Preventing Injuries intexas. A Resource for State Policy Makers

Transcription

1 Preventing Injuries intexas A Resource for State Policy Makers

2 Preventing Injuries in Texas Dear Texas Policy Leader, Thank you for working to ensure that all Texans are safe and healthy and free from injuries and violence that can lead to long-term physical and emotional disabilities. Although deaths due to injuries and violence are the fourth leading cause of death in Texas, the majority of these deaths can be prevented. This document, Preventing Injuries in Texas: A Resource for State Policy Makers, was developed to provide you with factual information on injuries and violence in Texas, as well as information on scientifically-proven policies that are effective in reducing these injuries and deaths. Strong, evidence-based policies have reduced deaths and disability and associated costs. Nationally from , the number of deaths due to cigarettes and other smoking-material fires fell by an average of 21 percent following enactment of fire-safe cigarette legislation. It is projected the reduction will reach approximately 30 percent for the year 2012, when the laws are effective in all 50 states. In May 2012, Trust for America s Health released The Facts Hurt: A State-By-State Injury Prevention Policy Report. The report scored states on a set of 10 key indicators of steps states can take to prevent injuries. Texas received a score of five out of 10, garnering high marks for strong laws for primary enforcement of seat belt use, booster seats for children until 8 years of age, youth sports concussion prevention, and prescription drug monitoring. The Facts Hurt report, which was funded by the Robert Wood Johnson Foundation, and produced in collaboration with the Safe States Alliance and the Society for Advancement of Violence and Injury Research, concluded that millions of injuries could be prevented each year if more states adopted additional research-based injury prevention policies, and if programs were fully implemented and enforced. Since 1994, the Injury Prevention Center of Greater Dallas has been working with state and local agencies in Texas to implement evidence-informed strategies to prevent deaths due to intentional (e.g., violence) and unintentional ( accidents ) injuries. We look forward to working with you to ensure that all Dallas County and Texas residents remain safe and healthy. Thank you for the important work you do. Shelli Stephens Stidham Director, Injury Prevention Center of Greater Dallas

3 Preventing Injuries in Texas The Injury Prevention Center of Greater Dallas (IPC) works to provide citizens with an opportunity to live to their full potential where they have safe places to live, work and play. The IPC helps citizens avoid injuries that could lead to a lifetime of physical and emotional disabilities by implementing proven strategies that use the science of injury prevention to reduce the risk of violence, injury and their associated consequences. Not only does investing in prevention save lives and decrease pain and suffering, but it also saves money. The estimated economic return on investment is substantial when evidence-based injury prevention strategies are implemented. By joining forces with businesses, government, police and fire departments, school districts, faith-based organizations and others, we can help people live fulfilling lives, free from injury and harm. In an unprecedented move in 1994, the IPC was established with funding from five of the city s local hospitals (Parkland Health & Hospital System, Baylor Health Care System, Methodist Health Systems, Texas Health Resources and Children s Medical Center of Dallas), as well as several private foundations and corporations. The establishment of the IPC was also endorsed by numerous local organizations/agencies including the Dallas County Commissioners, Parkland Board of Managers, City of Dallas, Dallas Medical Association and Dallas/Fort Worth Hospital Council. Since the IPC was established, injury death rates have decreased in Dallas and safe behaviors have increased. The results are measurable and the cost savings are real. Acknowlwdgements The Injury Prevention Center of Greater Dallas would like to thank Angela Morris, MPH, for her assistance in researching and drafting this Policy Resource. We would also like to acknowlwdge the contributions of Dallas area injury and violence prevention coalitions, including Dallas County Child Death Review Team, Child Abuse Prevention Coalition, Domestic Violence Awareness Coalition, Family Violence Prevention Coalition, and Citizens for Traffic Safety for their expertise and time in reviewing the document.

4 Alcohol And Injury

5 Alcohol and Injury Background: Every day, almost 30 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. 1 This amounts to one death every 48 minutes. 1 The annual cost of alcohol-related crashes totals more than $51 billion. 1 Federal, state and local governments paid almost $8 billion of this, while employers paid almost $11 billion. 2 A report from the Centers for Disease Control and Prevention (CDC) found that U.S. drivers got behind the wheel after drinking too much about 112 million times in The report also found that certain groups are more likely to drink and drive than others. Men were responsible for 4 in 5 episodes (81 percent) of drinking and driving in Young men ages made up only 11 percent of the U.S. population in 2010, yet were responsible for 32 percent of instances of drinking and driving. 85 percent of drinking and driving episodes were reported by people who also reported binge drinking. Binge drinking means 5 or more drinks for men or 4 or more drinks for women during a short period of time. How Does This Impact Texas? In 2010, there were 1,259 deaths due to alcohol-related motor vehicle crashes in Texas, which is 12 percent of the total alcohol-related crashes in the United States, making Texas the national leader in alcohol-related crashes. 4 How Does This Impact Dallas County? In 2010, there were 2,531 motor vehicle crashes in Dallas County where a driver was under the influence of alcohol, resulting in 84 deaths, and 881 serious injuries. 5 The Texas Legislative Landscape: Current Law It is illegal for a person under 21 years of age to operate a motor vehicle or watercraft while having ANY detectable amount of alcohol in their system. Minors on a 1st offense face a Class C misdemeanor (punishable by a fine up to $500), alcohol awareness class, 8 to 40 hours community service and 30 to 180 days loss or denial of driver s license. Consequences increase for 2nd and 3rd offenses. 6 Driving while intoxicated (DWI) is a Class B misdemeanor, with a minimum term of confinement of 72 hours. DWI with an open container is a Class B misdemeanor, with a minimum term of confinement of six days. DWI with a passenger younger than 15 years of age is a state jail felony. 6 Sale to a minor is a Class A misdemeanor, punishable by a fine up to $4,000, confinement up to a year in jail, or both. 6 Ignition interlocks are mandatory for first offenders with a high blood alcohol concentration (0.15 percent or higher) and repeat offenders. 7,8 The following bills passed during the 82nd Legislative Session: 6,9 - HB 1199 creates an enhanced penalty (Class A misdemeanor) for DWI with a BAC of.15 or over and creates an enhanced penalty (2nd degree felony) for an intoxication assault if the commission of the offense causes a traumatic brain injury that results in a persistent vegetative state. - HB 2582 repeals 25 percent excise tax exemption for beer manufacturers and brewpubs whose annual production of beer in Texas does not exceed 75,000 barrels.

6 Alcohol and Injury - HB 2702 increases the population numbers in multiple statutes to maintain status quo following the release of the 2010 census results (e) Alcoholic Beverage Code: A city that meets certain population requirements may regulate the location of a private club if the club derives 35 percent or more of their gross revenue from alcoholic beverages, it is in a dry area, and it is not a fraternal or veterans organization or the holder of a food and beverage certificate. - SB 364 requires the Texas Department of Public Safety (DPS) to collect and maintain certain information about DWI arrests and prosecutions in Texas and to provide that data to the legislature. Agencies who participate in DWI arrests and prosecutions are also required to provide this information to DPS. - SB 1331 provides immunity for possessing or consuming alcohol to a minor who calls 911 because someone is a possible victim of alcohol poisoning and enhances penalty for providing alcohol to a minor at a gathering that involved binge drinking or coerced drinking. Best Practices to Prevent Alcohol-Related Traffic Injuries: The Centers for Disease Control and Prevention: 1 - Require ignition interlocks for all convicted DWI offenders. States that mandate ignition interlocks for everyone convicted of DWI can reduce alcohol-impaired driving crashes and save lives. States that have passed laws requiring all convicted DWI offenders to use ignition interlocks have seen a decrease in alcohol-related motor vehicle crash fatalities by 36 to 46 percent. 2 Ignition interlocks have resulted in decreases of re-arrest rates for alcohol-impaired driving by 50 to 90 percent. 10,11 - Sobriety checkpoints deter impaired driving by increasing drivers perceived risk of arrest if they choose to get behind the wheel after drinking. - States should maintain their minimum legal drinking age at 21 and vigorously enforce these laws. The Community Preventive Services Task Force: 12 - Enhance enforcement of laws prohibiting sale of alcohol to minors (e.g. retailer compliance checks). - Maintain existing limits on the days and hours on which alcoholic beverages are sold. - Use regulatory authority to limit alcohol outlet density.

7 Alcohol and Injury Additional Resources Injury Prevention Center of Greater Dallas: www. Mothers Against Drunk Driving: Central Texas (Austin): West Texas (El Paso): Southeast Texas (Houston): South Texas (Edinburg): South Texas (Corpus Christi): South Texas (San Antonio): North Texas (Dallas): East Texas (Beaumont): East Texas (Bryan/College Station): East Texas (Tyler): National Headquarters (Irving): National Center for Injury Prevention and Control, CDC: Center for Substance Abuse Research: Center on Alcohol Marketing and Youth: References 1 Centers for Disease Control and Prevention. Impaired Driving. Retrieved from Injury Prevention & Control: Motor Vehicle Safety: (accessed October 2011). 2 Mothers Against Drunk Driving. Report to the Nation. Irving, Texas: Mothers Against Drunk Driving, Centers for Disease Control and Prevention. Drinking and Driving: A Threat to Everyone. Retrieved from (accessed May 2012). 4 U.S. Department of Transportation, National Highway Traffic Safety Administration. Alcohol-Impaired Driving. Retrieved from (accessed May 2012). 5 Texas Department of Transportation. Texas Motor Vehicle Crash Statistics Retrieved from (accessed May 2012).

8 Alcohol and Injury 6 Texas Alcoholic Beverage Commission. (n.d.). Laws, Rules and Regulations. Retrieved from Texas Alcoholic Beverage Commission: 7 Insurance Institute For Highway Safety. DUI/DWI Laws. Retrieved from Insurance Institute For Highway Safety - Highway Loss Data Institute: (accessed February 2012). 8 National Conference of State Legislatures. State Ignition Interlock Laws. Retrieved from National Conference of State Legislatures: (accessed February 2012). 9 Telicon. (n.d.). Telicon - Progressive legislative information for Texas. Retrieved from com/www/tx/index.htm 10 Centers for Disease Control and Prevention. Impaired Driving Re-Arrests. Retrieved from cdc.gov/media/matte/2011/02_ignitioninterlocks.pdf (accessed May 2012). 11 Mothers Against Drunk Driving. Ignition Interlocks: Every State, For Every Convicted Drunk Driver. Retrieved from: (accessed May 2012). 12 Community Preventive Services Task Force. Preventing Excessive Alcohol Consumption. Retrieved from The Guide to Community Preventive Services:

9 Teen Driving

10 Teen Driving Background: Motor vehicles crashes are the leading cause of death for U.S. teens. 1 In 2009, 3,000 teens ages in the United States were killed. 1 In 2008, more than 350,000 were treated in emergency departments for injuries suffered in motor vehicle crashes. 1 In one year alone, crash-related injuries and deaths among teens ages 15 to 19 cost $14 billion in medical care and productivity losses. 1 How Does This Impact Texas? In 2010, 74,078 teen drivers years of age were involved in motor vehicle crashes; 358 teen drivers were involved in fatal crashes. 2 How Does This Impact Dallas County? In 2010, 5,237 teen drivers years of age were involved in motor vehicle crashes. 3 The Texas Legislative Landscape: Current Law All drivers 18 years and under must meet the licensing requirements for a learner or provisional driver license. They are also subject to additional requirements, including graduated driver licensing (GDL) and driver education. 4 All drivers licenses, other than a learner license, issued to persons under 18 years of age will be marked Provisional. 4 Minors who purchase, attempt to purchase, possess, or consume alcoholic beverages, as well as minors who are intoxicated in public or misrepresent their age to obtain alcoholic beverages, face penalties and other consequences. 5 It is illegal for a person under 21 years of age to operate a motor vehicle in a public place while having any detectable amount of alcohol in their system. 5 Individuals 8 years of age and older are required to wear a seat belt in all seats while the vehicle is being operated. Law enforcement officers are allowed to ticket a driver for not wearing a seat belt, without any other traffic offense taking place. 6,7 Best Practices to Prevent Teen Driving Injuries: The Centers for Disease Control and Prevention: 1 - No nighttime driving for teenagers holding a graduated driver s license from at least 10 p.m. to 5 a.m. Texas s GDL program nighttime driving restriction is from midnight to 5 a.m. unless the operation of the vehicle is necessary for the operator to attend or participate in employment or a school-related activity or because of a medical emergency. National Highway Traffic Safety Administration: - Enforce underage purchase, possession and provision laws, which can create a significant deterrent for violation of youth access laws, reduce underage drinking and decrease alcohol-related crashes. 8

11 Teen Driving - Primary safety belt laws, if highly publicized, have shown to increase safety belt use in the general population. Teen belt use is also higher in states with primary safety belt laws. 9 Texas has a primary seat belt law that covers all ages and all seating positions in the vehicle (including front and back seat). Additional Resources Injury Prevention Center of Greater Dallas: www. National Center for Injury Prevention and Control, CDC: Insurance Institute for Highway Safety: National Highway Traffic Safety Administration: References 1 Centers for Disease Control and Prevention. (n.d.). Teen drivers. Retrieved from Injury Prevention and Control: Motor Vehicle Safety: 2 Texas Department of Transportation. Texas Motor Vehicle Crash Statistics Retrieved from (accessed May 2012). 3 Texas Department of Transportation. Crash Records Information System (CRIS) Data Extract from North Central Texas Council of Governments. April Texas Department of Public Safety. (n.d.). Teen and Under 25 Drivers. Retrieved from state.tx.us/driverlicense/teendriver.htm 5 Texas Alcoholic Beverage Commission. (n.d.). Underage Drinking Laws. Retrieved from Texas Alcoholic Beverage Commission: 6 Texas Department of Public Safety. (n.d.). Texas Occupant Restraint Laws. Retrieved from Texas Department of Public Safety: 7 Governors Highway Safety Association. (2012). Seat Belt Laws. Retrieved from Governors Highway Safety Association: 8 National Highway Traffic Safety Administration. Increasing Teen Safety Belt Use: A Program and Literature Review National Highway Traffic Safety Administration. (n.d.). Teen Drivers. Retrieved from Driving Safety:

12 Distracted Driving

13 Distracted Driving Background: Distracted driving is any activity that could divert a person s attention away from the primary task of driving. All distractions endanger driver, passenger, and bystander safety. 1 These types of distractions are, but not limited to, texting, using a cell phone, grooming, and talking to passengers. 1 In 2009, 5,474 people in the United States were killed in crashes involving driver distraction and an estimated 448,000 were injured. 1 Sixteen percent of fatal crashes in 2009 involved reports of distracted driving. 1 Twenty percent of injury crashes in 2009 involved reports of distracted driving. 1 How Does This Impact Texas? According to the Texas Department of Transportation, nearly one in four crashes involves driver distraction. 2 In 2009, more than 100,000 vehicles were involved in crashes where distraction in the vehicle, driver inattention or cell phone use was cited. Of those crashes, 408 were fatal. 2 How Does This Impact Dallas County? In 2010, 13 percent of motor vehicle crashes in Dallas County were due to distracted drivers. 3 The Texas Legislative Landscape: Current Law Drivers are prohibited from using cell phones and texting in school crossing zones. 4,5 Drivers younger than 18 years of age are prohibited from using cell phones and texting. 4,5 School bus drivers are prohibited from using cell phones and texting when a passenger 17 years of age and younger is present. 4,5 Novice drivers are prohibited from using cell phones and texting. Novice drivers are defined as all drivers at the intermediate stage. 4,5 Distracted driving is a required component of driver education in Texas and information is included in the state s driver manual. 6 Distracted driving has been included in Texas Strategic Highway Safety Plan since However, the Texas Legislature or Governor has not convened a distracted driving task force and/or summit to address distracted driving statewide. 6 Failed Legislation Several bills were introduced during the 82nd Texas Legislature, yet hearings were held on a few (HB 37 and 243; SB 119 and 138) to ban the use of cell phones while driving. 7 Governor Rick Perry vetoed HB 242 after being passed by the 82nd Texas Legislature. This bill would have banned texting while driving in Texas to all drivers. 7,8 Best Practices to Prevent Distracted Driving Injuries: The National Transportation Safety Board: 9 - Nationwide ban of nonemergency use of portable electronic devices for all drivers.

14 Distracted Driving - Use the National Highway Traffic Safety Administration model of high visibility enforcement to support these bans. - Implement targeted communication campaigns to inform motorists of the new law and enforcement. The Governors Highway Safety Association (GHSA): 1 - Implement distracted driving communications programs. - Cell phone and texting laws should be publicized broadly to increase their effects. - Other communication and education activities should address the broader issues of avoiding distractions while driving. -Record distracted driving in crash reports, to the extent possible, to assist in evaluating distracted driving laws and programs. Texas currently collects information about the number of crashes in which distraction (of any kind) is a factor in a crash and also collects data of any kind on distracted driving crashes on the crash reports. 6,10 Trust for America s Health (The Facts Hurt: A State-by-State Injury Prevention Policy Report): 11 - Conduct research expeditiously on the effectiveness of cell phone and texting bans and campaigns to reduce distracted driving. Additional Resources Injury Prevention Center of Greater Dallas: www. Texas Department of Transportation: National Center for Injury Prevention and Control, CDC: Advocates for Highway and Auto Safety: National Highway Traffic Safety Administration (NHTSA): References 1 National Highway Traffic Safety Administration. Get the Facts. Retrieved from D!STRACTION.GOV: Official US Government Website for Distracted Driving: (accessed May 2012).

15 Distracted Driving 2 Texas Department of Transportation. Talk, Text, Crash Distracted Driving Campaign. Retrieved from (accessed May 2012). 3 Texas Department of Transportation. Crash Records Information System (CRIS) Data Extract from North Central Texas Council of Governments. April Governors Highway Safety Association. Key Highway Safety Laws in Texas. Retrieved from Governors Highway Safety Association: The States Voice on Highway Safety: bystate/tx (accessed December 2011). 5 Insurance Institute for Highway Safety. Laws and Regulations: Highway Safety Laws in the U.S. Retrieved from Insurance Institute for Highway Safety: Highway Loss Data Institute: laws/statelaws.aspx?stateabbr=tx (accessed May 2012). 6 Governors Highway Safety Association: The States Voice on Highway Safety. (2010). Curbing Distracted Driving: 2010 Survey of State Safety Programs. 7 Telicon. (n.d.). Telicon - Progressive legislative information for Texas. Retrieved from com/www/tx/index.htm 8 Office of the Governor Rick Perry. (2011, June 17). Governor Perry Vetoes House Bill 242. Retrieved from Office of the Governor Rick Perry: 9 National Transportation Safety Board, Office of Public Affairs. NTSB Press Release: December 13, Retrieved from National Transportation Safety Board: (accessed May 2012). 10 Governors Highway Safety Association: The States Voice on Highway Safety. (2011). Distracted Driving: What Research Shows and What States Can Do. 11 Trust for America s Health: The Facts Hurt: A State-by-State Injury Prevention Policy Report. Retrieved from (accessed May 2012).

16 Motorcycle Safety

17 Motorcycle Safety Background: Preventing motorcycle injuries and deaths is a growing public health concern. In 2009, more than 4,400 motorcyclists were killed and 90,000 were injured in the United States. 1 From 2000 to 2009, motorcycle fatalities increased by 54 percent. 1 Motorcycle crash-related injuries and deaths totaled $12 billion in one year, in medical care costs and productivity losses. 2 The National Highway Traffic Safety Administration (NHTSA) estimates that motorcycle helmets reduce the likelihood of crash fatalities by 37 percent. 1 NHTSA estimates that helmets saved the lives of nearly 1,500 motorcyclists in It estimates that if all motorcyclists had worn helmets, more than 700 additional lives could have been saved. 1 How Does This Impact Texas? In 2010, there were 7,732 motorcycle crashes in Texas; 429 motorcyclists (drivers and passengers) were killed. Fifty-six percent of motorcyclists killed were not wearing helmets. 3 How Does This Impact Dallas County? In 2010, there 611 motorcycle crashes in Dallas County, with 33 deaths. Thirty-three percent of motorcyclists that died were not wearing a helmet at the time of the crash. Thirty percent of motorcycle operators were legally intoxicated at the time of death. Of those operators who were legally intoxicated, 60 percent had a blood alcohol concentration twice the legal limit. 4 The Texas Legislative Landscape: Current Law Texas universal helmet law was repealed in ,6 Currently, only persons under 21 years of age are required to wear a motorcycle helmet. 6 The helmet exemption sticker program was repealed in A DPS-issued sticker was required to be displayed on a motorcycle by a motorcycle owner. Persons 21 years of age and older are exempt from wearing a motorcycle helmet if the driver meets the helmet exemption requirements (completion of a motorcycle safety course or has health insurance). The minimum amount of health coverage needed ($10,000) was removed by the 81st Texas Legislature. 5,7 Motorcycle passengers must be at least 5 years old. 8 A peace officer is prohibited from stopping or detaining a motorcycle driver or passenger for the sole purpose of determining whether the person completed a motorcycle safety course or has health insurance. 7 Best Practices to Prevent Motorcycle Driving Injuries: The National Highway Traffic Safety Administration: - States should enact legislation that requires all motorcycle riders to wear helmets. 9 Repealing helmet laws is associated with increased deaths. In Texas, repeal of the universal law led to a 31 percent increase in fatalities in The Texas Trauma Registry reported a large increase in hospital charges for traumatic brain injury cases following the repeal of the universal helmet law Conduct comprehensive motorcycle safety programs that include motorcycle helmet use, rider education, motorcycle operator licensing, and responsible use of alcohol. 9

18 Motorcycle Safety Additional Resources Injury Prevention Center of Greater Dallas: www. National Center for Injury Prevention and Control, CDC: Insurance Institute for Highway Safety: National Highway Traffic Safety Administration: Advocates for Highway and Auto Safety: References 1 National Highway Traffic Safety Administration. Traffic Safety Facts: Motorcycles. Retrieved from (accessed May 2012). 2 The Centers for Disease Control and Prevention. Motorcycle Safety: Helmet Save Lives. Retrieved from The Centers for Disease Control and Prevention: Safety/ (accessed June 2011). 3 Texas Department of Transportation. Texas Motor Vehicle Crash Statistics Retrieved from (accessed May 2012). 4 Texas Department of Transportation. Crash Records Information System (CRIS) Data Extract from North Central Texas Council of Governments. April Teigen, A. (2007). National Conference of State Legislatures - Transportation Review: Motorcycle Safety. 6 Governors Highway Safety Association. Helmet Laws. Retrieved from Governor Highway Safety Association: (accessed January 2012). 7 Texas Department of Public Safety. (n.d.). Motorcycle Helmet Exemptions. Retrieved from Texas DPS - Motorcycle/ATV Safety Unit: 8 Texas Department of Public Safety. (n.d.). MSB Frequently Asked Questions. Retrieved from Texas DPS: Motorcycle/ATV Safety Unit: 9 National Highway Traffic Safety Administration. (2004). Traffic Safety Facts - Motorcycle Helmet Use Laws. 10 Preusser, D. H. (2000). Evaluation of Motorcycle Helmet Law Repeal in Arkansas and Texas.

19 Home Fires

20 Home Fires Background: Home fires continue to pose a significant public health problem in the United States. 1 In 2010, fire departments responded to 384,000 home fires, causing $7 billion in property loss. 2 Of the home fires, 279,000 fires occurred in one- and two-family homes and 90,500 fires occurred in apartments. 2 In all, fires in the home (one- and two-family homes including mobile homes and apartments) resulted in 2,640 deaths and 13,350 injuries. 2 From , cooking equipment was the leading cause of home fires and fire injuries. 3 During this same period, smoking was the leading cause of fire deaths. 3 Heating equipment was the second most common cause of fire deaths. 3 Although the number of fatalities and injuries caused by residential fires has declined gradually over the past several decades, many residential fire-related deaths remain preventable and continue to pose a significant public health problem. Rates of death due to fires are substantially higher in homes without sprinklers than in homes with sprinklers. Sprinklers are effective in reducing death and injury because they react quickly to reduce heat, flames and smoke, allowing residents time to safely evacuate the home. In homes without sprinklers, fires are likely to grow to dangerous levels by the time the fire department is able to arrive. Homes with sprinklers are estimated to have 42 percent fewer property damage costs due to fires than homes without sprinklers. 5 How Does This Impact Texas? In 2010, there were 16,250 residential house fires in Texas, resulting in 113 deaths and $284,528,457 in property loss. 6 How Does This Impact Dallas County? In 2010, there were 22 deaths due to residential house fires in Dallas County. 7 Forty-nine Dallas County residents were hospitalized due to residential fires. 8 The average charge for hospitalization was $131,792; 49 percent of charges were paid by government sources such as Medicaid/ Medicare. Sixty-one percent of residential fire patients were hospitalized for more than five days. 8 The Texas Legislative Landscape: Current Law Municipalities are prohibited from requiring fire protection sprinkler systems in a new or existing one- or two-family dwelling. Municipalities may adopt an ordinance allowing a multipurpose residential fire protection sprinkler specialist or other contractor to offer, for a fee, the installation of a fire sprinkler protection system in a new one- or two-family dwelling. 9 All rental units, including apartments, duplexes, condos, and single-family homes must have smoke detectors. At least one smoke detector must be installed outside each bedroom. 10 The Texas Department of Insurance shall prepare and distribute information of public interest relating to fire safety and the dangers of carbon monoxide. 10

21 Home Fires The following bill passed during the 82nd Legislative Session: 9 - HB 1168 makes Texas law regarding the placement of smoke alarms in rental properties consistent with international model codes by requiring alarms to be placed in bedrooms. Owners of properties occupied before Sept. 1, 2011 will have until Jan. 1, 2013 to install battery-operated devices in existing properties. Failed Legislation HB 2682 failed during the 82nd Legislative Session. The bill would have required upholstered furniture sold in Texas to be manufactured with burn resistant materials and created an offense for a person who sells upholstered furniture that does not meet the applicable requirements. 9 Best Practices to Prevent Home Fire Injuries: A working smoke alarm reduces the risk of death from residential fire by at least 50 percent, however, only about three quarters of U.S. households report having one that functions. 11 A number of policies exist, such as requiring landlords to install smoke detectors to meet National Fire Protection Association standards for all rental units and for smoke alarms to be installed in all new residential buildings. Most of these policies are city or local ordinances, although a few states have detector laws. 12 There is strong evidence that residential sprinklers are highly effective in quickly dampening the spread of fires and preventing injuries and deaths related to fires. For more than 100 years, sprinkler systems have been used in commercial properties, and for decades they have been used with great success in hotels and multi-family residences. Sprinklers can help save the lives of families and firefighters, limit the damage and cost-of-damage from a fire and are environmentally friendly. 13 The 2009 International Residential Code (IRC) has adopted this requirement, but currently only three states have adopted the 2009 code (California, Maryland and South Carolina) while eight states have prohibited the adoption of the IRC sprinkler mandate. Some officials and builders have expressed concern over the costs of putting in residential sprinklers. Research by the Fire Protection Research Foundation indicates that the cost would not be prohibitive. 12 The United States Fire Administration (USFA): - All houses should be equipped with both smoke alarms and automatic fire sprinklers. 5 Trust for America s Health: - All states should adopt the 2009 International Residential Code requirement that all new one- and two-family homes include a residential sprinkler system. 12 Additional Resources Injury Prevention Center of Greater Dallas: www. National Center for Injury Prevention and Control, CDC: National Fire Protection Association:

22 Home Fires Texas Department of Insurance, State Fire Marshal s Office: Local Fire Departments References 1 Centers for Disease Control and Prevention. Fires. Retrieved from Injury Prevention & Control: Home and Recreational Safety: (accessed September 2010) 2 Karter, J. M. (2011). Fire Loss in the United States During Ahrens, M. (2011, May). Home Structure Fires. Retrieved from National Fire Protection Association - Fire Analysis and Research Division: 4 National Fire Protection Association. Fast facts about smoke alarms and fire. Retrieved from nfpa.org/search.asp?query=smoke+alarms&%26lid%3dsearch.x=8&%26lid%3dsearch.y=8 (accessed January 2012). 5 United States Fire Administration. USFA Position on Residential Fire Sprinklers. Retrieved from (accessed January 2012). 6 Texas Department of Insurance. State Fire Marshal s Office. Fires in Texas Retrieved from (accessed May 2012). 7 Dallas County Institute of Forensic Sciences. Medical Examiner s Office data. 8 Parkland Health & Hospital System, Population Medicine. Dallas/Fort Worth Hospital Council Foundation. Data Use File, Telicon. (n.d.). Telicon - Progressive legislative information for Texas. Retrieved from com/www/tx/index.htm 10 Texas Department of Insurance. State Fire Marshal s Office. Retrieved from fire/fmcoalarms (Accessed May 2012). 11 Ballesteros M, Jackson M, Martin MW. Working towards the elimination of residential fire deaths: CDC s Smoke Alarm Installation and Fire Safety Education (SAIFE) Program. Journal of Burn Care and Rehabilitation 2005;26(5): Trust for America s Health: The Facts Hurt: A State-by-State Injury Prevention Policy Report. Retrieved from (accessed May 2012). 13 Fire Sprinkler Initiative. National Fire Protection Association. Retrieved from firesprinklerinitiative/are-sprinklers-green/ (accessed May 2012).

23 Intimate Partner Violence

24 Intimate Partner Violence Background: Intimate partner violence (IPV), also known as domestic violence, describes physical, sexual, or psychological harm by a current or former partner or spouse. More than one in three women (35.6 percent) and more than one in four men (28.5 percent) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime. 1 The medical care, mental health services, and lost productivity (e.g., time away from work) costs of IPV was an estimated $5.8 billion in Updated to 2003 dollars, IPV costs exceeded $8.3 billion. 2 Dating violence is also a type of intimate partner violence. Dating violence is a serious problem in the United States, especially among teenagers. 2 From September 2008 to December 2009, about 10 percent of students nationwide reported being physically hurt by a boyfriend or girlfriend in the past 12 months. 3 How Does This Impact Texas? In 2009, there were 196,713 family violence incidents in Texas; 111 women were killed by an intimate partner. 4 More than 12,000 adults and almost 16,000 children received shelter from abusive relationships. In 2002, the Texas Council on Family Violence conducted a statewide poll on the prevalence and attitudes on domestic violence. Thirty-one percent of Texans reported that they had been severely abused at some point in their lifetime. Women reported severe abuse at a higher rate than men. 4 Two out of every five Hispanic Texas females (39 percent) reported experiencing severe abuse, while one out of every five Hispanic Texas females (18 percent) reported being forced to have sex against their will. 4 How Does This Impact Dallas County? From 2008 to 2011, there was an average of 10,902 cases of domestic violence assaults and an average of more than 1,000 aggravated domestic violence assaults reported to the Dallas Police Department each year. 5 Additionally, there was an average of 65 rapes reported each year to the Dallas Police Department during that time period. 5 The Texas Legislative Landscape: Current Law A first offense for assault is a Class A misdemeanor, punishable with up to 1 year in a county jail and/or fine up to $4,000. Subsequent offenses can increase the degree and range of punishment. 6 Firearm possession is prohibited for five years following release from jail or community supervision. However, federal law prohibits the purchase and possession of firearms and ammunition by persons who have been convicted in any court of a domestic violence misdemeanor and/or subject to certain domestic violence protective orders. 7 Persons subject to domestic violence protective orders are also prohibited from possessing firearms. 7 Protective orders are valid for the time specified in the order up to a maximum of two years. 8 Each Texas school district is required to adopt and implement a dating violence policy. 9,10 The following bills were passed during the 82nd Legislative Session: 11,12 - HB 649 allows protective orders for sexual assault victims without requiring the victim to show a threat of further harm by the assailant.

25 Intimate Partner Violence - HB 1028 prohibits an offender from contacting the victim during the term of his/her imprisonment. - HB 1721, SB 82 and SB 250 enhance protections for stalking victims. - SB 736 allows a school district to appoint representatives of a local domestic violence program to serve on the district s local School Health Advisory Council (SHAC). - HB 2496 provides that on the recommendation of the prosecuting attorney, a juvenile court may defer adjudication of a first-time offender who has committed a misdemeanor dating violence offense, requiring the juvenile defendant to complete a 12-week teen dating violence court program. Failed Legislation HB 1723 failed to pass during the 82nd Legislative Session. The bill would have held an offender more accountable for a second or subsequent violation of a certain court order. 11 Best Practices to Prevent Intimate Partner Violence Injuries and Deaths: Break the Cycle, a national nonprofit organization, gave Texas a grade of C in their 2010 State Law Report Cards: A Survey of Teen Dating Violence Laws, and recommend the following changes to improve Texas response to teen dating violence: 13 - Allow minors to petition for Protective Orders (POs) on their own behalf and explicitly describe the procedure for doing so. - Allow victims of intimate partner sexual abuse, stalking and harassment to access POs. - Allow minors to access all sensitive services without parental involvement. The state of Texas issued a September 2011 Texas Family Violence Benchmark, a ready reference manual prepared for the judges of the state of Texas. 14 The manual includes the following best practices: - Although Texas prohibits the possession of firearms, Texas has no law requiring the removal of firearms from persons who have become prohibited from possessing them. Each court or jurisdiction should work with local, state, and federal law enforcement to arrange firearm surrender procedures for persons subject to the prohibitions. - Judicial monitoring of offender accountability significantly improves compliance rates of protective orders. - The victim or applicant should be educated on how to report a violation of a protective order as well as stress the importance of reporting any violations of the prohibition on firearms possession.

26 Intimate Partner Violence Additional Resources Injury Prevention Center of Greater Dallas: www. National Center for Injury Prevention and Control, CDC: Break the Cycle: Texas Council on Family Violence: Texas Association Against Sexual Violence: References 1 National Center for Injury Prevention and Control - Division of Violence Prevention. The National Intimate Partner and Sexual Violence Survey Summary Report. 2 The Centers for Disease Control and Prevention. Intimate Partner Violence. Retrieved from Centers for Disease Control and Prevention - Injury Center: Violence Prevention: tion/intimatepartnerviolence/index (accessed December 2011). 3 Centers for Disease Control and Prevention. Youth Risk Behavioral Surveillance United States, MMWR 2010;59 (No.SS-5). 4 Texas Council on Family Violence. Facts and Statistics. Retrieved from facts-and-statistics (accessed June 2012). 5 Dallas Police Department Statistics, (personal communication, June 2012). 6 Texas Association Against Sexual Assault. Sexual Assault Legal Advocacy Manual. Retrieved from Texas Association Against Sexual Assault: 7 Legal Community Against Violence. Summary of State Firearms Law - Texas. Retrieved from Legal Community Against Violence: (accessed June 2012). 8 American Bar Association. Domestic Violence Civil Protection Orders by State. Retrieved from American Bar Association - Commission on Domestic and Sexual Violence: dam/aba/migrated/domviol/docs/dvcpochartjune07.authcheckdam.pdf (accessed June 2012). 9 Texas Council on Family Violence. Honoring Texas Victims: Family Violence Fatalities in Texas Council on Family Violence. Teen Dating Violence Policy. Retrieved from: resources/teen-dating-violence-policy 11 Telicon. (n.d.). Telicon - Progressive legislative information for Texas. Retrieved from con.com/www/tx/index.htm 12 Texas Association Against Sexual Assault. TAASA 2011 Sexual Assault Legislative Update: Highlighting The New Laws From The 82nd Legislative Session. Retrieved from Texas Association Against Sexual Assault. 13 Break the Cycle State Law Report Cards: A National Survey of Teen Dating Violence Laws. Los Angeles, CA: Break the Cycle, The Office of Court Administration. The Texas Family Violence Benchmark September 2011 Edition: A Ready Reference Manual Prepared For the Judges of the State of Texas.

27 Child Maltreatment

28 Child Maltreatment Background: Child maltreatment includes neglect or emotional, physical or sexual abuse under the age of 18 by a parent, caregiver, or another person in a custodial role. More than 740,000 children and youth are treated in hospital emergency departments as a result of violence each year. 1 The total lifetime cost of child maltreatment is $124 billion each year. 1 Children who suffer from child maltreatment are at increased risk of chronic diseases due to the effects of extreme stress on the nervous and immune systems. This can lead to increased risk for heart, lung, and liver disease in adulthood, as well as unhealthy behaviors including risky sexual behavior, smoking, illicit drug use and alcohol abuse. 2 How Does This Impact Texas? According to Prevent Child Abuse Texas, there were 66,897 cases of confirmed child abuse/neglect in Texas in 2010; 280 children died. 3 How Does This Impact Dallas County? In 2010, 5,591 children were confirmed victims of abuse and neglect, which is equivalent to 72 fully loaded school buses full of children. 4 Between 2006 and 2009, there were 100 deaths due to child maltreatment in Dallas County. Of those deaths, 37 percent were due to neglect and 63 percent were due to child abuse. 5 Dallas County and Texas rates of child maltreatment death (3.8 and 4.1 per 100,000 respectively) 5,6 are consistently greater than the national rate (2.3 per 100,000). 7 The Texas Legislative Landscape: Current Law Anyone having cause to believe that a child s physical or mental health or welfare has or may be adversely affected by abuse or neglect must report the case to any state or local law enforcement agency and to the Department of Family and Protective Services. 8 All volunteers and employees who work with children at Texas youth camps are required to complete a sexual abuse and child molestation awareness training course approved by the Texas Department of State Health Services. Each school district is required to adopt and implement policy addressing sexual abuse of children to be included in the district improvement plan and any information handbook provided to students and parents. 9 The following bills were passed during the 82nd Legislative Session: 9,10 - SB 434 establishes a task force to examine the relationship between family violence and child abuse and neglect. - SB 471 requires school district improvement plans to include policies on sexual abuse and child maltreatment. School districts, day-care centers and child-placing agencies must provide employee training on child maltreatment and implement policies to address this issue. - SB 993 seeks to address issues relating to certain arrangements to provide care for a child during an investigation of abuse or neglect.

29 Child Maltreatment - SB 434 establishes a task force to examine the relationship between family violence and child abuse and neglect. - SB 471 requires school district improvement plans to include policies on sexual abuse and child maltreatment. School districts, day-care centers and child-placing agencies must provide employee training on child maltreatment and implement policies to address this issue. - SB 1154 reestablishes the task force for the development of a strategy to reduce child abuse and neglect and improve child welfare. - SB 1178 enhances regulations of certain day-care facilities, child-care facilities and individuals providing child care services. - increases protections for children in certain child-care facilities by amending current law relating to regulation of certain shelter day-care facilities, child-care facilities, and individuals providing child-care services, and access to certain criminal history record information. - SB 1414 closes the gap on missing training on sexual abuse and child molestation needed to protect youth who attend camps on the campuses of institutions of higher education. Failed Legislation HB 681 failed during the 82nd Legislative Session. The bill sought to provide for better and more uniform means of assessing the placement, treatment, and service needs of children in the child welfare system by creating a task force to study the assessments of children in the child welfare system. 9 Best Practices to Prevent Child Maltreatment Injuries and Deaths: To help prevent child maltreatment, the National Conference of State Legislatures suggest states consider the following: 11 - Establish programs or policies that increase children s exposure to safe, stable nurturing relationships and environments. - Authorize a comprehensive examination of the state s current child fatality review system or develop local and state review teams that require reviews of deaths of children in the child welfare system or unexplained deaths of children from birth to age 18. Founded in 1992, the Dallas County Child Death Review Team was one of the first local teams to review child and adolescent fatalities in Texas. - Provide evidence-based training that teaches parents safe and nurturing child-rearing and management skills. - Support evaluation of programs to document effectiveness and to identify areas for improvement.

30 Child Maltreatment Prevent Child Abuse America: 12 - Increase evidence-based education programs for parents and other caregivers, to improve their parenting skills. These programs should focus particularly on single parents, teen parents and parents otherwise at greater risk of child abuse. - Implement home visitation programs, in which public health workers visit pregnant mothers and families with new babies or young children in order to strengthen parenting skills. - Implement respite and crisis care programs, which offer short-term child care to help parents and other caregivers in stressful situations. - Implement programs to reduce and prevent Shaken Baby Syndrome, which involves violently shaking an infant or young child. These programs should include education as well as instruction in coping strategies. Additional Resources Injury Prevention Center of Greater Dallas: www. National Center for Injury Prevention and Control, CDC: Prevent Child Abuse Texas: Family Compass: References 1 Centers for Disease Control and Prevention. Child Maltreatment Prevention. Retrieved from cdc.gov/violenceprevention/childmaltreatment/index (accessed February 2012). 2 Safe States Alliance. Injury & Violence Prevention are Essential to U.S. Health Reform. Retrieved from States%206%2009%20update%206%2010.pdf (accessed May 2012). 3 Prevent Child Abuse Texas. Texas Yearly Abuse Facts. Retrieved from org/vitialstexas (accessed May 2012). 4 Texas Department of Family and Protective Services Data Book. Retrieved from state.tx.us/about/data_books_and_annual_reports/2010/default.asp (accessed May 2012). 5 Dallas County Child Death Review data U.S. Department of Health and Human Services. Administration for Children and Families, Administration on Children, Youth and Families, Children s Bureau. Child Maltreatment 2009.

31 Child Maltreatment 7 Centers for Disease Control and Prevention. Preventing Child Maltreatment. Retrieved from cdc.gov/injury/about/priorities (accessed May 2011). 8 Prevent Child Abuse Texas. (n.d.). What s The Law. Retrieved from Prevent Child Abuse Texas: Telicon. (n.d.). Telicon - Progressive legislative information for Texas. Retrieved from Telicon: Texas Association Against Sexual Assault. (2011). Sexual Assault Legislative Update - Highlighting the New Texas Laws From the 82nd Legislative Session. 11 National Conference of State Legislators. (2009). Injury and Violence Policy: Strategies for Prevention. 12 Prevention Programs and Strategies: State Legislative Experiences. Prevent Child Abuse. Retrieved from (accessed May 2012).