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2013 Year in Review Violence and Injury Prevention Laws

2013 Year in Review: Violence and Injury Prevention Laws

7/17/2014

By Hollie Hendrikson

This report summarizes select state laws related to violence and injury prevention that were enacted by state legislatures in 2013. It also provides information about current violence and injury prevention issues. Links to additional resources on the topics covered are also included throughout this report.

Prescription drugsPrescription Drug Overdose. Twenty-five states passed laws aimed at preventing prescription drug abuse, misuse and overdose. Many of these laws modified a state’s prescription drug monitoring program.

Traumatic Brain Injury. Eleven states passed laws to address traumatic brain injury. Seven of these states created or modified youth sports-related concussion laws.

Youth Violence. Seven state legislatures enacted laws to prevent youth violence before it starts. Six of these states passed laws aimed at preventing bullying.

Traffic Safety. At least 30 states passed laws to address traffic safety issues including distracted driving, child passenger safety, ignition interlock devices and graduated drivers licensing for teen drivers.

Older Adult Falls. One state passed a law that aims to prevent older adult falls.

Suicide. Four states enacted laws that aim to prevent suicide among young adults and students.

Intimate Partner Violence, Sexual Violence and Teen Dating Violence. Three states passed laws to address intimate partner violence and sexual violence prevention. Two states passed laws to address teen dating violence by creating or modifying school curriculum.

Child Maltreatment. Six states passed laws related to home visitation, and three states passed laws to create task forces to make policy recommendations for preventing child maltreatment.

Introduction

Unintentional and violence-related injuries are the leading cause of death for Americans ages 1 through 45. This means that, for young and middle-aged Americans, injuries from car crashes, suicides, poisonings or falls are prominent risks. For adults over age 65, both falls and injuries related to motor vehicle crashes can result in lengthy hospitalizations and reduced independence.

State legislative efforts to reduce injury fatalities and hospitalizations include a wide range of interventions. This review of violence and injury prevention laws is intended as a resource for state legislators and legislative staff who seek to learn about other state policy actions that aim to reduce the burden of violence and injuries.

This report provides a summary of laws and a brief overview of select policy issues including prescription drug overdose, traumatic brain injury, youth violence, traffic safety, older adult falls, suicide, intimate partner violence, sexual violence and teen dating violence, and child maltreatment.

Prescription Drug Overdose

Prescription opioid painkiller overdose deaths in the United States quadrupled between 1999 and 2010, claiming more than 16,500 lives in 2010 alone. Deaths caused by prescription painkiller overdose now outnumber deaths from all illicit drugs, such as heroin and cocaine, combined.

State legislatures continue to explore ways to reduce prescription drug overdose and prevent people from using these drugs for recreational purposes. In 2013, 25 states passed 35 laws to address this growing public health concern.

Controlled Substances Definition: Thirteen states passed laws in 2013 relating to prescribing or reporting  “controlled substances.” Drugs and chemicals labeled as “controlled substances” are identified by the federal government as having some potential for abuse or dependence, and are divided into five categories, or “schedules.”  Schedule I drugs have no accepted medical use and have a high potential for abuse. Schedule II through V have accepted medical uses, but also have a potential for abuse; schedule II has a higher potential for abuse, and schedule V has the lowest.  Many prescription painkillers are schedule II through V controlled substances. Authorized health care practitioners can write prescriptions for these controlled substances, but many states are placing more restrictions on how these substances are prescribed and distributed. In addition to the federal controlled substance schedules, states maintain their own schedules of controlled substances.

Prescription Drug Monitoring Programs 

Prescription Drug Monitoring Programs (PDMPs) are statewide programs that aim to track prescription painkillers electronically from the time they are prescribed to the time they are distributed to a patient. These programs are designed to curb inappropriate prescribing behavior and prevent “doctor shopping,” or prevent people from obtaining multiple prescription pain killers from multiple providers. Prior to 2013, legislatures in 49 states enacted laws to create PDMPs, and each state’s program operates differently. Fourteen states enacted legislation in 2013 to modify an existing PDMP. A brief description of these laws follows.

Alabama
House Bill 150 amends existing law to require prescription payment information to be included in the controlled substances database. This law also expands the entities allowed to access the database to include, authorized representatives of the Alabama Medicaid Agency and up to two employees on behalf of a physician. It also allows professional licensing boards to require practitioners to access the controlled substances database prior to prescribing, dispensing or administering medications.

California
Senate Bill 809 establishes the Controlled Substance Utilization Review and Evaluation System Fund to support the operation and maintenance of the statewide prescription monitoring system. On April 1, 2014 an annual fee of $6 is to be paid by people with certain professional licenses, including those authorized to prescribe, order, administer, furnish or dispense controlled substances, and is to be deposited into the Fund.

Connecticut
House Bill 6406 allows the Commissioner of Consumer Protection to identify products or substances to be included in the electronic prescription drug monitoring program. It also requires weekly reporting to this monitoring program from pharmacies, nonresident pharmacies, outpatient pharmacies in a hospital or institution, and dispensers. Every practitioner who distributes, administers or dispenses any controlled substance is required register with the electronic prescription drug monitoring program.

Delaware
Senate Bill 59 requires that dispensers of controlled substances check the prescription drug monitoring program’s utilization report for any patient that the dispenser suspects may be seeking controlled substances for a non-medical reason. This law allows licensed chemical dependency professionals or licensed professional mental health counselors to obtain a utilization report for patients who are receiving treatment in substance abuse treatment programs. It allows the Chief Medical Examiner or licensed physician designee to obtain a patient utilization report for the purpose of investigating the death of an individual. This law also authorizes the exchange of prescription information submitted to program through an interstate commission with an authorized state.

Indiana
House Bill 1465 establishes the Indiana Scheduled Prescription Electronic Collection and Tracking Program interim study committee to study potential enhancements to the program, including real time reporting of prescription information, reporting of criminal convictions involving controlled substances and illegal drugs, and requiring health care practitioners who prescribe medications to use the program.

Maine
House Bill 263/Legislative Document 388 requires the Substance Abuse Services Commission to develop strategies to increase prescriber registration in the controlled substances prescription monitoring program.

Maryland
Senate Bill 80 requires prescription drug monitoring program data to be shared with the Division of Drug Control within the Department of Health when the information is relevant to an ongoing investigation.

Montana
Senate Bill 323 allows prescribers to search the prescription drug registry prior to prescribing a schedule II or schedule III drug for treatment of a workers' compensation injury or occupational disease.

Rhode Island
House Bill 5756/Senate Bill 647 requires the director of the Department of Health to develop rules and regulations for an electronic monitoring system for schedule II and III controlled substance prescriptions.  This law also authorizes certain individuals to access data from the system, and identifies information to be collected by the system.

Texas
Senate Bill 1643 creates the Interagency Prescription Monitoring Work Group. The purpose of this work group is to evaluate the effectiveness of prescription monitoring and offer recommendations to improve the recordkeeping and other functions related to regulating prescribed controlled substances. The Work Group is required to submit recommendations to the legislature on December 1 of each even-numbered year.

Utah
House Bill 270 allows designees of the director of the Department of Health to access de-identified data in the controlled substances database. It also allows database access to designated individuals conducting scientific studies regarding the use or abuse of controlled substances.

Vermont
House Bill 522 requires health care providers to search the Vermont Prescription Monitoring System (VPMS) prior to prescribing a controlled substance, and expands the categories of entities that may access the VPMS.

Virginia
House Bill 1704 requires the Department of Health Professions to disclose prescription monitoring program information to designated law enforcement officers when the information is relevant to a specific investigation.  It also allows the Department to disclose program information to prescribers.

Washington
House Bill 1565/Senate Bill 5493 fund the prescription monitoring program from the state’s Medicaid fraud penalty account.

Pain Management Clinics

Pain management clinics are privately owned facilities that provide pain management services to patients, and often include prescriptions for controlled substances. At least  11 states have laws that require some type of state oversight of pain management clinics, with three states enacting legislation in 2013. A brief description of these laws follows.

Alabama
House Bill 151 allows the Board of Medical Examiners to regulate physicians providing pain management services and expands the board’s regulatory power over pain management clinics.

Georgia
House Bill 178 enacts the Georgia Pain Management Clinic Act requiring pain management clinics to be licensed.

Tennessee
Senate Bill 676 requires pain management training for practitioners who dispense and prescribe controlled substances for the purpose of treating chronic pain.
House Bill 868 prohibits pain management clinics from dispensing controlled substances.

Emergency Treatment for Drug Overdoses

In 2013, five states passed laws to reduce the number of overdose-related deaths by encouraging people to seek help.  These laws allow health care providers or other authorized people to dispense an opioid antagonist, such as naloxone, to counter the effects of a drug overdose.  A brief description of these laws follows.

California
Assembly Bill 635 authorizes licensed health care providers to prescribe and dispense an opioid antagonist to treat a person who is at risk of an opioid-related overdose. This law also allows these licensed health care providers to distribute the opioid antagonist to a family member, friend, or other person in a position to assist a person at risk of an opioid-related overdose.

Maryland
Senate Bill 610 requires the Department of Mental Health and Hygiene to develop an Overdose Response Program for the purpose of authorizing certified individuals to possess and administer naloxone to individuals experiencing, or believed to be experiencing, an opioid overdose.

Ohio
Senate Bill 57 establishes a pilot project in Lorain County. The pilot will run from Aug. 1, 2013 until July 31, 2014 to allow qualified emergency responders to obtain and administer naloxone to revive a person suffering from an apparent opioid-related overdose.

Oklahoma
House Bill 1782 allows first responders to administer opiate antagonists when encountering a person who is exhibiting signs of a drug overdose.

Oregon
Senate Bill 384 requires the Oregon Health Authority to develop training criteria on opiate overdose treatments. People who successfully complete this training are authorized to possess and administer naloxone for the treatment of an opiate overdose.

Immunity from Prosecution

Laws that address immunity from prosecution encourage emergency treatment of drug overdoses. These laws provide a degree of legal immunity to people who seek medical assistance for themselves or others, or provide medical assistance to someone who is experiencing a drug overdose.  In 2013, four states passed this type of law. A brief description of these laws follows.

Colorado
Senate Bill 14 allows a person who acts in good faith to administer an opiate antagonist to another person experiencing an opiate-related drug overdose to be immune from criminal prosecution.

Delaware
Senate Bill 116 provides a degree of criminal immunity for people who seek medical attention for someone, including themselves, when experiencing an alcohol or drug overdose.

New Jersey
Senate Bill 2082/Assembly Bill 3095 create the Opioid Antidote and Overdose Prevention Act to provide immunity from civil and criminal liability and professional discipline for health care professionals who prescribe or dispense opioid antagonists. This law also provides immunity from civil and criminal liability for other people who administer these drugs in an emergency to an individual who the person believes, in good faith, is experiencing an opioid overdose.

North Carolina
Senate Bill 20 provides immunity from civil or criminal liability for practitioners who prescribe, dispense, or distribute an opioid antagonist, such as naloxone, to a person experiencing a drug-related overdose. It also extends this immunity to third parties in a position to assist a person at risk of experiencing an opiate-related overdose.

Prescribing Practices

Amending prescribing practices for certain painkiller prescriptions may mitigate unnecessary prescribing of painkillers by some providers. Five states passed laws in 2013 to amend prescribing practices for certain health care practitioners or certain prescription painkillers. A brief description of these laws follows.

Florida
House Bill 239 prohibits certified optometrists from administering or prescribing prescription drugs listed as a schedule I or schedule II controlled substance.

Oregon
Senate Bill 136 allows the Oregon State Board of Nursing to authorize certified registered nurse anesthetists to write prescriptions and dispense prescription drugs, including prescriptions for scheduled controlled substances.

Tennessee
Senate Bill 962 requires a pharmacist to make every reasonable effort to prevent the abuse of drugs which the pharmacist dispenses, by utilizing education, skill, experience and professional judgment. A pharmacist may decline to dispense a drug if it lacks therapeutic value, or if it is not for a legitimate medical purpose.

Texas
Senate Bill 316 requires the Board of Pharmacy to develop a continuing education program to address opioid drug abuse. This program must include information about the delivery and dispensing of tamper-resistant opioid drugs.

Utah
Senate Bill 214 establishes continuing education requirements for health care practitioners who prescribe controlled substances.

Other Prescription Drug Overdose Laws

California
Senate Bill 670 authorizes the California Medical Board to inspect and copy the medical records of a patient that died from a prescription drug overdose, without the consent of the patient's next of kin or a court order.

New Hampshire
Senate Bill 71 establishes a committee to study the use and misuse of prescription drugs in workers' compensation cases.

Oklahoma
House Bill 1783 creates the Oklahoma Prescription Drug Reform Act of 2013 and prohibits more than two prescription refills for any product containing hydrocodone

West Virginia
Senate Bill 108 creates the Unintentional Pharmaceutical Drug Overdose Fatality Review Team under the Office of the Chief Medical Examiner to review and analyze deaths related to unintentional prescription or pharmaceutical drug overdoses.

For more information about strategies to prevent prescription drug overdose, please see:

Traumatic Brain Injury

Traumatic brain injury (TBI) is a serious public health problem in the United States. In 2010, at least 2.5 million emergency department visits, hospitalizations or deaths included a diagnosis of TBI, either alone or in combination with other injuries. Approximately 85 percent of TBIs are concussions or mild brain injuries. Children, adolescents and older adults are most likely to sustain a TBI. Since 2009, 50 states and the District of Columbia passed laws to address traumatic brain injury. The majority of laws target youth sports-related concussions and require student athletes to be removed from competition or practice if a concussion is suspected. About half of these states also require guidelines for concussion management or concussion awareness materials, and require coaches or athletic trainers to be trained in concussion awareness.

In 2013, 12 states passed laws related to traumatic brain injuries. Ten states passed laws to create or modify youth sports-related concussion rules.  Two states—Iowa and North Dakota— also passed laws that address traumatic brain injury services for veterans.

Youth Sports-Related Concussion Laws

Seven states enacted youth sports-related concussion laws in 2013. California, New Hampshire, Utah and Vermont modified existing sports concussion laws. Brief descriptions of these laws follow.

Arkansas
Senate Bill 1158 creates the Arkansas Concussion Protocol Act, which requires the Department of Health to develop concussion protocols to protect youth athletes engaged in youth athletic activities.

California
Assembly Bill 588 amends existing sports concussion law to include athletes attending charter schools and private schools.

Georgia
House Bill 284 enacts the Return to Play Act of 2013 and requires public and private schools that offer youth athletic activities, and public recreation facilities, to provide information to parents on the nature and risks of concussion and head injury. It also requires these entities to establish concussion management and return to play policies.

Montana
Senate Bill 112 requires each school district to adopt a policy addressing the dangers of concussions. This law also requires that a youth athlete who exhibits signs, symptoms or behaviors consistent with a concussion be removed from participation until medical clearance is obtained.

New Hampshire
House Bill 180 limits existing student head injury policies to intramural sports programs conducted outside the regular teaching day and competitive sports programs between schools for students in grades four through 12.

South Carolina
House Bill 3061 requires the Department of Education to develop and distribute model policies that incorporate best practices for identifying and managing student athlete concussions. It also requires the removal from play and medical evaluation of a student athlete believed to have sustained a concussion during play, and allows the evaluation to be undertaken by a volunteer health care provider.

Tennessee
Senate Bill 882 requires the governing body of each school to develop guidelines, information and forms to educate coaches, school administrators, youth athletes and their parents or guardians of the nature, risk and symptoms of concussion and head injury. These governing bodies also must establish policies that require a youth athlete to be removed from play when they sustain a concussion. These athletes may not return to practice or competition until the youth athlete is evaluated by a health care provider and receives written clearance for a full or graduated return to play.

Vermont
Senate Bill 4 requires that school athletic coaches and referees receive training on how to prevent concussions during athletic activities. The law also prohibits a coach or trainer from allowing an athlete to participate in an event if the athlete has sustained a concussion or head injury, and requires the “home team” to ensure that a licensed athletic trainer or health care provider is present at any athletic event involving a contact sport.

Utah
House Bill 269 allows a school nurse to assess a child who sustains a concussion or traumatic head injury during school hours on school property. This law prohibits a school nurse from providing a written statement permitting the child to return to free play or physical education class after sustaining a concussion or traumatic head injury, unless the nurse has been trained in the evaluation and management of head injuries.

West Virginia
Senate Bill 336 establishes protocols and protections to limit and treat head injury to youth athletes and students, including removal-from- and return-to play requirements.

Veterans with Traumatic Brain Injuries

Two state legislatures passed laws in 2013 to address veterans with traumatic brain injuries. A brief description of these laws follows.

Iowa
House File 545 allows the state’s Veterans Trust Fund to pay for screening or treatment related to a military service-connected traumatic brain injury. This fund may only be used if payment is not available through other federal or state programs or a veteran's private insurance or managed care organization.

North Dakota
House Bill 1424 provides for a legislative management study of the feasibility of nontraditional healing therapies for post traumatic stress, traumatic brain injury, and other neurological conditions that afflict veterans.

Other Traumatic Brain Injuries Laws

South Carolina
Senate Bill 127 creates the State Brain Injury Leadership Council and requires the Council to provide statewide coordination in promoting support services for people with brain injuries, their families and caregivers.

For more information about strategies to prevent traumatic brain injury, please see:

Youth Violence Prevention

Bullying, assault and homicide affect millions of children and adolescents in the United States each year.  More than 925,000 young adults were treated in an emergency department for violence-related injuries in 2010, according to the Centers for Disease Control and Prevention.  Violence can also negatively affect the health of communities. According to a report from the World Health Organization, communities with high rates of youth violence also experience decreased property value, increased health care costs, and disrupted social services.

In 2013, seven states enacted laws to prevent youth violence.

Bullying

Prior to 2013, 46 states adopted anti-bullying laws. Of these, 45 directed school districts to adopt bullying policies. In 2013, six states passed laws aimed at preventing bullying by creating new requirements for schools, or modifying existing bullying laws. A brief description of these laws follows.

California
Assembly Bill 256 allows students to be suspended or expelled for engaging in electronic acts of bulling on or off school sites.

Florida
House Bill 609 prohibits bullying or harassment through electronic means that are accessed at a nonschool-related location or activity.

Illinois
House Bill 2322 allows school social services to establish and implement bullying prevention and intervention programs.

Indiana
House Bill 1423 requires the Department of Education to develop guidelines to assist schools in establishing bullying prevention programs. These programs must include investigation and reporting procedures, and discipline rules. This law also allows the Department of Education to provide bullying prevention education to students.

Oklahoma
House Bill 1422 allows students to be transferred to another school on an emergency basis when a student has been the victim of harassment, intimidation or bullying.
House Bill 1661 requires the state Board of Education to establish and maintain a central repository for the collection of information regarding documented and verified incidents of bullying. An annual report must be published on the Department of Education’s website regarding the number of documented and verified incidents of bullying within public schools.

Virginia
House Bill 1871 requires school boards to prohibit students and school employees from engaging bullying. It also requires local school boards to implement policies and procedures on reporting, investigating and addressing acts of bullying

Other Youth Violence Laws

Rhode Island
Senate Bill 801 directs school districts to conduct a school safety assessment with help from local police and fire departments. It also directs the Department of Elementary and Secondary Education to develop a model school safety plan.

For more information about strategies to prevent youth violence, please see:

Traffic Safety

Motor vehicle crashes are one of the leading causes of death for Americans in their first three decades of life. In 2012, more than 33,000 people died in crashes. The annual economic cost of motor vehicle crashes nationwide is estimated at $99 billion; $17 billion of that is spent on medical costs alone.

In 2013, at least 45 states passed laws to address some aspect of traffic safety. This report summarizes only the 2013 laws that relate to distracted driving, child passenger safety, ignition interlock and graduated drivers licensing. For a complete overview of 2013 enacted traffic safety legislation and research, see NCSL’s Traffic Safety Trends: State Legislative Action, 2013.

Distracted Driving

The National Highway Traffic Safety Administration (NHTSA) reports that 10 percent of fatal crashes and 17 percent of injury crashes in 2011 were reported as distraction-affected crashes. NHTSA defines a distraction-affected crash as “any crash in which a driver was identified as distracted at the time of the crash.” Since 2000, legislatures in every state have considered legislation related to distracted driving or, more specifically, to driver cell phone use. In 2013, legislators in 18 states passed at least 21 distracted driving laws. Brief descriptions of these laws follow.

California
Senate Bill 194 prohibits a person who is under 18 years of age from using an electronic wireless communication device while driving even if it is hands-free.

Connecticut
House Bill 6033 increases fines for using a mobile device while driving a motor vehicle. This law also requires that distracted driving violations appear in driving history records that are available to motor vehicle insurance providers.

Florida
Senate Bill 52 creates the Ban on Texting While Driving Law, which prohibits the driving of a motor vehicle while using a wireless communication device. This law specifies information that is admissible as evidence for a texting while driving violation.

Hawaii
House Bill 980 prohibits the use of hand held mobile electronic devices while operating a motor vehicle.

Illinois
House Bill 2585 establishes that a person convicted of driving while using a video device, wireless telephone, or electronic communication device commits a Class A misdemeanor if this action caused a motor vehicle accident that resulted in great bodily harm, permanent disability, or disfigurement to another.

Louisiana
Senate Bill 147 prohibits using a wireless communication device to access, read or post to a social networking site while operating a motor vehicle.

Maryland
Senate Bill 339/House Bill 753 establish primary enforcement of violations of current bans on driving while operating a wireless communication device.

Michigan
House Bill 4254 restricts sending and receiving text messages and using a hand-held mobile phone while operating a commercial vehicle or school bus.

New Jersey
Senate Bill 69 imposes a driver’s license suspension for talking or texting on a hand-held device while driving.
Assembly Bill 3873 requires the Department of Transportation commissioner to erect signs and use variable message signs to inform motorists of the law prohibiting texting while driving.

New York
Senate Bill 5656 allows the suspension of a probationary driver's license for violations relating to the use of mobile telephones or portable electronic devices while driving.

Oregon
Senate Bill 9 requires signage on all state highways that alert drivers to a potential $1,000 fine for using a mobile communication device for texting while driving.

Rhode Island
Senate Bill 546/House Bill 5675 allow the suspension of a driver’s license for a violation of the texting while driving ban.
Senate Bill 660/House Bill 5655 require distracted driving issues, including cell phone use, to be included as part of the curriculum for and testing related to the state's driver's license examination.

South Dakota
Senate Bill 44 allows commercial driver licenses to be disqualified if the driver is convicted of violating texting bans while driving a commercial vehicle.
Senate Bill 106 prohibits minors with an instruction permit from using wireless communication devices while operating motor vehicles on public highways.

Texas
House Bill 347 prohibits using a wireless communication device while operating a motor vehicle on school property.

Utah
Senate Bill 19 allows the suspension of a commercial driver’s license for using a handheld wireless communication device while operating a commercial motor vehicle.
House Bill 103 prohibits drivers younger than 18 years old from using a wireless telephone to communicate with another person while operating a motor vehicle.

Virginia
Senate Bill 1222 establishes that driving while using a handheld communication device for something other than verbal communication constitutes driving a motor vehicle that is not under proper control, which is punishable as reckless driving.

West Virginia
Senate Bill 515 prohibits video screens, video monitors, televisions and television receivers in view of the driver while a motor vehicle is in motion.

Child Passenger Protection

Motor vehicle crashes are a leading cause of death for children in the United States. More than 650 children age 12 and under died in crashes in 2011. The most effective way to keep children safe in cars is to ensure that they are properly restrained in appropriate child restraint systems for their weight, height and age in the back seat. NHTSA estimates that child safety seats reduce the risk of fatal injury by 71 percent for infants and by 54 percent for toddlers in passenger cars. In 2013, at least three states passed child passenger protection laws. Brief descriptions of these laws follow.

Arkansas
House Bill 1232 requires all people operating passenger vehicles to comply with child safety restraint laws by properly placing, maintaining and securing the child in a child passenger restraint system.

Maryland
Senate Bill 87 prohibits people under 16 years old from being a passenger in the rear seat of a motor vehicle unless the person is restrained by a seat belt.

New Hampshire
House Bill 242 changes child restraint system requirements for motor vehicle operation. This law requires children under the age of seven, or under 57 inches in height, to be properly secured by a child restraint system.

Impaired Driving and Ignition Interlock Devices

All 50 states and the District of Columbia have some type of law related to ignition interlocks, which prevent a car from being started if alcohol is detected on the driver’s breath. Some require all offenders to use them; others require only those convicted with a high blood alcohol concentration (BAC) or with a repeat offense. In some states, a judge decides if the device is required, and in others, their use is administratively sanctioned. In 2013, 16 states and the District of Columbia passed laws related to ignition interlocks. A brief description of these laws follows.

Arizona
House Bill 2182 prohibits a person that is required to use an ignition interlock device from operating an employer’s vehicle that is not equipped with the device. It also prohibits a person from being placed in a continuous alcohol monitoring program instead of equipping any motor vehicle the person operates with an ignition interlock device.

Arkansas
House Bill 1694 allows for an ignition interlock restricted license to be available immediately if a person is charged with driving while intoxicated.

Colorado
House Bill 1240 authorizes the Department of Revenue to provide assistance to low-income persistent drunk driving offenders to pay for ignition interlock devices.

District of Columbia
DC B19-673 establishes an ignition interlock program for people convicted of a first or subsequent driving under the influence.

Georgia
House Bill 407 requires the mandatory use of ignition interlock devices following a second conviction for driving under the influence of alcohol or drugs.

Maine
Senate Bill 36 authorizes the Secretary of State to reinstate the license of a person with four or more operating under the influence offences, after four years of suspension, if the person has installed an ignition interlock device.
House Bill 899 increases the license suspension period for an operating under the influence first-time offender. The law also allows the license of a person convicted of operating under the influence to be reinstated immediately if the person installs an ignition interlock device.

Mississippi
House Bill 481: Under this law, people convicted of driving under the influence may operate vehicles equipped with an ignition interlock device. This law also provides for a ignition-interlock-restricted driver's license. 

Nebraska
Legislative Bill 158 extends the minimum period that a vehicle is required to have ignition interlock to a full year for a repeated driving under the influence offender.

New Hampshire
Senate Bill 20 requires ignition interlock devices sold or distributed in the state to be approved by the Department of Safety.

New Mexico
Senate Bill 190 amends the local Driving While Under the Influence Grant Program Act to provide local grants for the leasing of interlock devices by qualified indigent offenders.
Senate Bill 442 requires an ignition interlock license for people convicted of homicide by vehicle or great bodily harm by vehicle while under the influence of intoxicating liquor or drugs.

New York
Assembly Bill 2285 clarifies that young “driving while intoxicated offenders” are subject to ignition interlock requirements for at least 12 months.

North Carolina
Senate Bill 659 requires the installation of an ignition interlock device as a condition of  restoring a driver’s license that was revoked as a result of a conviction for driving under the influence. 

Oklahoma
House Bill 1441 requires every person convicted of driving under the influence who is seeking a driver license to have an ignition interlock device placed on the vehicles owned by their employer if the person operates the vehicle.

Oregon
House Bill 2116 exempts people in the Driving Under the Influence of Intoxicants Diversion program from having to operate a motor vehicle with an ignition interlock device if they have a valid medical reason why they cannot do so. It also exempts people in this program from the ignition interlock device requirement while they are operating an employer’s vehicle.

Tennessee
House Bill 353 specifies that any person who is convicted of driving under the influence may only operate a motor vehicle that is equipped with a functioning ignition interlock device.

Virginia
House Bill 279/Senate Bill 378 require a person convicted of driving under the influence to have an ignition interlock on the first offense, as a condition of a restricted license. 

Washington
Senate Bill 5912 requires the installation of an ignition interlock device for people with a previous record of serious traffic violations, such as vehicular homicide or driving under the influence.

Graduated Driver’s Licenses for Teen Drivers

Motor vehicle crashes, a leading cause of death for teens, killed more than 1,900 young drivers (ages 15 to 20) in 2011. According to a report released by the Children’s Hospital of Philadelphia, among the more than 55,000 teen drivers and their passengers seriously injured each year in 2009 and 2010, 30 percent suffered head injuries, including concussion, skull fractures and traumatic brain injuries (TBI).

GDL: The Basics : Graduated driver licensing (GDL) systems are proven effective in keeping teens safer on the road. They help new drivers gain experience under low-risk conditions by granting driving privileges in stages. As teens move through the stages of GDL, they are given extra privileges, such as driving at night or driving with passengers. According to a study completed by the Johns Hopkins Bloomberg School of Public Health, states with strong GDL laws reduced fatalities of 16-year-old drivers by 11 percent. The National Highway Traffic Safety Administration defines a comprehensive GDL law as one that includes five of seven of the following components: a minimum age of 15 years and six months for obtaining a learner’s permit; a waiting period after obtaining a learner’s permit of at least three months before applying for an intermediate license; a minimum of 30 hours supervised driving; a minimum age of at  least 16 and six months for obtaining an intermediate state license; a minimum age of at least 17 for full licensing; nighttime driving restrictions and passenger restrictions.

In 2013, three states passed laws to create or change graduated driver’s license restrictions for teen drivers. Brief descriptions of these laws follow.

Iowa
Senate Bill 115 limits the number of unrelated minor passengers in the motor vehicle to one when a minor with an intermediate driver’s license is operating the motor vehicle.

Texas
House Bill 3483 increases the number of behind-the-wheel instruction hours required in a driver education course from 20 to 30 hours and prohibits a person under 18 years of age from operating a motor vehicle after midnight and before 5 a.m.

Virginia
Senate Bill 1165 prohibits minors with a provisional driver’s license from driving with passengers younger than 21 years old in the vehicle.
House Bill 2033 restricts minors with a provisional driver’s license from operating a motor vehicle between midnight and 4 a.m.

For more information about strategies to prevent motor vehicle-related injuries and fatalities, please see:

Older Adult Falls

Each year in the United States, one in three adults over 65 years of age falls. Long-term physical injuries, such as hip fractures and traumatic brain injuries, are just two of the many consequences and costs of older adult falls. While the federal Medicare program pays for the bulk of these costs, the AARP estimates that state Medicaid programs pay for 11 percent of the direct costs associated with older adult falls.

Falls are not an inevitable part of aging and are largely preventable. The CDC has developed a fall prevention tool kit for health care providers called STEADI (Stopping Elderly Accidents, Deaths and Injuries) to help them reduce falls by implementing the American Geriatrics Society’s clinical guideline for fall prevention.

Increasingly, state legislatures are playing a role in reducing older adult falls by establishing programs and appropriating funds to address these issues. In 2013, Minnesota passed a law to address older adult falls. A brief description of this law follows.

Minnesota
House Bill 1233/Senate Bill 1034 establishes training requirements for home care providers, such as competency evaluations for unlicensed providers. Training for unlicensed home care providers must include instruction on preventing falls for those working with the elderly or individuals at risk of falls.

For more information about strategies to prevent older adult falls, please see:

Suicide

Every day in the United States, an average of 105 people take their own lives, according to the CDC. Nationally, the suicide rate has increased and in 2010 suicide rates were the highest they have been in 15 years. In 2010, more than 38,000 Americans committed suicide, making suicide the second leading cause of death among young people aged 20 to 29 in that year.

In 2013, four state legislatures enacted suicide prevention laws.  A brief description of these laws follows.

Iowa
Senate File 446 directs the Department of Education to develop recommendations for suicide prevention training among people who work with students.

Maine
House Bill 428/Legislative Document 609 requires school administrative units to develop a plan for suicide prevention awareness education for all school personnel. This law also requires at least two people in each school to be trained in suicide prevention and intervention and allows these activities to be incorporated into in-service training.

Vermont
House Bill 530 requires that funds appropriated to the Department of Mental Health for suicide prevention enhance coordination among youth and adult suicide prevention programs.

Washington
House Bill 1336 requires school counselors, psychologists, social workers and nurses to complete a training program in youth suicide screening and referral services.

For more information about strategies to prevent suicides, please see:

Sexual Violence, Intimate Partner Violence and Teen Dating Violence

Intimate partner violence, sexual violence and teen dating violence have been identified as major public health problems by the CDC. A recent national CDC survey found that more than 12 million people were victims of rape, physical violence or stalking by an intimate partner in 2010. Victims of violence were more likely to report physical and mental health problems, including frequent headaches, chronic pain and difficulty sleeping. A separate survey from the CDC found that one in 11 adolescents report being the victim of physical dating violence.

In 2013, two states passed laws to address intimate partner violence and sexual violence prevention. Brief descriptions of these laws follow.

Iowa
Senate File 446 appropriates $203,032 from the emergency medical services fund to the Department of Public Health for sexual violence prevention. These funds are to be used for activities that serve victims of sexual violence through the Department of Public Health’s sexual violence prevention program.

Maine
Senate Bill 432/Legislative Document 1238 require professional licensure requirements for psychologists, clinical professional counselors and clinical social workers to include a minimum number of course work hours in spousal or partner abuse screening, referral and intervention strategies.

Teen Dating Violence

In 2013, Colorado and Illinois passed laws that require school boards to develop curriculums on teen dating violence. Prior to 2013, 19 states had laws that urged or required adoption of teen dating violence prevention and education in school curricula. Many states also adopted teen dating violence awareness weeks or months in an effort to draw public attention to a national campaign that promotes prevention and safe dating practices and offers information and resources. Brief descriptions of these laws follow.

Colorado
House Bill 1081 creates the Comprehensive Human Sexuality Education Grant Program in the Department of Public Health and Environment. This law requires schools receiving these grants to include instruction about the prevention of sexual violence in dating relationships. These programs must also teach young people how to recognize and respond safely in situations where sexual or physical violence may be occurring.

Illinois
House Bill 3379 amends the Critical Health Problems and Comprehensive Health Education Act and requires school boards to adopt a policy stating that teen dating violence is unacceptable and is prohibited. School boards are required to incorporate age-appropriate education about teen dating violence into new or existing training programs for students in grades seven through 12.

For more information about strategies to prevent teen dating violence and sexual violence, please see:

Child Maltreatment

Each year nearly 4 million reports of child maltreatment are received by state and local agencies, and 740,000 children are treated in hospital emergency departments as a result of violence. Child maltreatment includes physical abuse, sexual abuse, psychological abuse and neglect of children under age 18 by a parent, caregiver or another person in a custodial role (e.g., clergy, coach, or teacher).

The predominant and most thoroughly researched child maltreatment prevention strategy is early childhood home visitation.  Lawmakers have invested state funds in home visiting for more than a decade. In 2010, the Affordable Care Act included a provision to provide additional funding for state home visitation programs.  Home visiting supports pregnant mothers and new parents to promote infant and child health, foster healthy child development and improve school readiness. Evidence-based home visiting evaluation findings show positive well-being outcomes for children and families while creating long-term savings for states.

For more information about child maltreatment policies, programs, and activities, please see "Essentials for Childhood: Steps to Create Safe, Stable, Nurturing Relationships." This is a CDC guide that provides an overview of interventions that can support safe, stable, nurturing relationships and environments for children to prevent maltreatment and reduce the negative effects of child maltreatment and other adverse childhood experiences.

Eight states passed laws related to home visitation in 2013. Three of these states passed laws to create task forces to make policy recommendations for preventing child maltreatment. Brief descriptions of these laws follow.

Arkansas
Senate Bill 491 requires the Child Abuse and Neglect Prevention Board, the Department of Health, and the Department of Human Services to develop a home visitation program to provide face-to-face home visits by trained health care providers including, nurses and social workers. This law also requires at least 90 percent of program funding to be used toward evidence-based and promising practice home visitation models. Home visiting contractors are required to report to the legislature and governor on outcome measurements, collective impact of program outcomes and demographic data on families.

Senate Bill 1011 establishes a specific violation in the Educator Code of Ethics concerning an educator's inappropriate relationship with a student.

House Bill 1988 creates the Arkansas Task Force for the Prevention through Education of Child Sexual Abuse. The role of this Task Force is to gather information about the prevalence of child sexual abuse throughout Arkansas and make evidence-based recommendations to the legislature and the governor on ways to prevent child sexual abuse through education. This Task Force is also required to make recommendations on age-appropriate curricula for students in kindergarten through fifth grade concerning child sexual abuse prevention.

Connecticut
Senate Bill 972 requires the Department of Children and Families to develop a comprehensive plan to prevent or reduce the long-term negative impact of mental, emotional and behavioral health issues on children. This law also requires the Office of Early Childhood to provide recommendations to the legislature on coordinating home visitation programs that offer services to vulnerable families with young children, and design and implement a public information and education campaign on children's mental, emotional and behavioral health issues.

Hawaii
House Bill 908 establishes, within the Department of Health, the Hawaii Home Visiting Program, which is responsible for statewide hospital-based screening and home visiting services for families of newborns at risk for poor health and safety outcomes. The goal of this program is to promote healthy child development and strengthen families.

Mississippi
Senate Bill 2133 creates the Erin's Law Study Committee to explore creating and implementing a curriculum for the prevention of sexual abuse of children for students from kindergarten through fifth grade.

Nevada
Senate Bill 258 creates the Task Force on the Prevention of Sexual Abuse of Children. The purpose of this Task Force is to recommend a policy that educates people about the sexual abuse of children and the support services available to children in Nevada, who may be affected by sexual abuse.

New Mexico
Senate Bill 297 broadens the scope of the Children's Trust Fund Act to include advocacy and education for preventing of child abuse and neglect.

Senate Bill 365 requires the Children, Youth, and Families Department to establish a home visiting program to promote parental competence.

Texas
Senate Bill 426 requires the Health and Human Services Commission to create a voluntary-enrollment home visitation program. Under this program, early childhood and health professionals, such as nurses or social workers, visit the homes of pregnant women or families with children under the age of six who are born with or exposed to one or more risk factors, which include preterm birth, poverty, low parental education, having a teen mother or father, poor maternal health, and parental underemployment or unemployment.

House Bill 748 requires the Department of Family and Protective Services apply for a waiver from the federal government to use certain federal funds to test innovative strategies in child welfare programs, such as demonstration projects to accomplish providing more permanency for children by reducing time in foster care, promoting successful transitions to adulthood for former foster youth, and preventing child abuse and neglect.

Washington
Senate Bill 5809 requires certain federal funds to be deposited into the Home Visiting Services Account. The Department of Early Learning is identified as the lead state agency for home visiting system development and oversees this account.

For more information about strategies to prevent child maltreatment, please see:

Additional Resources

NCSL Resources

Other Resources

This publication was made possible by contract number 200-2013-M-57330 from Centers for Disease Control and Prevention. Its contents and the links to non-CDC websites are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the National Center for Injury Prevention and Control, or the U.S. Department of Health and Human Services.

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