BILL NUMBER: SB 518 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Leno
(Coauthor: Senator Hancock)
FEBRUARY 26, 2015
An act to amend Section 13963.1 of, and to add Sections 13963.2
and 13963.3 to, the Government Code, relating to victims of violent
crimes.
LEGISLATIVE COUNSEL'S DIGEST
SB 518, as introduced, 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 would require the
board to use the evidence-based Integrated Trauma Recovery Services
model developed by the Trauma Recovery Center at San Francisco
General Hospital University of California, San Francisco (UCSF TRC)
when it provides grants to trauma recovery centers. This bill would
also require the board, upon appropriation of funds by the
Legislature, to enter into an interagency agreement with the Trauma
Recovery Center of the Regents of the University of California, San
Francisco, to establish the UCSF 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.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 13963.1 of the Government Code is amended to
read:
13963.1. (a) The Legislature finds and declares all of the
following:
(1) Without treatment, approximately 50 percent of people who
survive a traumatic, violent injury experience lasting or extended
psychological or social difficulties. Untreated psychological trauma
often has severe economic consequences, including overuse of costly
medical services, loss of income, failure to return to gainful
employment, loss of medical insurance, and loss of stable housing.
(2) Victims of crime should receive timely and effective mental
health treatment.
(3) The board shall administer a program to evaluate applications
and award grants to trauma recovery centers.
(b) The board shall award a grant only to a trauma recovery center
that meets both all of the following
criteria:
(1) The trauma recovery center demonstrates that it serves as a
community resource by providing services, including, but not limited
to, making presentations and providing training to law enforcement,
community-based agencies, and other health care providers on the
identification and effects of violent crime.
(2) Any other related criteria required by the board.
(3) The trauma recovery center uses the core elements established
in Sections 13963.2 and 13963.3.
(c) It is the intent of the Legislature to provide an annual
appropriation of two million dollars ($2,000,000) per year. All
grants awarded by the board shall be funded only from the Restitution
Fund.
(d) The board may award a grant providing funding for up to a
maximum period of three years. Any portion of a grant that a trauma
recovery center does not use within the specified grant period shall
revert to the Restitution Fund. The board may award consecutive
grants to a trauma recovery center to prevent a lapse in funding. The
board shall not award a trauma recovery center more than one grant
for any period of time.
(e) The board, when considering grant applications, shall give
preference to a trauma recovery center that conducts outreach to, and
serves, both of the following:
(1) Crime victims who typically are unable to access traditional
services, including, but not limited to, victims who are homeless,
chronically mentally ill, of diverse ethnicity, members of immigrant
and refugee groups, disabled, who have severe trauma-related symptoms
or complex psychological issues, or juvenile victims, including
minors who have had contact with the juvenile dependency or justice
system.
(2) Victims of a wide range of crimes, including, but not limited
to, victims of sexual assault, domestic violence, physical assault,
shooting, stabbing, and vehicular assault, and family members of
homicide victims.
(f) The trauma recovery center sites shall be selected by the
board through a well-defined selection process that takes into
account the rate of crime and geographic distribution to serve the
greatest number of victims.
(g) A trauma recovery center that is awarded a grant shall do both
of the following:
(1) Report to the board annually on how grant funds were spent,
how many clients were served (counting an individual client who
receives multiple services only once), units of service, staff
productivity, treatment outcomes, and patient flow throughout both
the clinical and evaluation components of service.
(2) In compliance with federal statutes and rules governing
federal matching funds for victims' services, each center shall
submit any forms and data requested by the board to allow the board
to receive the 60 percent federal matching funds for eligible victim
services and allowable expenses.
(h) For purposes of this section, a trauma recovery center
provides, including, but not limited to, all of the following
resources, treatments, and recovery services to crime victims:
(1) Mental health services.
(2) Assertive community-based outreach and clinical case
management.
(3) Coordination of care among medical and mental health care
providers, law enforcement agencies, and other social services.
(4) Services to family members and loved ones of homicide victims.
(5) A multidisciplinary staff of clinicians that includes
psychiatrists, psychologists, and social workers.
SEC. 2. Section 13963.2 is added to the Government Code, to read:
13963.2. (a) The Legislature finds and declares all of the
following:
(1) Victims of violent crime may benefit from access to structured
programs of practical and emotional support. Research shows that
evidence-based trauma recovery approaches are more effective, at a
lesser cost, than customary fee-for-service programs.
State-of-the-art fee-for-service funding increasingly emphasizes
funding best practices, established through research, that can be
varied but have specific core elements that remain constant from
grantee to grantee. The public benefits when government agencies and
grantees collaborate with institutions with expertise in establishing
and conducting evidence-based services.
(2) The Trauma Recovery Center at San Francisco General
Hospital/University of California, San Francisco (UCSF TRC), is an
award-winning, nationally recognized program created in 2001 in
partnership with the California Victim Compensation and Government
Claims Board. The UCSF TRC was established by the Legislature as a
four-year demonstration project to develop and test a comprehensive
model of care as an alternative to fee-for-service care reimbursed by
victim restitution funds. It was designed to increase access for
crime victims to these funds.
(3) The results of this four-year demonstration project have
established that the UCSF TRC model was both clinically effective and
cost effective when compared to customary fee-for-service care.
Seventy-seven percent of victims receiving trauma recovery center
services engaged in mental health treatment, compared to 34 percent
receiving customary care. The UCSF TRC model increased the rate by
which sexual assault victims received mental health services from 6
percent to 71 percent, successfully linked 53 percent to legal
services, 40 percent to vocational services and 31 percent to safer
and more permanent housing. Trauma recovery center services cost 34
percent less than customary care.
(b) The California Victim Compensation and Government Claims Board
shall use the evidenced-based Integrated Trauma Recovery Services
(ITRS) model developed by the UCSF TRC when it selects, establishes,
and implements trauma recovery centers pursuant to Section 13963.1.
In replicating programs funded by the California Victims Compensation
and Government Claims Board, the ITRS can be modified to adapt to
different populations, but it shall include the following core
elements:
(1) Provide outreach and services to crime victims who typically
are unable to access traditional services, including, but not limited
to, victims who are homeless, chronically mentally ill, of diverse
ethnicity, members of immigrant and refugee groups, disabled, who
have severe trauma-related symptoms or complex psychological issues,
or juvenile victims, including minors who have had contact with the
juvenile dependency or justice system.
(2) Victims of a wide range of crimes, including, but not limited
to, victims of sexual assault, domestic violence, physical assault,
shooting, stabbing, and vehicular assault, human trafficking, and
family members of homicide victims.
(3) A structured evidence-based program of mental health and
support services provided to victims of violent crimes or family
members of homicide victims that includes crisis intervention,
individual and group treatment, medication management, substance
abuse treatment, case management, and assertive outreach. This care
shall be provided in a manner that increases access to services and
removes barriers to care for victims of violent crime. This includes
providing services in the client's home, in the community, or other
locations outside the agency.
(4) Staff shall include a multidisciplinary team of integrated
trauma specialists that includes psychiatrists, psychologists, and
social workers. The integrated trauma specialist shall be a licensed
clinician, or a supervised clinician engaged in completion of the
applicable licensure process. Clinical supervision and other support
are provided to staff on a weekly basis to ensure the highest quality
of care and to help staff deal constructively with vicarious trauma.
(5) Psychotherapy and case management shall be provided by a
single point of contact for the client, that is an individual trauma
specialist, with support from an integrated trauma treatment team. In
order to ensure the highest quality of care, the treatment team
shall collaboratively develop treatment plans in order to achieve
positive outcomes for clients.
(6) Services shall include assertive case management, including,
but not limited to, a trauma specialist accompanying the client to
court proceedings, medical appointments, or other community
appointments as needed. Case management services shall include, but
not be limited to, assisting clients file victim compensation
applications, file police reports, help with obtaining safe housing
and financial entitlements, linkages with medical care, assistance in
return to work, liaison with other community agencies, law
enforcement, and other support services as needed.
(7) Clients shall not be excluded from services solely on the
basis of emotional or behavioral issues resulting from trauma,
including, but not limited to, substance abuse problems, low initial
motivation, or high levels of anxiety.
(8) Trauma recovery services shall incorporate established
evidence-based practices, including, but not limited to, motivational
interviewing, harm reduction, seeking safety, cognitive behavioral
therapy, dialectical behavior, and cognitive processing therapy.
(9) The goals of a Trauma Recovery Center shall be to decrease
psychosocial distress, minimize long-term disability, improve overall
quality of life, reduce the risk of future victimization, and
promote post-traumatic growth.
(10) In order to ensure that clients are receiving targeted and
accountable services, treatment shall be provided up to 16 sessions.
For those with ongoing problems and a primary focus on trauma,
treatment may be extended after special consideration with the
clinical supervisor. Extension beyond 32 sessions shall require
approval by a clinical steering and utilization group that considers
the client's progress in treatment and remaining need.
SEC. 3. Section 13963.3 is added to the Government Code, to read:
13963.3. (a) The legislature finds and declares all of the
following:
(1) Systematic training, technical assistance, and ongoing
standardized program evaluations are needed to ensure that all new
state-funded trauma recovery centers are evidenced based,
accountable, and clinically effective and cost effective.
(2) By creating a Trauma Recovery Center of Excellence (TR-COE),
it is the intent of the Legislature that these services will be
delivered in a clinically effective and cost effective manner, and
that victims of crime in California will have increased access to
needed services.
(b) Upon appropriation of funds by the Legislature pursuant to
subdivision (c), the board shall enter into an interagency agreement
with the Trauma Recovery Center of the Regents of the University of
California, San Francisco, to establish the UCSF TRC as the State of
California's Trauma Recovery Center of Excellence. This agreement
shall require:
(1) The board to consult with the TR-COE in developing language
for grant applications and development of grant review criteria for
grants pursuant to Section 13963.1.
(2) The TR-COE to define the core elements of the evidence-based
practice.
(3) The board to consult with the TR-COE in the replication of the
integrated trauma recovery services approach.
(4) The TR-COE to assist by providing training materials,
technical assistance, and ongoing consultation to the board and to
each center to enable the grantees to replicate the evidence-based
approach.
(5) The TR-COE to assist in evaluation by designing and a
multisite evaluation to measure adherence to the practice and
effectiveness of each center.
(c) This section does not apply to the University of California
unless the Regents of the University of California, by appropriate
resolution, make this section applicable.