Amended in Senate May 31, 2016

Amended in Senate April 26, 2016

Amended in Senate March 29, 2016

Senate BillNo. 1404


Introduced by Senator Leno

February 19, 2016


An act to amend Section 13963.1 of, and to add Sections 13963.2, 13963.3, and 13963.4 to, the Government Code, relating to victims of violent crimes.

LEGISLATIVE COUNSEL’S DIGEST

SB 1404, as amended, Leno. Victims of violent crimes: trauma recovery centers.

Existing law requires the California Victim Compensation and Government Claims Board to administer a program to assist state residents to obtain compensation for their pecuniary losses suffered as a direct result of criminal acts. Payment is made under these provisions from the Restitution Fund, which is continuously appropriated to the board for these purposes. Existing law requires the California Victim Compensation and Government Claims Board to administer a program to evaluate applications and award grants to trauma recovery centers funded by moneys in the Restitution Fund.

This bill would make legislative findings and recognize the Trauma Recovery Center at San Francisco General Hospital, University of California, San Francisco, as the State Pilot Trauma Recovery Center (State Pilot TRC). The bill would require the board to use the evidence-based Integrated Trauma Recovery Services model developed by the State Pilot TRC when it provides grants to trauma recovery centers. This bill would also require the board to enter into an interagency agreement with the Trauma Recovery Center of the University of California, San Francisco, to establish the State Pilot TRC as the State of California’s Trauma Recovery Center of Excellence (TR-COE). The agreement provided for in this bill would require the TR-COE to support the board by defining the core elements of the evidence-based practice and providing training materials, technical assistance, and ongoing consultation and programming to the board and to each center to enable the grantees to replicate the evidence-based approach. The bill would require the board to create an advisory committee to advise the board on matters pertaining to the administration of funds designated for use at trauma recovery centers, and criteria for awarding grants to trauma recovery centers.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) Victims of violent crime may benefit from access to
4structured programs of practical and emotional support. Research
5shows that evidence-based trauma recovery approaches are more
6effective, at a lesser cost, than customary fee-for-service programs.
7State-of-the-art fee-for-service funding increasingly emphasizes
8funding best practices, established through research, that can be
9varied but have specific core elements that remain constant from
10grantee to grantee. The public benefits when government agencies
11and grantees collaborate with institutions with expertise in
12establishing and conducting evidence-based services.

13(b) The Trauma Recovery Center at San Francisco General
14Hospital, University of California, San Francisco (UCSF TRC),
15is an award-winning, nationally recognized program created in
162001 in partnership with the California Victim Compensation and
17Government Claims Board. The UCSF TRC is hereby recognized
18as the State Pilot Trauma Recovery Center (State Pilot TRC). The
19State Pilot TRC was established by the Legislature as a four-year
20demonstration project to develop and test a comprehensive model
21of care as an alternative to fee-for-service care reimbursed by
P3    1victim restitution funds. It was designed to increase access for
2crime victims to these funds.

3(c) The results of this four-year demonstration project have
4established that the State Pilot TRC model was both clinically
5effective and cost effective when compared to customary
6fee-for-service care. Seventy-seven percent of victims receiving
7trauma recovery center services engaged in mental health treatment,
8compared to 34 percent receiving customary care. The State Pilot
9TRC model increased the rate by which sexual assault victims
10received mental health services from 6 percent to 71 percent,
11successfully linked 53 percent to legal services, 40 percent to
12vocational services, and 31 percent to safer and more permanent
13housing. Trauma recovery center services cost 34 percent less than
14customary care.

15(d) California voters approved Proposition 47, known as the
16Safe Neighborhoods and Schools Act of 2014. The measure was
17enacted to ensure that prison spending is focused on violent and
18serious offenses to maximize alternatives for nonviolent and
19 nonserious crimes and to invest the resulting savings into
20prevention and support programs.

21(e) The Safe Neighborhoods and Schools Act of 2014 requires
2210 percent of the moneys in the Safe Neighborhoods and Schools
23Fund to be allocated to the California Victim Compensation
24
begin delete Program to administer a grant program to establish trauma recovery
25centers modeled after the UCSF TRC.end delete
begin insert and Government Claims
26Board to make grants to trauma recovery centers to provide
27services to victims of crime.end insert

28(f) Systematic training, technical assistance, and ongoing
29standardized program evaluations are needed to ensure that all
30new state-funded trauma recovery centers are evidence-based,
31accountable, clinically effective, and cost effective.

32(g) By creating the Trauma Recovery Center of Excellence, it
33is the intent of the Legislature that these services will be delivered
34in a clinically effective and cost-effective manner, and that the
35victims of crime in California will have increased access to needed
36 services.

37

SEC. 2.  

Section 13963.1 of the Government Code is amended
38to read:

39

13963.1.  

(a) The Legislature finds and declares all of the
40following:

P4    1(1) Without treatment, approximately 50 percent of people who
2survive a traumatic, violent injury experience lasting or extended
3psychological or social difficulties. Untreated psychological trauma
4often has severe economic consequences, including overuse of
5costly medical services, loss of income, failure to return to gainful
6employment, loss of medical insurance, and loss of stable housing.

7(2) Victims of crime should receive timely and effective mental
8health treatment.

9(3) The board shall administer a program to evaluate applications
10and award grants to trauma recovery centers.

11(b) The board shall award a grant only to a trauma recovery
12center that meets all of the following criteria:

13(1) The trauma recovery center demonstrates that it serves as a
14community resource by providing services, including, but not
15limited to, making presentations and providing training to law
16enforcement, community-based agencies, and other health care
17providers on the identification and effects of violent crime.

18(2) Any other related criteria required by the board, including
19those developed pursuant to subdivision (c) of Section 13963.4.

20(3) The trauma recovery center uses the core elements
21established in Section 13963.2.

22(c) It is the intent of the Legislature to provide an annual
23appropriation of two million dollars ($2,000,000) per year from
24the Restitution Fund.

25(d) The board may award a grant providing funding for up to a
26maximum period of three years. Any portion of a grant that a
27trauma recovery center does not use within the specified grant
28period shall revert to the Restitution Fund. The board may award
29consecutive grants to a trauma recovery center to prevent a lapse
30in funding.

31(e) The board, when considering grant applications, shall give
32preference to a trauma recovery center that conducts outreach to,
33and serves, both of the following:

34(1) Crime victims who typically are unable to access traditional
35services, including, but not limited to, victims who are homeless,
36chronically mentally ill, of diverse ethnicity, members of immigrant
37and refugee groups, disabled, who have severe trauma-related
38symptoms or complex psychological issues, or juvenile victims,
39including minors who have had contact with the juvenile
40dependency or justice system.

P5    1(2) Victims of a wide range of crimes, including, but not limited
2to, victims of sexual assault, domestic violence, physical assault,
3shooting, stabbing, human trafficking, and vehicular assault, and
4family members of homicide victims.

5(f) The trauma recovery center sites shall be selected by the
6board through a well-defined selection process that takes into
7account the rate of crime and geographic distribution to serve the
8greatest number of victims.

9(g) A trauma recovery center that is awarded a grant shall do
10both of the following:

11(1) Report to the board annually on how grant funds were spent,
12how many clients were served (counting an individual client who
13receives multiple services only once), units of service, staff
14productivity, treatment outcomes, and patient flow throughout
15both the clinical and evaluation components of service.

16(2) In compliance with federal statutes and rules governing
17federal matching funds for victims’ services, each center shall
18submit any forms and data requested by the board to allow the
19board to receive the 60 percent federal matching funds for eligible
20victim services and allowable expenses.

21(h) For purposes of this section, a trauma recovery center
22provides, including, but not limited to, all of the following
23resources, treatments, and recovery services to crime victims:

24(1) Mental health services.

25(2) Assertive community-based outreach and clinical case
26management.

27(3) Coordination of care among medical and mental health care
28providers, law enforcement agencies, and other social services.

29(4) Services to family members and loved ones of homicide
30victims.

31(5) A multidisciplinary staff of clinicians that includes
32psychiatrists, psychologists, social workers, case managers, and
33peer counselors.

34

SEC. 3.  

Section 13963.2 is added to the Government Code, to
35read:

36

13963.2.  

The Trauma Recovery Center at the San Francisco
37General Hospital, University of California, San Francisco, is
38recognized as the State Pilot Trauma Recovery Center (State Pilot
39TRC). The California Victim Compensation and Government
40Claims Board shall use the evidence-based Integrated Trauma
P6    1Recovery Services (ITRS) model developed by the State Pilot TRC
2when it selects, establishes, and implements trauma recovery
3centers pursuant to Section 13963.1. All ITRS programs funded
4through the Safe Neighborhoods and Schools Fund shall do all of
5the following:

6(a) Provide outreach and services to crime victims who typically
7are unable to access traditional services, including, but not limited
8to, victims who are homeless, chronically mentally ill, members
9of immigrant and refugee groups, disabled, who have severe
10trauma-related symptoms or complex psychological issues, are of
11diverse ethnicity or origin, or are juvenile victims, including minors
12who have had contact with the juvenile dependency or justice
13system.

14(b) Serve victims of a wide range of crimes, including, but not
15limited to, victims of sexual assault, domestic violence, battery,
16crimes of violence, vehicular assault, human trafficking, as well
17as family members of homicide victims.

18(c) Offer a structured evidence-based program of mental health
19and support services that provide victims with services that include
20intervention, individual and group treatment, medication
21management, substance abuse treatment, case management, and
22assertive outreach. This care shall be provided in a manner that
23increases access to services and removes barriers to care for victims
24of violent crime, such as providing services to a victim in his or
25her home, in the community, or other locations that may be outside
26the agency.

27(d) Be comprised of a staff that includes a multidisciplinary
28team of integrated trauma clinicians made up of psychiatrists,
29psychologists, and social workers. A trauma clinician shall be
30either a licensed clinician or a supervised clinician engaged in
31completion of the applicable licensure process. Clinical supervision
32and other supports shall be provided to staff regularly to ensure
33the highest quality of care and to help staff constructively manage
34vicarious trauma they experience as service providers to victims
35of violent crime.

36(e) Offer psychotherapy and case management that is
37coordinated through a single point of contact for the victim, with
38support from an integrated multidisciplinary trauma treatment
39team. All treatment teams shall collaboratively develop treatment
40plans in order to achieve positive outcomes for clients.

P7    1(f) Deliver services that include assertive case management.
2These services shall include, but are not limited to, accompanying
3a client to court proceedings, medical appointments, or other
4community appointments as needed, case management services
5such as assistance in the completion and filing of an application
6for assistance to the California Victims’ Compensation Program,
7the filing of police reports, assistance with obtaining safe housing
8and financial entitlements, providing linkages to medical care,
9providing assistance securing employment, working as a liaison
10to other community agencies, law enforcement, or other supportive
11service providers as needed.

12(g) Ensure that no person is excluded from services solely on
13the basis of emotional or behavioral issues resulting from trauma,
14including, but not limited to, substance abuse problems, low-initial
15motivation, or high levels of anxiety.

16(h) Adhere to established, evidence-based practices, including,
17but not limited to, motivational interviewing, harm reduction,
18seeking safety, cognitive behavioral therapy, dialectical behavior,
19and cognitive processing therapy.

20(i) Maintain as a primary goal a decrease in psychosocial
21distress, minimize long-term disability, improve overall quality of
22life, reduce the risk of future victimization, and promote
23post-traumatic growth.

24(j) Provide holistic and accountable services that ensure
25treatment shall be provided for up to 16 sessions. For those with
26ongoing problems and a primary focus on trauma, treatment may
27be extended after special consideration with the clinical supervisor.
28Extension beyond 32 sessions shall require approval by a clinical
29steering and utilization group that considers the client’s progress
30in treatment and remaining need.

31

SEC. 4.  

Section 13963.3 is added to the Government Code, to
32read:

33

13963.3.  

(a) The board shall enter into an interagency
34agreement with the Trauma Recovery Center of the University of
35California, San Francisco, to establish the State Pilot TRC as the
36State of California’s Trauma Recovery Center of Excellence
37(TR-COE). This agreement shall require:

38(1) The TR-COE to define the core elements of the
39evidence-based practice.

P8    1(2) The board to consult with the TR-COE in the replication of
2the integrated trauma recovery services approach.

3(3) The TR-COE to assist by providing training materials,
4technical assistance, and ongoing consultation to the board and to
5each center to enable the grantees to replicate the evidence-based
6approach.

7(4) The TR-COE to assist in evaluation by designing a multisite
8evaluation to measure adherence to the practice and effectiveness
9of each center.

10(b) The board shall not spend more than 5 percentbegin delete annually of
11the moneys appropriated to it from the Safe Neighborhoods and
12Schools Fund for administrative costs.end delete
begin insert of the total funds it receives
13from the Safe Neighborhoods and Schools Fund on an annual
14basis for administrative costs.end insert

15(c) The board shall, in compliance with Section 9795, annually
16report to the Legislature on the funding received from the Safe
17Neighborhoods and Schools Fund with a detailed summary of the
18programs funded by the moneys allocated to it from said fund.

19(d) This section does not apply to the University of California
20unless the Regents of the University of California, by appropriate
21resolution, make this section applicable.

22

SEC. 5.  

Section 13963.4 is added to the Government Code, to
23read:

24

13963.4.  

(a) The board shall create an advisory committee to
25advise the board on matters pertaining to the administration of
26funds designated for use at trauma recovery centers.

27(b) The advisory committee shall have the authority to make
28recommendations to the board related to regulations governing
29funds for trauma recovery centers that are administered by the
30board.

31(c) The advisory committee shall have the authority to make
32recommendations to the board relating to the criteria for awarding
33grants to trauma recovery centers, including, but not limited to,
34any funds received from the Safe Neighborhoods and Schools
35Fund.

36(d) The advisory committee shall be composed as follows:

37(1) One representative from each trauma recovery center in
38California.

39(2) Three services providers who are experts in the field of
40trauma recovery services, each representing a distinct geographic
P9    1region within the state, including at least one provider who has
2significant experience in providing services to rural communities.

3(3) Three people who have previously received or are the current
4recipients of services from a trauma recovery center.

5(e) The advisory committee shall convene public hearings for
6the purpose of acting on any of the authority delegated to it by this
7section.

8(f) All meetings of the advisory committee shall be publicly
9noticed and a record of those hearings maintained.

10(g) Nothing in this section shall prohibit, limit, or otherwise
11prevent the board from consulting with additional experts in the
12performance of the boards duties.



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