Amended in Assembly August 1, 2016

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 Sectionsbegin delete 13963.2, 13963.3, and 13963.4 to,end deletebegin insert 13963.2 and 13963.3 to,end insert 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 Compensationbegin delete and Government Claimsend delete 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 Compensationbegin delete and Government Claimsend delete 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 thebegin delete 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 andend deletebegin insert technical assistance provider to the board for the period between July 1, 2017, and June 30, 2019. The bill would require the board to select a trauma recovery center, through a competitive process, to be the technical assistance provider every 2 years thereafter and would require that provider to assist the board byend insert 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.begin delete 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.end deletebegin insert The bill would authorize the board to provide grants, upon appropriation by the Legislature, to the technical assistance provider, up to a specified amount. The bill would require the board, through a competitive process, to select a 3rd party evaluator to conduct a review of the effectiveness of the trauma resource center model and the work done by grant recipients with the trauma resource center funds.end insert

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
P3    1and grantees collaborate with institutions with expertise in
2establishing and conducting evidence-based services.

3(b) The Trauma Recovery Center at San Francisco General
4Hospital, University of California, San Francisco (UCSF TRC),
5is an award-winning, nationally recognized program created in
62001 in partnership with the California Victim Compensationbegin delete and
7Government Claimsend delete
Board. The UCSF TRC is hereby recognized
8as the State Pilot Trauma Recovery Center (State Pilot TRC). The
9State Pilot TRC was established by the Legislature as a four-year
10demonstration project to develop and test a comprehensive model
11of care as an alternative to fee-for-service care reimbursed by
12victim restitution funds. It was designed to increase access for
13crime victims to these funds.

14(c) The results of this four-year demonstration project have
15established that the State Pilot TRC model was both clinically
16effective and cost effective when compared to customary
17fee-for-service care. Seventy-seven percent of victims receiving
18trauma recovery center services engaged in mental health treatment,
19compared to 34 percent receiving customary care. The State Pilot
20TRC model increased the rate by which sexual assault victims
21received mental health services from 6 percent to 71 percent,
22successfully linked 53 percent to legal services, 40 percent to
23vocational services, and 31 percent to safer and more permanent
24housing. Trauma recovery center services cost 34 percent less than
25customary care.

26(d) California voters approved Proposition 47, known as the
27Safe Neighborhoods and Schools Act of 2014. The measure was
28enacted to ensure that prison spending is focused on violent and
29serious offenses to maximize alternatives for nonviolent and
30 nonserious crimes and to invest the resulting savings into
31prevention and support programs.

32(e) The Safe Neighborhoods and Schools Act of 2014 requires
3310 percent of the moneys in the Safe Neighborhoods and Schools
34Fund to be allocated to the California Victim Compensationbegin delete and
35Government Claimsend delete
Board to make grants to trauma recovery
36centers to provide services to victims of crime.

37(f) Systematic training, technical assistance, and ongoing
38standardized program evaluations are needed to ensure that all
39new state-funded trauma recovery centers are evidence-based,
40accountable, clinically effective, and cost effective.

P4    1(g) Bybegin delete creating the Trauma Recovery Center of Excellence,end delete
2begin insert providing assistance to the board in administering grants to trauma
3recovery centers,end insert
it is the intent of the Legislature that these
4services will be delivered in a clinically effective and cost-effective
5manner, and that the victims of crime in California will have
6increased access to needed services.

7

SEC. 2.  

Section 13963.1 of the Government Code is amended
8to read:

9

13963.1.  

(a) The Legislature finds and declares all of the
10following:

11(1) Without treatment, approximately 50 percent of people who
12survive a traumatic, violent injury experience lasting or extended
13psychological or social difficulties. Untreated psychological trauma
14often has severe economic consequences, including overuse of
15costly medical services, loss of income, failure to return to gainful
16employment, loss of medical insurance, and loss of stable housing.

17(2) Victims of crime should receive timely and effective mental
18health treatment.

19(3) The board shall administer a program to evaluate applications
20and award grants to trauma recovery centers.

21(b) The board shall award a grant only to a trauma recovery
22center that meets all of the following criteria:

23(1) The trauma recovery center demonstrates that it serves as a
24community resource by providing services, including, but not
25limited to, making presentations and providing training to law
26enforcement, community-based agencies, and other health care
27providers on the identification and effects of violent crime.

28(2) Any other related criteria required by the board, including
29those developed pursuant to subdivision (c) of Section 13963.4.

30(3) The trauma recovery center uses the core elements
31established in Section 13963.2.

32(c) It is the intent of the Legislature to provide an annual
33appropriation of two million dollars ($2,000,000) per year from
34the Restitution Fund.

35(d) The board may award a grant providing funding for up to a
36maximum period of three years. Any portion of a grant that a
37trauma recovery center does not use within the specified grant
38period shall revert to the Restitution Fund. The board may award
39consecutive grants to a trauma recovery center to prevent a lapse
40in funding.

P5    1(e) The board, when considering grant applications, shall give
2preference to a trauma recovery center that conducts outreach to,
3and serves, both of the following:

4(1) Crime victims who typically are unable to access traditional
5services, including, but not limited to, victims who are homeless,
6chronically mentally ill, of diverse ethnicity, members of immigrant
7and refugee groups, disabled, who have severe trauma-related
8symptoms or complex psychological issues, or juvenile victims,
9including minors who have had contact with the juvenile
10dependency or justice system.

11(2) Victims of a wide range of crimes, including, but not limited
12to, victims of sexual assault, domestic violence, physical assault,
13shooting, stabbing, human trafficking, and vehicular assault, and
14family members of homicide victims.

15(f) The trauma recovery center sites shall be selected by the
16board through a well-defined selection process that takes into
17account the rate of crime and geographic distribution to serve the
18greatest number of victims.

19(g) A trauma recovery center that is awarded a grant shall do
20both of the following:

21(1) Report to the board annually on how grant funds were spent,
22how many clients were served (counting an individual client who
23receives multiple services only once), units of service, staff
24productivity, treatment outcomes, and patient flow throughout
25both the clinical and evaluation components of service.

26(2) In compliance with federal statutes and rules governing
27federal matching funds for victims’ services, each center shall
28submit any forms and data requested by the board to allow the
29board to receive the 60 percent federal matching funds for eligible
30victim services and allowable expenses.

31(h) For purposes of this section, a trauma recovery center
32provides, including, but not limited to, all of the following
33resources, treatments, and recovery services to crime victims:

34(1) Mental health services.

35(2) Assertive community-based outreach and clinical case
36management.

37(3) Coordination of care among medical and mental health care
38providers, law enforcement agencies, and other social services.

39(4) Services to family members and loved ones of homicide
40victims.

P6    1(5) A multidisciplinary staff of clinicians that includes
2psychiatrists, psychologists, social workers, case managers, and
3peer counselors.

4

SEC. 3.  

Section 13963.2 is added to the Government Code, to
5read:

6

13963.2.  

The Trauma Recovery Center at the San Francisco
7General Hospital, University of California, San Francisco, is
8recognized as the State Pilot Trauma Recovery Center (State Pilot
9TRC). The California Victim Compensationbegin delete and Government
10Claimsend delete
Board shall use the evidence-based Integrated Trauma
11Recovery Services (ITRS) model developed by the State Pilot TRC
12when it selects, establishes, and implements trauma recovery
13centers pursuant to Section 13963.1. All ITRS programs funded
14through the Safe Neighborhoods and Schools Fund shall do all of
15the following:

16(a) Provide outreach and services to crime victims who typically
17are unable to access traditional services, including, but not limited
18to, victims who are homeless, chronically mentally ill, members
19of immigrant and refugee groups, disabled, who have severe
20trauma-related symptoms or complex psychological issues, are of
21diverse ethnicity or origin, or are juvenile victims, including minors
22who have had contact with the juvenile dependency or justice
23system.

24(b) Serve victims of a wide range of crimes, including, but not
25limited to, victims of sexual assault, domestic violence, battery,
26crimes of violence, vehicular assault, human trafficking, as well
27as family members of homicide victims.

28(c) Offer a structured evidence-based program of mental health
29and support services that provide victims with services that include
30intervention, individual and group treatment, medication
31management, substance abuse treatment, case management, and
32assertive outreach. This care shall be provided in a manner that
33increases access to services and removes barriers to care for victims
34of violent crime, such as providing services to a victim in his or
35her home, in the community, or other locations that may be outside
36the agency.

37(d) Be comprised of a staff that includes a multidisciplinary
38team of integrated trauma clinicians made up of psychiatrists,
39psychologists, and social workers.begin insert Psychiatrists on this team may
40be on staff or on contract.end insert
A trauma clinician shall be either a
P7    1licensed clinician or a supervised clinician engaged in completion
2of the applicable licensure process. Clinical supervision and other
3supports shall be provided to staff regularly to ensure the highest
4quality of care and to help staff constructively manage vicarious
5trauma they experience as service providers to victims of violent
6crime.

7(e) Offer psychotherapy and case management that is
8coordinated through a single point of contact for the victim, with
9support from an integrated multidisciplinary trauma treatment
10team. All treatment teams shall collaboratively develop treatment
11plans in order to achieve positive outcomes for clients.

12(f) Deliver services that include assertive case management.
13These services shall include, but are not limited to, accompanying
14a client to court proceedings, medical appointments, or other
15community appointments as needed, case management services
16such as assistance in the completion and filing of an application
17for assistance to the California Victims’ Compensation Program,
18the filing of police reports, assistance with obtaining safe housing
19and financial entitlements, providing linkages to medical care,
20providing assistance securing employment, working as a liaison
21to other community agencies, law enforcement, or other supportive
22service providers as needed.

23(g) Ensure that no person is excluded from services solely on
24the basis of emotional or behavioral issues resulting from trauma,
25including, but not limited to, substance abuse problems, low-initial
26motivation, or high levels of anxiety.

27(h) Adhere to established, evidence-based practices, including,
28but not limited to, motivational interviewing, harm reduction,
29seeking safety, cognitive behavioral therapy, dialectical behavior,
30and cognitive processing therapy.

31(i) Maintain as a primary goal a decrease in psychosocial
32distress, minimize long-term disability, improve overall quality of
33life, reduce the risk of future victimization, and promote
34post-traumatic growth.

35(j) Provide holistic and accountable services that ensure
36treatment shall be provided for up to 16 sessions. For those with
37ongoing problems and a primary focus on trauma, treatment may
38be extended after special consideration with the clinical supervisor.
39Extension beyond 32 sessions shall require approval by a clinical
P8    1steering and utilization group that considers the client’s progress
2in treatment and remaining need.

3

SEC. 4.  

Section 13963.3 is added to the Government Code, to
4read:

5

13963.3.  

(a) The board shall enter into an interagency
6agreement with the Trauma Recovery Center of the University of
7California, San Francisco, to establish the State Pilotbegin delete TRC as the
8State of California’s Trauma Recovery Center of Excellence
9(TR-COE). This agreement shall require:end delete
begin insert TRC as the technical
10assistance provider to the board for the period between July 1,
112017, and June 30, 2019. After June 30, 2019, and every two years
12thereafter, the board shall select a technical assistance provider
13through a competitive grant process. The technical assistance
14provider shall be a trauma recovery center that meets the
15requirements in subdivision (b) of Section 13963.1.end insert

begin delete

16(1) The TR-COE to define the core elements of the
17evidence-based practice.

end delete
begin insert

18
(b) The technical assistance provider shall receive a grant of
19no more than five hundred thousand dollars ($500,000) per year
20from funds appropriated by the Legislature from the Restitution
21Fund pursuant to subdivision (c) of Section 13963.1.

end insert
begin insert

22
(c) The technical assistance provider shall do all of the
23 following:

end insert
begin delete

24(2) The board to consult with the TR-COE

end delete

25begin insert(1)end insertbegin insertend insertbegin insertConsult with the board to assist the boardend insert in the replication
26of the integrated trauma recovery services approach.

begin delete

27(3) The TR-COE to assist

end delete

28begin insert(2)end insertbegin insertend insertbegin insertAssist the boardend insert by providing training materials, technical
29assistance, and ongoing consultation to the board and to each center
30to enable the grantees to replicate the evidence-based approach.

begin delete

31(4) The TR-COE to assist in evaluation by designing a multisite
32evaluation to measure adherence to the practice and effectiveness
33of each center.

end delete
begin delete

34(b)

end delete

35begin insert(d)end insertbegin insert(1)end insertbegin insertend insertThe board shall not spend more than 5 percent of the
36total funds it receives from the Safe Neighborhoods and Schools
37Fund on an annual basis for administrative costs.

begin insert

38
(2) (A) From the funds received from the Safe Neighborhoods
39and Schools Fund and used for administrative costs, the board
40shall, through a competitive process and for a period not to exceed
P9    1three years, select and provide a grant for a third-party evaluator
2to conduct a review of the effectiveness of the trauma resource
3center model and the work done by grant recipients with trauma
4resource center funds.

end insert
begin insert

5
(B) The evaluator shall consult with the technical assistance
6provider in its design of its evaluation.

end insert
begin delete

7(c)

end delete

8begin insert(e)end insert The board shall, in compliance with Section 9795, annually
9report to the Legislature on the funding received from the Safe
10Neighborhoods and Schools Fund with a detailed summary of the
11programs funded by the moneys allocated to it from said fund.

begin delete

12(d)

end delete

13begin insert(f)end insert This section does not apply to the University of California
14unless the Regents of the University of California, by appropriate
15resolution, make this section applicable.

begin delete
16

SEC. 5.  

Section 13963.4 is added to the Government Code, to
17read:

18

13963.4.  

(a) The board shall create an advisory committee to
19advise the board on matters pertaining to the administration of
20funds designated for use at trauma recovery centers.

21(b) The advisory committee shall have the authority to make
22recommendations to the board related to regulations governing
23funds for trauma recovery centers that are administered by the
24board.

25(c) The advisory committee shall have the authority to make
26recommendations to the board relating to the criteria for awarding
27grants to trauma recovery centers, including, but not limited to,
28any funds received from the Safe Neighborhoods and Schools
29Fund.

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

31(1) One representative from each trauma recovery center in
32California.

33(2) Three services providers who are experts in the field of
34trauma recovery services, each representing a distinct geographic
35region within the state, including at least one provider who has
36significant experience in providing services to rural communities.

37(3) Three people who have previously received or are the current
38recipients of services from a trauma recovery center.

P10   1(e) The advisory committee shall convene public hearings for
2the purpose of acting on any of the authority delegated to it by this
3section.

4(f) All meetings of the advisory committee shall be publicly
5noticed and a record of those hearings maintained.

6(g) Nothing in this section shall prohibit, limit, or otherwise
7prevent the board from consulting with additional experts in the
8performance of the boards duties.

end delete


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