BILL ANALYSIS Ó
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Loni Hancock, Chair
2015 - 2016 Regular
Bill No: SB 518 Hearing Date: April 28, 2015
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|Author: |Leno |
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|Version: |April 20, 2015 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant:|JM |
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Subject: Victims of Violent Crimes: Trauma Recovery Centers
HISTORY
Source: Californians for Safety and Justice
Prior Legislation:SB 71 (Budget and Fiscal Review) - Ch. 28,
Stats 2013
SB 733 (Leno) (2010) - died on Senate Floor
AB 1669 (Leno) - 2007, vetoed
AB 50 (Leno) - Ch. 884, Stats. 2006
AB 1768 (Committee on Public Safety) - 2005,
vetoed
Support: California Catholic Conference; California Attorneys
for Criminal Justice; University of California
Opposition:None known
PURPOSE
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The purpose of this bill is to 1) to require the Victims
Compensation and Government Claims Board (board) to use the
evidence-based model developed by the University of California,
San Francisco, General Hospital Trauma Recovery Center (UCSF
TRC) when giving a grant to a Trauma Recovery Center (TRC); 2)
to require a TRC receiving a grant to meet specified statutory
requirements and standards; 3) to establish the UCSF TRC as the
California Trauma Recovery Center of Excellence (TRC COE); and
4) to require the board to complete an interagency agreement
with TRC COE in establishing core elements of an evidence-based
TRC.
Existing law creates the Victims of Crime Program, administered
by the California Victim Compensation and Government Claims
Board ("CVCGCB"), to reimburse victims of crime for the
pecuniary losses they suffer as a direct result of criminal
acts. Indemnification is made from the Restitution Fund, which
is continuously appropriated to the board for these purposes.
(Gov. Code §§ 13950-13968.)
Existing law authorizes reimbursement to a victim for "[t]he
medical or medical related expenses incurred by the victim?."
(Gov. Code § 13957, subd. (a)(1).)
Existing law provides that CVCGB shall enter into an interagency
agreement with the UCSF to establish a recovery center for
victims of crime at the San Francisco General Hospital for
comprehensive and integrated services to victims of crime,
subject to conditions set by the board. The University Regents
must approve the agreement. The section shall only be
implemented to the extent that funding is appropriated for that
purpose. (Gov. Code § 13974.5.)
Existing law includes the Safe Neighborhoods and Schools Act of
2014. As relevant to this bill, the act does the following:
Reclassifies controlled substance felony and alternate
felony-misdemeanor crimes as misdemeanors, except for
defendants convicted of a sex offense, a specified drug
crime involving specified weight of volume of the drug, a
crime where the defendant used or was armed with a weapon,
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a homicide, solicitation of murder and any crime for which
the sentence is a life term.
Requires the Director of Finance, beginning in 2016, to
calculate the savings from the reduced penalties.
The Controller transfers the amount of savings
calculated by the Finance Director and transfers that
amount from the General Fund to the "Safe Neighborhoods and
Schools Fund.
The Controller then distributes the money in the fund
according to the following formula:
o 25% to the Department of Education for a grant
program to public agencies to improve outcomes for
kindergarten through high school students at risk of
dropping out of school or are crime victims.
o 10% to the Victims of Crime Program to fund
for grants to TRCs.
o 65% to the Board of State and Community
Corrections for a grant program to public agencies for
mental health and drug abuse treatment and diversion
programs, with an emphasis on reducing recidivism.
(Gov. Code § 7599-7599.2.)
This bill includes the following legislative findings:
Systematic training, technical assistance and
standardized evaluations are necessary to ensure that all
new state-funded TRCs are evidence based, accountable,
clinically effective and cost-effective.
The creation of the Trauma Recovery Center of Excellence
(TR-COE) is intended to make TRC services meet these
standards
This bill provides that the VCP shall use the evidence-based
Integrated Trauma Recovery Services (ITRS) model developed by
the UCSF in establishing and funding TRCs. Programs using ITRS,
as modified to apply to different populations, shall do or
include the following:
Serve and make reach out to victims unable to access
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traditional services. These include those who are
homeless, mentally ill, of diverse ethnicity, immigrants
and refugees, disabled, suffering from severe trauma and
psychological symptoms or issues, juveniles, including
juveniles who have been through the dependency or
delinquency systems.
Serve victims of a wide range of crimes, including
sexual assault and other forms of violence.
Use a structured evidence-based program of mental health
and support services for victims of violence and family
members of homicide victims. The services shall include
crisis intervention, case management, individual and group
treatment and shall be provided so as to increase access,
including providing services in the community and the homes
of clients.
Employ multidisciplinary, integrated trauma specialists
including psychiatrists, psychologists and social workers
who are licensed clinicians or engaged in supervised
completion of licensure. Clinical supervision and support
shall be given to staff on a weekly basis.
Psychotherapy shall be provided by a single point of
client contact with a trauma specialist, with support from
the team and a collaboratively developed treatment plan.
Provide aggressive case management, including
accompanying clients to treatment appointments, community
appointments and court appearances. Case management shall
include assisting clients in filing for victim
compensation, police reports, housing assistance and other
basic support needs.
Clients shall not be excluded from treatment solely on
the basis of "emotional or behavioral issues resulting from
trauma, such as drug abuse, serious anxiety or low initial
motivation.
TRC services shall incorporate established,
evidence-based practices, such as cognitive behavioral
therapy, dialectical behavior and cognitive processing.
TRC goals shall be to decrease psychological distress
and improve long-term positive outcomes.
Treatment shall be given for up to 16 sessions, with an
extension for those with a "primary focus on trauma" after
special consideration with a supervisor. Extensions beyond
32 sessions shall require the approval of a clinical
steering group.
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This bill provides that, upon legislative appropriation, the
Victims Compensation Board (board) shall enter into an
interagency agreement with TRC 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 shall require the following:
The board shall consult with the TR-COE in developing
language for grant application and criteria for reviewing
grants.
The TR-COE shall define an evidence-based practice.
The TR-COE shall assist the board in providing training
materials, technical assistance and provide ongoing
consultation with the board.
The TR-COE shall assist in designing a multisite
evaluation for TRCs.
This bill provides that the University of California must agree
to these provisions through a resolution.
COMMENTS
1.Need for This Bill
According to the author:
By setting clear guidelines and providing training for
new TRCs, this bill will ensure that victims of crime
in California receive the comprehensive and timely
services they need in order to heal, and to avoid
negative economic consequences for themselves and
their communities. The physical and psychological
trauma experienced by victims of crime requires early
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treatment and comprehensive care. However, in
California today, victims and survivors of crime often
face significant hurdles in accessing the immediate
and comprehensive support needed to recover
adequately, and are often unaware that the state
offers assistance for certain health and support
services.
In order to address this pressing need, a grant
program to replicate the successful TRC pioneered by
UC San Francisco was created in 2013. This program,
housed at the VCGCB, funds $2 million in grants
annually. The TRC treatment model was developed in
2001 to address the multiple barriers victims face
recovering from crime, and utilizes a comprehensive,
flexible approach designed to meet the unique needs of
crime victims suffering from trauma. TRCs utilize a
multidisciplinary staff to provide direct mental
health services and health treatment while
coordinating services with law enforcement and other
social service agencies, and all services are housed
less than one roof, with one coordinating point of
contact for the victim.
The TRC model has proven to be extremely successful,
and since the grant program began, survivors of crime
who received services through the TRC saw significant
increases in health and wellness. 74% of those served
showed an improvement in mental health, and 51%
demonstrated an improvement in physical health.
People who receive services at the TRC are 56% more
likely to return to employment, 44% more likely to
cooperate with the district attorney, and 69% more
likely to generally cooperate with law enforcement.
All of these benefits are provided at a 33% lower cost
than traditional providers.
The Legislative Analyst's Office (LAO) estimates
future additional funding for the TRC grant program at
anywhere between $10-20 million annually, stemming
from language in Proposition 47 of 2014 that directed
10% of the savings realized from the proposition to
this program. Proposition 47 was passed by nearly 60%
of the California electorate, and the LAO has
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recommended that these savings be spent as effectively
as possible. SB 518 will ensure just that, and is
consistent with the recommendations of the LAO in
their recent report "Improving State Programs for
Victims of Crime."
2.Research About Victim Recovery and The Community-Wide Harm
Caused by Crime
The concerns of victims have become increasingly recognized over
the past decades. Penalties in a determinate sentencing system
like California's have been informed greatly by victim
advocates. In addition, victim compensation has developed as an
important response to crime which is rooted in a growing
awareness of the impact of crime on victims.
The TRC model addresses what may be lacking in California's
current approach to victims - healing the harm that comes to
communities through the commission of crime. (The Culture of
Control, Garland, Univ. of Chicago Press, 2001, pp. 11-12.)
Arguably, the TRC program demonstrates that harm to the specific
victim of a crime spreads through the community. This is
especially true in relatively poor and marginal communities
where residents have limited access to, and perhaps some
discomfort with, medical care and counseling.
A victim who loses a job because he or she is too traumatized to
work may be the sole support for more than one generation of
relatives. Younger relatives of such victims may stop attending
school and become delinquent. Untreated victims may seek
retribution, especially those who live in areas where the police
are not trusted. Retribution will lead to more victims.
Untreated victims often turn to drugs and alcohol, which further
damages the victim and his or her community.
Recent research shows that crime can be seen as equivalent to a
disease process.<1> Recent studies have even shown that public
health research methods can predict where and when violence will
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<1> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684449/
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occur.<2> It is clear that crime, especially violent crime,
causes trauma and stress, which often leads to depression and
loss of employment, which in turn prevents crimes victim from
adequately caring for their families, which leads to truancy,
delinquency, illness and so on. <3> Violent crime victims in
minimally functioning communities typically rely on retaliation,
not the justice system. In broken communities with gang
problems, most residents do not trust the justice system. Law
enforcement can be seen as an occupying or invading army, not a
source of protection. Retaliation crimes create an increasing
cycle of violence. The disease process spreads and essentially
metastasizes.
The study on Adverse Childhood Experiences (ACE) jointly
conducted by the Kaiser Foundation and the Centers for Disease
control interviewed 17,000 Kaiser patients from 1995-1997.<4>
The landmark study showed that childhood abuse, neglect and
exposure to trauma is clearly associated with a wide range of
physical and mental health problems throughout a person's life.
TRC programs can intervene or interrupt cycles of trauma and
harm that plague high-crime communities.
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<2>
http://msutoday.msu.edu/news/2012/homicide-spreads-like-infectiou
s-disease/
<3> http://www.ncbi.nlm.nih.gov/books/NBK262831/
<4> http://www.cdc.gov/violenceprevention/acestudy/findings.html