BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 518| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: SB 518 Author: Leno (D), et al. Amended: 5/20/15 Vote: 21 SENATE PUBLIC SAFETY COMMITTEE: 7-0, 4/28/15 AYES: Hancock, Anderson, Leno, Liu, McGuire, Monning, Stone SENATE APPROPRIATIONS COMMITTEE: 6-1, 5/28/15 AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza NOES: Nielsen SUBJECT: Victims of violent crimes: trauma recovery centers SOURCE: Californian's for Safety and Justice DIGEST: This bill 1) requires 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) requires a TRC receiving a grant to meet specified statutory requirements and standards; 3) establishes the UCSF TRC as the California Trauma Recovery Center of Excellence (TRC COE); and 4) requires the Board to complete an interagency agreement with TRC COE in establishing core elements of an evidence-based TRC. ANALYSIS: SB 518 Page 2 Existing law: 1)Creates the Victims of Crime Program (VCP), administered by the Board, 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.) 2)Authorizes reimbursement to a victim for "[t]he medical or medical related expenses incurred by the victim?." (Gov. Code § 13957, subd. (a)(1).) 3)Provides that Board 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.) 4)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, 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: SB 518 Page 3 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 VCP to fund 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: 1)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 TRC COE is intended to make TRC services meet these standards. Evidence-based trauma recovery services are more effective and less costly than fee-for-service programs and the public benefits from collaboration between government entities and experts in the field. The UCSF TRC is a nationally recognized, award-winning program developed in 2001 in partnership with the VCP. A four-year demonstration projected established the clinical and fiscal benefits of an evidence-based TRC program. Specifically, the UCSF TRC greatly increased the rate at which victims accessed services and cost 34% less than customary care. 2)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: SB 518 Page 4 Serve and make reach out to victims unable to access 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. SB 518 Page 5 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. 3)Provides that, upon legislative appropriation of funds from the VCP, the 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 (TRC COE). The agreement shall require the following: The Board shall consult with the TRC COE in developing language for grant application and criteria for reviewing grants. The TRC COE shall define an evidence-based practice. The TRC COE shall assist the board in providing training materials, technical assistance and provide ongoing consultation with the board. The TRC COE shall assist in designing a multisite evaluation for TRCs. 4)Provides that the University of California must agree to these provisions through a resolution. Background 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. SB 518 Page 6 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. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684449/.) Recent studies have even shown that public health research methods can predict where and when violence will occur. (msutoday.msu.edu/news/2012/homicide-spreads-like-infectious-dise ase/.) 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 other social ills (http://www.ncbi.nlm.nih.gov/books/NBK262831/ 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. 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. (http://www.cdc.gov/violenceprevention/acestudy/findings.html.) FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: No According to the Senate Appropriations Committee: SB 518 Page 7 Administrative costs to the Board of $100,000-$300,000 (Special Fund). Upon appropriation of funds, the board will be required to develop language for grant applications, and grant review criteria; and to provide training and technical assistance to applicants in conjunction with the UCSF TRC. Additionally, there will be costs with evaluating and measuring grantees' adherence to the model. SUPPORT: (Verified5/28/15) Californians for Safety and Justice (source) California Attorneys for Criminal Justice California Catholic Conference California Chapter of the American College of Emergency Physicians California Psychological Association City and County of San Francisco Crime Victims United of California Natividad Medical Foundation San Francisco Department of Public Health Society for Social Work Leadership in Health Care California Chapter University of California OPPOSITION: (Verified 5/28/15) None received Prepared by:Jerome McGuire / PUB. S. / 5/31/15 12:09:33 **** END **** SB 518 Page 8