Amended in Senate April 26, 2016

Amended in Senate March 29, 2016

Senate Bill No. 1404

Introduced by Senator Leno

February 19, 2016

An act to amend Section 13963.1 of, and to add Sections 13963.2, 13963.3, and 13963.4 to, 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 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 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 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. 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.

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.  

The Legislature finds and declares all of the
following:

(a) 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.

(b) 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 is hereby recognized
as the State Pilot Trauma Recovery Center (State Pilot TRC). The
State Pilot 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.

(c) The results of this four-year demonstration project have
established that the State Pilot 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 State Pilot
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.

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

(e) The Safe Neighborhoods and Schools Act begin insert of 2014 end insert requires
10 percent of the moneys in the Safe Neighborhoods and Schools
Fund to be allocated to the California Victim Compensation
Program to administer a grant program to establish trauma recovery
centers modeled after the UCSF TRC.

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

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

SEC. 2.  

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 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, including
those developed pursuant to subdivision (c) of Section 13963.4.

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

(c) It is the intent of the Legislature to provide an annual
appropriation of two million dollars ($2,000,000) per begin delete year. All
grants awarded by the board shall be funded only end delete begin insert year end insert 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.

(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, human trafficking, 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, social workers, case managers, and
peer counselors.

SEC. 3.  

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

13963.2.  

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

(a) 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, members
of immigrant and refugee groups, disabled, who have severe
trauma-related symptoms or complex psychological issues, are of
diverse ethnicity or origin, or are juvenile victims, including minors
who have had contact with the juvenile dependency or justice
system.

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

(c) Offer a structured evidence-based program of mental health
and support services that provide victims with services that include
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, such as providing services to a victim in his or
her home, in the community, or other locations that may be outside
the agency.

(d) Be comprised of a staff that includes a multidisciplinary
team of integrated trauma clinicians made up of psychiatrists,
psychologists, and social workers. A trauma clinician shall be
either a licensed clinician or a supervised clinician engaged in
completion of the applicable licensure process. Clinical supervision
and other supports shall be provided to staff regularly to ensure
the highest quality of care and to help staff constructively manage
vicarious trauma they experience as service providers to victims
of violent crime.

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

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

(g) Ensure that no person is 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.

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

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

(j) Provide holistic and accountable services that ensure
treatment shall be provided for 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. 4.  

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

13963.3.  

(a) The board shall enter into an interagency
agreement with the Trauma Recovery Center of the University of
California, San Francisco, to establish the State Pilot TRC as the
State of California’s Trauma Recovery Center of Excellence
(TR-COE). This agreement shall require:

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

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

(3) 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.

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

(b) The board shall not spend more than 5 percent annually of
the moneys appropriated to it from the Safe Neighborhoods and
Schools Fund for administrative costs.

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

(d) 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.

SEC. 5.  

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

13963.4.  

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

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

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

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

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

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

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

(e) The advisory committee shall begin delete have the authority to end delete convene
public hearings for the purpose of acting on any of the authority
delegated to it by this section.

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

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