well received by the Chief's Association and they felt that the findings were a reflection of the problem as they are seeing it in their work. Namely, that the priority area to be addressed is interpersonal assaults and homicides in West Contra Costa. They did not provide specific program recommendations in the area of education or policy, but did provided excellent input into how firearm injury and violence prevention programs should be structured to be more effective. They also provided feedback to staff on how the information contained in this report as well as areas of future study indicated below would aid their work. 17 D,3 Recommendations For Establishing Firearm Injury Prevention Programs: -Focus current program resources to where there is the greatest problem, specifically, in West Contra Costa to address firearm homicide and assaults. -They felt many of the current efforts and programs are fragmented and competing for funding. They recommended that resources should be consolidated and focused to address the issues. -Rather than continuing to do "band-aid" type programs, they would like to see county government address the root causes of violence, namely, poverty and unemployment. -Define what success is in violence prevention efforts. -Work to make programs more results oriented and increase program evaluation. Support those programs and policies that are determined to be effective. -Develop a multi-agency - government partnership to address this issue. Recommendations For Further Study & Ways To Improve The Existing Data: -The FIRST Report provides a good starting point for prevention and they would like to see increased study of West County shootings and circumstances. -Study the contributing factors of violence such as unemployment, poverty and alcohol and other drug use. -Direct future reports to address the issue of domestic and partner abuse. •Increased attention and study to the purpose and or greater detail behind the circumstance of a shooting. This would provided the crime prevention staff with better data. -One area included in the report involved "circumstance" of the injury or homicide. The Chief's association would like more information regarding this finding. Staff utilized police reports to gather the data reflected in this table. Because the cases were frequently not resolved at the time the data was collected there was concern that it was not a true reflection of circumstances in which a firearm was used. Staff will look at the raw data again and work to provide additional tables that would be of greater use to Police. 18 . e �. 3 B. Recommendations For Firearm Injury Prevention Made By The East County Community Action Coalition: Community Education Strategies: • Provide police with sensitivity training, to increase their knowledge of domestic violence and substance abuse and assist them in dealing with these situations in community settings. • Provide comprehensive violence prevention programs for youth with the following elements: • Peer education. • Education in schools, juvenile hall, shelters, and Independent Living Centers. • Parent and Parent/Teachers Association (PTA) involvement. • Start'youth education early (ideally 6th grade). • Revise overall school curriculum to include violence prevention as a required life skills course for graduation. • Utilize community colleges as a possible pool of peer educators. • Generate violence prevention proposals in collaboration with the Health Services Department to include the following concepts: • Sufficient planning and significant implementation period. • Collaboration with cities, counties, government entities, and community leaders to initiate substantive environmental changes. Create widespread support systems for those re-entering the community after violent episodes, i.e., gang disengagement, crime, drug use. Policy And Legislation: • Implement and support increased regulation of gun sales and circulation. 19 i APPENDIX 1 Evaluation of National Violence Prevention Programs A search was conducted by utilizing the following major resource centers for violence prevention programs. Other programs discussed in this report were identified through Handgun Control Incorporated and the National Rifle Association. 1. National Center for Injury Prevention and Control, Center for Disease Control. Eleven violence prevention projects evaluated with the help of CDC funding. To date, only received information on the following: a. RCCP (Resolving Conflict Creatively) Tom Roderick, (212) 870-3318 b. PeaceBuilders Henry Atha, (602) 740-5205 c. SMART Kris-Bosworth, PhD, (812) 856-8133 d. Yes I.Can L. Rowell Huesmann, PhD, (313) 764-8385 e. Attributional Retraining on Aggression Reduction Cynthia Hudley, PhD, (805) 893-8324 2. Identified large violence prevention programs with focus on firearms: a. STAR (310) 475-6714 (in CA), (202) 289-7319 (in D.C.) b. Eddie Eagle (800) 231-0752. No evaluation. c. Second Step (800) 634-4494 3. Carnegie Council on Adolescent Development. Publication: The State of the Art of Program Evaluation. (202) 429-7979. 4. Prevention Violence: A Framework for Schools and Communities A number of programs discussed in this directory were contacted to determine if there were any program evaluations. 5. National Directory of Youth Violence Prevention Resources Contacted a number of programs and institutes to determine if they had conducted any evaluation on the effectiveness of various programs/approaches. Following is a summary of the results of the program search. The programs were divided into six program areas including: handgun violence prevention, general violence prevention, school and family/community, conflict resolution/peer mediation, "high-risk" adolescent, evaluation guidelines. 1. Handgun Violence Prevention Projects: a. STAR (Straight Talk About Risks) Curriculum Developed by the Center to Prevent Handgun Violence Program: A grade specific, pre-K through 12th grade curriculum aimed at reducing firearm related violence. New Jersey Evaluation: Primarily formative in nature and based on focus groups and teacher responses to a survey. Results: Many schools linked STAR to other prevention programs, including self-esteem development, values education, conflict mediation, drug abuse prevention, crime prevention. Many schools fit STAR into subject areas, including English, Language Arts, and U.S. History. General positive feeling that students learned how to deal better with threatening firearm related situations, and conflict management. L.A. Evaluation: Again, primarily formative in nature, conducted looking at LA schools (3-12 grade) and NYC schools (pre-K through 2nd grade). Results: Found that 83% of preK-2 grade teachers, 92% of 3-5 grade teachers, 95% of 6-8 grade teachers, and 100% of 9-12 grade teachers would use the program again. The STAR program has an outcome oriented evaluation projected to begin in this year (1996) and to extend for a number of years. b. Eddie Eagle Gun Safety Developed by the National Rifle Association (NRA) (800) 231-0752 Program: PreK-6 grade curriculum based on gun safety. Evaluation: None has been conducted. 2. General Violence Prevention curricula/school programs a. Second Step: A Violence Prevention Curriculum Developed by the Committee for Children, Seattle WA Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Leihua Sylvester, and Karin Frey (800) 634-4449 �-3 Program: Consists of a 32 lesson curriculum for classrooms and other group settings based on empathy, impulse control, problem solving, and anger management. The program is used throughout the country, with Los Angeles currently sponsoring an evaluation. Evaluation: The Seattle pilot test included pre/post test interviews resulting in a significant improvement from pre to post interviews compared to the control group. The purpose of this pilot test was primarily formative and to be used to make changes in the curriculum. The major weaknesses of the evaluation included non-equivalent control groups, and no measure of actual student behavior. Results: Differences between pre/post interview score were statistically significant in areas of predicting consequences, anger management, and brainstorming solutions. b. SMART Talk Developed by Center for Adolescent Studies Learning Multisystems, Inc. (800) 362-7323 Program: This is a computer program for adolescents which includes sections on Anger Management, Dispute Resolution, and Social Skills. Uses a panel of celebrities and teen mediators to provide personal stories and serve as role models. The program can be used by oneself or with a partner to help resolve a conflict or work on a relationship. Evaluation: A pre/post test was given to students who used the system. It measured knowledge, intentions, and included a self-report on caring behaviors, self-esteem, impulsiveness, non-violent role models, and peer influence. No changes in actual behavior were measured. Results: A significant increase in knowledge, self-reported frequency of pro-social behavior, and intentions to use non-violent strategies were found between the pre and post tests. There was also a significant decrease in self-reported getting into trouble. There was no significant difference in confidence in handling conflict situations with non-violence. Students responses about the program were positive. e. Gang Prevention and Intervention Program Garden Grove, CA. Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: Consists of an eight week curriculum for second to sixth graders, as well as one for 13-17 year old incarcerated violent offenders and high-risk children who exhibit characteristics of belonging to a gang. Evaluation: There was no systematic evaluation. Anecdotal evidence indicated a decrease in fighting among kids exposed to the curriculum. D .3 d. Project Stress Control School-Based Curriculum Atlanta, GA Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: Groups of fourth and fifth graders participate in stress reduction classes, cultural field trips, camping trips, and an eight week after school program focusing on study skills improvement. In addition, an anger-relaxation center was established for students to vent their anger and relax, a new discipline program was established, and parents were contacted by the school more often. Evaluation: An evaluation was done at two different schools that had implemented the program. The evaluation was based on both pre/post tests to measure changes in stress awareness and knowledge as well as an assessment of changes in school environment and behaviors. The two major weaknesses of the evaluation include the inability to separate the effect of the different components of the program and a sporadic use of control groups. Results: Evaluators at one school found a 50% drop in referrals to the principal's office, a 40% drop in suspensions, and small gains in reading and math scores. At the other school they found a 47% decrease in office referrals from those in participating classes. 3. School and Family/Community programs a. PeaceBuilders Heartsprings P.O. Box 12158 Tucson, AZ 85732 (520) 322-9977 Program: PeaceBuilders includes a K-5 comprehensive alternative to violence program (with a workbook for students and their families, and an action guide for teachers), parent education events and tools, and community outreach (including mass media components, fund-raising). Evaluation: They are currently undertaking a 10 year study in cooperation with the University of Arizona and the Case Western Reserve University and with initial funding from the CDC. They study will follow 5,000 children to measure long-term impacts of PeaceBuilders on juvenile arrest rates and other measurable outcomes. Data is also being collected on social skills and aggression in schools. Results: Visits to school nurses are down 12%from baseline for PeaceBuilders schools,compared to control schools which are up about 2%. Visits due to fighting are down 8% among PeaceBuilders schools, while for control schools they are up 55%. Case studies from specific schools report that school suspensions are down 65% in one school, and referrals to principals are down 50% at all case study schools. Playground fights and classroom disruptions also appear to be down at a number of schools. 03 b. Yes I Can The Metropolitan Area Child Study Evaluation done by L. Rowell Huesmann Research Center for Group Dynamics, Institute for Social Research University of Michigan Ann Arbor, Michigan 48106-1248. Program: Level A intervention consists of 20 general classroom lessons (social-cognitive enhancement curriculum called "Yes I Can") with trained teachers; Level B consists of Level A plus small group social cognitive training with high risk peers; Level C consists of Level B plus family intervention. Evaluation: In the process. Supported in part by CDC grants. Schools assigned to one of the three levels or as a control. Will evaluate both overall impact, and impact on high risk vs. low risk children. c. The Paramount Plan: Alternatives to Gang Membership Paramount, CA. Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: This program consists of a fifteen weekly presentations to all fifth graders in the school district on topics including graffiti, the impact of gang membership on families, drugs and gangs, and alternatives. It is followed by eight biweekly sessions in seventh grade. The program includes parent and community interventions with basic parent-community awareness meetings for parents and other community members, and family counselors who work with high-risk teens and their parents. Evaluation/Results: There have been a number of separate studies. The first one was a simple pre/post test which measured students' attitudes towards joining a gang. Prior to the program 50% were undecided about joining a gang, while after the program, 90% responded negatively. In the second evaluation, a control group was added,whose responses remained at 50%undecided on both tests. The third evaluation included a one year follow-up, in which 90% of the students who were a part of the program continued to indicate a negative attitude toward gang membership. The major weakness with this evaluation was the problem of relying on self-reports, and the lack of data on actual behavior. d. The Violence Prevention Project Health Promotion Program for Urban Youth, Boston Department of Health and Hospitals Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: This is a community-wide, multi-institution project with the goals of reducing the number of fights,assaults, and intentional injuries, and for the community involvement to become self-sustaining. It consists of curriculum development, community-based prevention education, clinical treatment services, and a media campaign, with a community educator for each target community, who uses the curriculum as a foundation in as many community settings as possible. D. 3 Evaluation: Consisted of dual community-wide random telephone surveys-one immediately prior to implementation, and the second at the end of the first year. The preliminary analysis indicated minimal impact relative to the control group during the start-up year. However, they are already witnessing outgrowths of the project, such as the Community Coalition to Prevent Black Homicide. They are in the process of instituting surveillance systems in hospitals and other institutions to measure impact. 4. Conflict Resolution/Peer Mediation Programs a. School Mediation Associates School Mediation Associates 134 Standish Road, Watertown, MA 02172 (617) 876-6074 Program: Trains student leaders to help peers resolve interpersonal conflicts Evaluation: Conducted by SMA and consisted of research questionnaires mailed out to the 200 schools that use their program; one hundred surveys were returned. Results: Their preliminary findings include that 70% to 95% rate of agreement between parties post mediation. The rest of their findings were based on program implementation and perceived overall "health" of the program, rather than outcomes. b. The Fighting Fair Model/The Rules for Fighting Fair Developed by Peace Education Foundation. David V. Jacobsen, (904) 487-3220 Florida Injury Prevention and Control Program, Office of Health Promotion and Wellness Program: Using the Fighting Fair Model curriculum, teaches students to deal with conflict constructively. Evaluation: Supported with grant from the CDC. Three classes selected randomly as experimental groups, and three classes as control groups. Results were analyzed through use of a survey given to students in which they responded to hypothetical situations, and through school staff evaluations of behavior. Results: Pre/post survey scores improved significantly for the experimental group, but changed little for control group. Weighted behavior scores improved significantly for both groups before and after although more significantly for participants. C. "The Rules for Fighting Fair" Plus Peer Mediation Orange County, North Carolina middle schools Program: Combination conflict resolution curriculum to sixth graders("The Rules for Fighting Fair") and peer mediation with student mediators nominated by their peers. Evaluation: Looked at disciplinary records for the sixth grade and the whole school. There was no control group, no discussion about whether the baseline year was a representative year, and no way of separating out the effects of the curriculum and the peer mediation. Results: From year prior to implementation to year of implementation, for sixth graders, disciplinary referrals dropped 82%, in school suspensions 42%, and out of school suspensions 97%. For the entire schools, in-school suspensions dropped 25%, out-of-school suspicions 26%. d. BRAVE (Baltimoreans Reducing All Violent Encounters) Joseph L. Washington, Director, Project BRAVE (410) 383-5755 Program: Implemented at an elementary school in Baltimore. A group of school mediators were nominated by teachers, interviewed, and trained. Upon seeing a dispute, ask students if want peer mediation. Evaluation: Programmers kept track of the results of peer mediated conflicts. No control group was used. Results: Disputants who accepted peer mediation signed contracts following 93% of the incidents and 95% honored these contracts for the remainder of the year. e. Kansas City Schools (Westwood Elementary, Washington Elementary, Fort Riley Elementary, Milford Elementary, Custer Hill Elementary, City Middle School, Junction City High School) Program: Conflict mediation lessons and trained peer mediators. Evaluation: Programmers kept data on the number of conflicts mediated and successfully resolved, anecdotal information, a pre/post self-concept scale to compare conflict managers with regular students, post "how to handle conflict" survey, and incidence of aggressive behavior. No control group was measured, except on the pre/post self conflict scale. Results: Eighty-nine percent of disputes mediated by a student manager were successfully resolved. They did not use nearly enough students on the pre/post self-concept scale measurement to have significant results, and partially as a result, the results were mixed. The incidence of aggressive behavior on the playground, however, dropped 65% at one school, and 40% at another. Students who received the conflict mediation lessons scored better on the "how to handle conflict" survey than those who did not. L "Boston Conflict Resolution Program" Boston Area Educators for Social Responsibility. Found in Carnegie Report "Violence Prevention for Early Teens. The State of the Art..." Program: Includes a grade specific conflict resolution curriculum and a peer mediation program. Evaluation: They are in the process of conducting an evaluation which consists of biannual interviews with children from each grade, with a comparison group at a different school. The � J major weakness in this evaluation is that it does not evaluate actual behavior changes. The program staff sites lack of funds, as well as overworked teachers, lack of support services for schools to deal with severe student needs, and failure of society to address root causes as barriers to program and evaluation success. g. Conflict Management/Peer Mediation Program Kansas Child Abuse Prevention Council Topeka, Kansas. Found in Carnegie Report "Violence Prevention for Early Teens. The State of the Art..." Program: Includes an eight week curriculum on non-violent problem solving, and peer mediation. Evaluation: Kansas University conducted an evaluation in four elementary schools consisting of pre/post tests based on knowledge gains. They looked at differences in knowledge gains between the control and experimental groups, and between genders. equivalent control group. The major weaknesses of the evaluation were that it did not study behavioral changes, and it did not include the impact of peer mediation in its evaluation. Results: The experimental group showed significant improvements while the control group scores remained about the same. Girls in both the experimental and control groups started out more "solution oriented." Girls in experimental group showed the most significant gains. Although they showed significant improvement, boys in the experimental group ended up a little less "solution oriented" than pre-intervention girls. h. "Resolving Conflict Creatively Program" (RCA) The NYC Board of Education and NYC Educators for Social Responsibility. Found in Carnegie Report "Violence Prevention for Early Teens. The State of the Art..." Program: Consists of a twenty hour training course for teachers, a ten unit curriculum on creative conflict resolution for children, classroom visits by expert consultants, monthly two hour follow-ups with individual schools, and a school mediation component (added later and only to a few schools). Evaluation: Consisted of a survey of teachers and administrators about training and implementation, student achievement tests based on knowledge of concepts and self-reported conflict resolution, and a survey of teachers and students on peer mediation and perceived impact. The major weaknesses were that the evaluations were that the teachers knew that the students had been involved in the program and there were no control group of teachers. Results: The surveys indicated positive responses about the program,training and implementation, and its perceived impact on student behavior and methods of conflict resolution. Teachers also felt they were personally impacted in their own understandings of dealing with conflict, in their ability to listen, and their sensitivity in dealing with students of different backgrounds. The achievement scores indicated an increase in knowledge about conflict resolution terms relative to the control group. Anecdotal evidence is also very strong for this program and consequently the program is highly endorsed by teachers and schools. D,3 i. Violence Prevention Curriculum Project Education Development Center Newton, Mass. Program: Consists of a ten session curriculum focused on providing information on risk factors, role of anger in interpersonal violence/constructive channeling, and alternative means of conflict resolution. Evaluation: The evaluation was described by the Carnegie Foundation as "quasi experimental" based on an opinion survey given to students and teacher behavior ratings. The results indicated a marginally significant improvement in behavior, but teachers were not blind to which students were in the experimental group. 5. Programs that Target "High Risk" Adolescents a. PACT (Positive Adolescent Choices Training) School of Professional Psychology Wright State University Ellis Human Development Institute, Dayton, OH (513) 873-4300 Program: This program trains "high risk" middle schoolers selected by their teachers, for small group, classroom training twice a week for the semester. Pilot study: Selected a group of 15 trainees and a control group. The teachers, who were not blind to group assignments, a pair of outside observers who were blind to group assignments, and the adolescents themselves rated communication, negotiation, and problem-solving skills before and after the program period. Results: Teachers, observers, and adolescents all reported gains, often significant gains, in most areas for the trained adolescents. School records also document reduced violence-related school behavior for the trained group. They did not find similar gains for the control group. They also found that the most significant increases came in areas that were the most deficient prior to the training. Results from outcome study: A 1992-1993 outcome study documented the following changes among PACT students--a 50% drop in physical aggression at school (a greater drop than for similar non-trained students), behavior improvements that lasted beyond project duration, and a 50% fewer overall and violence-related juvenile court charges than non-trained control group. b. Attributional Retraining "Long Term Effects of Attributional Retraining on Aggression Reduction" Cynthia Ann Hudley Graduate School of Education University of California-Santa Barbara Santa Barbara, CA 93106 D,3 Program: Aggressive children are prone to "attributional error," that is, the inappropriate assignment of harmful intentions to peers. An aggressive child, for example, may perceive an accidental bump as a push. The "Attributional Retraining" program is a 12 week curriculum designed to train aggressive boys to infer non-hostile intent. Evaluation: Supported by a grant from the CDC. The study used four different sites, and, at each site, designated a group of aggressive and non-aggressive boys who receive attributional retraining, a similar group who receives a placebo critical thinking skills course, and a third group who receives no training. Data was collected pre/post, with a six month follow-up. The researcher will continue follow up for another 18 months. Data consisted of a questionnaire with scenarios to assess attributional changes, and behavior tracking. Results: Preliminary results have been gathered for pre/post and the 6 month follow-up. Referrals to disciplinarian related to aggressive behavior fell significantly for the attributional retraining group only. Teachers who rated students on cooperation, self control, and overall class behavior documented an improvement for the retrained boys compared to the other two groups of children (although not statistically significant). Finally, when students rates their own levels of cooperation and self-control,only the retrained group's self-assessment corresponded significantly to the teachers' assessment. c. Project Stress Control through Stress Management for Juveniles in Youth Development Centers Atlanta, Ga. Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: Trains staff and parents in workshops and troubled youth in a six week course on stress management and drug education. Evaluation: Consisted of pre/post test questionnaires on stress and coping skills, and behavioral reports from teachers. The major weaknesses in this evaluation were the use of an non-validated instrument to measure stress, the exposure of the control group to trained staff, and the sporadic use of control groups. Results: They used a control group only for the pre-post tests, and discovered no statistically significant difference between the control and experimental groups. They did find a 30% reduction in behavioral problems for the experimental group, with no data on a control group. d. Viewpoints Training Program Chicago Found in Carnegie Report "Violence Prevention for Early Teens: The State of the Art..." Program: Focuses on improving the problems solving skills of juvenile offenders and challenging their beliefs about aggression. It consists of 12 hour long group discussion sessions and a workbook. The evaluation itself was different than the others because it was designed by researchers as an empirical study. The major problem was that the curriculum was published and evaluated by the same group. D- 3 Evaluation: Looked at adolescents who were incarcerated for violent criminal acts, using three different, randomly assigned groups. One group had no-treatment, another was an "attention placebo" group, and the third received the treatment. There were both pre/post testing and behavior ratings. The participants showed an increase in social problem solving skills, and a decrease in endorsement of aggression, both relative to the control groups. While participants were somewhat less likely to be recidivists, the results were not statistically significant. 6. Guidelines for Program Evaluation a. "Violence Prevention for Early Teens: The State of the Art and Guidelines for Future Program Evaluation" In July of 1990, the Carnegie Foundation funded a conference to look at the proliferation of violence prevention programs and their effectiveness. Prior to that conference, they sent a survey to 83 different violence prevention programs throughout the country, focusing on those whose explicit goals included violence prevention. Fifty-one programs responded and the foundation examined the individual project goals and evaluations. The foundation includes a summary of the evaluation process of eleven different programs in the "State of the Art" paper. The eleven evaluated programs are meant to serve as "case studies" or samples of the types of program evaluations currently in the field. The goals of the fifty-one responding programs include the following:violence prevention, conflict resolution, gang prevention, domestic/family violence prevention, self-esteem development, peer mediation, non-violence education,teen dating violence/rape, battered women and batterers, behavior management, battering during pregnancy, supporting assault victims, handgun violence, and safe schools. Note that most programs had more than one major goal. The programs focused on the following populations: children, adolescents, teachers/school administrators, parents, staff of youth organizations, social workers, health care providers, police/probation officers, inmates, juvenile offenders, judges, counselors/therapists, and interfaith/church groups. Of the fifty-one respondents, 16% had no evaluation of any kind. This is probably an underestimate of the total percentage of programs with no evaluation, because of selection bias associated with voluntary participation. In addition, the program evaluations were often not very vigorous. Only one quarter of the programs held evaluations based on outcomes, and most of these were based on simple pre/post tests which measured attitude and knowledge changes rather than actual behavior changes. In addition, none of the evaluations were longitudinal, following participants for an extended time frame. According to the Carnegie Foundation, no evaluations met rigorous methodological studies. Barriers to this type of evaluation included resources, the desire to do something quickly, and not using available research on aggressive behavior effectively in program and evaluation design. D,? b. Comprehensive Peer Mediation Evaluation Project Funded by The Hewlet Foundation Researcher: Dr. Tricia Jones (215) 204-8543 V5431E@vm.temple.edu Evaluation: In the process of conducting a two year research project. It involves nine schools at each of four different sites. The schools fall into one of three categories. Peer Mediation Training schools (schools who are trained to implement a peer mediation program), Peer Mediation Plus schools (schools who receive the above training plus additional training on communication and conflict management skills to adults in the larger community, and training for teachers on implementing a conflict management and communication program for 3-12 graders), and finally Control schools who cannot have any skills development classes (peer mediation, conflict skills training) during the two years of the study. Researchers will collect data including general violence and suspension rates with baseline data from 1-3 years prior, violence and suspension rates of peer mediators and a select group of other students, surveys on the school climate to be administered to teachers and students, tests on attitudes about conflict, information on dispute resolution success, observations conducted by researchers, and case narrative histories from each school. The project appears comprehensive, in that it allows for both anecdotal as well as empirical evidence, and involves both tests that measure behavioral changes as well as attitude and knowledge changes. The use of three different types of schools allows researchers to separate the effect of peer mediation from the impact of combined peer mediation, curriculum, and community skill building. C. "Teaching Students to be Peacemakers: Results of Five Years of Research" (1994) David W. Johnson and Roger T. Johnson University of Minnesota 202 Pattee Hall Minneapolis, Minnesota 55455 Evaluation: The researchers conducted seven studies between 1988 and 1994, evaluating the effectiveness of two types of peer mediation programs: "total student body," in which all of the students were trained in conflict resolution skills, and "school cadre," in which a small group of students were trained to be peer mediators. Five studies included control groups, in three of which the control groups were randomly selected from the same school. The studies looked at knowledge gain and retention on mediation skills, empirical and anecdotal evidence on incidents of peer mediation and teacher mediation, empirical data on numbers and types of conflicts, interviews, and simulations. The results come from different studies and include the following. Most of them come from "total student body" programs: 1. Untrained students were two times more likely than trained students to go to the teacher for help in conflict resolution. Trained students often negotiated their own solutions, while no untrained student attempted to do so. Before training, half or more students would go to the teacher for help in resolving a conflict, whereas after the training, students would only 15% of the time. 2. Studies showed significant retention of negotiation and mediation steps three months after training. 3. Many students reported, and their parents reported about their children, using mediation skills to resolve their conflicts outside of the classroom and even outside of school (such as with brothers and sisters at home). In fact, one study found that students used strategies learned in school as frequently at home as in school. 4. Strategies used in resolving conflicts were classified and appeared similar for control and experimental groups prior to training,but significantly different after training, with many students using integrative negotiation rather than "win-lose" approaches after training. 5. Interviews with principals and teachers indicated a perceived positive impact on classroom environment and individual conflict management. One group of teachers reported an 80% drop in conflicts referred to them and the conflicts referred to principals dropped to zero. All teachers reported that they would continue using peer mediation training. 6. When conflict scenarios were given in written, interview, and video tape simulation, many trained students used mediation skills while no control students or "mixed"pairs did. In summary, peer mediation training appears successful in developing both self- regulation among children, both in and out of school, and in improving conflict management from "win-lose" strategies to negotiation. Conclusions: Ideally,a rigorous evaluation would have the following components: randomized selection of participants and controls within target populations, measurements of the separate effects of various components, measurements of behavior as well as knowledge increases and perceived changes in climate, and a large enough sample population. It would useful for some evaluations to measure gender differences and impact on "high risk" versus "low risk" adolescents. Finally, there is a dearth of longitudinal studies similar to the PeaceBuilders evaluation which measure long term impacts. Barriers to this type of evaluation include funding, understanding of the importance of built in evaluations, wanting to do "something" quickly to respond to high rates of violence, and support from overburdened teachers and staff. Notably, the better evaluations have been done by a University or with seed money from the Centers for Disease Control. Even if the programs are evaluated rigorously, however, it may be difficult to accumulate data or predict the transferability of findings to similar approaches, since program details and implementation vary so widely even within program "types." The same project may be much more successful at one school than another due to different student populations, level of training, and commitment of teachers, administrators, and parents. The above list is only a sample of violence prevention programs and studies available. The list does provide important insight, however. First, there are very few programs which include both schools and families or communities around them, although it is clear that lessons taught in schools should be reinforced in order to be most effective. Second, the large number of "conflict resolution" and "peer mediation" programs indicate that field experts consider the skills learned in these programs valuable and promising. Finally, many violence prevention programs appear moderately successful in meeting at least their short term goals. Anecdotal evidence indicates that teachers, administrators, program directors, and adolescents are relatively pleased with the programs. APPENDIX 2 Research For Firearm-related Suicide And Unintentional Injuries/Deaths Background. In Contra Costa County during the period of July 1, 1992 to June 30, 1993, 8% of all firearm injuries and deaths were unintentional, 25.5% of firearm deaths and 1.5% of firearm injuries were suicides and suicide attempts, and firearms are the most effective method of suicide (85% of attempts were successful). Given this information, staff investigated strategies and the availability of programs aimed at reducing firearm-related suicides and unintentional injuries.l 1. Unintentional Injuries The following strategies could be effective in preventing firearm related unintentional injuries and death: Category A: General firearm injury/violence prevention curricula incorporated into the classrooms. Findings: There are only a handful of such programs. The most flexible, comprehensive, and widely used is the Straight Talk About Risks (STAR) program. (See report on firearm curricula for more detailed information). Category B: Firearm injury prevention curricula with no violence prevention component Findings: Again, only a few. The most prominent is the Eddie Eagle Gun Safety Program. Category C: Adult safety courses aimed at teaching gun owners, particularly parents, gun safety such as storage, cleaning, and firing. Findings: 1. Firearm Safety and Responsibility Act (Penal Code Section 12.800-12.809) requires all handgun buyers to receive a Basic Firearms Safety Certificate (BFSC) or be exempt, as of April 1, 1994, prior to purchasing the handgun. The California Department of Justice has a Firearms Program which is responsible for the BFSC program. In order to qualify, one must: -Complete a Department of Justice video course (a two hour presentation of basic firearm safety/information). OR -Pass a Department of Justice objective test, which includes questions on safe use, handling, and storage of handguns; methods of childproofing handguns; the laws applicable to carrying and handling handguns; and responsibilities of firearm ownership. OR -Enroll in and pass Department of Justice certified safety course. 2. The National Rifle Association Range, Training, and Recreational Shooting Department (1-800-231-0752) offers referrals to 35,000 certified instructors for classes in both shooting safety (in rifles, handguns, and other firearms), and a Home Firearm Safety course which D -3 addresses basic safety rules (storage, keeping away from children, and cleaning). This five hour course does not address firing weapons. Category D: Hospital/Health Department based education on firearm safety. Findings: 1. The American Academy of Pediatrics (847-228-5005) offers a brochure, "Keeping Your Family Safe". The brochure addresses home safety with respect to firearms. While it recommends that families with children do not possess a firearm in the home, it does explain basic safety information regarding storage, toddlers, depression and adolescents, and more. A number of other organizations offer similar brochures which should be made available in health clinics, and other health settings along with other injury prevention material. 2. The STOP Program developed by the Center to Prevent Handgun Violence (202-289-7319) In this program, pediatricians discuss home gun safety with parents and children. Center to Prevent Handgun Violence also produced a brochure on safety guidelines. 3. Monterey County Health Department (408-755-8486) The department developed a gun storage education and trigger lock coupon program that is directed to parents who have guns in their homes and health care providers. The goal was to educate health department staff on the dangers of unintentional firearm-related injuries. They successfully obtained 25% off trigger lock coupons from gun dealers to offer to health care providers, including WIC, and public health nursing, to give out to parents. They developed bilingual education material on gun safety, and worked to incorporate gun storage education into public health services. Their staff made presentations to various public audiences on firearm injuries. 4. Harborview Injury Prevention and Research Center (206-521-1520) They are beginning a public education campaign in which they encourage people to lock up guns, use lock boxes, and buy guns with trigger locks. A component of the public education program includes a high profile media campaign, working through physicians and primarily family practitioners, who will provide patients with information and give them a lock box coupon. The program will also work with manufacturers and other community members. Category E: General community education on firearm safety. Findings: 1. The Alliance for a Safer, Greater Detroit (313-224-5826, Andrea Solak) The Alliance uses education to promote awareness of risk factors, responsibility of gun ownership, and gun safety. They produced a small, user friendly booklet called "Safety First: Guidelines for Gunowners" to show readers how to disable guns in the home with trigger locks, padlocks, and cable locks. Together with KMart, the Alliance gave 3500 trigger locks to people who purchased firearms. The group created a PSA to be aired on local radio stations about gun safety in the home. They are in the process of producing a series of trainings to train cops who could then train community members how to handle weapons safely. Category F: Reduce the availability of guns, specifically handguns (Note: The Pacific Center for Violence may have a more complete list of these laws) Findings: 1. Waiting Periods: Brady Bill requires a 15 day wait, for the purpose of a cooling-off period and time for authorities to conduct a background check. Legislation recently passed reduced the wait to 10 days. 2. "Straw Sale" Restriction (California State Legislation): A part of Firearm Safety and Responsibility Act which declares it a felony for anyone to purchase, or help purchase, a firearm on behalf of someone else (anyone else). 3. Local gun dealer regulations: (See attached chart which details ordinances within Contra Costa County) a. In Oakland, the City Attorney's office drafted an ordinance requiring all gun dealers, including those working out of homes, to register and operate as a business. This would mean that guns had to be locked in a safe, and that deliveries could not be left on doorstep. b. In Oakland, a gun dealer ordinance was passed requiring gun dealers to carry $1 million in liability insurance. c. Encourage community reporting of gun dealers who sell to minors or participate in otherwise illegal activities. 4. Restriction on Sale to Minors: As a part of the California Firearm Safety and Responsibility Act, it is a felony for any person to illegally provide a firearm to a minor. 5. Restriction on Possession of a Firearm by a Minor. As a part of the California Firearm Safety and Responsibility Act, it is a felony for anyone under the age of 21 to possess a firearm without direct adult supervision, except on private property. Note: most suicides/unintentional firearm injuries take place on private property. 6. Outright ban on handguns: Some advocates claim that waiting periods, background checks and other gun control acts will not affect change, since so much of firearm injury is committed by non-previous offenders, especially in family related violence, and is committed with guns already located within a person's home. The principle argument against the ban is that law abiding citizens have a right/need to protect themselves. Category G: Consumer product regulation. Advocates claim that guns are like any other potentially dangerous consumer good, and ought to be regulated to reduce risks. The primary argument against this regulation is that guns cannot be made safe, because their intention is to injure. Findings: 1. Endorsed by the California Police Chiefs Association. 2. Endorsed by the Violence Policy Center.2 They suggest that the ATF be given the authority, staff, and budget to set safety standards, monitor compliance, issue recalls, and restrict specific classes of firearms. 3. Handgun Control, Inc. indicates that there currently is nothing in the works within the Federal Legislature. 4. Mandatory Sale of Trigger Locking Device. As a part of the California Firearms Dealers Responsibility and Liability Act, no firearm may be sold without a trigger locking device. 2. Suicides The following strategies could be effective in preventing firearm related suicides: Category A: General strategies to reduce accessibility to firearms. Findings: See above listed strategies for unintentional injuries. Category B: General programs to reduce depression and suicide. Findings: 1. In their report on Programs for Suicide Prevention, the Centers for Disease Control, made the following observations: a. Links between suicide prevention programs and existing community mental health resources are rare. b. School-based education programs focusing specifically on suicide are applied frequently, but there is no substantial evidence to suggest that they are effective. c. While there is evidence that restricting access to lethal means, such as guns and drugs, and reducing risk factors, such as alcohol and handguns, can help prevent suicide, few programs use in their "suicide" prevention curricula. d. Programs that probably are effective in reducing suicide, likealcohol/drug abuse treatment, counseling for teen pregnancies, other problems, are not considered "suicide reduction" and so not evaluated as such. e. There is very little evaluation on effectiveness of various programs. f. Relying on a single prevention strategy would not be an effective approach. 2. Sample suicide prevention programs: a. "Working in School-Based Clinics to Prevent Adolescent Suicides." Jennifer Bryson, Adolescent Health Coordinator MCH, Kentucky Department of Human Resources (502-564-2154) The Maternal and Child Health Agency within the Kentucky Department of Human Resources works through its school-based clinics to prevent adolescent suicide. Program components: -Identify adolescents at-risk through a comprehensive health history which all students complete on their first visit. Survey covers depression, family issues, and access to a gun, among other topics. -Counsels at-risk students at the.school-based clinics. Gets parents �+ 3 involved unless teen requests confidentiality. -Refers at-risk students to comprehensive care clinics, encourages them to keep appointments, and more. b. 'Bilingual Emergency Room Intervention for Adolescent Women Who Attempt Suicide." John Piacentini, Director, Adolescent Suicide Disorders Clinic. (212-960-2327) This program was developed because few adolescents who attempt suicide and receive initial treatment, return for follow-up care. Program components: -Provide specialized training for emergency room staff -Provide a video-tape presentation for adolescents and parents which encourages them to receive ongoing care. -Provide bilingual, crisis social worker 24 hours/day. Once an adolescent is brought in, the social worker acts as a liaison, linking family to follow-up care. c. "Suicide Prevention Program For California Schools" Grew out of California Bill 947 (1983), authorizing the development of a statewide Youth Suicide Prevention School Program. Tested in Los Angeles and San Mateo County. Program is composed of lesson guides for 9-12 graders, as well as guides for staff and parent awareness. According to CDC recommendations, the program should not be implemented alone. d. Crisis intervention team A crisis intervention team is a group of counselors working in concert to help students cope with crises that might otherwise cause depression/suicide attempts, i.e., friend committing suicide, sudden losses. During or immediately after a crisis, the team meets with students, teachers, and staff to offer a sense of safety/stability/forum for discussion. 3 e. Peer counseling/mediation in the schools Peer counselors are available to discuss anything from child abuse, to divorce, suicide, and dating.4 f. Drug and alcohol awareness/intervention programs Contacts: Center to Prevent Handgun Violence, Rick Bilky, (202) 289-7319 Handgun Control Inc., (202) 898-0792 Santa Clara Maternal and Child Health: the Childhood Injury Prevention Program, (408) 299-5850 San Francisco Injury Center, (415) 821-8209 Disability Rights, Education, and Defense Fund (A legal group), (510) 644-2555 Child Health and Disability Prevention, (916) 842-8240 California Department of Justice, Firearm Safety Certificate Program, Linda Dickinson, (916) 227-4882 California Emergency Preparedness and Injury Control, Branch of CA Department of Health Services, Roger Trent, (916) 323-3611 San Joaquin County Injury Prevention, Lynn Walton, Injury Prevention Coordinator, (209) 468-0327 American Academy of Pediatrics, (847) 228-5005 Constitutional Rights Foundation, Kathleen Kirby, Education Director, (213) 487-5590 CSUSD Childhood Injury Prevention Center, Anne Hammond, (619) 594-3691 Injury Prevention Research Center, Jess F Kraus, Director, (310)206-4115 Office of Violence and Injury Prevention, Alicia Dixon-Diggs, Program Coordinator (619) 285-6559 Center for Gun Policy and Research, Susan De Fransesco (410) 614-3243 National Rifle Association, Range, Training, and Recreational Shooting Department, (800) 231-0752 Children's Safety Network, Leona Gill, (703) 524-7802 Harborview Injury Prevention and Research Center, Louane D'Ambrosio (206) 521-1520 The Alliance for a Safer, Greater Detroit, Andrea Solak, (313) 224-5826 Resources/Directories: The Campaign to Prevent Handgun Violence Against Kids, Resource Directory, 1995-1996 "Building Safe Communities" State and Local Strategies for Preventing Injury and Violence "Preventing Violence. A Framework for Schools and Communities," C.H.E.F. "Taking Action to Prevent Adolescent Violence: Educational Resources for Schools ad Community Organizations" "National Directory of Youth Violence Prevention Resources," Center to Prevent Handgun Violence. "The Prevention of Youth Violence. A Framework for Community Action," CDC. Contra Costa County, CW&PP files. 1 FIRST Report 2 Rolling Stone, March 10, 1994 3 Suggested by the National School Safety Center at Pepperdine University 4 Suggested by the National School Safety Center at Pepperdine University ❑ ro V 'n S C! c° d r n tT� > A o G T T : y obi �f e II II o O r, = A a o a Z > a 3 w 3 3 a-e c +o o d: 7 2 to el f7 ...I n t5 9 �. ria °n d p C ni C w _ m �ro �' •.S ro > N •�. .dn. N 3 ° O O wd[ ! '� "� Ot a ""• o C " y �' ro �! _ _ ° A °n 3 _. = .rod. ro O n o 5. a n a 'L. Q ,� ro d. m S -s su — :°. ro "• n o c ro a, " . y 'o C t4 cr T ' � p (a" a nM ° � a in a ro 1 w �• � d 1 t a4 d � r� 7 T r� 3 - a c :t t tip G "R "� CIO W1 BL f1bC CL+ .. • A d'. ry. r C Cr o- Im 3 m ro c - a :: O •�, tr'o d0. a ro A ro e�0 SLl ep �• rRi o 3 a fi tv vi •M•� p d v, < to o a n o ` ro n rt e A = = d n 7 m > ado W 7 a02 x 3 ro d ^« a CrZ C n a Cr 0. =rA' w o CI-C _ m = 3 �-` n 0 n „ d `" =• � � CrZ A `n Antioch Brentwood Clayton Concord Danville E!Cerrito Hercules Lafayette Martinez Moraga Orinda xxxxx Pinole Pittsburg Pleasant hill x x -Xxxx x Richmond San Pablo 'XX x San Ramon Walnut Creek ccc Unincorp. 10-16-1996 11 : 16AM FROM P. 1 Y _rrr Joseph A_ Ovick, Ed.D., Superintendent CONTRA COSTA • 77 Santa 8arbam Road • Pleasant Hill, California 94523 OFFICE of EDUCATION (510)942-3388 MEMO To: CONTRA COSTA COUNTY COORDINATING COUNCIL& DATE/PREVENTION COORDINATORS From: Bianca Bloom Subject: REPORT ON FIREARM INJURIES Date: October 1, 1996 We have been requested by the County Board of Supervisors Family and Human Services committee to offer a venue for a report prepared by the Health Services Department of Firearm Injuries in Contra Costa County for school educators. Cassandra Youngblood, Community Violence Prevention Coordinator,and Susan Leahy, manager of the Violence Prevention Program, would like to present data which gives a one year snapshot of firearm injury and death in Contra Costa County. Firearms have become the leading cause of injury death for all 10 to 14 year old youth in this county. This, and other facts of their report, is important information for educators. This Violence Prevention team would also like our recommendations about school programs and policies which address violence. They, in tum, will take our recommendations to the County Board of Supervisors to inform future policy. Please plan to attend this important meeting on MONDAY NOVEMBER 4, 1996 9 TO I 0 AM COUNTY OFFICE OF EDUCATION BOARD ROOM If you have any questions or concerns, I can be reached at the number below. cc: District Superintendents Alternative Education Programs • 77 Santa Barbara Road • Pleasant Hill, CA 94523 (510)942-3408 0 FAX(510)INSIOW 942-3353 Bianca Bloom, Ed.D., Director OCT-16-1996 11:24 96% P.01 Request to Speak Form �3 ( THREE (3) MINUTE LIMIT) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name; u A-i Address: Sal � v t�ty: 1M fi� 1 am speaking for myself_or o ganiration: omm of orsaoN CH ONE I wish to speak on Agenda Item #-LL#—LDate; My comments will be: genera! _,fo�mairrst—_____. 1 wish to speak on the ,object of I do not wish to speak but leave these -omments for the Board _, to consider: