Against the Backdrop of a Dramatic Increase in Gun-Related Homicides, Legislation Would Leverage Federal Funds to Expand Hospital-Based Violence Intervention Services
- Dana Alpert
- Legislative/Communications Assistant
SACRAMENTO, CA — Earlier this week, Assemblymember Jesse Gabriel (D-Woodland Hills) introduced legislation that would dramatically expand funding for lifesaving gun violence prevention efforts. If enacted, Assembly Bill (AB) 1929 would provide Medi-Cal reimbursement for Hospital-Based Violence Intervention Programs (HVIPs) that work to curb retaliation and reduce the risks of further violence.
“Gun violence is an urgent public health crisis that has brought trauma, injury, and death to far too many Californians,” said Assemblymember Jesse Gabriel. “Like the current pandemic, this public health crisis demands that we take action to protect those most at risk. AB 1929 will allow California to expand Hospital-Based Violence Intervention Programs, which have proven effective at reducing violence and saving lives. I look forward to working with my co-authors to move this important bill through the Legislature.”
The COVID-19 pandemic has intensified the country's gun violence crisis. Record increases in gun sales, homebound children, social isolation, and economic struggles due to COVID-19 have put many people at increased risk for gun violence. 2020 was one of the deadliest years on record for the United States, with gun homicides and non-suicide-related shootings taking approximately 19,300 lives—a 25 percent increase from 2019. Early data on 2021 shows it to be on pace as the worst year for gun violence in decades, surpassing even the high levels of 2020.
In urban areas of the United States, studies have shown that up to 41% of patients treated for violent injuries, such as shootings, are re-injured within five years. One survey of victims of violence at a five-year follow-up found that 20 percent of patients treated for violent injury had died. This “revolving door” phenomenon is well-documented in the medical literature and a recent systematic review of 19 studies on violent reinjury rates has confirmed its prevalence. Moreover, being the victim of violence significantly increases a person’s likelihood of engaging in violent behaviors against others, often as retaliation for the initial injury.
In response to these alarming trends, Hospital-Based Violence Intervention Programs (HVIPs) have been identified as one of the most innovative and effective strategies for reducing rates of violent injury recidivism. These programs—which now number over 40 across the country—bring targeted, community-based prevention specialists into the hospital setting to counsel and work with the patient and reduce the risks of violent re-injury.
Integrating HVIP services into hospital trauma centers corresponds with large reductions in rates of injury recidivism and long-term increases in patients’ wellbeing. In San Francisco, a study of the Wrap-Around Project found that over a 10-year period, the 466 clients enrolled in the program experienced a 50 percent reduction in the historical re-injury rate.
“Our healthcare systems have saved countless lives from gun violence, but while emergency physicians can treat a bullet wound, we have a difficult time addressing a patient's risk of re-injury and retaliation. After treatment, at-risk patients are often discharged right back into the same conditions that led to their violent victimization in the first place. This creates a revolving door of injury between the community and our emergency departments,” said Dr. Lori Winston, President of The California Chapter of the American College of Emergency Physicians. “Fortunately, HVIPs have proven to address the root causes of violence and stop that revolving door. AB 1929 ensures that we provide much-needed healthcare to people and communities at risk of violent injury.”
AB 1929 is expected to be heard in Assembly policy committees in the coming weeks. The bill is jointly authored with Assemblymember Mike Gipson (D-Carson) and Senator Anthony Portantino (D-La Cañada Flintridge) and Assemblymember Buffy Wicks (D-Oakland) as coauthors.