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HomeMy WebLinkAboutMINUTES - 05211996 - D7 �f 1 � D. 7a BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on Mav 21,19% by the following vote: AYES: Supervisors DeSaulnier, Torlakson and Smith NOES: None ABSENT: Supervisors Rogers and Bishop ABSTAIN: None SUBJECT: Viewing in County Detention Facilities of Televised Violence On this date following the approval of the recommendations in the staff report on the status of the implementation of the Violence Prevention Action Plan and later in the Board meeting, Supervisor Torlakson moved to direct the Sheriff/Coroner, Juvenile Hall Staff and Social Services Department to review a possible policy for Board implementation relative to the viewing in County detention facilities of televised violence . IT IS BY THE BOARD ORDERED that the Sheriff/Coroner, Juvenile Hall Staff and the Social Services Department are DIRECTED to review and report to the Board of Supervisors on a possible policy for Board implementation relative to the viewing in County detention facilities of televised violence . 1 hereby certify that this lea true and correcteopyof an action taken and entered on the minutes of the Board of Suisors on� da e s 0 ATTESTED: j!,) b PHIL BATC E A,Clerk o the Boar of ervisors Countyni5trator 0 By Deputy Sheriff/Coroner Juvenile Hall Staff Social Services Department County Counsel County Administrator CC : * 7 . �`�.�C�"ia'51���J�?33�€9Ptit:''6t1^f•i17��£���1�+''`i3J`��3;..•#� to ul%unira aril q,-6 .rr,M !)a, 111: 's 171 C i 1 r : D. 7 BOARD OF SUPERVISORS F&HS-05 Contra FROM: FAMILY AND HUMAN SERVICES COMMITTEE �' - Costa :: . �o County DATE: May 13, 1996 SUBJECT: REPORT ON THE STATUS OF THE IMPLEMENTATION OF THE VIOLENCE PREVENTION ACTION PLAN SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 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. BACKGROUND: On November 14, 1995, at the request of Supervisors DeSaulnier and Smith, the Board of Supervisors referred to our Committee the County's Violence Prevention Action Plan and asked that our Committee look into the status of the implementation of the Plan. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OFB R CO TEE APPROVE OTHER QhAI SIGNATURES lb�LSAWLNIF=R SMITH ACTION OF BOARD ONMay 211996 APPROVED AS RECOMMENDED X OTHER e 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 May 21 , 1996 Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF CC: See Page 3 SUPERVISORS AND COUNTY ADMINISTRATOR 0 BY DEPUTY F&HS-05 VVV On May 13, 1996, our Committee met with Dr. Wendel Brunner, Public Health Director, and members of his staff from the Community Wellness and Prevention Programs. Dr. Brunner introduced this subject by indicating that the problem of community and domestic violence goes well beyond the enactment of local firearms ordinances and firearms policy and requires a long-term commitment from community agencies and community organizations to change the environment that leads to violence in our communities and deal with it on a grass-roots level. He noted that the overall policy of the Health Services Department in their violence prevention efforts is to increase the capacity of community agencies to successfully implement locally based violence prevention activities. Dr. Brunner emphasized that the listing of activities is clearly not exhaustive and that the Department will be undertaking a survey of community based agencies to try to provide a more complete listing of activities that are being undertaken in the community. Susan Leahy, Director of the Community Wellness and Prevention Program, reviewed the attached report with our Committee in some detail. She highlighted the "Increase the Peace" month activities countywide in April, 1996, and several of the other programs and activities which are listed in the report, plus the Contra Costa Coalition to Prevent Gun Violence which grew out of the work on the gun dealer ordinance. Ms. Leahy also noted that the Department had State and Federal funding available from 1992 to 1995 for its violence prevention activities. Current funding is limited to a $100,000 grant from the State specifically in the area of domestic violence, with one-half of this dedicated to providing technical assistance to State agencies in the area of domestic violence prevention strategies. Without additional funding it will not be possible to maintain community interest and involvement in order to fully implement the Violence Prevention Action Plan. One of the things the Department would like is funding for a series of mini-grants which can increase the capacity of community agencies to effectively prevent violence. She noted the survey which is designed to obtain information on how people are using the Plan, whether technical assistance is wanted or needed, and to do a profile on those agencies in the community that are actually doing this work. It is also necessary to have consistent staffing. Ideally this would include three positions and total funding of perhaps $300,000 per year. Ms. Leahy outlined the efforts which have been made to seek funding from several foundations and other sources. Thus far, these efforts have not been successful. Without some source of funding it will not be possible to fully implement the Plan. Jim Hernandez, gang worker in Concord, commented on his work and his dedication to trying to help young people become more harmoniously developed people. He commented on how his activities further the goals of the Violence Prevention Action Plan. He also noted the enormous cost of failing to prevent violence in terms of the public cost to apprehend, prosecute, and imprison those who have committed violent acts. Our Committee noted that at the time the Violence Prevention Action Plan was put on the ballot in 1994, the Board made a commitment to dedicate .5% of the General Fund Budget of the County to prevention activities. It is not clear that we have been able to adhere to this commitment. -2- I F&HS-05 Our Committee is interested in at least funding a Coordinator position to oversee the coordination of the implementation of the Violence Prevention Action Program and provide funding for mini-grants in this area. Jim Hernandez also suggested the need for matching grants where individuals in the community could provide the matching grants, either in terms of money or in terms of the dedication of time and personal involvement. We are asking that this item be rescheduled for our Committee at a time when we can devote sufficient time to reviewing our prevention activities and priorities and try to find a source of funding for at least a minimal commitment to prevention activities. cc: County Administrator Sheriff-Coroner Health Services Director Social Service Director County Probation Officer Community Services Director Public Health Director Mental Health Director Susan Leahy, Director, Community Wellness and Prevention Programs, HSD -3- Contra Costa County •; .; Health Services Department •; - ';y PUBLIC HEALTH DIVISION =a s Administrative Offices 597 Center Avenue Suite 200 v Martinez,California 94553 COUP (510)313-6712 TO: Jeff Smith, Supervisor, District 2 Mark DeSaulnier, Supervisor, District 4 Family & Human Services Committee® FROM: Wendel Brunner, M.D. Director of Public Health DATE: May 7, 1996 SUBJECT: STATUS OF IMPLEMENTATION OF THE VIOLENCE PREVENTION ACTION PLAN Enclosed is a report from the Health Services Department prepared by the Community Wellness and Prevention Programs of the Public Health Division on progress towards implementation of the countywide Violence Prevention Action Plan. This report outlines some of the activities that have been undertaken by the County Health Services Department, community organizations, and other government and civic groups directed towards reducing and preventing violence in Contra Costa County. Much of the public attention over the last six months has been focused on the efforts of the Health Services Department, the Board of Supervisors, and a number of city councils to develop firearms policy. Certainly the widespread presence of firearms in the community escalates the level of violence, increasing the rate of serious injury and death in community and domestic altercations. The residential gun dealer ordinance unanimously approved by the Board of Supervisors last November as well as similar ordinances approved by a number of city councils are important policy achievements which can help lower the level of violence in our community. The problem of community and domestic violence, however, goes well beyond the enactment of local firearms legislation. Preventing violence requires a long-term commitment involving any different organizations and agencies throughout our communities, often working on a neighborhood, school, and local agency level to change individual behavior and community norms about violence. The goal of the Health Services Department is to increase the capacity of local communities and community based organizations to successfully implement effective violence prevention programs and involve a diverse cross-section of community members in violence prevention efforts. A372 (7/91) � 7 Family & Human Services Committee May 7, 1996 Page 2 The enclosed progress report identifies some of the accomplishments made by the Health Services Department and other government and community agencies towards violence prevention. The report also describes some of the current efforts underway in violence prevention. This report is undoubtedly incomplete;many important activities are certainly underway at a community level which have not been included in this report. As described on Page 8, the Health Services Department will be undertaking a survey in June of community based agencies, schools, and other service providers to better gauge the number and type of violence prevention activities currently underway. A survey will help link ongoing violence prevention activities and promote effective collaboration. Finally, the report outlines Next Steps to be undertaken by the Health Services Department and other agencies and a series of proposed activities which would advance the implementation of the Action Plan. Expanding violence prevention activities, while cost effective in both financial and human terms, will require the development of additional funding. WB:ah Attachment cc: William Walker, M.D., Health Services Director Preventing Violence in Contra Costa County: A Countywide Action Plan& Framework for Action Progress Report Prepared By The Contra Costa Health Services Community Wellness & Prevention Programs Submitted To The Family And Human Services Committee Of The Board Of Supervisors, May 13, 1996 I. Introduction A. Background/History In 1994, the Contra Costa County Health Services Department Prevention Program prepared a comprehensive plan for preventing violence that was formulated with the premise that violence is a health issue. This document, Preventing Violence in Contra Costa County:A Countywide Action Plan, was comprised of 25 recommendations for preventing violence and enumerated many of the specific actions that local communities and governmental bodies could undertake to reduce and prevent violence. The document also explored the magnitude and costs of violence, and outlined the root causes and risk factors that seem to underlie the problem of violence. The Contra Costa County Board of Supervisors firmly believes that violence is preventable and that all opportunities to reduce and prevent violence in Contra Costa should be pursued. Accordingly, on August 9, 1994, the Board of Supervisors placed the Action Plan on the November ballot. In endorsing the Action Plan, the Board joined with cities, school districts, and community members throughout the county to make violence prevention a priority. In November 1994, the Action Plan was passed by a substantial majority of voters. B. Continued Importance of the Action Plan The Action Plan has drawn a significant amount interest from communities interested in mobilizing to prevent violence. The Prevention Program distributed over 1,000 copies of the Action Plan to communities in the county, the state and in selected areas nationally. Staff have used components of the Plan in providing technical assistance to communities, violence prevention programs, health departments and local governments, as well as in violence prevention workshops and conferences. Most notable among these communities were the Lincoln/Lancaster County Health Department, in Nebraska, to whom Prevention Program staff provided consultation on the development of a violence prevention program and policy and the City of Sacramento, which adopted Contra Costa's Action Plan as the framework for developing their violence prevention coalition and program. 1 Within Contra Costa County, the Plan has been used extensively within the Health Services Department as a guideline for the Violence Prevention Project, as well as by local professionals and community members as a reference point for developing new and expanding existing local efforts. The Health Services Department understands that preventing violence and reducing its impact on our communities requires a long-term view and commitment. The Department therefore views the Plan as a living document that can continue to provide a framework for coordinated efforts throughout the county and a mechanism to involve all sectors of the community in prevention efforts. C. Implementation of the Action Plan: Current Challenges II. Accomplishments Below is a summary of recommendations from the Plan that have been accomplished in the community and within county programs. Specific Plan recommendations are noted in parentheses, most activities include multiple numbers because they encompass more than one recommendation. Because the Community Wellness and Prevention Programs (CW&PP) may not be aware of many efforts currently underway in the community, this summary is by no means a complete listing. The CW&PP will be conducting a survey to determine what additional violence prevention strategies are being implemented in the county (discussion of the survey can be found in Section III, Current Efforts Underway). [Please note that discussion of staff and program activities prior to May, 1996 are identified as having been coordinated and implemented by the Prevention Program. As of May 1, 1996, the Prevention Program has been referred to by its new title, Community Wellness and Prevention Programs (CW&PP).] A. Community Education Accomplishments • "Increase the Peace" Countywide (Recommendations 6,8,9,10,11,13,14) For five years, the PACT (Policy, Action, Collaboration, and Training) for Violence Prevention Coalition adopted the month of April as "Increase the Peace"month. These efforts grew first in the western region of the county and included the service, business, and education communities. Activities have ranged from peace rallies to art shows, and from school conflict resolution classes to educational theater. The Channel, a local paper, dedicates its April edition to "Increase the Peace" advertisements and articles. On April 27, 1996, a violence prevention conference for child care providers was held at Contra Costa College. This year, both central and east county have joined with west county to make "Increase the Peace" a countywide effort. Most cities and the Board of Supervisors proclaimed April as "Increase the Peace" month. The Center for Human Development convened the central county committee. Event highlights in central county included the Broadway Plaza Community Faire on 2 April 6, and an Interfaith Community Speakout on April 19 - 21, at which worship services of every denomination promoted the message of peace. Delta 2000 convened an east county committee. East county highlights included a youth created"Increase the Peace" quilt to be displayed throughout east county; an"Increase the Peace"day at County East Mall featuring cultural performances and displays; and high school peace assemblies and mural creations. • City of Concord Gang Initiative (Recommendations 4,6,7.10,15,) The City of Concord Police Department, under the leadership of gang mediator Jim Hernandez, is using the Action Plan as a tool for developing and implementing strategies for gang mediation/violence prevention. He is currently conducting gang prevention sessions in Concord middle schools. • Teen Initiative Project/Youth Vote (Recommendations 10,12,15) The Teen Initiative Project, supported by the Health Services Department's Substance Abuse Division, is collaborating with the County Youth Commission to promote Youth Vote '96. Participating teens are working to put together a ballot representative of national and local issues, including high rates of violent injuries and deaths among youth. Participants are particularly interested in spot-lighting youth issues. Once completed,the ballot will be circulated to Contra Costa junior and senior high schools for countywide voting. Similar efforts are being made in Alameda, Marin, and San Francisco counties to make this a Bay Area wide effort. The youth plan to take the results of the vote to Sacramento in order to advocate for youth in future state policy initiatives. • Walnut Creek Police Department/Probation Department Trainings (Recommendations 4,5,6,10,12,15,19,25) From August 27 - 31, 1995, Violence Prevention Project staff from the Prevention Program planned and conducted a training series for the Walnut Creek Police Department on"The Public Health Approach to Violence Prevention." The same training was offered on five consecutive days, thereby assuring that each officer could attend according to his/her shift. Topics included violence risk factors, gun policy, and domestic violence reporting guidelines, as well as discussion on the role of the health department in violence prevention. Violence Prevention Project staff also trained Probation Department employees in 1995 on violence as a public health issue B. Health Services Department Accomplishments • Violence Prevention Committee (Recommendations 20,21,22,25) The Health Services Department's Violence Prevention Committee has been active in promoting healthy ways to discipline children. The Committee's Healthy Discipline Zones sub-committee 3 successfully collaborated with the Richmond Health Clinic Management Team on a new children's play area which draws on the theme of peace and healthy parenting. An event was held on April 19th to celebrate the opening of the play area and included a mini-health faire, entertainment, prizes, and speakers. The clinic worked closely with the west county "Increase the Peace" committee and plans to promote "Increase the Peace" ideas year-round in conjunction with the promotion of healthy discipline. Future plans include a provider/client produced"Quilt of Tears,"to allow expression of grief caused by violence and a brown bag speaker series featuring violence prevention topics. • The Firearms Injury Reporting, Surveillance, and Tracking (FIRST)Report (Recommendations 14,19,20) In April of this year, the Prevention Program completed its Injury Reporting, Surveillance, and Tracking project, FIRST,which collected firearm injury data in Contra Costa County with the unanimous and voluntary support of 20 law enforcement agencies, ten hospitals, and the County Coroner. The resulting report, which provides a valuable snapshot of all intentional and unintentional firearm injuries that occurred in the county between July 1, 1993 and June 30, 1994, will be used by policy makers and community organizations to prioritize violence prevention activities. Information included in the report includes demographic data on gunshot victims and offenders, types of guns involved in a firearm injury or death, location of the shooting, circumstances surrounding the shooting, and source of payment for medical care. • The Violence Prevention Update (Recommendations 14,17,20) For the past two years,the Prevention Program has been producing the Health Services Department's Violence Prevention Update. Originally intended as a way to keep staff informed about activities related to the Action Plan, the Update has evolved into a report on violence prevention activities throughout the HSD, including progress reports on the development of gun dealer ordinances, healthy discipline zones, and more. The Update is produced approximately four times per year and is distributed to a list of more than 100 people, including the Board of Supervisors and other key county staff. • Health Services Department Guidelines for Domestic Violence Screening and Reporting (Recommendations 1,2,3,20,21) To comply with California laws that stipulate that health care providers must conduct routine screening of all patients for domestic violence and must also report to law enforcement injuries they know or reasonably suspect were caused by domestic violence, the Health Services Department, with staff coordination from the Prevention Program, developed Guidelines for Domestic Violence Screening and Reporting. The Guidelines are innovative in two important ways. First, Guidelines contain a protocol which was developed in conjunction with Battered Women's Alternatives (BWA). BWA has agreed to assist patients with crisis intervention, counseling, safety planning and linkage to shelter services. BWA will respond with trained 4 advocates in the health care setting to provide victims of violence with culturally-appropriate crisis and follow-up services. Second,the Guidelines urge providers to work with local law enforcement agencies and domestic violence coalitions to ensure that reporting does not place the victim at risk for retaliation. The Guidelines, which include assessment tools, safety planning and reporting forms and instructions, and a comprehensive list of local domestic violence services, were distributed in January to approximately 2,000 Health Services Department staff. The HSD is currently in the process of identifying a points person to coordinate training for staff on implementing the Guidelines in a broad range of clinic and hospital settings. • Research on Firearm Safety Curricula(Recommendations 9,19) During the hearings on the Residential Gun Dealer Ordinance, members of the Board of Supervisors requested that Prevention Program staff research existing firearm safety curricula and make recommendations on curricula appropriate for elementary,middle, and high school classrooms. Staff reviewed a range of violence prevention and firearm safety curriculums. It should be noted that data collected on firearm deaths in the county indicate that unintentional firearm injury deaths among minors account for only a small percentage of the total deaths by firearms. For that reason, staff recommend that any curricula considered look at reducing risks for violence in addition to firearm safety. One curriculum of interest has been reviewed, Straight Talk About Risks (STAR) developed by Handgun Control, Inc. The STAR curriculum would be appropriate for firearm injury prevention because its objective is to discourage the purchase and handling of firearms. C. Policy Accomplishments 1. Legislation and Ordinances • Residential Gun Dealer Ordinance (Recommendations 9,14,20,22,24) Contra Costa County has joined seven cities in the county that have adopted ordinances regulating the operation and location and gun dealers under their jurisdictions. On November 28, 1995, following a series of hearings and debate,the county Board of Supervisors unanimously adopted an ordinance regulating gun dealers in the county's unincorporated areas. The ordinance affirms the prohibition on home gun sales; establishes a gun sales and conditional use permitting process; requires dealers to sell or provide a trigger lock with each weapon they sell; prohibits new gun shops from opening within 500 feet of a residential neighborhood, school, church, park, day-care center, liquor store, or other gun shop; and requires ammunition buyers to register at a gun shop when purchasing ammunition. The objective of the ordinance is to decrease the likelihood of unintentional injuries resulting from firearms without trigger locks and decrease access to ammunition by minors and persons 5 with criminal records. • Resolution Opposing Conceal and Carry Law(Recommendations 9,14,20,22,24) On February 20, The Board of Supervisors voted unanimously to oppose AB 638. The bill that would make it easier for people to obtain permits and would allow police chiefs and sheriffs to issue permits to carry a concealed firearm. The bill is also opposed by Attorney General Dan Lundgren, the CA Police Chiefs Association, Californians for Responsible Gun Laws, and Handgun Control, Inc.. 2. Organizational and Program Policy • Healthy Discipline Zones (Recommendations 21,25) The Healthy Discipline Zones sub-committee of the Health Services Department Violence Prevention Committee is advocating for HSD clinics to adopt the Healthy Discipline Zone concept(see Section IIB, Health Services Department Accomplishments for a description of the pilot Healthy Discipline Zone project) as the official policy for their children's play areas. This non-intrusive policy would be implemented through displays and handouts that describe non- violent parenting. A proposed brown bag training series for Richmond Health Clinic staff will serve as the groundwork for the polices implementation. • Domestic Violence Screening, Mandatory Reporting, and Training Policy (Recommendations 1,2,3,20,21) In January, 1996, the Health Services Department adopted policy no. 576, which addresses Domestic Violence Screening, Mandatory Reporting, and Training. The policy references the Department's Guidelines for Domestic Violence Screening and Reporting(see Section IIB, Health Services Department Accomplishments) and is intended to ensure compliance by Department employees with mandates and regulatory obligations to screen, assess, and intervene with patients exposed to domestic violence and to report known or reasonably suspected injuries resulting from domestic violence. D. Coalition Development and Collaboration • PACT (Policy, Action, Collaboration, Training) for Violence Prevention Coalition (Recommendations 1,2,5,6,8,9,10,11,15,19,25) PACT was funded in 1990 by the federal offices of Maternal and Child Health and Health& Human Services Office Of Minority Health. Funding for the project ended in December of 1995. However, west county's PACT Coalition has chosen to continue its mission of promoting a pubic health response to violence throughout the communities served by its eight member agencies. PACT was instrumental in the initiation of the former Prevention Program's extensive work in 6 9,q the area of local firearm dealer ordinances, and, as noted previously, has played a key role in annual "Increase the Peace" activities. Members are interested in addressing the links between community and family violence, with the goal of increasing coordination among youth-serving and domestic violence service agencies. • East County Violence Prevention Task Force (Recommendations 1,2,3,11,14,23,25) The East County Violence Prevention Task Force,under the direction of Tom Torlakson, sponsored a violence prevention forum on May 9, 1995 to bring community agencies and community members together to dialogue about perceived violence problems and propose solutions. East county involvement in"Increase the Peace" activities has renewed interest among a number of east county agencies in reconvening the Task Force. Delta 2000 is currently acting as the convener, and efforts are now underway to rejuvenate the group. East County Community Action Coalition(Recommendations 1,2,3,11,14,23,25) The East County Community Action Coalition is a new coalition body that is forming out of the recently dissolved Substance Abuse Action Committee. The group's proposed mission statement includes violence prevention initiatives. Subcommittees addressing HIV/aids, substance abuse, and youth and family issues have been formed. • Advisory Council Against Domestic Violence (Recommendations ) A Contra Costa County Advisory Council Against Domestic Violence (ACAD), authorized by the state Office of Criminal Justice Planning, was convened last summer by the County's Superior Court to develop a coordinated response to domestic violence in the county. The Violence Prevention Manager for the CW&PP is the Department's designee to ACAD. The Health Services Department is participating in three ACAD subcommittees (Police/Victim Relations; Data; and Community Education, Resources, and Prevention) and has been asked to convene a Health and Medical subcommittee. • East Bay Public Safety Corridor(Recommendations 20,23) In 1984, a joint effort involving government, health, and social services representatives and violence prevention advocates was established to begin building cooperation on violence prevention strategies between Contra Costa and Alameda Counties. Government, law enforcement, schools, community based groups and citizens from Alameda and Contra Costa counties are participating in the planning and implementation of the project. This is a very important effort at addressing violence prevention from a regional systems approach. On May 10, 1996 the CW&PP is participating in a Corridor-sponsored forum on developing violence prevention policies. 7 M. Current Efforts Underway • Safe Futures (Recommendations 4,6,7,10,12,15,20,22) Contra Costa County was one of six local governments, out of 76 applicants, to be awarded a "Safe Futures" grant from the U.S. Department of Justice's Office of Juvenile Delinquency Prevention. "Safe Futures,"headed by the County Administrator's Office, will focus on developing after-school tutoring and recreational programs, mentoring programs for adolescent girls, and substance abuse/mental health counseling for inmates at the county's juvenile facility. The grant award has not been released, but once the funding is released, a staff member from CW&PP's Violence Prevention Project will dedicate time to "Safe Futures"to ensure that it coordinates with existing violence prevention efforts in the county. • Community Survey (Recommendations 14,19) A survey developed by the CW&PP will be distributed throughout the county to community based agencies, schools, and other service providers in order to gauge the number and type of violence prevention efforts currently underway. The purpose of the survey is three fold: to assess the extent to which the Action Plan is being used; to identify technical assistance and training needs of violence prevention programs; and to develop a database of organizations involved with violence prevention, including agency profiles and project descriptions. The survey will be disseminated in June, 1996 and results will be tabulated over the summer. A report will be prepared and distributed in the fall of 1996. • The Tools For Violence Prevention Notebook(Recommendations 14,19.25) Violence Prevention Project staff been developing the Tools for Violence Prevention. Tools will document the Health Services Department's 13 year history in violence prevention and will include information on planning and implementing violence prevention programs. Tools is organized along the Spectrum of Prevention, with chapters on strengthening individual knowledge and skills; promoting community education; educating providers; fostering coalitions; changing organizational practices and promoting policy and legislation. When completed, the Tools notebook will be used in technical assistance and disseminated nationally through the Children's Safety Network. • Community Education, Resources, and Prevention Committee of the Advisory Council Against Domestic Violence (Recommendations 1,3,6) One of the more active Advisory Council Against Domestic Violence (ACAD) subcommittees has been the Community Education, Resources, and Prevention Committee, which is being Chaired by Battered Women's Alternatives (BWA). This Committee has developed recommendations for integrating domestic/dating violence prevention education into county elementary, middle, and high schools, establishing a speakers' bureau, identifying and responding 8 1 1 I } IrL to funding opportunities for primary prevention or domestic violence, and training law enforcement agencies and neighborhood watch groups throughout the county on how to identify and respond to domestic violence. • Violence Against Women: A Profile of Homicides of Women in Contra Costa County (Recommendations 19,25) This study by CW&PP, currently being edited for distribution, analyzes 12 years' worth of data on female homicide victims. When completed,the study will help to inform policy and program development related to reducing women's risk for homicide in the county. Additional studies of violence against women are being planned looking at assaults on women, an analysis of service data from Battered Women's Alternatives, Rape Crisis, and Crisis & Suicide Intervention Services, and an analysis of secondary crime data. • Domestic Violence Death Review Team (Recommendations 1,3,19,21) In 1995, the state legislature authorized the formation of domestic violence death review teams. BWA, with support from CW&PP, is working to establish the Team. Members of the Team should include representatives of the Sheriffs office, Coroner, law enforcement, BWA, the Health Department, medical providers and any other organizations with an interest in preventing violence against women. The homicide study described above will be used to inform the Team in planning how they will look at prevention and improve systems of coordination. IV. Next Stens A. Countywide Task Force When the Action Plan was adopted by the Board of Supervisors in 1994, one of the next steps identified was the implementation of a Countywide Violence Prevention Task Force which would involve government, schools,businesses, agencies, and residents throughout the county in coordinating local violence prevention efforts. In 1995, the Prevention Program worked with the County Administrator's Office to develop guidelines for the Countywide Task Force and sought additional funds to develop and support it, without success. In subsequent discussion with the Board of Supervisors, it was agreed that using such a cumbersome mechanism to implement the Plan was probably neither strategically appropriate nor cost effective. B. Future Role of the Health Services Department in Implementing the Action Plan The Health Services Department has a unique role to play in the implementation of the Action Plan as part of the County's commitment to prevent violence. The goal of the Health Services Department is to increase the capacity of local communities and community based organizations to successfully implement effective violence prevention programs and involve a diverse cross- section of community members in violence prevention efforts. 9 The role of the Health Services Department in violence prevention is to: • Build consensus on methods for preventing violence, including those which address the root causes of violence. • Convene coalitions, task forces, and collaborative networks to implement the recommendations of the Action Plan. • Facilitate and provide technical assistance to existing, coalitions,task forces, and collaborative networks. • Provide coordination and staff support to county governmental violence prevention initiatives. • Facilitate integration of violence prevention into programs of the Health Services Department. • Track and facilitate the passage of violence prevention policies and legislation. • Collect and analyze data related to violence, and generate reports for application by community based organizations, other county programs, cities, and school districts. • Increase community awareness about the root causes of, and factors that contribute to, violence. • Identify risk factors related to becoming a victim or perpetrator of violence, and disseminate the information to community based organizations, other county programs, cities, and school districts. • Work with community-based organizations and schools to increase their capacity to prevent violence through training, technical assistance, direct funding via mini- grants, and contract administration. • Identify and seek funding on behalf of the county to continue violence prevention efforts and implementation of the Action Plan. C. Operationalizing and Implementing the Action Plan Adequate resources will allow the Health Services Department to coordinate and implement many aspects of the Action Plan (please see Section V, Personnel and Financial Resources). The Health Services Department would like to operationalize its role in preventing violence as defined above and work ensure that the Action Plan remains viable and useful. To that end, staff 10 have reviewed and updated the existing steps originally outlined in Preventing Violence in Contra Costa County:A Framework for Action and propose to implement the following activities: Planning and Technical Assistance • Conduct an assessment of community needs related to violence prevention. • Develop a technical assistance plan based on the results of the Action Plan survey. • Facilitate violence prevention planning efforts with community-based organizations, schools, law enforcement, and juvenile justice in the four regions of the county. • Develop community, business, school district, and governmental partnerships to achieve the recommendations in the Plan. • Provide active county representation on key violence prevention coalitions and task forces. • Coordinate a local conference structured to facilitate implementation of the Plan. • Offer mini-grants to community based organizations and schools to build their capacity in the following areas (not an exhaustive list): - Training - Policy efforts - Youth-sponsored efforts - "Increase.the Peace" events -Networking via computer on-line forums and web sites • Finalize and disseminate the Tools For Violence Prevention. Continue to distribute other violence prevention resources, such as the Profile of Violent Injury. • Provide technical assistance to community-based organizations on coalition building, the root causes of violence, application and use of violence-related data, program evaluation, policy advocacy, use of media, and program development. • Establish a clearinghouse of information on effective violence prevention programs and strategies. 11 Policy Development • Track violence prevention-related legislation. • Evaluate the impact of the Residential Gun Dealer Ordinance. • Work with the East Bay Public Safety Corridor to identify and pursue firearm and violence prevention legislation. • Work with the Health and Medical Committee of the Advisory Council on Domestic Violence to develop a uniform response by CCC law enforcement agencies to third-party (e.g., health care provider)reports of domestic violence. Public Information and Community Education • Continue to expand the annual "Increase the Peace"events in collaboration with the Juvenile Justice and Delinquency Prevention Commission. • Continue to write and disseminate the Violence Prevention Update, expanding the newsletter to feature community based efforts to prevent violence and broadening distribution. • Produce and distribute a master calendar of CCC violence prevention events. Data Collection and Analysis • Present the findings of the FIRST Report and Profile of Violent Injury to community-based organizations, local governments, law enforcement agencies, and other groups and individuals interested in sponsoring violence prevention efforts. • Develop a database of organizations involved in violence prevention, including agency profiles, descriptions of violence prevention programs,populations served, etc. Utilize database to facilitate information sharing between agencies and annual reports on progress towards implementing the Action Plan. • Complete a data profile of violence against women in Contra Costa County; present the results to based organizations, local governments, law enforcement agencies, and other groups and individuals. V. Personnel and Financial Resources CW&PP is currently receiving funding in the area of domestic violence for its Domestic 12 Violence Prevention Project (DVPP). One full time and one part time staff persons are funded by the California Department of Health Services, Maternal and Child Health Branch to provide technical assistance and training to maternal and child health programs in the area of domestic violence. These same staff have been able to develop collaborations with Battered Women's Alternatives locally and participate in ACRD. DVPP staff would be able to participate only on a minimal level in the implementation of the Action Plan, given their current responsibilities. Securing funding for implementation of the Action Plan and for community violence prevention has been an immense challenge for the Health Services Department. Seven proposals were submitted to a range of funding agencies including the California Department of Health Services, Cities and Foundations. While the quality of our proposals was rated highly, none of the proposals were funded. Feedback from funding sources indicated that there is great interest in the Action Plan but there is increased competition for funding in the field of violence prevention. Many funders are providing support to new and first time violence prevention efforts in the state. Due to the decline in federal funding for violence prevention, staff has been cut-back in the area of community violence prevention from four full time equivalents to one full time equivalent. Current staff will be able to maintain only minimal activities towards the implementation of the Action Plan. Below is an outline of staffing and other related efforts that would allow the Health Services Department to develop a variety of activities around the Action Plan. Based on this outline, it would cost approximately $300,000 per year to implement this complete spectrum of activities. We believe violence prevention is cost-effective, both in financial and human terms. Realistically however, it is unlikely we will develop on additional $300,00 per year in violence prevention funding in the near future from outside grant sources. We will continue to seek funding to implement portions of this program, as part of a comprehensive and long-term effort of the Contra Costa communities to respond to this public health issue. • Fund an annual conference for organizations and individuals implementing/interested in implementing violence prevention strategies outlined in the Action Plan. • Fund the writing and distribution of a community violence prevention newsletter and calendar. • Provide mini-grants to community based organizations for violence prevention interventions and to support their participation in"Increase the Peace"The Peace and other Action Plan efforts. • Fund a full time community violence prevention coordinator, who would be responsible for planning, resource and program development, coordinating linkages within the community, and overseeing the awarding of mini-grants. 13 • Fund a full time community violence prevention associate, who would research effective programs, identify and track policy efforts, and coordinate the annual violence prevention conference. • Fund a full time community violence outreach coordinator,who would be responsible for coordinating the annual Increase the Peace events, developing partnerships with community groups,participating on key violence prevention committees and coalitions, and supporting community-based organizations in implementing violence prevention projects. • Continued funding for data and public information to support community violence prevention efforts. 14 91 APPENDIX ' DI Contra Costa County Violence Prevention Survey Instructions: Note that the survey is in THREE parts - part one queries your perspective of the problem of violence and viable solutions; part two inquires to your knowledge and use of the countywide Action Plan for Violence Prevention; part three requests background information about your agency which will assist the overall assessment of the survey. Please notice that some questions allow for more than ONE answer. Part One - Violence Prevention 1. Please rank on a scale of 1 to 5 (1 = greatest problem 5 = least problem) the types of violence that you see as being a problem for the community that you serve. Please rate ALL of the categories. [ ] Child Abuse [ ] Rape / Sexual assault [ ] Domestic violence [ ] Suicide/self-destructive behavior [ ] Fighting/Assault [ ] School-based violence [ ] Gang involvement [ ] Elder abuse [ ] Gun violence [ ] Youth vs. youth violence [ ] Hate crimes [ ] (other) b. Of the problems listed under #1, which, if any, are a focus/priority area for your organization? [ ] Child Abuse [ ] Rape / Sexual assault [ ] Domestic violence [ ] Suicide/self-destructive behavior [ ] Fighting/Assault [ ] School violence [ ] Gang involvement [ ] Youth vs. adult violence [ ] Gun violence [ ] Youth vs. youth violence [ ] Hate crimes [ ] 2. The Health Services Department can offer technical assistance to community groups (see list below). Does your organization have an interest or need for this assistance? [ ] Yes [ ] No go to question 2b. go to Part Two b. Please check off the following areas of technical assistance in terms of your interest or need. On a scale of I - 5 please rate your interest level for each of the following items: [1 = most interest 5 = least interest] Training [ ] Provide trainings/conferences on violence prevention concepts and strategies [ ] Provide training on how to utilize violence data specific to your community [ ] Provide training and/or technical assistance on accessing media [ ] Provide training and/or technical assistance on developing public policy 01 Coalition-building / Collaboration [ ] Facilitate collaboration between your organization and other organizations with an interest in violence prevention [ ] Facilitate the development of a community coalition to coordinate violence prevention activities Program Development [ ] Distribute information on funding sources for violence prevention [ ] Assist with violence prevention program development [ ] Assist with violence prevention program planning [ J Develop program evalauation tools [ ] Serve as a clearinghouse for violence prevention materials Part Two - Contra Costa County Violence Prevention Action Plan 1. A countywide Action Plan for preventing violence in Contra Costa County was placed on the 1994 ballot and was approved by 78.8 percent of voters. The plan delineates 25 recommendations which serve as a concrete foundation for reducing and preventing violence in Contra Costa County. a. Prior to this survey, were you aware of the Action Plan for reducing violence in Contra Costa County? [ ] Yes [ ] No go to question 3b. go to Part Three b. Being aware of the Action Plan, have you utilized the Action Plan in your work? [ ] Yes [ ] No If YES go to question 2 If NO go to question 3 2. If YES, please briefly list ways in which you've used the Plan. a. Please check which ONE of the Action Plan themes best describes your work: [ ] Safe Homes [ ] Safe Neighborhoods [ ] Safe Schools [ ] Safe Workplaces [ ] Violence Prevention policy development 3.' If NO,please state reasons why the Plan is NOT useful to you: Par Three - Background of Survey Participant A. Service Area 1. Which of the following best describes your work arena? (Please check the ONE best choice) A [ ] Community-based agency C [ ] Health E [ ] Education B [ ] Law enforcement D [ ] Local government F [ ] Other: 2. Services offered by your organization (check all that apply): A [ ] client-based direct services B [ ] school-based programs C [ ] community organizing D [ ] policy development E [ ] community education F [ ] other: G [ ] coordination / coalition building 3. Please briefly describe your organization's violence prevention activities. Or, if available, please attach a brochure which describes your services. 4. Total staff size: A [ ] less than 10 B [ ] 10 to 20 C [ ] 20 to 30 D [ ] 30 to 50 E [ ] more than 50 5.' Please indicate the area of the county that you serve (If it is only one or two cities within a given area, please check the city) a[ ] All WEST cnty 1[ ] All CENTRAL cnty w[ ] All EAST cnty ff[ ] All SOUTH cnty Or check specific cities if you do not serve the entire region. b[ ] Bayview m[ ] Clayton x[ ] Antioch gg[ ] Alamo c[ ] E. Richmond n[ ] Concord y[ ] Bay Point hh[ ] Blackhawk d[ ] El Sobrante o[ ] Crockett z[ ] Bethel Island ii[ ] Danville e[ ) Hercules p[ ] Lafayette aa[ ] Brentwood jj[ ] San Ramon f[ ] Kensington q[ ] Martinez bb[ ] Byron g[ ] N. Richmond r[ ] Moraga cc[ ] Discovery Bay h[ ] Pinole s[ ) Orinda dd[ ] Knightsen ff ] Richmond t[ ] Pacheco ee[ ] Pittsburg j[ ] Rodeo u[ ] Pleasant Hill k[ ] San Pablo v[ ] Walnut Creek OR kk[ ] ENTIRE Contra Costa County B. Clientele Served (If you are direct services agency) 1. Number of clientele served per year A [ ] less than 100 B [ ] 101 - 300 C [ ] 301 - 500 D [ ] 501 - 750 E [ ] 750 - 1200 f [ ] more than 1200 2. Age of clientele (check all that apply) a [ ] Birth to5 b [ ] 12 - 17 c [ ] 26 - 55 d [ ] 6 - 11 e [ ] 18 - 25 f [ ] 55 or older 3. Race/Ethnicity of clientele (check all that apply) a [ ] African American e [ ] Caucasian b [ ] Latino f [ ] Asian American c [ ] Native American g [ ] Other d [ ] Southeast Asian / Pacific Islander 4. Gender of clientele A [ ] All male B [ ] All female C [ ] % males and % females r 5: LarigUages other than English spoken by clientele (check all that apply) a [ ] Spanish b [ ] Tagalog . c [ ] Mandarin d [ ] e [ ] Thank you for your time! Please return the survey in the enclosed envelope by X date. We look forward to hearing from you. (Optional) Please print Name Organization Address Phone Fax TO: BOARD OF SUPERVISORS Contra 'i IROM. Mark DeSaulnier Jeff Smith Costa s DATE: County November 14, 1995 SUBJECT- Violence Prevention Action Plan SPECIFIC REOUEST(S)OR RECOMMENDATION(S)!BACKGROUND AND JUSTIFICATION RECOMMENDATION: Refer to the Family and Human Services Committee and the Violence Prevention Project "Preventing Violence in Contra Costa County: A Countywide Action Plan" to look into implementation of the Plan. BACKGROUND: In November 1994, the voters of Contra Costa County ratified by 78.8 percent "Preventing Violence in Contra Costa County: A Countywide Action Plan." The Plan was written with the intent to provide a road map for future violence prevention efforts which the residents of the county have acknowledged as a leading problem in our communities. Unfortunately, though, the Plan has yet to be implemented as was intended, primarily due to lack of funding, not lack of interest. The Plan has been widely discussed by the Violence Prevention Project staff and community organizations and has been hailed nationally for its foresight and workability. Also, several attempts have been made to get funding, including a August 9, 1994, Board Order in which the Supervisors unanimously agreed to set aside .5 to 1 percent of the General Fund (copy attached). The Order was referred to the Finance Committee but a report never came back to the Board. Also the Prevention Project tried for a grant in spring of 1995 that did not get funded. A prime example of the effectiveness of the Plan is the work of Jim Hernandez, Gang Mediator for the City of Concord. Mr. Hernandez is currently successfully implementing several of the 25 recommendations listed in the Plan, including CONTINUED ON ATTACHMENT: AYES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATUREIS): ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER MOTE OF SUPERVISORS _____ ---- 1 HEREBY CERTIFY THAT THIS 18 A TRUE X UNANIMOUS(ABSENT - AND CORRECT COPY OF AN ACTION TAKEN AYES:_. -- NOES: AND ENTERED 4`N THE MINUTES OF THE BOARD ABSENT:- ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. County Aft CC: -rami y .- uman Service Cte. ATTESTED November 14, 1995 -Finance Committee via CAO) PHIL BATCHELOR,CLERK OF THE BOARD OF oumt Coun$el ea t Services Director UP VISORS AND COUNTY ADMINISTRATOR Auditor-Controller M382 (10/88) rZ4ZW1UTY i Violence Action Plan November 15, 1995 Page Two developing a conflict management program for high school students (Recommendation #4); outreaching to youth in at-risk environments through counseling, field trips, support to parents, youth employment, grief counseling, and academic achievement (Recommendation #8); and creating an indoor recreation area (a "safe haven") for residents of the Village Green Apartments in Concord (Recommendation #9). It was Mr. Hernandez's direct use of the Plan which inspired us reexamine the Plan and decide that we need to find a way to make it work. We do recognize that many non-profit agencies, individuals, community volunteer organizations, county staff, and city staff do use portions of the Plan. However a coordinated effort needs to be established. People are duplicating efforts and some who work in the violence prevention field do not even know this vital document exists. This is a waste of time, energy, and money. Therefore, a means for funding and consolidation needs to be found so we can begin to work together to decrease violence in all of the communities in Contra Costa County. t 2.4 a THE BOARD OR SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on _August 9, 1994 by the following vote: AYES: Supervisors Smith, Bishop, DeSaulnier, •Torlakson, Powers NOES: None ABSENT: None ABSTAIN: None s:asaaaaaaaaaaaaaaaasaaaaaaaaaaaasaaaaaaaaaaaasaasaaasssasssaaaaaaaaaaaaaaaaaa SUBJECT: Violence Prevention In its approval of two ballot measures on a Violence Prevention Action Plan andSupport of a Statewide Surcharge on the sale of firearms and ammunition to fund firearm safety education and violence prevention programs, the Board also took the following actions: A. AGREED to commit one-half to one percent of the County's General Fund revenues to fund violence prevention programs and REFERRED this matter to the Finance Committee; B. APPOINTED Supervisors Tom Torlakson and Mark DeSaulnier as Co-chairs of the Countywide Violence Prevention Task Force with instructions to work with staff in the development of a resolution setting forth the charge and membership of the Task Force for subsequent consideration by the Board of Supervisors; and C. REQUESTED Larry Cohen, Director of the County's Prevention Program, to report to County Counsel on potential local revenue sources to fund violence prevention programs. I hereby certify thot this is a true and correct copy of an action taken and entered on the minutes of the Boar+of Supervisors on the date shown.,p ATTESTED: 9cc� 9. /! f,/ -., PHIL BATcbtLoR.Clark of the Board cc: Health Services Director of Supervisors and County Administrator Larry Cohen _ County Administrator �' " `�"1� �'Deputy Finance Committee Supervisor Torlakson Supervisor DeSaulnier County Counsel Auditor-Controller TO, ' BOARD OF SUPER6SORS Contra FROM: Mark Finucane `jontra -Health Services Costa DATE: AU$USt 9, 1994 ("boy q, SUBJECT: Ballot Measure: Violence Prevention Action Plan vim" "' SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKr9ROUND AND JUSTIFICATION RECOMMENDED ACTION: 1) PLACE the following measure on the November ballot for voter approval. For the ballot itself: Should the County-wide Action Plan to prevent violence be endorsed,and; should a county-wide effort be conducted to build upon and coordinate existing violence prevention activities involving all city,county and school jurisdictions, leading to the expansion of violence prevention efforts in Contra Costa County. For the voter's pamphlet: Support of this ballot initiative indicates that a county-wide effort should be conducted to build upon and coordinate violence prevention activities involving all city, county, and school jurisdictions, leading to expansion of violence prevention efforts in Contra Costa County. Recognizing that violence is a costly and complex problem affecting the lives of many Contra Costa residents;is a learned behavior and is therefore preventable;and that worthwhile solutions are emerging throughout the country, state and nation, this initiative indicates support for the County-wide action plan to prevent violence. It indicates the priority Contra Costa County places on pursuing programmatic initiatives and funding plans to prevent violence. Individuals and families must be responsible for appropriate and responsible behavior. Cities, the county, and school districts must';provide leadership and direction based on current knowledge of and research on violence prevention. Systematic coordination which builds upon existing local efforts, and an access to a wide range of programmatic responses is essential. Direct activities, programs and policies should be incorporated into all relevant organizations at every level of the community. A broad array of alternatives, including conflict resolution, professional training, public education, neighborhood based efforts, youth involvement and diversion activities should be planned and implemented. Y CONTINUED ON ATTACHMENT: ,t_ YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOA4D COMMITTEE APPROVE OTHER SIGNA E S : ACTION OF BOARD ONt;-- APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS IS A TRUE 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. Contact: Mark Finucane �s Cc: CAO ATTESTED _yam! -- Supervisor Torlakson PHIS BATCHELOR, CLERK OF THE BOARD OF Mark Finucane SUPERVISORS AND COUNTY ADMINISTRATOR Larry Cohen Ilonn/� ne BY_75-- V ✓ /J nFPI ITY ' 1 BACKGROUND: On February 1, 1994 the Board Of Supervisors adopted a preliminary plan for violence prevention as presented by the Health Services Department. The Board directed the Health Services Department to work with cities, school districts and non-profit organizations to coordinate a county-wide effort. Numerous meetings have been held throughout the county, to supplement and reinforce existing violence prevention activities of community residents and agencies. Violence is a severe problem in Contra Costa County as elsewhere in the nation. Local residents endure significant physical and emotional suffering; widespread daily feu, grief, and loss of personal safety; and a burden of real financial costs primarily borne through support to the health care and criminal justice systems. The examples below partially illustrate the magnitude of the problem. In 1992, firearm injuries were the leading cause of injury deaths to Contra Costa residents, nearly twice as many as deaths related to motor vehicles. From 1988-1990, firearm injuries were the leading cause of death for Contra Costa youth between the ages of 10 and 14. Throughout the county, 4346 aggravated assaults were reported to law enforcement agencies during 1992. As reported to local law enforcement agencies, 309 forcible rapes were perpetrated on Contra Costa residents during 1992. It is estimated that reported rapes are only 1/3 1/2 of those that actually take place. Domestic violence is a greater cause of injury to women than car accidents,rapes, and muggings combined. Violent crimes appear to be increasing although crime as a whole is diminishing across the country. This situation is not acceptable. The Contra Costa County Board of Supervisors, however, firmly believes that violence is preventable, that we must seize all opportunities to reduce and prevent it. Therefore the Board joins with cities and school districts throughout the county to make violence prevention a priority issue in this county. Many laudable efforts have already begun in our communities. In the past few months a Youth Summit and two regional summits have advanced the progress of local violence prevention efforts. We can weave them together further, sharing good ideas and building upon efforts developed in our various and diverse communities. To effectively prevent and reduce violence,we must link together the various sectors throughout the county to further develop and implement a county-wide action plan to reduce and prevent violence. COST As an advisory measure, there is no cost to the county. Violence prevention saves money. "Violence caused almost one-fifth of injury medical care costs ($13.5 billion) nationally in 1992." according to U.S. Senate Finance Committee. The average cost of medical treatment for one hospitalized gunshot wound victim among all age groups is over$33,000, according to the Children's Safety Network. Preventing Violence in Contra Costa County: A Framework for Action submitted to the Contra Costa County Board of Supervisors August 9, 1994 for further information contact: Contra Costa Health Services Department Prevention Program (510) 646-6511 Preventing Violence In Contra Costa County: A Framework for Action EXECUTIVE SUMMARY The Contra Costa County Board of Supervisors firmly believes that violence is preventable and that all opportunities to reduce and prevent violence in Contra Costa should be pursued. Therefore, the Board joins with cities, school districts, and community members throughout the county to make violence prevention a priority. Violence is a learned behavior and therefore preventable. The Framework for Action is formulated with the premise that violence is a health issue. As a health issue, violence requires attention not just to the outcomes of violent injury, but to the symptoms and, ultimately,to the prevention of violence. The term "health" is used here in the broadest sense, not just the medical consequences, but as an approach that pinpoints the underlying causes and risk factors, and recommends the systematic integration of community, private and public entities in the development of solutions. For more than ten years, community agencies and government departments have been coordinating a variety of violence prevention efforts. Many efforts by community-based programs predate the county government's role in violence prevention. The increased awareness, concern, commitment, and involvement of the entire Contra Costa County population can be directed so that a significant reduction in violence will be achieved. The purpose of The Framework for Action is to describe the problem of violence, its impact in Contra Costa County, and, most importantly, some of the critical initiatives that will reduce violence in the county. The Framework is intended as a working supplement to the countywide Action Plan for Violence Prevention. The Framework enumerates examples of specific activities for each of the 25 recommendations in the Action Plan. This Framework for Action is intended as a "work in progress." A fully inclusive list of recommendations would require surveying existing and proposed violence prevention measures throughout communities and government. A completely effective violence prevention plan would also ensure that the underlying, root cause of violence had been dealt with, including issues relating to unemployment, oppression and mental health. However, the 25 recommendations enumerated here can serve as focal points to help identify priorities and allocate resources. These recommendations deal with six'themes: Safe Homes, Safe Schools, Safe Communities, Safe Workplaces, Government Service, and Policy initiatives. Under each recommendation a set of actions is listed; these actions are generally applicable to more than one recommendation. The actions are intended as steps and examples, but may require modification in a particular community, and certainly there are numerous other steps that could be listed and should be undertaken. This document is primarily concerned with assault, homicide, sexual assault and battering. Child abuse, elder abuse, and suicide are not as thoroughly addressed, although attention to the recommendations here would have a significant impact on every one of these concerns. Preventing violence is a responsibility that will take many years and perhaps lifetimes to achieve. This Framework for Action will serve as a road map to help us reach our goals more effectively. For further information on The Framework for Action, please call the Health Services Department Prevention Program, (510) 646-6511. I. BACKGROUND On February 1, 1994 the Board Of Supervisors adopted the preliminary plan for violence prevention presented by the Health Services Department. The Board directed the Health Services Department to work within county government, as well as with cities, school districts, and non-profit organizations, in a concerted effort to reduce violence in Contra Costa. Meetings were held in various regions of the county to find out how to supplement and reinforce existing violence prevention activities. Board of Supervisor's representatives hosted violence prevention summits in Central County in May and East County in June. From these summits, a series of recommendations was developed dealing with the themes of Safe Homes, Safe Neighborhoods, Safe Schools, and Safe Workplaces. West County has sponsored numerous initiatives such as The Enterprise Community, Increase The Peace Month, and the Opportunity West Community Substance Abuse Partnership. Many sectors of the community, including non-profit agencies and government, are already taking important steps to prevent.violence. The Framework proposes actions that will enhance existing efforts and integrate them with new initiatives for preventing violence. It looks at the role of government and institutions, as well as collaborative activities that would benefit from partnerships between communities, government and the private sector. The Framework for Action incorporates the recommendations which grew out of the two regional summits; West county recommendations; research conducted by Health.Seivices Department staff reports on violence prevention efforts in other communities; and the expertise.of individuals who have developed local programs and policies. It addresses six areas: Safe Homes, Safe Schools, Safe Communities, Safe Workplaces, Government Service, and Policy Initiatives. Information from organizations throughout the United States was incorporated into this Framework. Special acknowledgement is due to the City of Seattle's Violence Prevention Work Group. Because the problem of violence is so complex, it is crucial that all who live and work in Contra Costa County support the development and implementation of effective violence prevention initiatives. 11. THE MAGNITUDE OF THE PROBLEM A) Rates of Violence Violence has reached what public health officials conclude is epidemic proportions. Too many lives are lost or radically altered by violence, costing not only grief and emotional suffering, but also a huge financial burden on the public_to bear the costs of emergency medical services, law enforcement and jails. Violence is as severe a problem in Contra Costa County as in much of the rest of the nation. As the following figures show, the toll is great. The rates for interpersonal violence are higher in the United States than any other 2 industrialized nation. For example, in 1990, the rape rate in the U.S. was 8 times higher than in France, 15 times higher than in England, 20 times higher than in Portugal, 23 times higher in Italy, 26 times higher than in Japan, and 46 times higher than in Greece.' Nationally, motor vehicles are the leading cause of injury death among persons aged 1-34. According to data currently being analyzed by the Health Services Prevention Program, in 1992 and 1993, the number of homicides in Contra Costa surpassed motor vehicles as the leading cause of injury death. Violence (homicide and suicide) accounted for 44.8 percent of injury deaths in the county between 1988 and 1992. Of these violent deaths, 54 percent were suicides and 46 percent homicides. In 1993, however, homicide outranked suicide, comprising 61 percent of injury deaths versus suicides (39 percent). There are 60 million handguns in private hands in the United States. From 1988-1990, firearm injuries were the leading cause of death for Contra Costa youth between the ages of 10 and 14. Firearms were the weapon most frequently reported in violent deaths in Contra Costa between 1988 and 1992 (more than 63 percent). In 1992, firearm injuries were the leading cause of injury deaths to Contra Costa residents, nearly twice;as many as deaths related to motor vehicles. Throughout the county, 4346 aggravated assaults were reported to law enforcement agencies during 1992. As reported to local law enforcement agencies, 309 forcible rapes were perpetrated on Contra Costa women during 1992. Itis estimated that reported rapes are only one-third to one-half of those that actually take place. According to-a majority staff report prepared for the Senate Judiciary Committee, at least one out of five women will be sexually assaulted in her lifetime.z Battering is the leading cause of injury to women and accounts for nearly one third of all emergency room visits by women. Each year, domestic violence generates more than 21,000 hospitalizations, 99,800 hospital days, and 39,900 physician visits.' A study by California Crime Commission estimates that alcohol is associated with two-thirds of all violent behavior; one-third of teen suicides are alcohol-related; and more than half of all convicted rapists were drinking at the time of their offense. 3 Causes of Injury Death Contra Costa County Residents, 1992 Or,wn..poR 22% .FeWArm 72% 1Ao orM.htr.16.5% &2% 4.3% FUw++r i, Omwntip as% Fiv/&+n 2.,% poYontq 1sA% (N-3M) . iaiw:CAWank Depwbnent aMwO SwWoss,MW S W= Firearm Injury Deaths Contra Costa County Residents,1992 Total Number of Firearm Injury Deaths=115 Mew pA% aukke 41.7% HamkJde . btA% lhitMsn9aiel FMneM 3.5% SwAv a Cmffw*Dnpw&wt d HooM SeMoee.NW SAWN= Homicides by Weapon Richmond,CA 1988-1993 100% 0-55)(�-m1 (�- 60% 60% ®Other tKnife MotherGun 40% MKandgun 2096 0% 1988 1989 1990 1091 1992 1993 Soave:C&Wbn*Depn6+ad NJusdce(,99&1992);WchnOnd Po&a DgMM7W9(1999) B. COSTS OF VIOLENCE "Violence caused almost one-fifth of injury medical care costs ($13.5 billion) nationally in 1992," according to testimony before the U.S. Senate Finance Committee. According to national statistics compiled by the American Medical Association, direct medical costs related to violence exceed $5 billion annually, and many of the estimated 1.5 million victims of assault each year are uninsured, placing an incredible burden on the public to bear the cost. The average cost of treating a child wounded by gunfire could provide a student with a year of college education. Researchers surveyed hospital discharges from 44 acute care children's hospitals and found that in 1991, the average hospital charges for gunshot wounds to children were $14,434. In 1992, the cost of direct medical and claims processing for the victims of gun violence _ nationwide totaled approximately $3 billion! According to the Physicians for a Violence Free Society, more than 80 inner city hospitals have abandoned their emergency rooms in recent years due to unmanageable costs. Between 1982 and 1992, the share of government spending going to the criminal justice system rose from 5.4% to 7.5% (Business Week December 13, 1993). Incarcerating a 25 year-old for life costs a total of$600,000- $1,000,000. Average annual cost per prisoner is $27,000.5 III. ROOT CAUSES AND RISK FACTORS The first step to effective action is to define the problem. Only after understanding the dimensions of violence, its root causes and risk factors, can appropriate solutions be developed. Nationally, as well as locally, experts are finding that the same elements underlie the problem of violence. Three causes (economics, oppression and mental health) and six community risk factors have been identified. Addressing these causes is critical and requires substantial re-ordering of political and social priorities. Although the risk factors are also difficult to change, they are more amenable to modification. A. Three Root Causes 1. Economics: The depressed economic conditions within a given community, as well as individual cases of unemployment and underemployment, lead to significantly higher levels of violence. 2. Oppression: Sexism, racism, and discrimination based on age, class, and cultural background lead to a sense of inequality and powerlessness that is an underlying component of many types of violence. 5 3. Mental Health: In the absence of individual responsibility and family support for responsible behavior, violence is more likely to occur. An unsupportive home life, including physical or psychological abuse, can produce low self-esteem in both the victim and perpetrator. Violence begets violence; it is frequently cyclical. A culture which reinforces violence makes the goal of individual responsibility more difficult to achieve. It is important to note that while African Americans are the most severely affected by violence and the most likely to be jailed for violent offenses, neither race nor ethnicity is a primary risk factor. The disproportionately high levels of violence among the African American population are indicators of the underlying economic and social conditions in which the population is likely to find itself. The devastation of these communities by violence is best understood, according to Dr. Deborah Prothrow-Stith, author of Deadly Consequences, as a reaction to poverty and to over-crowding, in the context of an American culture where violence "is as American as apple pie."6 B. Six Community Risk Factors, 1. Guns: By virtue of the fact that guns are involved in the vast majority of homicides and suicides, their availability and lethality is a major concern that needs to be addressed. 2. Media: Although the mass media justify sensationalization of violence and sexual objectification by claiming that these are what the public wants for entertainment, studies show the psychological damage of such programming. 3. Alcohol and Other Drugs: The drug most frequently associated with violence is the one subsidized by the government and legally marketed to consumers: alcohol. The illicit drug trade also contributes significantly to violence. 4. Incarceration: Although incarceration is frequently necessary, if there is no funding for adequate prevention, treatment, and rehabilitation programs, then it is the only form of violence reduction available. When incarceration is the only option, prisons can become a training ground for more violence. Building and maintaining jails also uses resources that could be channeled to violence prevention efforts. S. Witnessing Acts of Violence: Experiencing violence can produce Post Traumatic Stress Disorder (PTSD), similar to that experienced by war veterans. Exposure to, or direct involvement in, violence is likely to create the belief that violence is the normal form of conflict resolution. 6. Community Deterioration: The funding for community services throughout the United States has taken a notable downturn. Schools, health and mental health services, libraries, recreational centers, and parks are all critical institutions that provide a buffer against the likelihood of violence. At the same time, the "web" of community participation seems to be unravelling, with people's attention focused more on the needs of their own families than the health of the community as a whole. 6 IV . A PUBLIC HEALTH APPROACH As a health issue, violence requires attention not just to the outcomes of violent injury, but to the symptoms and, ultimately, to the prevention of violence. The term "health" is used here in the broadest sense, not just the medical consequences, but as an approach that pinpoints the underlying causes and risk factors, and recommends the systematic integration of community, private and public entities in the development of solutions. The health of a community is a composite of physical, psychological, social, and economic variables. Consequently, the responsibility for overall community health resides in a number of systems, including the family, education, health, work, criminal justice, and social services. An African proverb states, "It takes a village to raise a child." Ending violence will require that people in each neighborhood assume responsibility for the problem -- even if doing so is risky and frustrating. Stopping the momentum of violence requires a "critical mass" of people who are willing to speak out and to work together to change the structures and policies that frame the way we live. V. PRINCIPLES AND GUIDELINES The Framework for Action plan delineates 25 recommendations. They are intended as focal points for identifying priorities and.allocating resources. They are meant to augment, refine, and broaden the efforts already initiated by citizens and institutions throughout Contra Costa County. This plan is a "work in progress." A fully inclusive list of recommendations would require a much more detailed description of existing and projected activities. The concepts of Safe Homes, Safe Schools, Safe Communities, Safe Workplaces, Government Leadership and Service, and Policy Development deserve further elaboration. The recommendations in this Framework for Action are followed by suggested-actions. The actions are intended as steps and examples, and may require modification in a particular community. Certainly, there are numerous other steps that could be investigated and considered. All of the recommendations include the following principles, which are guidelines for planning, policy development, and implementation. a) Build on existing local efforts and support initiatives that arise from within communities: Many community groups and organizations, individuals, and collaboratives throughout the county grapple with violence-related prevention efforts. Their work must be acknowledged, supported, and enhanced. i b) Foster individual responsibility and involvement. Each person has the responsibility for behaving nonviolently. Resources to support individual and family mental health need to be readily accessible. c) Utilize available data and state-of-the-art violence prevention strategies. Violence prevention efforts can be most effective when based on accurate information about what worksi 7 d) Encourage partnerships, collaboration,and integration of services. Violence is a complex issue which requires removing barriers that inhibit solutions from emerging. Pay special attention to the expertise of existing coalitions. e) Emphasize a multi-level approach. Individual change, institution-wide programs, community activities, and county-wide policies are needed. Every level of involvement, from home to school and board room, is critical to changing the "culture of violence." f) Support and involve youth in decision-making. Many young people feel isolated and unsupported. Some are victims and/or perpetrators. Changing the experience of young people, and adult attitudes about young people, is crucial to finding a solution to violence. g) Resources must be made available. Those who work with young people in schools and, communities throughout the county are painfully aware of the dearth of resources for violence prevention activities. There can be no substitute for funding such programmatic efforts. h) Develop concrete criteria for success. The accomplishments of the elements of this Framework must be measured and reviewed. Furthermore, it is not enough to simply put programs in place; they must be of high quality and play a clear role in achieving the goal of reducing violence in Contra Costa County. Recommendation 1: Promote the concept that all Contra Costa home environments can and should be violence free. Key elements to include: * Conflict and anger management * Communication with children * Communication with schools and other organizations * Discipline guidelines and techniques * Reducing.the impact of television violence * Instilling respect and kindness * Diminishing risk associated with firearms in homes * Developing a family s4fety plan * Alcohol and other drug risks Encourage parents to demonstrate alternatives to aggressive interpersonal confrontations at home. Recommendation 2: Provide community and governmental support to families that assists them in reducing the risk of violence. Provide education, materials, and referrals which assist residents in becoming more aware of community and school resources, current violence prevention related services and alternative activities. 8 Develop ongoing care, services, and training in parenting, conflict resolution, substance abuse, and. mental health, to victims of violence, perpetrators, and high risk families. Using an integrated service model, provide enhanced support services for youth who are having difficulty at home Recommendation 3: Recognize family violence as a significant problem in all parts of the community and reduce its prevalence and impact. Initiate a county-wide Domestic Violence Council to advise government and improve community support for family violence reduction and prevention. Mandate treatment for spousal abusers. Require vertical prosecution (a consistent prosecutor for an entire family violence case) to maximize consistency and competence in prosecuting such cases. Provide domestic violence treatment in county jails to inmates convicted of spousal abuse. Confiscate firearms in any home that is the site of a domestic assault, and immediately restrict ownership of all guns by people who are under court restraining orders. Encourage health care providers to establish and maintain referral systems for victims of domestic violence. Enhance police training for handling domestic violence situations and making appropriate referrals. Support shelters and provide bed space for people at risk of domestic violence. Recommendation 4: Conduct activities which help create a sense of community and draw on the natural strengths of groups and individuals in their neighborhoods. Initiate and strengthen such neighborhood networks as block parties, neighborhood watch groups, neighborhood watch fairs, neighborhood associations and councils. Identify and support natural helpers for children/block parents to provide after school supervision and support when parents are unavailable. Encourage retired persons and other community members to volunteer in school and community activities. Support community initiated and neighborhood based projects. Increase and support the presence of knowledgeable, caring adults in the lives of young people, with special emphasis on high-risk children and youth. 9 Recommendation 5: Promote efforts which assist in creating an atmosphere of safety in streets and neighborhoods. Expand community policing to encourage improved police and community relations and enhance violence prevention efforts.. Develop a cadre of trained gang intervention specialists to work directly with gang- affiliated young people. Create "Safe Havens" for youth and families in community resource rooms, churches, private homes, and businesses. Strengthen and expand "Take Back the Night" activities and community events which promote peace and honor victims of violence. Improve lighting and security in vulnerable locations; e.g. ATM's, community centers. Recommendation 6: Promote awareness, knowledge, and involvement of the diverse cultures in Contra Costa County, including "youth culture." Develop activities and materials which highlight the contributions of specific cultural groups and individuals. Broaden the representation of all cultural groups on county and city boards and commissions. Create a county-wide youth council to foster feedback from young people, and solicit input on realistic prevention activities. Sponsor youth forums and summits to foster youth involvement. Provide trainings on cultural diversity to employees in public and private workplaces throughout,the county. Increase the availability of parenting classes which are culturally and ethnically appropriate for diverse communities, through churches, health clinics, schools, and other public, private,and community agencies. Create or expand inter-generational programs and messages which promote respect and tolerance for both youth and elders. Recommendation 7: Enhance opportunities which enable individuals, families and the community as a whole to heal from-the impact of violence. Coordinate and enhance emergency mental health response to victims and witnesses of violent incidents similar to that which exists for other epidemics or natural disasters, including critical incident debriefing after violent incidents, violence risk assessment and referral to ongoing supportive services. 10 Train and support community groups and individuals that provide ongoing emotional support to affected individuals. Recommendation 8: Assure that all youth have the opportunity to engage in constructive, safe, and supervised activities during non-school hours. Open more late-night recreation areas, library homework centers, and education programs for youth; include tutoring, computer skills, and athletics; e.g. midnight basketball, midnight Shakespeare. Adjust staffing patterns and scheduling as necessary to accommodate afternoon and evening activities for young people in sites such as community centers. Make parks and playgrounds safe. Recommendation 9: Expand public and private employment opportunities for young people while encouraging them to remain in school. Increase number of job opportunities for youth. Provide school and community based job skills training, job search and career guidance and mentoring programs. Link school and business efforts to create mentoring and internship programs for high school youth. Train and employ youth to help achieve violence prevention goals. Recommendation 10: Enhance the involvement of religious leaders and congregations in providing education and support to individuals and families. Increase the use of churches, mosques, and synagogues as place to meet and collaborate. J Enhance training to clergy and lay leaders to address violence related issues. Encourage religious leaders to,become involved in violence prevention efforts throughout the community. Recommendation 11: Disseminate violence prevention information and resources through traditional and non-traditional media and public information avenues. Emphasize the message that violence is preventable, highlight the positive actions of youth, and promote violence prevention efforts. Develop an extensive media campaign using effective anti-violence messages. Re-establish Bay Area Information and Retrieval Services (BAIRS). 11 �. pl Publicize crisis intervention and other "help" lines. Compile and distribute information guides which outline all available programs and agencies relating to violence prevention. Enhance the use of school and public libraries in collecting and displaying violence prevention materials; e.g. educational videos. Enhance the use of churches, schools, community based agency sites, and businesses as outlets for information. Recommendation 12: Develop educational interventions to empower youth who, despite disadvantages, develop social competence, problem-solving skills, autonomy, resiliency, and a sense of purpose or future. Develop and implement K-12 curriculum in all local schools which serves as a basis for violence prevention: * Communication skills, conflict and anger management; * History with a cultural perspective; * Causes and prevention of violence which integrates culturally diverse approaches; * Expand family life skills education; and * Alcohol and drug issues. Encourage appropriate opportunities for youth to express the impact of violence on their, lives. Improve reading skills of young people and adults. Include community service involvement as a requirement for graduation at all elementary, middle, and high school levels. Lobby for modifications in the Education Code that support the development and implementation of violence prevention curriculums, including any appropriate teacher training. Recommendation 13: Raise awareness of the link between violence, alcohol, and other drug abuse. Incorporate violence prevention into existing alcohol and other drug interventions in school and community settings. Include alcohol and other drug treatment in interventions for violent individuals. Publicize accurate information on the relationship of alcohol and other drug abuse to violence. 12 Recommendation 14: Create stronger linkages between schools, community groups, and government for violence prevention.° Enhance community access to school facilities for community events. Support programmatic,partnerships involving community and school groups. Coordinate school-based zero tolerance policies and existing county and community- based efforts. Recommend'ati'on. 15 Foster a school environment which provides for the safety of the campus community and creates an atmosphere conducive to learning and respect. Obtain a commitment from top-level school district officials to make violence prevention a priority. Promote clear guidelines,, procedures, and protocols related to incidents of violence on campus; e.g. zero tolerance. Create staff positions to deal with problems outside of the classrooms. . Create or strengthen alternatives to expulsion. Strengthen lines of communication between school and, home. Increase parent participation through parent contracts and other methods. Sponsor school-based events with violence prevention and cultural celebration themes, e.g. Violence Prevention month. Create student "Bill of Rights" where it doesn't already exist. Create or expand "student assistance" programs where young people are encouraged to work together to improve the school. Recommendation 16: Provide direct services to youth through community-based organizations which complement and enhance those provided in the school environment. Enhance violence prevention training and leadership programs. Expand and coordinate opportunities for leadership and community service. Create or expand tutoring and mentoring opportunities. Increase alternatives to incarceration and strengthen re-entry support for incarcerated young people. Promote positive peer interaction through peer counseling programs and education. 13 f Make community mental health resources more available to young people. Improve and expand the dissemination of information to youth about available programs and services. Recommendation 17: Create an atmosphere in which enhances employee safety and support for violence related concerns. Develop and provide materials, training, and consultation related to the problem of workplace violence and what can be done to prevent it. Provide forums for discussion, institute training and procedures for employer(ees) in the following areas: * Interpersonal skills; * Anger management; * Conflict resolution with clients, co-workers, and the public; * Stress management; * Fears related to violence in the work setting; and * Awareness of definitions, escalators and precursors of violence. Promote employee flexibility with schedules for violence prevention training. Involve labor unions in planning for effective, appropriate workplace violence prevention efforts. Create visual aids on conflict resolution in workplace settings. Provide childcare alternatives for workers. Promote awareness and encourage use of Employee Assistance Programs. Encourage individual businesses to develop a violence-related safety plan that acknowledges the needs of both workers and clients. Recommendation 18: Create an atmosphere conducive to the involvement of businesses as a partner in community violence prevention efforts. Involve private business in sponsoring paid internships for young people; encourage career ladders from paid internships to longer term jobs. Encourage business participation in mentoring, such as Compac and the School Volunteer Program. Coordinate business funding of local violence prevention efforts. Encourage business "Adopt-a-school" program and other community participation efforts. 14 Recommendation 19: Actively reduce the number of firearms in private ownership. Exercise local zoning and licensing powers to enhance local regulation of gun dealers. Impose applicable fees.on firearms and ammunition to fund local enforcement, prevention, and education programs. Restrict the availability of ammunition and ban high-velocity and fragmentation bullets. Limit firearms purchases to one per month. Encourage corporate and governmental sponsorship of gun buy-back programs. Call for the repeal of the state's pre-emption of firearms legislation and encourage stronger state regulations. Enforce existing laws that regulate the sale of firearms and encourage all coordination between county departments with responsibility for such enforcement. Continue to support emerging state and federal legislation which regulates firearm purchases, manufacturing, sales, and transfers and licensure. Recommendation 20: Assure that practitioners, policy makers, and advisors have adequate knowledge and skills to play a productive role in violence prevention efforts. Initiate a broad training program in violence prevention for county and community professions, with particular emphasis on these topics: * Conflict resolution involving coworkers, clients, and administration; * Recognizing emerging violent situations; * Assessing and referring with high risk individuals * Listening to clients/community; * Violence prevention strategies; * Contributing and risk factors; * Policy and environmental approaches; and * Data sources, interpreting and sharing data, epidemiology of violence. Make violence prevention training mandatory for HSD contracted service providers. Recommendation 21: Conduct and disseminate research and data that will assist practitioners, policy makers, and the public in understanding and intervening appropriately in the epidemic of violence. Analyze current local data to develop a violence profile for Contra Costa County. Conduct county-wide survey of firearm injuries and deaths, to be completed by July 1994. 15 Further refine and disseminate existing research on alcohol and other drug abuse related to violence. Participate in national forums and networks of violence prevention professionals to gain access to state of the art research and methods. Conduct targeted research into effective programs, models, and policies used locally, statewide, and nationally. Recommendation 22: Implement violence prevention activities within governmental settings which can serve as a model for other workplaces, and link these with community based efforts. Use government as a laboratory for new violence prevention approaches such as "Violence-Free Zones" in all county office and clinic settings. Identify and create an inventory of all current activities conducted in county departments related to the issue of violence. Train medical personnel to use current protocols better for serving clients affected by violence, including those for domestic violence. Provide a social worker trained in violence prevention to appropriate county clinics to conduct support programs and refer clients to community resources. Develop a pilot "clinic safety plan" in at least one governmental setting. Recommendation 23: Develop organizational guidelines and protocols which assure and streamline the delivery of violence prevention services. Develop uniform protocol for all Health Department settings which assists staff in identifying and referring patients affected by violence. Avoid waiting lists for persons in needof services; when waiting lists are inescapable, provide some immediate services/personal connections. Streamline internal communication within government regarding violence prevention services and related community services to inform or refer clients and community members. Recommendation 24: Provide government leadership which enables the county as a whole to enhance violence prevention efforts. Establish a Violence Prevention Task Force to coordinate implementation of The Framework for Action to include community leaders, community based organizations, young people, business representatives, elected officials and other governmental representatives. Sponsor an annual forum and hold frequent trainings on countywide violence-related 16 policies, programs, media advocacy and prevention strategies. Encourage newly trained advisory board members and staff to become participants in efforts sponsored by others throughout the county; see also Networks, Linkages, and Coalition Activities. Formalize existing linkages between substance abuse and violence prevention efforts throughout the county to incorporate violence and substance abuse prevention themes and activities. Support multi-disciplinary funding that includes community leaders, community-based organizations, government programs; support multi-disciplinary and multi-sectoral projects. Health Services Department (HSD) Administration must set priorities for violence as a public health issue in terms of funding, programming, staff development, and worker safety. Expand role of HSD committee to recommend violence prevention actions to Board of Supervisors, including those that involve state legislation. Use existing linkages with colleges and universities to help integrate violence prevention training into.all areas of professional practice. Recommendation 25: Encourage government, school district and city councils to enhance local programmatic efforts by advocating statewide and national changes in policy. Review all relevant statewide and national violence prevention legislation, and provide updates to all local officials and interested community members. Urge elected officials to review and take positions on relevant violence prevention legislation. Analyze policy related to media, firearms, educational issues, and similar issues in which local efforts are pre-empted or significantly controlled by state or national regulation. NEXT STEPS Initiate a county wide task force to review Framework for Action to determine priorities, and set immediate and long-term implementation steps.'This process should involve young people, community groups and individuals, violence prevention practitioners, religious and business representatives, and elected and appointed officials. Develop and implement an aggressive funding plan to support programmatic recommendations. Initiate broad training program to assist key groups involved in implementation to heighten 17 t olence prevention skills Map existing violence prevention efforts throughout the county. Identify roles, duties and resources of those involved in leadership and implementation of Framework for Action. Existing collaborative efforts should provide the underpinning for implementation. Specify mechanisms whereby individuals can become further involved in community efforts. Plan, develop, and advocate for an anti-violence legislative agenda. Assess progress on an annual basis. Recommendations must incorporate measures of success to monitor progress, assess direction and ensure that violence prevention is maintained as a key item on the public agenda throughout the county and state. 18 References 1. U.S. Senate Judiciary Committee 1990. 2. U.S. Judiciary Committee 1990. 3. Health Education Reports 1993. 4. Miller, T.R. Cohen, M.A., (Forthcoming). Costs of Penetrating Injury. Submitted for publication in Ivatury, R. and Cayten, E.G. ed., Textbook of Penetrating Trauma, Philadelphia: Lee and Civiga. [CSN fact sheet: The Financial Costs of Gun Violence] 5. Business Week December 13, 1993. 6. Prothrow-Stith 1991 19