Amended in Assembly July 8, 2015

Amended in Senate May 20, 2015

Amended in Senate April 20, 2015

Senate BillNo. 518


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 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 andbegin insert 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 billend insert would require the board to use the evidence-based Integrated Trauma Recovery Services model developed by thebegin delete Trauma Recovery Center at San Francisco General Hospital, University of California, San Francisco (UCSF TRC)end deletebegin insert State Pilot TRCend insert when it provides grants to trauma recovery centers. This bill would also require the board, upon appropriation of funds from the Victim Restitution Fund by the Legislature, to enter into an interagency agreement with the Trauma Recovery Centerbegin delete of the Regentsend delete of the University of California, San Francisco, to establish thebegin delete UCSF TRCend deletebegin insert State Pilot TRCend insert 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:

P2    1

SECTION 1.  

(a) The Legislature finds and declares all of the
2following:

3(1) 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(2) 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 TRCbegin insert is hereby recognized
18as the State Pilot Project Trauma Recovery Center (State Pilot
19TRC). The State Pilot TRCend insert
was established by the Legislature as
20a four-year demonstration project to develop and test a
21comprehensive model of care as an alternative to fee-for-service
P3    1care reimbursed by victim restitution funds. It was designed to
2increase access for crime victims to these funds.

3(3) The results of this four-year demonstration project have
4established that thebegin delete UCSF TRCend deletebegin insert State Pilot TRCend insert model was both
5clinically effective 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. Thebegin delete UCSF TRCend delete
9begin insert State Pilot TRCend insert model increased the rate by which sexual assault
10victims received mental health services from 6 percent to 71
11percent, successfully linked 53 percent to legal services, 40 percent
12to vocational services, and 31 percent to safer and more permanent
13housing. Trauma recovery center services cost 34 percent less than
14customary care.

15(b) The Legislature further finds and declares all of the
16following:

17(1) Systematic training, technical assistance, and ongoing
18standardized program evaluations are needed to ensure that all
19new state-funded trauma recovery centers are evidence-based,
20accountable, and clinically effective and cost effective.

21(2) By creating a Trauma Recovery Center of Excellence
22(TR-COE), it is the intent of the Legislature that these services
23will be delivered in a clinically effective and cost-effective manner,
24and that victims of crime in California will have increased access
25to needed services.

26

SEC. 2.  

Section 13963.1 of the Government Code is amended
27to read:

28

13963.1.  

(a) The Legislature finds and declares all of the
29following:

30(1) Without treatment, approximately 50 percent of people who
31survive a traumatic, violent injury experience lasting or extended
32psychological or social difficulties. Untreated psychological trauma
33often has severe economic consequences, including overuse of
34costly medical services, loss of income, failure to return to gainful
35employment, loss of medical insurance, and loss of stable housing.

36(2) Victims of crime should receive timely and effective mental
37health treatment.

38(3) The board shall administer a program to evaluate applications
39and award grants to trauma recovery centers.

P4    1(b) The board shall award a grant only to a trauma recovery
2center that meets all of the following criteria:

3(1) The trauma recovery center demonstrates that it serves as a
4community resource by providing services, including, but not
5limited to, making presentations and providing training to law
6enforcement, community-based agencies, and other health care
7providers on the identification and effects of violent crime.

8(2) Any other related criteria required by the board.

9(3) The trauma recovery center uses the core elements
10established in Sections 13963.2 and 13963.3.

11(c) It is the intent of the Legislature to provide an annual
12appropriation of two million dollars ($2,000,000) per year. All
13grants awarded by the board shall be funded only from the
14Restitution Fund.

15(d) The board may award a grant providing funding for up to a
16maximum period of three years. Any portion of a grant that a
17trauma recovery center does not use within the specified grant
18period shall revert to the Restitution Fund. The board may award
19consecutive grants to a trauma recovery center to prevent a lapse
20in funding. The board shall not award a trauma recovery center
21more than one grant for any period of time.

22(e) The board, when considering grant applications, shall give
23preference to a trauma recovery center that conducts outreach to,
24and serves, both of the following:

25(1) Crime victims who typically are unable to access traditional
26services, including, but not limited to, victims who are homeless,
27chronically mentally ill, of diverse ethnicity, members of immigrant
28and refugee groups, disabled, who have severe trauma-related
29symptoms or complex psychological issues, or juvenile victims,
30including minors who have had contact with the juvenile
31dependency or justice system.

32(2) Victims of a wide range of crimes, including, but not limited
33to, victims of sexual assault, domestic violence, physical assault,
34shooting, stabbing, and vehicular assault, and family members of
35homicide victims.

36(f) The trauma recovery center sites shall be selected by the
37board through a well-defined selection process that takes into
38account the rate of crime and geographic distribution to serve the
39greatest number of victims.

P5    1(g) A trauma recovery center that is awarded a grant shall do
2both of the following:

3(1) Report to the board annually on how grant funds were spent,
4how many clients were served (counting an individual client who
5receives multiple services only once), units of service, staff
6productivity, treatment outcomes, and patient flow throughout
7both the clinical and evaluation components of service.

8(2) In compliance with federal statutes and rules governing
9federal matching funds for victims’ services, each center shall
10submit any forms and data requested by the board to allow the
11board to receive the 60 percent federal matching funds for eligible
12victim services and allowable expenses.

13(h) For purposes of this section, a trauma recovery center
14provides, including, but not limited to, all of the following
15resources, treatments, and recovery services to crime victims:

16(1) Mental health services.

17(2) Assertive community-based outreach and clinical case
18management.

19(3) Coordination of care among medical and mental health care
20providers, law enforcement agencies, and other social services.

21(4) Services to family members and loved ones of homicide
22victims.

23(5) A multidisciplinary staff of clinicians that includes
24psychiatrists, psychologists, social workers, case managers, and
25peer counselors.

26

SEC. 3.  

Section 13963.2 is added to the Government Code, to
27read:

28

13963.2.  

The begin insertTrauma Recovery Center at the San Francisco
29General Hospital, University of California, San Francisco is
30recognized as the State Pilot Program Trauma Recovery Center
31(State Pilot TRC). The end insert
California Victim Compensation and
32Government Claims Board shall use the evidence-based Integrated
33Trauma Recovery Services (ITRS) model developed by thebegin delete UCSF
34TRCend delete
begin insert State Pilot TRCend insert when it selects, establishes, and implements
35trauma recovery centers pursuant to Section 13963.1. In replicating
36programs funded by the California Victim Compensation and
37Government Claims Board, the ITRS can be modified to adapt to
38different populations, but it shall include the following core
39elements:

P6    1(a) Provide outreach and services to crime victims who typically
2are unable to access traditional services, including, but not limited
3to, victims who are homeless, chronically mentally ill, of diverse
4ethnicity, members of immigrant and refugee groups, disabled,
5who have severe trauma-related symptoms or complex
6psychological issues, or juvenile victims, including minors who
7have had contact with the juvenile dependency or justice system.

8(b) Victims of a wide range of crimes, including, but not limited
9to, victims of sexual assault, domestic violence, physical assault,
10shooting, stabbing, and vehicular assault, human trafficking, and
11family members of homicide victims.

12(c) A structured evidence-based program of mental health and
13support services provided to victims of violent crimes or family
14members of homicide victims that includes crisis intervention,
15individual and group treatment, medication management, substance
16abuse treatment, case management, and assertive outreach. This
17care shall be provided in a manner that increases access to services
18and removes barriers to care for victims of violent crime. This
19includes providing services in the client’s home, in the community,
20or other locations outside the agency.

21(d) Staff shall include a multidisciplinary team of integrated
22trauma specialists that includes psychiatrists, psychologists, and
23social workers. The integrated trauma specialist shall be a licensed
24clinician, or a supervised clinician engaged in completion of the
25applicable licensure process. Clinical supervision and other
26supports are provided to staff on a weekly basis to ensure the
27highest quality of care and to help staff deal constructively with
28vicarious trauma.

29(e) Psychotherapy and case management shall be provided by
30a single point of contact for the client, that is an individual trauma
31specialist, with support from an integrated trauma treatment team.
32In order to ensure the highest quality of care, the treatment team
33shall collaboratively develop treatment plans in order to achieve
34positive outcomes for clients.

35(f) Services shall include assertive case management, including,
36but not limited to, a trauma specialist accompanying the client to
37court proceedings, medical appointments, or other community
38appointments as needed. Case management services shall include,
39but not be limited to, assisting clients file victim compensation
40applications, file police reports, help with obtaining safe housing
P7    1and financial entitlements, linkages with medical care, assistance
2in return to work, liaison with other community agencies, law
3enforcement, and other support services as needed.

4(g) Clients shall not be excluded from services solely on the
5basis of emotional or behavioral issues resulting from trauma,
6including, but not limited to, substance abuse problems, low initial
7motivation, or high levels of anxiety.

8(h) Trauma recovery services shall incorporate established
9evidence-based practices, including, but not limited to, motivational
10interviewing, harm reduction, seeking safety, cognitive behavioral
11therapy, dialectical behavior, and cognitive processing therapy.

12(i) The goals of a trauma recovery center shall be to decrease
13psychosocial distress, minimize long-term disability, improve
14overall quality of life, reduce the risk of future victimization, and
15promote post-traumatic growth.

16(j) In order to ensure that clients are receiving targeted and
17accountable services, treatment shall be provided up to 16 sessions.
18For those with ongoing problems and a primary focus on trauma,
19treatment may be extended after special consideration with the
20clinical supervisor. Extension beyond 32 sessions shall require
21approval by a clinical steering and utilization group that considers
22the client’s progress in treatment and remaining need.

23

SEC. 4.  

Section 13963.3 is added to the Government Code, to
24read:

25

13963.3.  

(a) Upon appropriation of funds from the Victim
26Restitution Fund by the Legislature, the board shall enter into an
27interagency agreement with the Trauma Recovery Center ofbegin delete the
28Regents ofend delete
the University of California, San Francisco, to establish
29thebegin delete UCSF TRCend deletebegin insert State Pilot TRCend insert as the State of California’s Trauma
30Recovery Center of Excellence (TR-COE). This agreement shall
31require:

32(1) The board to consult with the TR-COE in developing
33 materials and criteria for grant applications pursuant to Section
3413963.1.

35(2) The TR-COE to define the core elements of the
36evidence-based practice.

37(3) The board to consult with the TR-COE in the replication of
38the integrated trauma recovery services approach.

39(4) The TR-COE to assist by providing training materials,
40technical assistance, and ongoing consultation to the board and to
P8    1each center to enable the grantees to replicate the evidence-based
2approach.

3(5) The TR-COE to assist in evaluation by designing a multisite
4evaluation to measure adherence to the practice and effectiveness
5of each center.

6(b) This section does not apply to the University of California
7unless the Regents of the University of California, by appropriate
8resolution, make this section applicable.



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